2173 Salk Avenue, Suite 250 Carlsbad, CA

+ (516) 373-0809

Week 10: Therapy for Patients With Impulsive/Substance Use Disorders (SUD)

Impulsivity and compulsivity have a wide range of clinical presentations and often overlap with many other psychiatric disorders. Some individuals act without forethought and have difficulty saying “no” to certain things, such as using illicit drugs or spending money, whereas other individuals engage in compulsive behaviors with undesirable consequences. In some cases, these impulsive and compulsive behaviors also fuel issues with addiction. To effectively assess and treat patients, you must understand how these disorders differ as well as how their symptoms impact patients and their families.

This week, as you examine therapies for individuals with impulsivity, compulsivity, and addiction, you explore the assessment and treatment of patients with these disorders. You also consider ethical and legal implications of these therapies.

Learning Objectives

Students will:

  • Assess patient factors and history to develop personalized therapy plans for patients with impulsivity, compulsivity, and addiction
  • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring therapy for impulsivity, compulsivity, and addiction
  • Synthesize knowledge of providing care to patients presenting for impulsivity, compulsivity, and addiction
  • Analyze ethical and legal implications related to prescribing therapy for patients with impulsivity, compulsivity, and addiction

Learning Resources

Required Readings (click to expand/reduce)

Kelly, J. E., & Renner, J. A. (2016). Alcohol-Related disorders. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier.

Renner, J. A., & Ward, N. (2016). Drug addiction. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier.

Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders: Treatment improvement protocol series, no. 32. http://www.ncbi.nlm.nih.gov/books/NBK64350/ Chapter 1, “Substance Use Among Adolescents” Chapter 2, “Tailoring Treatment to the Adolescent’s Problem” Chapter 7, “Youths with Distinctive Treatment Needs” University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control. Journal of Psychosocial Nursing & Mental Health Services, 54(4), 15. Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling. British Journal of Clinical Pharmacology, 77(2), 375–381. https://doi.org/10.1111/j.1365-2125.2012.04457.x Hulvershorn, L. A., Schroeder, K. M., Wink, L. K., Erickson, C. A., & McDougle, C. J. (2015). Psychopharmacologic treatment of children prenatally exposed to drugs of abuse. Human Psychopharmacology, 30(3), 164–172. https://doi.org/10.1002/hup.2467 Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological Nursing, 42(4), 10–15. https://doi.org/10.3928/00989134-20160314-04 Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual Diagnosis, 8(1), 74–84. https://doi.org/10.1080/15504263.2012.648439 Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., Olvera, R., Swann, A. C., & Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents. Comprehensive Psychiatry, 55(6), 1337–1341. https://doi.org/10.1016/j.comppsych.2014.04.018 Medication Resources (click to expand/reduce) IBM Corporation. (2020). IBM Micromedex. https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkaccess?source=deepLink&institution=SZMC%5ESZMC%5ET43537

Note: To access the following medications, use the IBM Micromedex resource. Type the name of each medication in the keyword search bar. Be sure to read all sections on the left navigation bar related to each medication’s result page, as this information will be helpful for your review in preparation for your Assignments.

naltrexone (revia/vivitrol) naloxone acamprosate disulfiram

Required Media (click to expand/reduce) Case Study: A Puerto Rican Woman with Comorbid Addiction 
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources (click to expand/reduce) Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., Cinose, E., Di Iorio, G., Di Nicola, M., & Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review. Biomed Research International, 2014. https://doi.org/10.1155/2014/537306


Assignment: Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction

Impulsivity, compulsivity, and addiction are challenging disorders for patients across the life span. Impulsivity is the inclination to act upon sudden urges or desires without considering potential consequences; patients often describe impulsivity as living in the present moment without regard to the future (MentalHelp.net, n.d.). Thus, these disorders often manifest as negative behaviors, resulting in adverse outcomes for patients. For example, compulsivity represents a behavior that an individual feels driven to perform to relieve anxiety (MentalHelp.net, n.d.). The presence of these behaviors often results in addiction, which represents the process of the transition from impulsive to compulsive behavior.

In your role as the psychiatric nurse practitioner (PNP), you have the opportunity to help patients address underlying causes of the disorders and overcome these behaviors. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with impulsivity, compulsivity, and addiction.

Reference: MentalHelp.net. (n.d.). Impaired decision-making, impulsivity, and compulsivity: Addictions’ effect on the cerebral cortex. https://www.mentalhelp.net/addiction/impulsivity-and-compulsivity-addictions-effect-on-the-cerebral-cortex/

To prepare for this Assignment:

  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring therapy for impulsivity, compulsivity, and addiction.

The Assignment: 5 pages

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature. Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

By Day 7

Submit your Assignment. 

Struggling With a Similar Paper? Get Reliable Help Now.

Delivered on time. Plagiarism-free. Good Grades.

What is this?

It’s a homework service designed by a team of 23 writers based in Carlsbad, CA with one specific goal – to help students just like you complete their assignments on time and get good grades!

Why do you do it?

Because getting a degree is hard these days! With many students being forced to juggle between demanding careers, family life and a rigorous academic schedule. Having a helping hand from time to time goes a long way in making sure you get to the finish line with your sanity intact!

How does it work?

You have an assignment you need help with. Instead of struggling on this alone, you give us your assignment instructions, we select a team of 2 writers to work on your paper, after it’s done we send it to you via email.

What kind of writer will work on my paper?

Our support team will assign your paper to a team of 2 writers with a background in your degree – For example, if you have a nursing paper we will select a team with a nursing background. The main writer will handle the research and writing part while the second writer will proof the paper for grammar, formatting & referencing mistakes if any.

Our team is comprised of native English speakers working exclusively from the United States. 

Will the paper be original?

Yes! It will be just as if you wrote the paper yourself! Completely original, written from your scratch following your specific instructions.

Is it free?

No, it’s a paid service. You pay for someone to work on your assignment for you.

Is it legit? Can I trust you?

Completely legit, backed by an iron-clad money back guarantee. We’ve been doing this since 2007 – helping students like you get through college.

Will you deliver it on time?

Absolutely! We understand you have a really tight deadline and you need this delivered a few hours before your deadline so you can look at it before turning it in.

Can you get me a good grade? It’s my final project and I need a good grade.

Yes! We only pick projects where we are sure we’ll deliver good grades.

What do you need to get started on my paper?

* The full assignment instructions as they appear on your school account.

* If a Grading Rubric is present, make sure to attach it.

* Include any special announcements or emails you might have gotten from your Professor pertaining to this assignment.

* Any templates or additional files required to complete the assignment.

How do I place an order?

You can do so through our custom order page here or you can talk to our live chat team and they’ll guide you on how to do this.

How will I receive my paper?

We will send it to your email. Please make sure to provide us with your best email – we’ll be using this to communicate to you throughout the whole process.

Getting Your Paper Today is as Simple as ABC

No more missed deadlines! No more late points deductions!

}

You give us your assignments instructions via email or through our order page.

Our support team selects a qualified writing team of 2 writers for you.

l

In under 5 minutes after you place your order, research & writing begins.

Complete paper is delivered to your email before your deadline is up.

Want A Good Grade?

Get a professional writer who has worked on a similar assignment to do this paper for you