Drug Addiction and Pregnancy – The Case of Suzanne

Drug Addiction and Pregnancy – The Case of Suzanne

Most Addictive Drug

In the case of Suzanne, it is evident that she is using several drugs and substances. From the information given, one can see that Suzanne uses heroin, alcohol, valium, and Klonopin. In her story, as presented to the clinician, it is evident that she is more addicted to heroin because, in her story, she confesses that her boyfriend introduced her to the drug, which she has been using ever since they met. Moreover, some of the things that show that she is addicted to heroin are her confession that she must use at least 0.5 grams of heroin every day to make her feel comfortable or to function well. Also, she says that one of the reasons she is working is to get money for heroin, which, if she does not get enough, she adds other drugs like valium and Klonopin. Frazer, McConnell, and Jansson (2019) argue that one is addicted to a substance when one can no longer function properly unless one uses the drug or substance. Frazer, McConnell, and Jansson (2019) have also listed heroin as the first among the top ten most addictive drugs. Therefore, using this definition, it is evident that Suzanne is addicted to heroin.

The Drugs That Pose more Threat to withdraw from

As already seen, Suzanne is using heroin, valium, and Klonopin. She is, however, addicted to heroin. According to a study by Bluthenthal et al. (2020), a drug addict may experience withdrawal syndrome when they are trying to quit using a particular drug. In another report by Bluthenthal et al. (2020), it is made evident that heroin withdrawal syndromes are very painful, and sometimes certain features of the withdrawal syndrome may last for a very long time, even after one quit. For instance, lack of sleep, anxiety, and depression. Moreover, withdrawal from heroin can also be difficult because it sometimes leaves the person with an addiction with certain physical impairments (Bluthenthal et al., 2020). Withdrawal from valium and Klonopin, on the other hand, may also have withdrawal syndrome. However, Bluthenthal et al. (2020) revealed that withdrawing from these two may cause a syndrome lasting between ten and fourteen days. Another factor to consider is that Suzanne has a boyfriend who has a substance use disorder. As such, he is more likely to take her back to consumption of heroin even if she tries to quit. Based on this evidence, one can tell that leaving heroin may pose more danger to her when she tries to withdraw compared to the other drugs. Notably, sudden withdrawal from heroin can also affect the unborn baby and may even lead to death.

The Dangers for Suzanne and Her Unborn Baby

Suzanne is exposed to numerous dangers. Her abuse of heroin exposes her to changes in her brain’s physiology and even effects on her physique (Fisher & Harrison, 2018). As such, she is likely to have neurological impairments if she continues using heroin. When looking at her case, it is evident that Suzanne is engaging in commercial sex, and this places her at risk of contracting sexually transmitted diseases. However, it is unclear in her story whether her boyfriend has other affairs (Fisher & Harrison, 2018). Further, since they have sex without a condom, she is also at risk of contracting sexually transmitted diseases from her boyfriend since drug users sometimes share needles when injecting drugs, and as they do so, they may contract STDs and STIs. Moreover, the baby’s life is in danger because using heroin can cause congenital disabilities. It can cause placental abruption, premature birth, and giving birth to a baby with very low birth weight (Fisher & Harrison, 2018). It is also important to note, as stated above, that sudden quitting of heroin may also kill the fetus.

Treatment Options for Suzanne

The very first treatment option for Suzanne is helping her gradually quit heroin, valium, Klonopin, and alcohol. The use of these drugs and substances exposes her to several illnesses and neurological impairments. Also, it is highly likely to affect her pregnancy as she wants to keep the baby. Another treatment option for Suzanne is psychotherapy and drug treatment. According to Fisher and Harrison (2018), drug and substance addicts need treatment to help them quit their addiction. However, apart from the treatment on drugs to help Suzanne quit, she should be scheduled for behavior therapy and psychotherapy. Another treatment option for Suzanne is going to the clinic for a checkup on her health and that of her baby.

Referrals that Suzanne should be Given

Suzanne should be given referrals to a rehabilitation center where she can be helped to quit using heroin, valium, Klonopin, and alcohol. This is the first referral because drugs and substance abuse are putting her life in danger and also endangering the life of the fetus (Frazer, McConnell & Jansson, 2019). Therefore, Suzanne should first get help to quit these substances for her safety. The second referral is to a healthcare facility where she can check her health. Suzanne should be limited to ensure that she is healthy because she works as a commercial sex worker. Additionally, since she is pregnant and uses drugs, she should be checked to ensure the fetus is healthy.

Should Suzanne Quit Heroin

Suzanne needs to stop using heroin. According to Bluthenthal et al. (2020), sudden quitting of heroin can endanger the life of Suzanne and the life of the unborn baby, which can also lead to the death of the fetus. Therefore, it is advised that Suzanne should not quit suddenly, but she should do it gradually because using heroin is also endangering the fetus. Suzanne’s girlfriend is, therefore, correct in advising her not to stop using heroin. She should, however, encourage her to quit gradually.

