Risk Factor Review: Substance Use Homework Help

Risk Factor Review: Substance Use

Substance use is defined as the appropriate use or ingestion of a substance into the body and at times it is considered a medical condition which if not treated would result to worse. It could also be the use of a substance in increasingly amounts that involves actions of going to lengths to get the substance. This could result to experience of withdrawal symptoms on stopping the ingestion of the drug.
In a research study conducted to show the relationship between interpersonal violence and substance use problems showed that the acts of violence arise from addiction. Continuous substance use interferes with a person’s relationship with family or friends (Pergamon 1529). This is because lack of the substance that one has been used to ingesting triggers the brain and increases anger or anxiety. It also gets in the way of a person’s ability to fulfill their work, complete chores, and participate fully in school or in family obligations. When the brain is not functioning well, it causes strain and mismanagement to other parts of the body therefore generally normal activity of the body is made impossible. It also results to dangerous behavior because one is under the impulse to get another dose and in this quest they are uncontrollable and would do anything to get another dose of the drug. As such, individuals who engage in substance use are significantly more aggressive compared to their normal persona, with the aggressiveness partly being due to the need satisfy the persistent urge to abuse the drug in question.
The main connection between substance use and violence, especially family related, is also called domestic violence. Ironically, most of the victims of domestic violence due to substance abuse in child hood are the ones who grow up to be abusers. In most cases relating to this, there is the observance of physical, emotional and sexual abuse. This is because when one is under the influence of any substance, they do not perceive anything as wrong and all they will do is act on impulse. Substance use could also cause depressions to those who play victim. As a result they will use medications and drugs that calm them down and if this process is persistent they are also at the risk of being among the substance users. This shows that there is a chain of relationship that runs all the way back to problems of substance use.
In an analysis conducted towards finding the association between sensation seeking and alcohol use it was revealed that sensation seeking was strongly interrelated with alcohol use (Hittner & Swickert 1384). Sensational seeking is a character trait showed by the continued tendency to look for novel sensations. Higher levels of attention seeking have shown to increase the frequency of alcohol consumption and in turn domestic violence. Most alcohol and drug use occurs among people who are not violent (Boles & Miotto 155). Research shows that the connecting links between substance and violence are more of social and economic forces resulting to depression. In this research, results from studies conducted and from the laboratory prove that there is possibility of causal roles in violent behavior.
In a review conducted to show the relationship between substance abuse and dependency as a risk factor for delinquency and violent behavior in schizophrenic patients the evidence showed that the risk was increasing with increased substance abuse. Apparently there is a higher rate of violence and assaultive behavior in male schizophrenics with symptoms like vivid hallucinations and/or delusions.

Literature Review Mental Illness
One of the risk factor reviews that can be found in the HCR-20 (Historical-Clinical-Risk Management -20) is major mental illness (H6) which is under historical risk factor. According to the DSM a clear definition of it is “the presence, at any time, of a major mental illness as defined by some official nosological system” (DSM). According to The Public Health Agency of Canada (PHAC), they describes mental illness as “characterized by alterations in thinking, mood or behaviour (or a combination), and impaired functioning over an extended period of time. The symptoms vary from mild to severe depending on the type, the individual, the family and socio-economic environment” (“disturbances of thought affecting mood disorder” 379, Lecture 6, October 6, 2012). Indeed, Markowitz (2010) in his study of the relationship between mental illness, crime and violence highlights the manner through which mental illness can result in impaired functioning as well as alterations in behavior. This effect the author however argues does not only come about as a result of the illness itself, but also due to the deinstitutionalization of mental illness, which has inevitably had consequences that have affected the criminal justice system both at macro and individual levels. The effects of mental illness are therefore not only attributable to the disease process itself but also due to the public perceptions of it as well as public policy.
Markowitz (2010) actually examines how social demographic characteristics, individual factors such as certain psychotic symptoms, as well as the context within which violence unfolds contribute towards an understanding of mental illness, as well as its management, with the focus being on individuals who violate the law, as well as the effectiveness or lack thereof of diversionary programs. In particular, the author seems to take exception to the fact that changes within the field of mental health, have led to a situation in which people with mental illness are more likely to end up in jail than they are in hospitals. This is also in tandem with the shifting public perception that is increasingly viewing individuals with mental illness as dangerous criminals, a perception that is quite inaccurate when measured against an objective assessment of the situation. Finally, Markowitz criticizes the approaches being taken currently to address the problem of mental illness within the criminal justice system. In terms of deinstitutionalization of mental illness, the passage of ill advised policies have resulted in the discharge of mentally ill individuals into the community due to stricter regulations for involuntary admission, and this coupled with reductions in public hospital bed capacities as well as changes in the fiscal policy that shifted costs from states to the federal government have resulted in a significant increase in the number of patients roaming free within the community instead of being in confinement. In terms of the role of public perceptions, Markowitz argues that the perception that mentally ill individuals are dangerous was not helpful as they lead to unnecessary stigmatization and labeling which compound the problem. A fear that is also captured by Bruce and Phelan et al (1999), who argue that the continued social distance the public maintains between itself and the mentally ill, as well as the continued rejection of such individuals could actually lead to a lack of compliance to management by the mentally ill, worsening an already delicate situation. All in all, the author argues that while there is a risk for violence associated with mental illness, the minimal risk is compounded by poor public mental health approaches, wrong and harmful public perceptions, as well as criminal justice approaches to dealing with the situation.
Hiday (1997) after a review of literature agrees with Markowitz assessment, as she argues that the direct link between mental illness and violence is quite negligible, as is the risk for violence, seemingly implying that mental illness on its own does not really result in violence, instead advocating for a shift in focus to the social context within which the violence occurs. Hiday, cites numerous studies that fail to find a direct relationship between mental illness and violence, instead highlighting the findings of studies that point a finger towards the important role of the social context when it comes to violence. Hiday (1997) unlike Markowitz, disputes the assertion that in some severe cases mental illness can lead to violence, arguing instead that even in such cases, certain failures within the social control mechanisms are to blame for the violence, highlighting the higher likelihood of violence in situations of poverty and social disorganization as examples and evidence of this assertion.
Stuart (2003) agrees with Hiday’s assertions, as he argues that socio-demographic and socio-economic factors and not mental illness, are the greatest contributors to violence. The author actually avers that the public exaggerate the link between mental illness and violence, instead pointing towards the fact that individuals suffering from mental illness are at a higher risk of being subjected to violence. One of the significant conclusions the author arrives at, is that substance abuse is one of the major risk factors for violence.
Similarly, Bruce and Phelan et al (1999) also carry out a study aimed at answering three fundamental questions over whether or not the mentally ill individuals are violent, and the potential effect of public labeling and perception. While the public perception has improved, more so when it comes to the understanding of mental illness, a dangerous precedent is being set due to a misconception over the role of mental illness when it comes to violence. The authors posit that society is becoming increasingly discriminative towards the mentally ill, and the resulting stigmatization is no doubt leading to undesirable results, similar to assertions made by Markowitz (2010).