This paper is an overview of the chemical use, assessment, history and treatment recommendations of Jay W. a college student dealing with failing grades and alcohol. Upon interviewing Jay, his parents, and researching various textbooks and video teachings on the theory’s and treatments of substance abuse this paper will examine the spiritual, genetic, and psychosocial aspects of Jay’s behavior. The assessment will asses if Jay is in use, abuse, or addictive cycle, and will show if there are any co-occurring issues. This assessment of Jay W. makes a referral based on the determination of Jay’s current needs. This paper will give specific steps that our needed to be successful in the recovery process.
CHEMICAL USE ASSESSMENT/HISTORY AND TREATMENT RECOMMENDATIONS
Name: Jay W.
DOB/Age: May 2, 1991
Dates of Interviews: April 20, 2011
Evaluator: Richard M. Doucett
REASON FOR ASSESSMENT: Jay’s parents are concerned about his drinking and how it appears to be interfering with his aspirations of being a chemical engineer. Jay W. was referred for assessment after flunking out of his first year in college.
SOURCES OF INFORMATION: Beth’s (mother) interview, Don’s (father) interview, Jay’s interview, Doweiko, H.E. (2009). Concepts of Chemical Dependency (7th ed.) Belmont, Ca: Brooks/Cole Cengage Learning, May, G.G. (1991). Addiction & Grace; Love and Spirituality in the Healing of Addictions. New York, NY: HarperCollins, Hawkins, R. (2009). Theology and Addiction www.libertyuniversity.edu, Clinton, T. (2009). Addiction and Recovery www.libertyuniversity.edu.
BACKGROUND INFORMATION: Jay W. was born May 2, 1991 to Don and Beth W. The pregnancy was reportedly normal with no complications to the labor and delivery. Jay W. met all his developmental milestones early and was described as an advanced baby. Jay reportedly excelled in school with needing very little effort to maintain a straight A report card even in the gifted and talented program.
Jay’s parents report that Jay began drinking at the age of 12. They described the drinking as experimental initially but they state they became excessively more concerned as he got older. Jay and his parents describe his early drinking years as “typical of teenage behavior”.
They all three began attending AA together but Jay dropped out after 3 months. Don and Beth state they are both still active in AA and Al-Anon. Jay states he stopped going because, “all they talk about is war stories”.
CURRENT STATUS: Jay appears reluctant to treatment but agreed to come because his parents state they will not continue financing his college if he does not get help.
Jay states that currently he drinks a 12 pack or more on the weekends. He qualified this by stating his friends help him drink the beer. He also does admit that his weekends sometimes start on Thursdays and don’t end until Mondays. He states that he does not believe his drinking is the issue with his grades in college. He states he just gets bored in classes and his professors don’t really know as much as they think they do. He states sometimes he just doesn’t feel like going to class because it is “dumb”.
Jay does admit to blackouts, drinking more than he intends to, and does seem to recognize that many of his friends have similar drinking patterns as he.
INDICATIOR OF USE/ABUSE/DEPENDENCY:
Attitude and Behavior of Jay W.: Jay W. uses alcohol because it makes him feel good; and because it does feel good he wants to repeat this experience.
Jay states he is willing to come to counseling but does not think he has a drinking problem but he would like to figure out how to “win” his girlfriend back. Dr. Clinton tells us that the “tragedy of addiction is that is destroys, individuals, families, and friendships” (Clinton, 2009) Jay W. does not feel like he needs counseling but wants his girlfriend back, his parents aren’t happy with him, and he is destroying his own life by failing the classes that he needs to succeed.
The basic laws of behavioral psychology hold that if something increases the individual’s sense of pleasure or decreases his discomfort, then he is likely to repeat that behavior. This process is called reward process. This consequence has a stronger impact on behavior than delayed consequences (Doweiko, 2009, p.10). That’s why, since Jay found the effects of alcohol to be pleasurable, he will be tempted to use it again and again.
Another meaningful fact is individual expectations as a component of alcohol use. The individual’s expectations for alcohol have been found to be a strong influence on how Jay interprets the effects of alcohol. These expectations evolve in early adolescence as a result of multiple factors, such as a peer group influences and Jay’s exposure to advertising (Doweiko, 2009, p.10).
