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Case Report

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Noormah Saghir
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6 views

Case Report

Uploaded by

Noormah Saghir
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Case Report

Substance Abuse
Cannabis Withdrawal

Noormah Saghir 1600


Identifying Data
Name N.A
Age 31 Years Old
Gender Female
No. of siblings 3 (2 sisters)
Birth Order 1st Born
Occupation Receptionist
Education Intermediate
Marital Status Single
Address Rawalpindi
Religion Islam
Socio-economic status Lower middle class
Informant Mother
Presenting complain

(according to informant)
According to the client her father died in 2006. After her father’s death, the
home atmosphere was very distant and was not communicative. Other than
this her family were very neglecting, and no attention was provided to the
children, so the client started making friendships outside home, soon she
made a group of friends and to make adjustment in it she started following
their rituals. She established a relationship with a boy. He uses to cared her
a lot. According to the client, that was the best time of her life when she got
emotionally attached with a boy to whom she decided that she will marry in
the future. The client wanted to continue his education but her financial
condition was not good. So she started a job. Her boyfriend promised her
that after their marriage he helped her to continue her education. Her
boyfriend is involved in several unethical acts that were stealing, taking
drugs and trafficking good. According to the client she smoked first time in
2010 to please her boyfriend. Her boyfriend never forced her to do drugs
but she started smoking in his and her friends influence. She seeks pleasure
and excitement in everything that she does with her boyfriend.
With time as her tolerance developed with smoking, she moved a step forward and stopped smoking as for her it was not the
source of relief, and pleasure for her. In 2016, she started taking Hash, she uses to take it in friend’s gathering, as she was
already vulnerable of it. Client reported that she used hash for about 5-6 years. In this time, the client had breakup with her
boyfriend. Now it’s been 3 years of client’s breakup but she is unable to forget him, and also is unable to move forward in life.
After the breakup she used to take hash frequently that provided her more relief as she reported.

Keeping in view client’s day by day progressing problem she was


taken to Roshni Drugs Rehabilitation by her mother, where she may
not get access to any kind of drug. In the starting time of client in
Roshni Drugs Rehabilitation, she reported the symptoms of experience
drowsiness, restlessness, muscle tension, somatic pains, laziness,
nausea, fever, and have severe carving for drug but currently the client
seems energetic, motivated, and a little craving of drug is reported by
her.
Personal history
• Client was born through normal delivery.
• Client reported that she was a brilliant student. She always got good grades. She used to go to government school and
college. Her education was till intermediate.
• Client had a sexual relationship with his boyfriend. The relationship last for 4 years, but ended up in breakup.
• Client belongs to a lower middle class family. She lives in a nuclear family system. According to client she was very close
to her father. The atmosphere of the family was good. At that time her father was the authoritarian figure of the family.
After her father died everything changed. Her mother went into depression. Her mother is an uneducated person and a
housewife.
Also her mother is diabetic patient. They did not talk much to each other. She
reported that she was neglected by her. She has two sisters. She had good
communication pattern with her sisters. When her elder sister got married she felt
lonely.
• The client started smoking in 2010 in the influence of her friends and boyfriend.
According to her at that time smoking gave her pleasure. After that she started
taking hash. Client reported that she used hash for about 5-6 years.
Case Formulation

Predisposing Factors

The history of client suggests that her childhood was not good and she didn’t have attention, love and affection from her
mother, and was a neglected child. She also belongs to a lower middle class family where her needs and desires were not
fulfilled.
Precipitating Factors
According to social learning theory, people use to learn the behavior from the environment, and this modeling behavior is
very common in addiction (Moos, 2007). As the client was much neglected at home so in order to gain some emotional
support and unconditional positive regard, client started to spend more time outside of home and try to make friends.
Unfortunately, the people he found were already involved in illegal acts like stealing, trafficking, and drug addiction. The
client didn’t understand the difference between right and wrong that time, and started to adopt the norms of the group to
adjust in it. That is why she did whatever was asked to her to do, and remaining in the company friends she
started smoking at first and moved to hash. As according to Lapidus and her colleagues (1980) the peer pressure was
found to be important reason for drug use. So in the present case the above mentioned factors were considered as
precipitating factors.
Perpetuating Factor

This is consistent with a study that suggested that the basic to many views of abuse and dependence is the premise
that substance use becomes a way for users to cope with the unpleasant feelings. That goes along with life
circumstances (Cooper, Russell, & Gerorge 1988). So in this case client’s bad company, and relationship break-up
proved to be the maintaining factors in this case.

Protective Factors

Currently, the client had proper insight about her problem, and is much
motivated to seek treatment, other than this client’s family is also supporting her
to get her out of her problem. So these factors proved to be the protective factors
in client’s case
Biopsychosocial and

Spiritual Model
Points in favor of prognosis

• The prognosis of the client is positive as the client insight about the problem was also intact and the
motivation level of the client was also high.
• Marked improvement in his behaviors, and social interaction was also seen as it was observed.
• Positive observable changes were also seen in client’s mood.

Points against the favorable prognosis

• Craving for drugs


• Relapse
Propose management plan
• By using supportive therapy build a level of trust with the client and create a supportive
environment that will facilitate the client to share his problems.
• Psycho educates the client about the harmful effects of the substance use.
• Asking the relevant questions to probe the underlying factors of her problems.
• Explore experiences from the client’s early life that contributes to develop the problem.
• Ask him to complete the Cost Benefit Analysis and to write down the advantages and
disadvantages of his addictive behavior and present living style.

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