Substance Use Disorders in Primary Care

In this activity, you will reflect on your workplace and explain how WHO mhGAP general principles of care and priority conditions can be integrated into your work’s specific settings.

Step 1. Review

Review the learning resources for this lesson, especially the mhGAP general principles.

Step 2. Study

Study the given scenario below:

Step 3. Respond

Write a 200-600 word workplace observation report that details the following:

• Period of observation
• Relevant elements in a working environment or workplace
  (Examples: physical features, organizational culture, psychological and social support, safety, workload management, among others)
  

• Description
• Observational challenges/needs/conflicts
• Successes/ Achievements
• Discussion of Insights
• Integration of the mhGAP general principles of care
• How are these incorporated into the workplace?
• How does the inclusion of these principles contribute to the successes or failures within the workplace?
• Importance of the seven mental health priority conditions
• Are all (or some of) the priority conditions frequent in your daily practice?
• Why is each of the 7 priority conditions frequent among your patients? If some priority conditions are not frequent among your patients, despite being listed by the WHO, could you explain why?
• Commendations and Recommendation

Step 4: Share

To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

Step 5: Interact

To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

In this activity, you will write and create a petition letter promoting care that is free from discrimination, as well as equality and inclusion of people with mental, neurological, and substance use disorders.

Step 1. Analyze

Reflect on instances where stigma, marginalization, and discrimination are observed in the healthcare setting. To be more specific, analyze and list the following:

• A documented account of discrimination in the healthcare setting in a region/location on any of the following bases:

• Race, color, sex, language
• Religion, political opinion, nationality, ethnicity, property, birth, age, social origin

• A documented account of discrimination in the same region/location due to any of the following

• Mental and neurological disorders
• Substance use disorders

• A personal account of discrimination experienced in the same region/location, if any

Step 2. Write

After analyzing and drafting, write a 200-600 word petition addressing two-three accounts of discrimination. To be specific, the petition letter must include the following details:

Step 3: Share

To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

Step 4: Interact

To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

In this activity, you will write dialogue about a case scenario on patients' right to privacy, confidentiality, and informed consent.

Step 1. Analyze

Study and analyze the given scenario below:

Step 2. Write

After studying the scenario, write a 200-500 word dialogue between the physician and the patient that will demonstrate the following:

• How to respond to this situation taking into consideration the principles for the protection of patient privacy and confidentiality
• How the patient (or their designated decision-maker) is aware of the proposed therapy 
• When consent is needed or provided
• What can be done in this scenario if the patient still does not give consent to share his medical information

Note: Indicate clearly which parts of the dialogue are said by the physician and which parts are said by the patient. 

Step 3: Share

To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

Step 4: Interact

To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

In this activity, you will simulate a fictional consultation between a physician and a patient suffering from substance use disorders. 

Step 1. Study

Analyze and study the given scenario:

Step 2. Draft

Draft a screening form that will be used during the fictional consultation, and that will assess the following details:

• Medical history of the patient
• Patient demographics 
• History of presenting complaints (i.e., use of the most frequent substances: tobacco, alcohol, cannabis, illicit drugs, misuse of prescription drugs…)
• Relevant past medical history
• Family history
• Allergies
• Social History
• Physical symptoms suggesting substance use disorders
• Red flags for substance use disorders

Step 3. Simulate

Administer the drafted screening form by simulating the fictional scenario to a friend (with consent) who will act as the patient or, in the absence of another person, simulate the fictional scenario by acting as the physician and, at the same time, the patient. Make a 3-5 minute audio recording of your simulation. Also, include in your simulation if the case addressed in the history presented red flags for substance use disorder. 

Step 4. Share

To share your audio recording, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

Step 5. Interact

Evaluate and categorize the work from one of your peers based on items A - E of the rubric below. Provide a rationale for the grade you have provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as an example:

Item A is  .…. because….  My suggestions for improvement are….
Item B is  .…. because….  My suggestions for improvement are….
Item C is  .…. because….  My suggestions for improvement are….
Item D is  .…. because….  My suggestions for improvement are….
Item E is  .…. because….  My suggestions for improvement are….

In this activity, you will assess the severity of the alcohol withdrawal symptoms presented by three different patients and suggest which patients need treatment or referral.

Step 1. Review

Review the learning resources for this lesson.

Step 2. Study

Study and analyze the three patient cases of alcohol withdrawal below:

Step 3. Assess

Assess which among Patients A, B, and C need/s immediate medical attention and treatment and which need/s referral using a formulated criteria based on the standard criteria of the Clinical Institute Withdrawal Assessment of Alcohol Scale.

Step 4. Respond

Write a 200-500 word assessment summary of your findings for Patients A, B, and C with the following inclusions:

• Rank Patients A, B, and C based on the severity of alcohol withdrawal symptoms
• Propose referral or treatment for each patient, specify which patient/s, if any, need/s immediate medical attention
• Justify the ranking, referral, and treatment proposals
• Include other recommendations for assessment and treatment options

Step 5: Share

To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

Step 6: Interact

To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

In this activity, you will role-play (audio only) a practice interview using the ASSIST Screening Tool between a physician and a patient suffering from substance use disorders and discuss treatment approaches suitable for the patient.

Step 1. Review

Review how to use the ASSIST Screening Tool from the learning resources of this lesson.