Social Functioning of Jay W.: Human beings are social animals. A given Jay’s decision to use or not use alcohol is made within the social group. Alcohol use can make mild social problems worse by causing people to be more irritable and likely to argue and by affecting judgment and control of behavior. Alcohol use can also be the topic of arguments.
Jay W. qualified this by stating his friends help him drink the beer. He also does admit that his weekends sometime start on Thursdays and don’t end until Mondays. He does seem to recognize that many of his friends have similar drinking patterns as he. He also reports a recent break up with his girlfriend of 2 years. He states he truly loves this girl but she broke up with him because “she doesn’t like his friends”.
One of the factors that influence recreational alcohol use is the social learning component of alcohol use. Individuals do not start life expecting to abuse alcohol. Rather, Jay W. must have been taught that alcohol is acceptable; he must have recognized the effects of the alcohol and interpreted it as desirable. All of these processes are accomplished through the process of social learning, which takes place through peer groups, mass media, family feedback etc (Doweiko, 2009, p.11).
Occupational Functioning of Jay W.: Jay W. is a student in a college, where he lives and spends time with his friends. Although he used to be a great student in school with needing very little effort to maintain a straight A report card even in the gifted and talented program. Jay is trying to become a chemical engineer in college, but he has already failed his first year. It seems that he has gotten in a circle of social failure and escape from feeling a looser. Alcohol and his alcohol use disorder (AUD) help him to forget about social responsibilities and attain the success among his drinking friends in Jay’s artificial world. He can control everything in this alcoholic world: Jay decides when he wants to get into this world of pleasure (‘from Thursday till Monday” or on weekends). Nevertheless when he goes out from these times of illusory euphoria, he gets into new troubles such as studying. To escape from these troubles, Jay buys a new pack of beer and starts the same circle of escape from responsibility. This is typical of a person starting on the road to addiction. Dr. Clinton tells us in our video presentation that the “key components to addiction our: control problems, compulsiveness, narrowing focus, denial, tolerance and withdrawal” (Clinton, 2009). We see many of these components in the occupational functioning of Jay.
Financial Aspects of Jay W.: Abuse of alcohol may make current financial problems worse and cause new ones, including: having less money for necessary expenses like food and clothing; neglecting to pay bills; and creating additional expenses, such as extra medical costs, fines, or car repairs. Jay W. reports spending an average of $75.00 a week on beer and his money doesn’t always last until the end of the month. He attributes that to his parents not giving him enough money. He states they only give him $1,000 a month. The adverse impact on the financial status of the family of the alcohol abuser is one of the harms related to alcohol. There is an increasing level of expenditure by the alcohol abuser to sustain his habit. Gradually, due to the restrictions that the family income imposes, the alcoholic abuser begins to borrow money, steal and/or sell household objects in order to sustain his habit (Doweko, 2009).
Familial Relationships of Jay W.: The relationship between an alcohol abuser and his family is complex. Family members report experiencing guild, shame, anger, fear, grief and isolation due to the presence of an alcohol abuser in the family. They are often subjected to moderate to severe forms of harassment, conflict and tense atmosphere when they confront the drinking behavior of their alcohol-abusing family member (Doweiko, 2009, p.300). Spouses in families where there is chronic, excessive use of alcohol are frequently separated. Children of alcohol abusing persons report a higher incidence of emotional and school-related problems. Don W., Jay’s father, is a neurosurgeon and his mother, Beth is a research scientist. Don was described by Beth as a “functional alcoholic” displaying heavy drinking patterns and binge drinking when he was not on call. She states however, Don quit drinking 3 years ago when they realized Jay had a problem. Both Beth and Don have fathers that were alcoholics. Don states he quit drinking after the DUI incident because he wanted to support Jay in stopping. They all three began attending AA together but Jay dropped out after 3 months. Dan and Beth state they are both still active in AA and Al-Anon.
