Rosa Lee Cunningham is a 52 twelvemonth old Afro-american individual female parent of eight. who is a long clip diacetylmorphine nut. and has an extended felon record. Of her eight kids six of them have followed her in her life of dependence and offense. These offenses include everything from junior-grade larceny. to harlotry. to drug trafficking. Rosa Lee has late showed up at the Howard University Hospital exigency room because her organic structure is seeking to close down due to her heroin dependence. and she has Acquired Immune Deficiency Syndrome ( AIDS ) . The staff in the exigency room studies that Rosa Lee is no alien to the exigency room. and her records show an extended 13 twelvemonth record of drug maltreatment including diacetylmorphine. cocaine. and pep pills. Rosa Lee was referred for reding for survey. in an effort to acquire a better apprehension of her habit-forming rhythm and an effort to assist Rosa Lee control her habit-forming behaviours. SOURCES OF INFORMATION:
Self-report. household members. condemnable records. and infirmary records PSYCHOSOCIAL History:Rosa Lee Cunningham was born on October 7. 1936. and was one of 11 kids from her female parent Rosetta. and one of seven from her male parent Earl Wright. who died when Rosa Lee was immature. They were hapless sharecrop farmers from Virginia who moved to the Washington DC country during the great depression for work. Her female parent remarried after her male parent died and had four more kids with her 2nd hubby.
Rosa Lee describes her childhood as being from a really hapless household. and her relationship with her female parent was really opprobrious. Rosa Lee started shoplifting and stealing at a really early age. which was a big ground for her and her mother’s bad relationship. Another possible ground for this astringed relationship is the fact that Rosa Lee became pregnant for the first clip when she was 13 old ages old. Rosa Lee had eight kids with six different work forces who all grew up in the same vicinity as Rosa Lee. Rosa Lee was married one clip to Alvin Cunningham. who was the male parent of her 3rd kid. Rosa Lee tried to keep on to work forces by holding kids by them which ne’er worked out. Besides these six work forces. Rosa Lee was besides involved in one long term sapphic relationship. which is when her substance maltreatment started. and she had many spouses due to her dependence job and that she was a cocotte at one clip to back up her drug wont. Of her eight kids. six of them have followed Rosa Lee into a life of poorness. dependence. and assorted offenses. while the other two are populating normal productive lives. Rosa Lee’s oldest boy died last twelvemonth after a long turn with Human Immunodeficiency virus ( HIV ) and AIDS.
Rosa Lee has an extended felon record get downing with shrinkage when she was 13 old ages old. She went to imprison for the first clip when she was 16 and pregnant with her 3rd kid. Over the old ages she was arrested for everything from shoplifting to petty larceny. to harlotry. to drug trafficking. including one apprehension for utilizing her grand-daughter to mule heroin and/or cleft cocaine. and selling stolen goods. She was imprisoned 12 times over her life-time. the longest for 9 months on several occasions. Rosa Lee’s drug dependence didn’t start until later in life. In the mid 70’s while in her sapphic relationship she started utilizing pep pills to assist command her weight. After a painful dissolution. she started utilizing diacetylmorphine with her girl. which rapidly inclined to utilizing heroin intravenously with two of her girls and two of her boies.
It was through her sharing acerate leafs with these kids or her ain harlotry that she contracted HIV which has developed into full blown AIDS. Currently she is traveling to a dolophine hydrochloride clinic. though I expect this is merely to keep off illness when she can non afford diacetylmorphine. Due to this dependence job and life in deep poorness for her full life. Rosa Lee moved a batch life in 18 different topographic points over her lifetime including two different homeless shelters. She presently lives in subsidised lodging with two of her kids and her grandchildren. Rosa Lee attended Mount Joy Baptist Church as a kid. and late she and two of her grandchildren were baptized. Other than this. I do non believe that she spent much clip during her life go toing much church since she ne’er mentioned much more about any type of spiritualty.
