Introduction
Alex was born in poor black South African family. His parents belong to the working class wherein father was an accountant and mother was the lecturer in the education department. He raised and got his early education in the UK. He was well in his education and had started training of nursing but due to the no support from parents because of their separation, he got stress and depression. It was difficult for him to continue his study with the depressed mind. To cope with the stress he overuses the drinking, which causes his homelessness and snatching of the material from the shops. The police caught him and in jail provide him counselling for his relaxation but after his release from the jail, he again started drinking. He was introduced to the IV drug use which is comprised of cocaine and heroin and mix with the speedball. The respiratory depression and the collapse of his veins in arms is the result of the regular use of speedball. Due to his repeated negligence of self-caring, he was admitted to the psychiatric centre to provide him necessary care and anti-psychotic medication. He also receives the diagnosis of schizophrenia during the admission to the care centre.
Discussion
Alex is now facing multiple diseases with his single body and he needs regular care and medication to recover from the disastrous state of weakness. Various diseases operating in his body as he knew but he was not aware of the attack of HIV antibody positive. It was because of the regular injections of drugs like that of cocaine and mixture of heroin. Specialists are of the view that people like Alex are having the high risk of blood-borne viruses and infections. The sharing of the injections and the needles provided HCV and HIV viruses. Various are the approaches used to limit and diagnose the hard drugs and certain countries have taken serious steps as the Netherlands that has applied harm reducing approach. Reducing the harm posed the positive result of the epidemic of HIV and HCV.[1] The aim of the harm reduction tools is to stop the drug users like Alex from excessive and harmful use. Amsterdam health service is providing methadone in collaboration with social health care and the exchange of the needle facilities. To detoxify the Alex from overuse of the drugs and related issues a comprehensive programme through the clinic of addiction can play a very important in recovering his health.
Studies have calculated the result of the methadone programme with different and conflicting results. The declining ratio of the HCV was reported through the diagnosing of the drugs addicts by needle exchange programme. Among the participants of the programme, very few of them have described the effects of the HIV. For the long period, the methodology can help Alex to remain at the lower stage of HIV and HCV diseases. The intervention of the Amsterdam Cohort Study is prospective research on the factors involve the viruses of HIV and those infections enter the body through the blood-borne transmission. The research was started in the late nineteen eighties and the intervention programme is still going on with the increased focus on the young people like that of Alex. It is the notable point that western countries are facing increasing number of the young’s addicting with the drugs with dangerous formulas.
Alex visits the Academy of the Amsterdam health service can easily recover his present state of the condition caused by the over drinking. With every visit, he can have the blood test for HIV. The health service will also complete the questioner regarding the health recovery from the drug’s use and the risk he takes after drinking. Through a systematic process and the combination of drug injections, NEP usage and the methadone dosage in the laboratory testing can reveal the actual results of the disease face by him. Better results can cure the problem more efficiently than those tests, which are not clear and most sophisticated. In the same way, his problem of stress and depression which was the primary cause of his conversion to make him as the uncivilized and weak person also needs due attention.
Researchers confirm that stress place overdue burden on the individual personality and mostly make them drugs addicts. The effects of the depression disturb the wellbeing of the people physically and mentally. However, the notable point is that stress is not as bad as compared the problem how to deal it with effectively. There are the cases that unfolded the positives of stress like convincing individual towards work or towards active life. The problem with the Alex was that he did not use the stress positively and drive himself to a more destructive and abnormal life. He can consult a psychologist or can have the opportunity of doing part-time work or some pleasure activity, which might decrease his depression and help him to continue his study.[2] The use of alcohol in eradicating stress is not a long-term solution but it is actually a tool to get relief for short span of time. The self-defeating techniques use by him drive him to a more complex life. There are certain useful techniques, which drug addicts can use to improve their life. It is necessary to discuss those interventions, which are helpful for the Alex in recovering his health mental problems.
