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Description
Howard is a 24 year-old male who presents to the clinic his wife for what he states is severe lower back pain. He states the pain is so bad that he rates it as a â50 out of 10.â He also tells you that due to a past medical history of an ulcer, he cannot take any medications âlike Motrin.â He states that the pain is from a car accident in 2012, and that it flairs up and he needs pain medications. He also tells you that he has a high pain tolerance, and that when he gets pain meds he requires the higher doses.
You are concerned that this patient may have a substance abuse problem.
What screening testing is available for you to use that is reliable and valid?
What strategies would you suggest for this patient if he was found to have a problem with substance abuse?
What type of referrals would you make for a patient with substance abuse problem?
Sample Solution
In 1975, Gacy’s business was developing rapidly and his craving for youngsters developed with it. Gacy frequently tricked youngsters under his work to his home, persuading them to place themselves in cuffs, and assaulting and tormenting them before choking them (Cahill 169-170). A large portion of Gacy’s killings occurred somewhere in the range of 1976 and 1978, the first of this time occurring in April 1976. A large number of the adolescents that were killed during this time were covered in a slither space under Gacy’s home. For the rest of the homicides, Gacy confessed to losing five bodies the I-55 extension into the Des Plaines River; be that as it may, just four of the bodies were ever recuperated (Linedecker 152). In December 1978, Gacy meets Robert Jerome Piest, a 15-year old kid working at a drug store and extends to him an employment opportunity at Gacy’s firm. Piest educates his mom regarding this and neglects to restore that night. The Piest family documents a missing individual’s report and the drug specialist advises police that Gacy would in all probability be the man that Jerome addressed about a vocation. When addressed by the police, Gacy denied any association in Piest’s vanishing. Be that as it may, the police were not persuaded, and Gacy’s history of sexual maltreatment and battery incited the police to look through his home. Among the things found at Gacy’s home were a 1975 secondary school class ring with the initials J.A.S., numerous driver’s licenses, cuffs, attire that was unreasonably little for Gacy, and a receipt for the drug store that Piest had worked at. Through the span of the following hardly any days, agents got different calls and tips about Gacy’s rapes and the puzzling vanishings of Gacy’s representatives. The class ring was inevitably followed back to John A. Szyc, one of Gacy’s exploited people in 1977. Futhermore, after looking at Gacy’s vehicle, specialists found a little bunch of strands taking after human hair, which were sent to the labs for additional investigation. That equivalent night, search hounds were utilized to distinguish any hint of Piest in Gacy’s vehicle, and one of the canines showed that Piest had, truth be told, been available in the vehicle. On December 20, 1977, under the pressure of steady police reconnaissance and examination, Gacy admits to more than 30 killings and illuminates his legal counselor and companion where the bodies were covered, both in the creep space and the waterway. 26 exploited people were found in the creep space and 4 in the waterway. Gacy is captured, indicted for 33 killings, and condemned to death by deadly infusion. He endeavored a craziness supplication yet was denied, and was executed on May 10, 1994. There were a few criminological pointers that examiners used to attach Gacy to the killings. A portion of these include fiber examination, dental and radiology records, utilizing the decay procedure of the human body, and facial remaking in recognizing the people in question. Specialists discovered strands that took after human hair in both Gacy’s vehicle and close to the creep space where the bodies were covered. Notwithstanding these hair tests, specialists likewise discovered strands that contained hints of Gacy’s blood and semen in a similar zone. Blood having a place with the unfortunate casualties was found on a portion of the filaments, which would later legitimately attach Gacy to the wrongdoings. The filaments in Gacy’s vehicle were broke down by scientific researchers and coordinated Piest’s hair tests. Moreover, the pursuit hounds that confirmed that Piest had been in Gacy’s vehicle showed this by a “demise response”, which told agents that Piest’s dead body had been within Gacy’s vehicle. Out of Gacy’s 33 known exploited people, just 25 were ever convincingly recognized. A significant number of Gacy’s exploited people had comparable physical depictions and were in this manner difficult to recognize by absolutely asking the general population. To recognize the people in question, specialists went to Betty Pat Gatliff, a pioneer in scientific science and facial reproduction. Facial reproduction is the way toward reproducing the facial highlights of a person by utilizing their remaining parts. Certain facial highlights, for example, facial structures, nasal structure, and in general face shape can be helpful in