Rosa Lee’s support system is her kids and grandchildren who depend on her more so she depends on them. Because of this. Rosa Lee truly has no support system. Current Status:Presently Rosa Lee starts her twenty-four hours around 5:30. when her dolophine hydrochloride wears off. She cleans herself up. wakes up her expansive kids to travel to school before the dolophine hydrochloride clinic opens at 7:30. Then she goes and gets her dolophine hydrochloride. After this she might travel shoplift. or petal diacetylmorphine. depending what might be traveling on during that twenty-four hours.
Rosa Lee has taught all of her kids and expansive kids to shoplift. It appears that shrinkage has become a manner of endurance for her and her household. If Rosa Lee is ill she will still seek to acquire up and travel acquire her dolophine hydrochloride but so she will travel place and travel back to bed. Many times those who are supposed to be her support are in more demand of support from her.
Rosa Lee is on several different medicines for ictuss and for her full blown AIDS. Not long ago she was admitted into the infirmary for taking excessively much of one of her medicines. This is due to the fact that she can non read good. While she was at that place. her girl Patty ripped off one of the local diacetylmorphine traders who came to the infirmary looking for Rosa Lee to roll up the debt that her girl created. When Rosa Lee eventually gets out she goes directly to the diacetylmorphine trader to work off Patty’s debt.
Rosa Lee believes that she is really cunning as a booster and as a crafty speaker. which she demonstrates when she has to travel to tribunal. Rosa Lee dresses in her best apparels. goes into the tribunal room and dramas on the justice that she is holding to assist raise her grandkids while her girl was in gaol. although her girl was already out. converting the justice to set off condemning for several months. INDICATORS OF USE/ABUSE/DEPENDENCY:
Attitude and Behavior: Rosa Lee’s activities are based around drug and condemnable activity while obtaining what she needs to go on utilizing diacetylmorphine. Social Functioning of Rosa Lee: Rosa Lee’s societal life involves her assisting her other addict kids score drugs. Rosa Lee has no existent support system. Occupational Operation: The closest thing that Rosa Lee has to a occupation is shoplifting which she has taught to her kids and expansive kids. Fiscal Aspects: Rosa Lee merely worries about what is go oning right now and is non concerned about tomorrow. Familial Relationships: Most of Rosa Lee’s household is besides nuts and I believe that her relationship with her kids who are non nuts is estranged. Legal History: Rosa Lee has an extended apprehension record for shoplifting. junior-grade larceny. drug trafficking. and harlotry. Health History: Rosa Lee suffers from shanghaiers due to her drug maltreatment. her organic structure has started closing down on her several times. she is HIV positive. and is now enduring from full blown AIDS. Religious History: Rosa Lee grew up go toing Mount Joy Baptist Church. but walked off from the church after go forthing place at age 16. Recently Rosa Lee and two of her grandchildren were baptized. but non certain what that means to her. Diagnostic Impression:
Rosa Lee has been enduring from a substance usage upset ( SUD ) for about 20 old ages plus. She besides has AIDS caused by either sharing subcutaneous acerate leafs. which she portions with four of her kids who are besides utilizing diacetylmorphine. or through harlotry. which her. her girl Patty. and her oldest boy. who passed off from AIDS last twelvemonth were all involved in. Harmonizing to Doweiko coexisting medical jobs and SUDs are common among people who have a SUDs suffer from an mixture of medical jobs such as bosom jobs. cirrhosis. and a host of infective diseases such as hepatitis C. HIV. and AIDS. This can besides ensue in a host of other mental upsets ( Doweiko. 2012 ) .
Rosa Lee does non kick of any mental upsets. though I expect she suffers from depression. and possible co-dependency as demonstrated through the many different relationships she has had over the old ages. Co-dependency can be defined as one individual in a relationship seeking to do it go on while the other does non ( Clinton & A ; Scalise. 2013 ) . In Rosa Lee’s instance it was any relationship she could happen. as demonstrated by her relationship with six different work forces. and one long-run sapphic relationship.
