Suzanne presents a case of severe and highly detrimental heroin, alcohol, and prescription drug abuse. Her situation is complicated by an unhealthy and dangerous relationship with her boyfriend and friends, her unsafe sex work practice, an unplanned pregnancy, and the effects of childhood and early adulthood trauma. Heroin seems to be the core drug that affects her mental and physical being in an especially negative way. Other substances such as Valium or Klonopin or even beer are often used as substitutes until Suzanne gains access to heroin. Due to the severe symptoms and effects of heroin withdrawal, it is likely the drug that will cause the most hardship to Suzanne during a treatment plan that excludes it.
Suzanne does meet the diagnostic criteria of a substance abuse disorder. Her reliance on heroin to feel calm depicts impaired control and physical dependence on the drug. Similarly, the use of heroin and the misuse of prescription medication indicate risky utilization not meant to treat a medical condition. A variety of social problems have also occurred as a result of substance abuse as well as collective trauma such as unprotected sex with her boyfriend, unsafe sex work, and possible plans to continue using drugs through her pregnancy. Suzanne seems to be subject to manipulation and mistreatment by her boyfriend who convinces her to practice unprotected sex and have a baby while working in prostitution and using heroin.
Heroin use during pregnancy is extremely dangerous during the pregnancy for both the mother and the child. The primary effects are function and appearance of birth defects, placental abruptions, premature birth, low birth weight, and stillbirths. Overall, heroin use during pregnancy can lead to catastrophic outcomes that may cause permanent compilations or even the deaths of the mother and the child.
Though cases may vary between states, there is currently no consistent legal repercussion for the use of illegal drugs while pregnant. However, in certain cases, mothers have been charged with child abuse as a result of illegal substance abuse during pregnancy. In the case that Suzanne chooses to keep her baby and improve her health, she may reach out to a number of organizations in order to receive support. This may include outpatient treatment, detox programs, and residential treatment, as well as support groups and community-founded organizations that may assist with housing, food, and other basic resources.
An evidence-based treatment plan that would benefit Suzanne would be focused on education components, an empathetic and non-judgmental approach, and provide a combination of medical detox treatment and a peer support group for psychological issues related to substance abuse. Because Suzanne is also pregnant and may decide to keep the baby it is vital to communicate the detriment of heroin and other substances on the development of the baby. Similarly, Suzanne should participate in a pregnancy plan that will outline and encourage checkups and assessments of her pregnancy throughout its course. If Suzanne plans to terminate the pregnancy, it is vital that she does it in a safe setting as she may receive a hazardous confrontation from her boyfriend. Peer conversation and sharing of experiences have been illustrated to be effective for a number of participants in substance abuse recovery cases (Tolomeo et al., 2020). As such, it is vital that Suzanne can observe her mental and physical progress if she chooses to reduce and eventually stop her substance abuse.
Reference
Tolomeo, S., Steele, J. D., Ekhtiari, H., & Baldacchino, A. (2020). Chronic heroin use disorder and the brain: Current evidence and future implications. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 111(1). Web.