Legal Issues Related to Suzanne’s Pregnancy

The one legal issue that is likely to emerge if Suzanne decides to keep the pregnancy is that she may be sued for endangering her child’s life. Several states in the US sue mothers who are using substances while pregnant. For instance, a state like Wisconsin sues women in such cases, and they can be charged with attempted first-degree intentional homicide. They can also be charged with reckless conduct.

References

Bluthenthal, R. N., Simpson, K., Ceasar, R. C., Zhao, J., Wenger, L., & Kral, A. H. (2020). Opioid withdrawal symptoms, frequency, and pain characteristics as correlates of health risk among people who inject drugs. Drug and alcohol dependence, 211, 107932. https://doi.org/10.1016/j.drugalcdep.2020.107932

Fisher, G. L., & Harrison, T. C. (2018). Substance Abuse: Information for School Counselors, Social Workers, Therapists, and Counselors. United States: Pearson.

Frazer, Z., McConnell, K., & Jansson, L. M. (2019). Treatment for substance use disorders in pregnant women: Motivators and barriers. Drug and alcohol dependence, 205, 107652. https://doi.org/10.1016/j.drugalcdep.2019.107652

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Drug Addiction and Pregnancy – The Case of Suzanne

Case Study 1 -Suzanne S.

Suzanne has come by the free “drop-in” counseling clinic where you work to get some information and advice. Suzanne is a 22-year-old single woman who has been living with her boyfriend Jack in Manhattan’s Lower East Side for the last four years. She and Jack have been heroin addicts for as many years. When Suzanne was 10 years old, her father, whom she says was a very heavy drinker, left her mom and the kids and never came back. At 14 she started drinking and smoking marijuana. At 16 she had dropped out of high school and at 18 she moved in with Jack. He introduced her to heroin. She reports using about a 1/2 gram of heroin per day just to be able to function and feel comfortable. In order to pay for the heroin and pay the rent on their apartment, Jack doesn’t work, instead, she works the streets at night. She usually drinks four or five beers each night before going out to work. If she can’t score enough heroin, she will try to score either some Valium or Klonopin to “tide me over until I can get some “horse”. She says she has tried cocaine but, “I really didn’t care for the high all that much.” Suzanne tells you that the alcohol and heroin help to calm her nerves and get her through the night. She and Jack are not having sex all that much. When they do make love he never wears a condom. He says that’s what makes him different from her “john’s” “Which is true because I won’t work without a condom.” Lately, she has noticed that her breasts have become swollen and more tender. She also hasn’t had her period in the last 12 weeks. She is pretty sure she is pregnant and knows it’s her boyfriend’s baby. However she is not sure she can stop using dope or work to have the baby even though Jack wants her to keep it. She is really confused at what she should do and is her asking for you to help her make some decisions. Her friend who works with her at night told her not to stop using dope if she is pregnant “Because it’s worse for the baby than to keep using.”. “I just don’t know what I should do?”

Questions-

1. What drug(s) does Suzanne seem to be most addicted to?

2. Of the drugs she is abusing, which one(s) pose more of a danger to withdraw from? Why?

3. What dangers do you see as you read this case? What are the dangers for Suzanne? What are the dangers for the baby?

4. What treatment options would you offer Suzanne and why?

5. What referrals would you give to her and in what order?

6. Is her girlfriend correct in her advice for Suzanne not to stop her heroin use if she is pregnant? If she is, why?

7. What legal issues are more than likely to present themselves in this case if she decides to keep the child?

HOW TO APPROACH A CASE STUDY:

While there are no definitive “right” answers, there are some responses that are more appropriate than others. The trick is to first use only the information given. Do not make up information that is not in the text of the case study. If the case says they are drinking alcohol, don’t make up that they are also doing cocaine if it hasn’t been mentioned anywhere in the case. Use only the given information. If you think a question wasn’t asked, you can say, I would want to ask him or her this. Just don’t fill in their answer. Think of the person in the case as a real live patient sitting in front of you and asking for help. Put on your best counselor therapist hat or simply thinking cap and approach the case from several levels. Try not to view a case from just a medical pharmacology approach but use or think about other clinical issues that might be involved. Think about other resources you can connect this person to and think about important referrals you would make for this patient or client, e.g., medical referrals, psychological evaluations, urine or toxic screens, etc. Most of the cases will begin with the patient or client showing up at the clinic. They will give a brief history and have some specific issues embedded in this text. Your job is to pull that information out and use to make a tentative assessment and develop a plan of action. In reading a case, first look for dangers. Is there anything in the body of the information that can be dangerous to the patient or client? An example would be if the patient appears depressed, think about their potential for suicide. That’s a danger. If they have in their position several medications that can be lethal, that’s a danger. Once you have recognized it, how will you handle it? What are you going to do to remove this danger?