Rosa Lee has an extended felon record dating back to age 13. at which clip she was non mistreating drugs. After get downing to mistreat drugs in her late 20s. a twine of drug trafficking and harlotry charges have followed. This is a major epidemic throughout the universe. with SUDs being a major portion of offense throughout the universe ( Doweiko. 2012 ) . Over the old ages Rosa Lee has turned to shoplifting and larceny non due to being a kleptomaniac but more out of a demand of endurance ( Clinton & A ; Scalise. 2013 ) .
Other factors that need to be taken into consideration are ; Rosa Lee has lived in utmost poorness for her full life. diffident how her diagnosing of HIV affects her mental province. while her kids are dependent on her. I believe that she is besides dependent on them. Rosa Lee besides puts herself at hazard physically while bicycling drugs. her engagement in harlotry. and sharing subcutaneous acerate leafs with her four other diacetylmorphine addicted kids. Recommendation:
There are several factors that need to be taken into consideration in the intervention program for Rosa Lee. One must see her medical status. the length of her diacetylmorphine usage. the deficiency of household support. and her environment. Other things to take into consideration are her condemnable record. and her opportunity of future captivity. First and for most Rosa Lee must hold a desire to alter. Once she shows a desire to alter. she is more disposed to perpetrate to a intervention plan. One of the first stairss within rehabilitation is a medically managed detoxification. Some people mistake detoxification as a signifier of rehabilitation. nevertheless one must understand that this is merely the first measure of rehabilitation and those who go through detoxification must besides hold a program of backsliding bar ( Doweiko. 2012 ) . Second is to go on pharmacological intercession to assist Rosa Lee better trade with backdown symptoms. The most common is methadone intervention which she is already on. Methadone is used to ease the procedure of detoxification off of prescription opiate drugs or illicit drugs such as diacetylmorphine ( Doweiko. 2012 ) .
Along with this dolophine hydrochloride intervention at that place must besides be a intervention program for her HIV/AIDS to assist forestall farther wellness impairment. While I believe that Rosa Lee should go on her dolophine hydrochloride intervention at the present clip. nevertheless due to the length of clip that she has been on dolophine hydrochloride medical staff should see detoxification from the dolophine hydrochloride and replacing it with another agonist medicine such as Buprenorphine. Buprenorphine. besides known as Suboxone. is a cousin of morphia. nevertheless when injected it is 25- 50 times more powerful as its cousin morphia. Because of its strength merely 0. 3 mgs of Buprenorphine is needed to hold the same consequence as 10 mgs of morphia. When this drug is token sublingually it blocks opiate receptors such as dolophine hydrochloride. with a much lower feeling of euphory than dolophine hydrochloride. doing it a really good replacement for dolophine hydrochloride ( Doweiko. 2012 ) . Because of Rosa Lee’s deficiency of support towards clean life in her current lodging state of affairs. and her medical status. a hospital-based residential intervention plan is recommended.
A hospital-based residential intervention plan offers different services including medical services. household therapy. single therapy. group therapy. psycho-educational therapy. and societal services for patients who need it ( Doweiko. 2012 ) . The first topographic point to get down is through single guidance where she can cover with her past including her rough upbringing. her alienated yesteryear relationship with her female parent to convey closing to that chapter of her life. Some of the advantages of single therapy are that the patient can turn to issues that may be excessively personal to turn to in group therapy ( Doweiko. 2012 ) . Another portion of both single guidance and group guidance is cognitive behavioural therapy. Cognitive behavioural therapy can assist the client to cover with ideas such as. “I need to make drugs to cover with my problems” ( Doweiko. 2012 ) . The most common signifier of dependence therapy is group therapy. With group therapy the members can cover with societal issues and besides construct a type of household group. This can assist the client to cover with unsolved relationship jobs. and to see healthy relationships and a pseudo-family unit ( Doweiko. 2012 ) .