He must breathe long and use visualization techniques, which can relax his body. Engagement in certain hobby or listening of songs will also dramatically reduce his stress level. For the waves of anger disorders like stress, the psychotherapy has been widely used to decrease and lessen the depression of individual. Same therapy can apply to him through the clinical interventions. A young man of thirty-eight years has gone through the therapy with depressive fits of anger and problems. The man was hospitalized to cope his depressive condition into an active and mindful life. Intervention approach applies to the person by following procedures of stress inoculation. There were three stages of the process preparation of the cognition, skill base acquisition and the rehearsal. The assessments before the intervention of anger entries reveal the ratio of three hundred and one. After the discharge from the hospital and with the twenty-five days regular intervention, the assessment score was calculated as two fifty-eight. The same case and the therapy can apply to Alex in order to recover him from the stress full life. Regular exercise also has the potential to normalize and enhance the endorphins, which will relax his mood. The brisk walk along with yoga can provide calm state of the mind and can reduce the muscular his tension.
Alex had a diverse effect of continuous usage of speedballing on his personality. It was destructive, and more than ending his enjoyable life. The original speedball comprises of the morphine sulphate and hydrochloride cocaine. It is also used for the pharmaceutical opium along with different stimulants. The use of the speedball provides numbness and drowsiness to the individual. For Alex as he uses heroin and cocaine to counter side effects but the said use resulted in the overdose and failure of his respiratory system.[3] Other than his problems and issues there, are numerous people directly affected by the use of cocaine and heroin? In the year of two thousand fifteen around thirteen, thousand people lost their lives with the use of speedballs. Even cocaine has sent seven thousand people in the valley of death. In the years between two thousand ten and fifteen, there were twenty thousand people killed by the destructive drugs. Numerous organizations have the coping techniques and therapies for addicts of speedballs. They include evaluation, detoxifying the individual, medicated assisted therapy, group and the individual therapy, the contingency management, and the dialectical behaviour therapy.
An educational programme can best apply to the intervention of Alex. Test and teach case methodology is an approach design to manage the issues related to the excessive use of the drugs. With the background of hypertension, Alex can use daily treatment of itraconazole. After the time of three weeks, he might have pain in his neck. With the discovery of brown color urine, he can discontinuous all of his medication and the required medical attention. When he will examine again, he could have tenderness in his muscles and blood pressure could rise to the level of one ninety.[4] His blood cells and the renal function will be normal. The urinalysis might be amber colored which is positive for occult blood and for the myoglobin. The time for the tests in the laboratory will take time of around one and half day. He will be diagnosed and treated with the hydration and anti hypertensive approach to resolving his issue of the mental problem. He can manage through certain drugs managing techniques and can increase normality in his life.
The intervention of the dialectical behavior therapy can have the positive impact on the cognition of the Alex. The therapy was developed by the Marshal Linehan. The basic phenomena of the intervention are the psychotherapy of individual along with the strategies to enhance the life experiences. The skills implied over the people are full mindedness, regulations of the emotions, tolerance of the distress, efficient interpersonal techniques. Comprises of the five basic components the therapy focuses on the enhancement of abilities of the client in behavioural moves. Alex can learn those group-teaching skills and the homework given by the teacher to apply them in his everyday life. Group meets after the break of one week for the time of three hours and he can interact with other people facing the same problem. In the model individual therapy consisted of the one week, programme which is also useful for him. To provide the necessary support the therapy can incorporate Alex coaching via telephone that how will use the DBT skills at home. Wherever he needs the help from his coach, he can frequently use the telephone for resolving the hurdles or issues not understood by him.
The management of the case will help the Alex to take care of his social and physical life without having the support of any other. Coach uses the same techniques, validations, problem-solving methodologies in order to make the person capable of becoming case head of his own problem. In these strategies, the coach will provide independent decision power to Alex case and will not intervene during the process of solving the problem. The focus of the therapist team is on those individuals, leader or the supervisors helping the client in intervention. To provide the best possible intervention the team will help Alex at every stage of operations and actions. The dialectical behavioural therapy has a history of rehabilitating many people like Alex facing the problem of mental disorder. Studies confirm that DBT is effective in decreasing the suicidal behaviors, injury of self, depression, anger and enhancing the global and social functioning of one’s life. Proper treatment and regular consultation with the respective coaches can help Alex in improving his life and health. The discussion on the case of Alex is revealing that his poor parents might have the problem related to mental health or cognitive issues. Genetic transmission of the virus is possible especially in those poor people belonging to the developing countries. Africa in this regard has the history full of diseases and international migration to eliminate and spread those disease attack people due to the poor clothing, food and living style.
