CONSEQUENCES
AH, CONSEQUENCES!!! IF A PATIENT HAS SIGNIFICANT LIFE PROBLEMS THAT CAN BE ATTRIBUTED TO THE USE OF A MOOD ALTERING SUBSTANCE AND CONTINUES TO USE THE SUBSTANCE IN SPITE OF THESE CONSEQUENCES THEN THEY MOST LIKELY MEET CRITERIA 6 AND 7. CRITERIA SIX TALKS ABOUT IMPORTANT AREAS IN ANY PERSON'S LIFE THAT REDUCED OR GIVEN UP BECAUSE OF THE SUBSTANCE USE I.E. "I CAN'T GO ON VACATION BECAUSE I MIGHT RUN OUT OF PILLS" OR "I DON'T WANT TO GO OUT. THAT RESTAURANT DOES NOT SERVE DRINKS". CRITERIA SEVEN DISCUSSES PSYCHOLOGICAL OR PHYSICAL PROBLEMS CAUSED BY OR MADE WORSE BY THE SUBSTANCE USE. MANY PATIENTS WHO ARE DEPRESSED HAVE TRIED DRINKING TO HELP THEIR DEPRESSION AND FOUND THAT SINCE IT IS A DEPRESSANT, IT MAKES THEM MORE DEPRESSED AND THEY QUIT. MOST LIKELY IF A PATIENT STATES THAT THEY ARE DRINKING HEAVILY BECAUSE THEY ARE DEPRESSED IT IS THE ALCOHOL THAT IS CAUSING OR EXACERBATING THE DEPRESSION.
CONSEQUENCES INCLUDE THINGS LIKE:
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LEGAL PROBLEMS RELATED TO THE USE OF THE SUBSTANCE I.E. DUI'S OR POSSESSION CHARGES |
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FINANCIAL PROBLEMS I.E. FINANCIAL INSTABILITY SECONDARY TO MONEY SPENT ON DRUGS, BAD CHECKS, PAWNING POSSESSIONS, SPENDING SPREES WHILE USING |
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HOSPITALIZATIONS/ER VISITS/DOCTOR'S VISITS SECONDARY TO THE DRUG OR ALCOHOL USE I.E. MOTOR VEHICLE ACCIDENTS WHILE USING, OVERDOSES, ELEVATED LIVER FUNCTION TESTS, HEPATITIS, SEIZURES, ILLNESSES FROM IMPURE DRUGS, FIGHTS, AIDS, HEART DISEASE |
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RELATIONSHIP PROBLEMS I.E. IF MY DRINKING BOTHERS MY SPOUSE AND I MAKE THE DECISION TO KEEP DRINKING DESPITE THE STRAIN ON THE RELATIONSHIP, I HAVE JUST PUT ALCOHOL ABOVE WHAT SHOULD BE THE PRIMARY RELATIONSHIP IN MY LIFE. MANY HAVE STRAINED RELATIONSHIPS WITH PARENTS, CHILDREN, SIBLINGS, AND HAVE LOST BOYFRIENDS AND GIRLFRIENDS SECONDARY TO THEIR USE. THEY BECOME ISOLATED AND STAY AWAY FROM FRIENDS THAT THEY DID THINGS SUCH AS GOLF, TENNIS OR FISHING WITH. THEIR ARE DIVORCES, SEPARATIONS, AND CUSTODY BATTLES. |
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JOB AND OCCUPATIONAL CONSEQUENCES I.E. LOSING OR QUITTING A JOB SECONDARY TO CHEMICAL USE. PATIENTS WILL CHANGE JOBS, MOVE GEOGRAPHICALLY, GO TO WORK LATE, GO HOME EARLY, AND HAVE POOR PERFORMANCE. |
| EDUCATIONAL CONSEQUENCES I.E. YOUNGER PATIENTS WHO GO TO COLLEGE OR PROFESSIONAL SCHOOL AND MAKE POOR GRADES, DROP OUT, OR FAIL OUT SECONDARY TO THE CHEMICAL USAGE. |
| WITHDRAWAL/TOLERANCE: I PERSONALLY TEND TO THINK THAT WITHDRAWAL AND TOLERANCE ARE PHYSICAL OR MEDICAL CONSEQUENCES OF A CERTAIN AMOUNT AND FREQUENCY OF USE WHICH IS INDIVIDUAL TO EACH PERSON. |
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HALLUCINATIONS/SEIZURES/BLACKOUTS/MEMORY LOSS: THESE CONSEQUENCES COULD PROBABLY BE LISTED UNDER MEDICAL CONSEQUENCES AND ARE THE RESULT OF A CERTAIN FREQUENCY AND AMOUNT OF USE WHICH WILL BE UNIQUE TO EACH PATIENT. |
DUI'S
DUI'S ARE A GOOD EXAMPLE TO ILLUSTRATE THE CONCEPT OF CONSEQUENCES. SOMEWHERE BETWEEN FIFTY AND SEVENTY FIVE PERCENT OF FIRST TIME DUI OFFENDERS IF FOLLOWED FOR FIVE YEARS WOULD EVENTUALLY MEET THE CRITERIA FOR ALCOHOL DEPENDENCE. MOST LAY PERSONS WOULD THINK THIS TO BE HIGHER AND A FEW LOWER BUT NOT EVERY PERSON THAT GETS A FIRST TIME DUI IS ALCOHOLIC. THIS IS THE REASON THAT FIRST TIME DUI OFFENDERS ARE NOT SENTENCED TO TREATMENT BUT TO ALCOHOL EDUCATION OR DEFENSIVE DRIVING COURSES. IF HOWEVER YOU FOLLOW PERSONS WHO HAVE JUST GOTTEN THEIR 2ND DUI AND FOLLOW THEM FOR FIVE YEARS, APPLYING THE CRITERIA FOR ALCOHOL DEPENDENCE, WE WOULD FIND THAT OVER 90% WOULD MEET THE CRITERIA. IF WE LOOK AT THIRD TIME DUI OFFENDERS ALMOST 100% WOULD MEET THE CRITERIA FOR ALCOHOL DEPENDENCE. PATIENTS WITH DEPENDENCE CANNOT ALTER THEIR BEHAVIORS AND THEREFORE CONTINUE TO DO THE SAME THINGS DESPITE ADVERSE LIFE CONSEQUENCES.
THIS IS A
SUMMATION OF CRITERIA SIX AND SEVEN.