Assessment comprises a medical and psychological history along with family, social, sexual, and drug use histories and a physical examination.
Who should assess? Clinical nurse specialist with experience in empathic motivational interviewing may perform intensive assessment after receiving training in, the signs and symptoms, biopsychosocial effect of drugs and likely progression of the disease, common comorbid conditions and medical consequences of abuse, use of the Diagnostic and Statistical Manual of Mental disorders, and their relationships to the findings the emerge during the assessment history, and the appropriate use, scoring, and interpretation of standardized assessment instruments.
Focusing on the in-depth assessment:
The Clinician should understand how patients’ gender and cultural background bear on the characteristics and severity of the disease. Studies have shown that more males than females abuse alcohol and drugs. Older women are more likely than older men to abuse prescription drugs.
Culture influence the patients’ recognition of their problems, norms may accept or condone male drunkenness, and their reaction to the assessment process and recommended treatment interventions. Substantial stigma may be associated with substance abuse treatment, especially for women and older patients of either sex.
The Clinician needs to be aware of the influence of their own gender and cultural background and their response to patients with suspected substance abuse problems.
Understanding of typical patterns is useful in anticipating problem areas, experienced clinicians resist the temptation to stereo type patients and subsume them within a broad categories based on language, ethnicity, age, education, and appearance.
In conclusion, when referring patients for assessment, Clinicians should consider whether a particular patient will relate more readily to a male or female assessor similar cultural backgrounds or if a patient who speaks English as a second language will respond more easily to question posed in his native tongue.
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