Stigma regarding the psychotic disorder infrequent among the families. Other than this disorder, it can be in any form or in any family. The general and the associative kinds of stigma is applicable to every individual. The process by which a single person is stigmatized through the virtue of associative stigma. The world health organization an international health agency has revealed that the stigma is one of the major hurdles in treating problems related to the mental health. According to the WHO, it is a process in society whereby imbalances in power, separation, stereotyping, loss of the status and the discrimination operating the respective society. All over the world, mental health related to mental health stigma causes numerous sufferings for the people. Social relations, limitation in opportunities education and employment, psychiatric morbidity and the stress are included in the result of the stigma. The problem of schizophrenia that is also operating in Alex is a major target for discrimination and the stigma. Due to the disruptive behaviour, distinctive symptoms it is frequently spread n members of the families.
Those individuals facing the problem of the schizophrenia along with the families are easily attacked by the stigma. In the years of nineteen ninety-six, the association of the world psychiatric campaigned to stop and to counter the stigma along with the discrimination overriding the problem of stigma.[5] Following years after the campaign studies conducted and concluded that negative influence is posing on the families and patients attack by the problem of schizophrenia. For example, the relative of Alex stigmatized through social exclusion experiences, and the guilt assignments faced every individual of the family as the patient of schizophrenia. Around seventy percent of specialist associated with the interventions of the people like Alex believe that people generally devalue patients and extended this discrimination to the family of the individual. The OMI scales are mostly used to assess the condition of the families and patient associated with the mental illness. The scale easily incorporates those elements of the stigma, which includes the labels of mental ill health to stereotypes like people who are ill by mind let them control their emotions through their own way. Loss of the status and the discrimination attached to as any individual admitted to the hospital should be banned from playing any role in the election process. The OMI was changed to decrease bias on the social desire. For example, to decrease the bias of response, entities were given positive and negative words with the same score for each as zero as for the stigmatize response. The reduced rate of scores reveal negativity towards the health of the mind and produce more stigma.
Along with the issue of stigmatization, there is the problem of increase death among those people release from the prison. Alex then left the prison to join the atmosphere of taking drugs in a more speedy way, which could cause his death if he was not admitted to the hospital. Inside the prison life, he was given regular counselling and the related interventions for her recovery from drug addiction. The period was comprised of around nine months. Time in the prison has also provided an activity managed by the staff of prison to the Alex for his hopeful life. However, if we look at the research and the studies conducted by several institutes concluded that overdose death after the release of the drug-related prisoner is very unacceptable. The key factors to this are the less tolerant behaviour after long period passed in the close house. The second leading factor can be the use of concurrent drugs with which every extra drug used as opioids, which significantly increase the risk related to the loss of individual life. However, the prisons have the facility of counselling during the time of the person in the prison life but pre-release counselling is very much necessary.[6] It must include the observation and monitoring of those young people releases from the prison. Long-term interventions are often required for the chronic disorder, which causes due to the opioid dependency. Different trials and the cohort studies concluded that opioid substitution therapy decreases the risk of overdose among the members of opioid users.
During the time when the prevalence of the illicit use of drug present between the prisoners, they try to learn about the issues related to the diagnosis of excessive use of drugs. In the years between two thousand and two thousand eleven research documented the lifetime prevalence of around fifty percent-imprisoned people in the region of European Union and the state of Norway. In other states, sixty percent of the prisoners accept that they use heroin cocaine and related drugs after their release. In the Asian, American societies, dependency on the use of the opioid is high which is affecting around eighty percent in Asia; the drug of favorite choice is also high among American prisoners.[7] Different harm reducing and the preventive responses can be applied to the criminal justice system. By doing this, it is hopeful news that rate of the overdose death might decrease after the immediate post-release time of prisoners. The same calculations apply to the patients like that of Alex who needs surveillance of the police and observation regarding his activities after his release from the prison. Pre-release counselling is essential and important for such kind of drug addicts who have destroyed their life by overusing the drugs.
