Addiction: Katie’s Case Study
Addiction: Katie’s Case Study
The client, Katie, is a 35 years old female. She is a professional, but her profession is not disclosed. She race is not disclosed either.
Type of addiction
Katie suffers from substance addiction. She abuses Vicodin, an opioid analgesics. Apart from causing the analgesic effect, Vicodin also causes euphoria, which explains why Katie used the drug to make her feel better. Katie’s addiction problem is classified as substance use disorder in the DSM-5. According to NIDA (2017), DSM-IV text revised had two classified named Substance Abuse and Substance Dependence. However, in 2013, the American Psychiatric Association (APA) joined the two disorders into the Substance Use Disorder category. Apparently, Katie was abusing the drugs before the initial treatment that led to her dependence on them. The second time, however, assuming she is telling the truth that she has been off the drugs for a week without any withdrawal symptoms, she is simply abusing Vicodin but has not developed dependence yet. Arguably, though she could be lying that she had stayed a week without using the drug, which means she could be physically dependent.
History of addiction to painkillers
According to Stolberg (2016), the opioid analgesics have been used in the United States in the last century for both medical and recreational purposes. The drug was first used in 1700 where a solution obtained from the poppy plant was used to makes a solution that was used as painkillers in wars. Morphine was later isolated from the raw opium in 1805. Soldiers and casualties greatly used these drug alongside opium in the 1861-1865 American Civil War, 1866 Franco-Austrian and the 1870-1871 Franco-Prussian wars in Europe. This led to massive addiction among the users resulting in the nickname “Soldier’s Disease.” During this time, the use of morphine was unregulated until the passage of Pure Food and Drugs Act bill of 1906 that prohibited the non-medical use and use of morphine without a doctor’s prescription. In 1937, Methadone was created for medical purposes as a painkiller. Shortly after, several other opioid analgesics were made using morphine as the derivative. Despite the law prohibiting and regulation of the morphine and other opioid analgesics, this class of drug was largely abused in the United States leading to massive addictions.
Harvard Medical School (2011) notes that a study conducted by Columbia University indicated that addiction to opioid prescription drugs tripled in 10 years. According to the report, the addiction proportion rose from 0.1 in 1991 and 1992 to 0.3 in the years 2001 and 2002. In 2009 a national survey on the Drug Use and Health in the United States indicated that approximately two million people were either abusing or dependent on the prescription pain relievers, which was twice the rate of cocaine abuse and dependence (Harvard Medical School, 2011). A previous study by CDC in 2007 had indicated that addiction to these drugs killed twice more people than cocaine and five times more people than heroin (Harvard Medical School, 2011).
Consequences of Katie’s addiction
Katie’s addiction has actual adverse effects on her family and herself. It also has potential adverse effects on her profession and community. First, her family is stressed and uncomfortable with her addiction. This is straining their relationship because her husband threatens to divorce her while her father is worried that she might lose her family and finally die out of lack of support, depression, and continued the abuse. Secondly, the financial security of her family is threatened because she buys the Vicodin at a higher price chronically. Thirdly, she is not able to take care of the children as is evidenced in the argument between her and her husband in the presence of her doctor. On the other hand, she is likely to cause tense relations in the workplace, which may lead to termination of her employment. Termination of employment undermines productivity, which indirectly harms the economic welfare of the community because her lack of financial contribution may lead to exploitation of community support resources by the husband.
Katie treatment had mixed results. She responded positively to the initial treatment three years before when she underwent a month’s program in a residential treatment facility. When she first went for treatment, she had abuse and dependence problem, which is classified as Substance Use Disorder in DSM-5. When she came out, she was no longer using the painkillers. She stayed away from them for slightly over two years when she gave birth to a second child and relapsed. She confessed that the pressures had made her start using the drugs again. Notably, though, the initial treatment was terminated inappropriately. Katie did not enroll in a follow-up program, she did not join an AA meeting, and nor did her husband attend a final family meeting. These overlooked measures could have probably helped her restrain from the temptation of using the drugs again. The outcome of the second attempt at treating her is also unsatisfactory. She refused to undergo a rehabilitation program in a residential home, and the family forfeited the outpatient counseling program. Therefore, is not clear whether her husband finally divorced her as he had threatened or whether they had decided to attempt resisting on their own without professional support. In either way, Katie’s might not recover from the addiction without the professional assistance.
Harvard Medical School. (2011, January 15). Painkillers fuel growth in drug addiction. Retrieved from Havard Medical School Web site: https://www.health.harvard.edu/newsletter_article/painkillers-fuel-growth-in-drug-addiction
NIDA. (2017, March 2). The Science of Drug Abuse and Addiction: The Basics. Retrieved from National Institute of Health Web site: https://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics
Stolberg, V. B. (2016). Painkillers: History, Science, and Issues. Santa Barbara: ABC-CLIO.
Social demographic information
The subject of the case study was a 16 years old male living in the United States. The teenager had Korean descent or roots and came to the United States with his mother and brother upon persuasion by his parents. The case study codes his name as HC to protect his privacy. HC suffers from process addiction. Specifically, he was addicted to digital gaming, which are games played over the internet.
