Tuesday, October 20, 2009

Assignment 3 of 9

I want to start by expressing my thoughts on the use of screening instrument/tool from the "Clinician's Desk Reference TIP 24. I have heard the questions from "The Audit Questionnaire", from clinicians at the VA(Veterans Affairs) Medical Center when I've gone there to receive my annual check up in the past. I did not know that the clinicians were using my answers to determine whether or not I was at risk for developing drug or- alcohol abuse- or dependency. I found it interesting that no 1 instrument is used in the examination of every patient. The reading states that, "certain instruments may work better for different age, gender, racial, and ethnic groups." I also found it interesting that the screening could reveal if a person in the patients family has problems with alcohol or other drugs. I chose the "TWEAK" test to practice my questioning methods on my sister-in-law. "TWEAK" is an acronym which stands for: T(tolerance), W(worried), E(eye-opener), A(amnesia), and K(c)(cut down); it has a sliding scale of seven, with 2 points going to positive answers for tolerance and worried, and 1 point going to positive answers for the final three letters. A woman scoring 2 or more is more likely to be a risk drinker. I also chose the "TWEAK" Test, because my sister- in- law is pregnant, and the reading state that this test is preferred by a panel from the Institute of Medicine for the best results for pregnant women. I am happy to say that my sister-in-law scored a one out of a possible seven, which indicates that she is not a risk drinker. The reading also mentions that a positive screening does not mean that a clinician has to give a diagnosis. The clinician should discuss the results with the patient, and explain the implications of including the results in the medical records. I would think that this would be a wise decision, because maybe that patient has had a bad week or month, and trying to diagnose a patient would be unreasonable, if the person is not a long time patient.

The videos I thought were very interesting and informative. Dr. Carl Hart video (Alcohol: A Women's Health Issue) was informative, because I learned that women are more pron to alcoholism than men and face more issues, such as breast cancer, hepatitis,though I disagree with the notion that alcoholism is a disease I do agree with someone getting help and if calling it a disease helps someone admit they have a problem with alcoholic, then I don't think it could do any more harm than allowing them to continue abusing the substances. I also do not agree with genetics being a factor for some one becoming an alcoholic. I think that its the up bring and surroundings that influences a child to drink ,and then continuous drinking is transforms into drinking habits which leads to alcohol abuse. Like the woman in the video said she had a lot of curiosity from seeing her family drink as well as pressure from her peers, just like the woman in the video says genetics is not your destiny. I disagree with the statement from the video that said, "there is no shame in being an alcoholic." I think it should be, I see no shame in being a recovering alcoholic, and Americans should make being an alcoholic shameful in some positive way. I think we as Americans want to find the the quick fix, so we give explanations for our mistakes and failures in life, and instead of working on the problems we want to diagnose and prescribe drugs. I' not saying that diagnosis and drugs are bad, I'm saying that we need to take responsibility for some of our problems.
The video states that alcohol kills more teenagers that all the illicit drugs put together, and yet getting alcohol is easier than taking the drugs off the streets. I heard some one say that if a child says they are going to be like their parents, or family members, who abused drugs and alcohol, their setting themselves up for failure, if the don't find someone positive to look up to.

Which brings me to the video on Dr. Nora Volkow, the director of The National Institute on Drug Abuse. I think that this woman really made the students feel like they have a voice in this video. One male student near the beginning of the video says, "They say, 'just say no', but they don't really care what I have to say." I know from experience, coming in drug infested projects and schools, sometimes its hard to believe that some one cares about what you say or do. For someone like Nora to take time to come and speak to a group of inner city students is a blessing indeed; they must have felt special. I think the approach of coordinating the students ideas into solving the problems students face when dealing with drugs is excellent. I thought that her explanation on why students who do marijuana on a regular basis do so poorly in school was simple and to the point. She said, that marijuana targets Cannabinoid receptors(modulating the pleasure center of the brain) and cannabinoids receptors are also located in the memory sensors of the brain; which allows you to learn,and can be completely taken over by marijuana. I guess I can start giving up on the reasons to legalize marijuana, because after taking these classes and learning that there are so many side effects to using it, I would not want my children to be able to use it. If I knew half of what I know now. I would not have used marijuana.