Conclusion
Concluding the detail discussion on the case of poor Alex, it is worth mentioning that individuals like him need regular counselling and education to prevent them from destroying their life. Disturbance of his family life and lack of support from parents who also have the problems lead him towards prison and then to the hospital. His story does not stop here and after he releases he face the same situation of increase stress to which he copes through the speed balling. The most important aspect is that he is poor but did not know that how to change the stress for the achievement of the positive goals. Theories, methodologies and the interventions are frequently available for Alex to adopt for the renewal of his life. Belonging to the poor society of African continent will not restrain him from using the exercise, regular consultation with the psychologist and the tools to relax his mind and breathe. By applying these he can have the prosperous, happy and positive life.
End Notes
Douglas, Thomas, Jonathan Pugh, Illini Singh, Julian Savulescu, and Seena Fazel. “Risk assessment tools in criminal justice and forensic psychiatry: the need for better data.” European Psychiatry 42 (2017): 134-137.
World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. World Health Organization, 2016.
Kolodny, Andrew, David T. Courtwright, Catherine S. Hwang, Peter Kreiner, John L. Eadie, Thomas W. Clark, and G. Caleb Alexander. “The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction.” Annual review of public health 36 (2015): 559-574.
Tsui, Judith I., Jennifer L. Evans, Paula J. Lum, Judith A. Hahn, and Kimberly Page. “Association of opioid agonist therapy with the lower incidence of hepatitis C virus infection in young adult injection drug users.” JAMA internal medicine174, no. 12 (2014): 1974-1981.
Conner, Mark, and Paul Norman. Predicting health behaviour. McGraw-Hill Education (UK), 2005.
Schwarzer, Ralf, and Britta Renner. “Social-cognitive predictors of health behaviour: action self-efficacy and coping self-efficacy.” Health Psychology 19, no. 5 (2000): 487.
Sipe, Theresa Ann, Terrika L. Barham, Wayne D. Johnson, Heather A. Joseph, Maria Luisa Tungol-Ashmon, and Ann O’Leary. “Structural Interventions in HIV Prevention: A Taxonomy and Descriptive Systematic Review.” AIDS and Behavior 21, no. 12 (2017): 3366-3430.
- Douglas, Thomas, Jonathan Pugh, Illini Singh, Julian Savulescu, and Seena Fazel. “Risk assessment tools in criminal justice and forensic psychiatry: the need for better data.” European Psychiatry 42 (2017): 134-137. ↑
- World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. World Health Organization, 2016. ↑
- Kolodny, Andrew, David T. Courtwright, Catherine S. Hwang, Peter Kreiner, John L. Eadie, Thomas W. Clark, and G. Caleb Alexander. “The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction.” Annual review of public health 36 (2015): 559-574. ↑
- Tsui, Judith I., Jennifer L. Evans, Paula J. Lum, Judith A. Hahn, and Kimberly Page. “Association of opioid agonist therapy with the lower incidence of hepatitis C virus infection in young adult injection drug users.” JAMA internal medicine174, no. 12 (2014): 1974-1981. ↑
- Conner, Mark, and Paul Norman. Predicting health behaviour. McGraw-Hill Education (UK), 2005. ↑
- Schwarzer, Ralf, and Britta Renner. “Social-cognitive predictors of health behaviour: action self-efficacy and coping self-efficacy.” Health Psychology 19, no. 5 (2000): 487. ↑
- Sipe, Theresa Ann, Terrika L. Barham, Wayne D. Johnson, Heather A. Joseph, Maria Luisa Tungol-Ashmon, and Ann O’Leary. “Structural Interventions in HIV Prevention: A Taxonomy and Descriptive Systematic Review.” AIDS and Behavior 21, no. 12 (2017): 3366-3430. ↑