Step 2. Prepare

Prepare the following prior to the role-play:

• The ASSIST-Lite form for general healthcare services (You can download the tool here: https://www.gov.uk/government/publications/assist-lite-screening-tool-how-to-use)
• The patient actor (ask a friend or a person to play as the patient suffering from a substance use problem)
• The environment where the role-play interview will be simulated
• This can be an audio recorded face-to-face interview or an audio-recorded virtual interview via Zoom/Skype/Microsoft Teams, etc.

Note: This should be a fictional interview. To respect privacy and confidentiality principles, do not record an interview with one of your actual patients.

Step 3. Record

Record a 3-5 minute audio demonstrating the role-playing of how to administer the ASSIST Screening Tool to the patient actor, your interpretation of the scores obtained by the patient actor, and your proposed actions/treatments. Make sure that the following will also be demonstrated in the video recording:

• Skills needed/required to screen for substance disorders using the ASSIST Screening Tool
• Correct administration of ASSIST Screening Tool
• Correct interpretation of the ASSIST Screening Tool scores
• Skills needed/required to set respectful limits on prescribing medication and drugs of dependence to the patient
• Skills needed/required to have clear and supportive recommendations on treatment options applicable to patients with substance use disorders

Step 4. Share

To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

Step 5. Interact

Evaluate and categorize the work from one of your peers based on items A - E of the rubric below. Provide a rationale for the grade you have provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as an example:

Item A is  .…. because….  My suggestions for improvement are….
Item B is  .…. because….  My suggestions for improvement are….
Item C is  .…. because….  My suggestions for improvement are….
Item D is  .…. because….  My suggestions for improvement are….
Item E is  .…. because….  My suggestions for improvement are….

In this activity, you will assess three case scenarios of patients suffering from substance use disorders and with varying severity of self-harm and suicidal thoughts.

Step 1. Study

Analyze and study the three cases of patients suffering from substance use disorders:

Select one case from Step 1 that matches your interest and propose a workable psychosocial support process/intervention for the chosen case that covers the following questions:

• What are the objectives/goals of the psychosocial intervention?
• Who is/are involved in the psychosocial intervention?
• What activities and actions are appropriate for the psychosocial intervention?
• What might be the challenges and barriers that may hinder the psychosocial intervention, and how to overcome these barriers?
• What are the expected outcomes of the intervention support process?

Step 3. Respond

Write a 300-600 word workable psychosocial support intervention plan for the chosen case that encompasses all the questions raised in Step 2 and which also includes a brief description of how the psychosocial support intervention may be modified and adapted to address the other two cases from Step 1. 

Step 4: Share

To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

Step 5: Interact

To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

In this activity, you will write an article that talks about the treatment and management of two substance use disorders among HIV patients.

Step 1. Review

Review all the learning resources for this lesson.

Step 2. Study

Study the given scenario:

Step 3. Respond

For social media post 1:

Write 200-500 words for a social media infographic post about two substance use disorders prevalent among the HIV-infected population with the following inclusions:

• The two substance use disorders chosen
• Prevalence of the two substance use disorders among the HIV-infected population
• Key risk factors for these substance use disorders among the HIV-infected population and/or key risk factors of getting infected with HIV for people using these substances
• Current status of the HIV-infected population with substance use disorders
• Treatment and management approaches 
• Challenges and barriers to treatment and management
• Recommendations and commendations 

Note: You can include graphics or pictures if relevant.

For social media post 2:

Write 200-400 words for a social media post identifying two useful self-help and well-being resources such as local and government websites for people suffering from mental health conditions and substance use disorders, including the following:

• Name of the resources and how to access them (e.g., insert a link to the website)
• Functions that these resources serve
• Types of information that the resources/websites can give
• Country of origin/Place of origin of these resources
• Source (e.g., government, national public health authorities, universities, etc.)

Note: You can include graphics or pictures if relevant.

Step 4: Share

To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

Step 5: Interact

To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

In this activity, you will write a full script dialogue depicting effective communication incorporated in group and individual therapy sessions.

Step 1. Review

Review all the learning resources for this lesson. Additionally, gather information on how the group and individual therapies and counseling are conducted.

Step 2. Write

Assume the role of a psychiatrist specializing in addiction medicine, who runs a group therapy for five (5) individuals suffering from alcohol addiction and substance use disorders. Now, write a 600-1200 word script dialogue as a full response for three round-robin discussions within a group therapy and an individual therapy. Each round-robin discussion’s script dialogue must cover at least 200 words.

Each round-robin discussion is described by the following scenarios below. The script dialogue must also demonstrate how the psychiatrist reacted and acted effectively to address each scenario.

Step 3. Finalize

Finalize your script dialogue by checking if all the required elements have been addressed. Also, check if all the learning outcomes have been demonstrated by the script dialogue.

Step 4: Share

To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

Step 5. Interact

Evaluate and categorize the work from one of your peers based on items A - E of the rubric below. Provide a rationale for the grade you have provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as an example:

Item A is  .…. because….  My suggestions for improvement are….
Item B is  .…. because….  My suggestions for improvement are….
Item C is  .…. because….  My suggestions for improvement are….
Item D is  .…. because….  My suggestions for improvement are….
Item E is  .…. because….  My suggestions for improvement are….