Finally is household therapy which in Rosa Lee’s place can be really hard. This is because her household is a immense portion of her habit-forming behaviours. Most household therapy is used to learn household members to cover with unfinished struggle and assist the household to larn the right manner to back up the client when they go place ( Doweiko. 2012 ) . Because of Rosa Lee’s household state of affairs when she finishes inpatient intervention I might urge that she enters into a halfway house if possible. A halfway house is a good pick for those who do non hold a strong support system at place. Most halfway houses have fewer people than a inpatient intervention centre with much less supervising. Most center houses require the client to work. pay rent. make jobs around the house. remain sober. and go to a 12-step plan such as Alcoholics Anonymous ( AA ) or narcotics Anonymous ( NA ) ( Doweiko. 2012 ) . This may be hard for Rosa Lee because she appears to be the chief caretaker of her household. If this is the instance so one must stress to Rosa Lee the importance of her strengths when she returns place. One such strength is her love for her household.
This is demonstrated when she comes to the realisation of how her learning her grandchildren to shoplift is a bad thought. If Rosa Lee realizes how her dysfunctional behaviours effects both her childs and grandkids she may alter her behaviour. and in return quit enabling her kids and even assisting them in the terminal. Finally are the religious beliefs of Rosa Lee and the religious facets of dependence. One must recognize that when we alter our chemical balance even a small spot it opens a religious window and alters one’s religious mentality ( Scalise. 2009 ) . With this being said we can non speak about recovery of dependence without including some of the religious facets of dependence and rehabilitation. While Rosa Lee hasn’t ever been involved with religious patterns. we know she grew up in church. and her and her grandchildren were late baptized. Rosa Lee should be unfastened to the thought of religious dependence therapy. One must recognize that when there is an dependence job it affects more than merely one’s head or organic structure but it besides affects one spirit. and all of these facets need to be addressed.
This is why the church needs to be involved in the rehabilitation procedure. First of all one must inquire themselves what would Jesus make? Jesus would make out in truth and love and assist these people. The bible Tells us in Ephesians 4:11-12 “So Christ himself gave the apostles. the Prophetss. the revivalists. the curates and instructors. to fit his people for plants of service. so that the organic structure of Christ may be built up” ( NIV ) . This shows us the demand for the priest who consuls one and shows empathy and love. for the prophesier who shakes people up and makes them uncomfortable. and makes the addict think about what they are making. These are countries that people who are enduring from dependence demand ( Scalise. 2009 ) . When one is enduring from an dependence they are in a love hatred relationship. the apostle Paul addresses this feeling in Romans 7:14-15 when he says. “We know that the jurisprudence is religious ; but I am unspiritual. sold as a slave to transgress. I do non understand what I do. For what I want to make I make non make. but what I hate I do” ( NIV ) ( Scalise. 2009 ) . For Rosa Lee this can be addressed in after attention plans such as Celebrate Recovery or Life Recovery. which can be found in most communities. While these plans are based on the same 12-steps as AA and NA. they besides focus on Biblical facets such as the blessednesss making recovery and encouraging clean and sober Christian life.
MentionsClinton. T. . & A ; Scalise. E. ( 2013 ) . Addiction and reovery guidance. Grand Rapids. Myocardial infarction: Baker Books. Doweiko. H. E. ( 2012 ) . Concepts of chemical dependecy ( 9th ed. ) . Stanford. Connecticut: Cengage Learning. Scalise. E. ( 2009 ) . The habit-forming rhythm. Addiction and recovery. American Association of Christian Counselors. Retrieved from hypertext transfer protocol: //learn. autonomy. edu/webapps/portal/frameset. jsp? tab_tab_group_id=_2_1 & A ; url=/webapps/blackboard/execute/courseMain? course_id=_98206_1