Peter is in the twelfth grade. He scored a 6 on the CRAFFT. During the interview, you learn that he drinks five or more beers on Fridays and Saturdays and smokes marijuana several times a day. You also learn that he stopped drinking after being arrested for drinking in a parked car. However, he does not have any intention of stopping marijuana. He does not believe that marijuana is addictive and believes that he can quit at any time. Ralph, Peter’s mother, is sitting in the waiting room. What counseling, interventions, and follow-up will you suggest to Ralph?

Peter is in the twelfth grade. He scored a 6 on the CRAFFT. During the interview, you learn that he drinks five or more beers on Fridays and Saturdays and smokes marijuana several times a day. You also learn that he stopped drinking after being arrested for drinking in a parked car. However, he does not have any intention of stopping marijuana. He does not believe that marijuana is addictive and believes that he can quit at any time. Ralph, Peter’s mother, is sitting in the waiting room. What counseling, interventions, and follow-up will you suggest to Ralph?

Substance use disorders particularly alcohol and marijuana use are more common in adolescents. In this scenario, Ralph (Peter’s mother) should be given the following counseling, interventions, and follow-up suggestions concerning his son who has a previous history of alcohol use and currently smoking marijuana.

Counseling

Following the creation of a therapeutic alliance, Ralph should be reassured and comprehensively educated on alcohol and marijuana use including the adverse effects (to enlighten his son). Additionally, she should be enlightened on the warning signs of marijuana and alcohol toxicity and when to consult a healthcare provider. Also, she should be warned of the risk of relapse of alcohol intake hence the need to closely monitor his son. Furthermore, Ralph should be informed of the importance of motivating, providing support, and educating his son on coping strategies (Patel & Marwaha, 2022). Finally, it is critical to ensure that she seeks the help of Peter’s peers and friends to support him through the cessation process.

Interventions

Currently, there is no FDA-approved drug to prevent marijuana addiction although naltrexone can be deployed to counter alcohol cravings. Subsequently, cognitive behavioral therapy (CBT), as well as motivational enhancement therapy, remain the mainstay interventions (Patel & Marwaha, 2022). The goal of these therapies will be to provide Peter with a vivid and elaborate comprehension and insight into marijuana use, adverse effects, and complications including addictive and amotivational syndromes (Connor et al., 2021). Similarly, the therapies will entail evoking an internally motivated change from the individual through stimulated discussion about personal substance abuse and eliciting self-motivational statements. This is backed by a build-up plan for change and coping strategies that include sustained abstinence.

Follow-up

Peter has a risk of relapse and should therefore be linked to an alcohol anonymous group for sustained and long-term cessation of alcohol intake. Additionally, periodic follow-up visits at the outpatient clinic where the therapist will monitor change, review cessation strategies, and makes necessary adjustments to ensure continued commitment towards the committed change (Connor et al., 2021).

References

Connor, J. P., Stjepanović, D., Le Foll, B., Hoch, E., Budney, A. J., & Hall, W. D. (2021). Cannabis use and cannabis use disorder. Nature Reviews. Disease Primers, 7(1), 16. https://doi.org/10.1038/s41572-021-00247-4

Patel, J., & Marwaha, R. (2022). Cannabis Use Disorder. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538131/

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Many primary care providers do not feel comfortable with screening adolescents for the use of drugs and alcohol. They do not feel as if they have the time, the right assessment tools, or the proper training to adequately detect and intervene in adolescent alcohol and substance abuse problems. However, primary care providers are those who are most likely to influence adolescence substance abuse. In addition, primary care providers must offer the anticipatory guidance that is needed for patients, parents, and caregivers. An easy way to screen adolescents for psychosocial problems is to use the HEADSS mnemonic. The CRAFFT screening tool is used specifically for alcohol and drugs. It is a series of questions designed to screen adolescents at high risk for alcohol and other drug use disorders.

Review the tool and discuss the following scenario.
• Peter is in the twelfth grade. He scored a 6 on the CRAFFT. During the interview, you learn that he drinks five or more beers on Fridays and Saturdays and smokes marijuana several times a day. You also learn that he stopped drinking after being arrested for drinking in a parked car. However, he does not have any intention of stopping marijuana. He does not believe that marijuana is addictive and believes that he can quit at any time. Ralph, Peter’s mother, is sitting in the waiting room. What counseling, interventions, and follow-up will you suggest to Ralph?