Other complications in the family include long absences from home, destruction of household objects in rage, lack of communication between the alcohol abuser and the remaining family members, hostility and criticism that marginalize the alcohol abuser, and domestic accidents (Doweiko, 2009, p.300-305).
Legal History of Jay W.: His parents state they first began worrying about Jay’s drinking when he totaled his first vehicle two weeks after his 16th birthday. Jay lost his drivers license at that time and was charged with a DUI. Jay seemed to suggest his parents are over reacting because he has had several friends that have lost their license. Jay is becoming like most people dealing with addiction in the fact that he is what Dr. Clinton says “destined to misunderstand the story we find ourselves in because hell loves to confuse us” (Clinton, 2009), Jay is confused and misunderstanding his story by thinking his parents are over reacting and lots of people have lost their license.
Health History of Jay W.: Jay W. was born May 2, 1991 to Don and Beth W. The pregnancy was reportedly normal with no complications to the labor and delivery. Jay W. met all his developmental milestones early and was described as an advanced baby. Although at this time he doesn’t have any special diseases, alcohol abuse may cause short-term and long-term problems. The short-term effects of alcohol on the body include: upset stomach; diarrhea; lack of coordination and judgment; headaches; and insomnia). Abuse of alcohol can cause many different long-term problems because the whole body is affected. Some of these problems can lead to death. The long-term effects of alcohol are: heart disease; cancer; liver problems; problems of the stomach, lungs kidney, skin, muscle, and bones; infections; mental disorders; insomnia; malnutrition; and impotence and infertility in men (Doweiko, 2009, p.75-85).
Spiritual History of Jay W.: When Jay entered the college he found new stresses, responsibilities, and work. He may have felt lonely; his girlfriend left him so he tried to relieve his pain. He hates feeling guilty, empty and alone. He longs to have acceptance and love; alcohol use provides a remedy that helps to forget the pain, at least for awhile. Alcoholism draws sorrow. Alcohol also provides Jay with predictable moments he can count on, an illusion of control, and the addiction masters him. The effect is always self-destructive bondage. Jay is forced to choose between his alcohol abuse and those, who love him. Although he does not want to lose those he loves, he does not want to quit drinking, even if he drinks every day.
DIAGNOSTIC IMPRESSION: Jay W. seems to have alcohol abuse problem on the level “heavy social use/early problem alcohol use”. Between social use and clear cut problem use. People whose chemicals use falls in this point in the continuum would use chemicals in such ways as to: be clearly above the norm of society, and/or begin to experience various combinations of legal, social, financial, occupational, and personal problems associated with chemical use (Doweiko, 2009). Jay can be classified as being “at risk” for a substance use disorder or of becoming “a problem drinker.” Thus, not everybody from this category would progress to an addictive disorder. Still, at this level, Jay attempts to hide or deny the problems that develop as a result of his alcohol abuse.
RECOMMENDATIONS: Jay needs new goals to become a fully functioning human. Dr. Hawkins in the video presentation Theology and Addiction list six ways out of addiction to recovery and they are; “have encounter with the Heavenly Father, allow for the power of the Holy Spirit, make a commitment to a new goal, submit to a new truth, have accountability to a new family, engage in a new process” (Hawkins, 2009). Dr. Hawkins firmly believes that recovery is an “inside out issue requiring the Holy Spirit” (Hawkins, 2009). Jay should start visiting again AA-group with his parents to start with. Jay W. does not need any hospitalization, he needs his own will. In our reading of the text Addiction and Grace the author tells us “for the power of addiction to be overcome, human will must act in concert with divine will.” (May, 1991, p.178) Second he needs the support of others: his family and possibly his girlfriend to be with him, and support him. Third he needs to understand his own vulnerability, desire and anger; our textbook also told us “we cannot make this empowerment happen on our own, we can pray for it, seek it actively, open our hands for it and try our best to live it” (May, 1991, p.178). If Jay wants to be a success, he has to open his eyes, his current illusion of power and control is only that an illusion. In Addiction and Grace we also learned that “the alignment of our will with God’s must happen at a heart level” (May, 1991, p.178). Studying hard and working hark is real life, sometimes it is lonely, but real life with real results can help you understand real love.