Clients use several physiological procedures to administer their addiction such as injection, oral, video gaming, and making phone calls. According to Lee (2011), HC’s physiological procedures for administration of his internet games addiction included video gaming. He developed his addiction and procedures because of his environment. Since moving to the United States four years before, HC had increasingly found himself alone unlike in his initial Korean environment. He withdrew from his friends and maintained an antisocial life where spent 3 to 5 hours daily on weekdays and an average of 13 hours during the weekends. Nonetheless, HC indicates a desire to reduce the hours of gaming that he has been spending. This indicates hope for him.
Addiction history and effects
According to Griffiths, Kuss, & King (2012), the first commercial video games emerged in the early 1970s but the first description of video game addiction appeared in the psychiatric and psychological literature about a decade later in the early 1980s. The phenomenon was described in peer-reviewed articles in 1983 by Soper and Miller who were basing their study on several reports from school counselors that claimed the problem was becoming a problem to the school going teenagers. The study of video addiction greatly transformed between the 1980s and 1990s. Griffiths, Kuss, & King (2012) observes that the study of video games in the 1980s was basically focused the pay-to-play video games and most entailed observational, anecdotal, or case studies were done on male teenagers. These early studies posited that cognitive behavioral therapy was effective in treating the new type of addiction. Apart from focusing on the pay-to-play games only, these studies also another common limitation or problem. They did not have a standardized measure for the diagnosis and recognition of video games addiction. They only relied on the confession of the victims who claimed that they were addicted to the video games (Griffiths, Kuss, & King, 2012). In the 1990s studies increased with the researchers’ expanding their focus to involve more than the pay-to-play games. The decade was characterized by additional examination of non-arcade games such as PC gaming, handheld games, and home console games (Griffiths, Kuss, & King, 2012). The phenomenon was officially defined as a disorder in 1995. Researchers in the 1990s used DSM-IV and DSM-III-R to identify and define video gaming. However, according to Griffiths, Kuss, & King (2012), despite the improvement from the previous decade, studies in the 1990s were still problematic because the definition of and tools used to assess video game addiction was very similar to the tool used in gambling examination. In addition, the studies were small scale and self-reported. The 2000s were characterized by better study designs and tools. Kuss (2013) observes that non-self-report tools and techniques were used to study the phenomenon. They included polysomnographic measures, verbal and visual memory tests, and medical examinations that included patient’s history, radiological, physical, pathological, and intraoperative findings, genotyping, electroencephalography, and functional Magnetic Resonance Imaging. These improved studied of the 2000s coincided with increased use of internet games. Kuss (2013) notes that internet games became most popular and prevalent in the 2000s. It is the same era in which gaming communities emerged with the introduction of the expanded game online media termed as MMORPGs (Massively Multiplayer Online Role-Playing Games).
Psychological and physiological effects
According to Attrill (2015), the physiological effects of video game addiction include lack of sleep, compulsive behavior, and eating and weight disorders. These normally develop after the addiction has well established. Lack of sleep sets in due to routine video gaming that fails to recognize time. Compulsive behavior develops due to the constant immediate gratification associated with video gaming. Eating and weight disorders develop primarily due to lack of exercises and increasingly sedentary lifestyle. The psychological effects include anxiety, social dysfunction, aggression, depression, irritability, loss of control, and restlessness (Attrill, 2015). HC had already started exhibiting some of these symptoms before his mother decided to seek help. HC had exhibited depression, antisocial behavior, and negative attitude, especially by displaying disrespect and lack of interest to engage in activities with his father. These symptoms are recognized in the diagnostic criteria of DSM-V. According to Lee (2011), video games addiction victims or clients tend to display four categories of symptoms which include a) excessive use of the games leading to loss of the sense of time, b) social withdrawal accompanied by increased feelings of tension, anger, and depression when unable to access the computer or game, c) tolerance involving many hours playing the game, and d) negative repercussions including arguments, lying, social isolation, fatigue, and poor achievements.
HC eventually responded positively to the treatment. However, the actual factors that contributed to the positive outcome are vague. Throughout his five sessions, HC did not seem to improve. In fact, he expressed boredom and dissatisfaction with the program that required him to make several entries of his emotions and activities every day. However, in his fifth session, he was encouraged to engage in activities that reduced his boredom other than playing the video games. Golfing is the activity that was suggested. After HC started playing golf with his mother, his gaming hours reduced. Perhaps it was the combined effect of cognitive therapy and implementation of a substitute (distractor) activity that made HC reduce his gaming hours. It could also be simply the substitute activity that made him reduce the gaming hours.
Attrill, A. (2015). Cyberpsychology. Oxford: Oxford University Press.
Griffiths, M. D., Kuss, D. J., & King, D. L. (2012). Video Game Addiction: Past, Present and Future. Current Psychiatry Reviews, 8(4), 1-11.
Kuss, D. J. (2013). Internet gaming addiction: current perspectives. Psychology Research and Behaviour Management, 6, 125-137.
Lee, E. J. (2011). A case study of Internet Game Addiction. Journal of Addictions Nursing, 22, 208-213.