recognizing an unfortunate casualty even long in the afterlife. By utilizing these highlights, and with the assistance of program, measurable specialists can make a picture of an individual’s face, which is instrumental in recognizing exploited people after their bodies have rotted. Facial remaking should be possible in a few measurements. Two-dimensional facial recreations is utilized with skull radiographs and depend on pre-demise photos and data. In any case, this isn’t really perfect on the grounds that cranial highlights are not constantly obvious or at the correct scale (Downing). So as to get a practical and increasingly exact delineation of the unfortunate casualty’s face, a craftsman and a legal anthropologist are generally essential (Downing). Three-dimensional facial reproduction is finished by models or high goals, three-dimensional pictures. PC programs can make facial reproductions by controlling examined photos of the remaining parts and use approximations to reproduce facial highlights. These will in general produce results that don’t look counterfeit (Reichs and Craig 491). At times, specialists will utilize a strategy called superimposition as a procedure for facial reproduction. Shockingly, it’s anything but a usually utilized strategy, as it expects agents to have some information about the personality of the remaining parts they are managing. By superimposing a photo of a person over the skeletal remains, agents can check whether the facial highlights line up with the anatomical highlights, permitting them to distinguish an injured individual. On account of John Wayne Gacy’s exploited people, specialists had the option to utilize facial remaking to recognize nine of the bodies found in the creep space. The accompanying realistic shows the facial reproductions of these nine exploited people: Since facial remaking was insufficient to recognize the entirety of the people in question, agents got DNA profiles from every one of the unidentified exploited people and effectively searched out DNA tests from guys over the United States who had been accounted for missing somewhere in the range of 1970 and 1979 (Cook County Sheriff’s Office 3). The rest of the unfortunate casualties were recognized utilizing dental and radiology records. Since dental polish is harder than bone, teeth outlive tissue and once in a while bone when the body decays. Teeth are entirely dependable in distinguishing exploited people, as they will in general uncover propensities about the individual, for example, nail gnawing, crushing and weight propensities, lip gnawing, and grasping (Ryan 254). Besides, the top of the mouth, which frames a curve, is remarkable to every person fit as a fiddle, size, and shape. Teeth likewise have singular attributes that are one of a kind to every individual in that the relationship of teeth to each other fluctuates, alongside size and state of the jaws and sense of taste (Ryan 255). So as to recognize an individual utilizing dental records, criminological dental specialists must secure the dental records of the person in question or perished. In cases including numerous passings, criminological dental specialists get a rundown of potential people and afterward contrast records with the teeth (Freeman standard. 2). By and large, X-beams are viewed as progressively solid and give the best correlations, yet these are not constantly accessible to legal agents. When the dental records have been obtained, legal specialists at that point take a gander at the individual tooth size, shading, and shape, curve sizes and types, and the connection between the jaws, which is utilized to help characterize facial sorts (Ryan 256). In spite of the fact that John Wayne Gacy’s latest unfortunate casualty was Robert Piest in 1978, specialists in Cook County are as yet looking for distinguishing proof for the rest of the bodies. The most as of late distinguished unfortunate casualty, William Bundy, was convincingly recognized in 2011. The Cook County Sheriff’s area of expertise declared that year that they were reestablishing their endeavors to recognize the staying seven of Gacy’s unfortunate casualties. In any case, nobody has since approached to indisputably recognize them, and their names stay obscure. John Wayne Gacy was one of America’s most productive sequential executioners. With an unfortunate casualty include of 33 youngsters in a three-year length of time, Gacy was condemned to death by willful extermination for his violations. Criminological researchers and specialists had the option to attach Gacy to the killings by utilizing dental and radiology records, facial recreation, and DNA proof. Without the utilization of criminological innovation and the exertion set forth by the agents, Gacy would have kept submitting murders and a considerable lot of the unfortunate casualties would have gone unnoticed. While the case has been cold for a long time, specialists are as yet attempting to distinguish the rest of the exploited people so as to give bit of brain to the groups of the expired. John Wayne Gacy has stood out forever for his wrongdoings, yet his unfortunate casualties will never be overlooked. About Essay Sauce>
In 1975, Gacy’s business was developing rapidly and his craving for youngsters developed with it. Gacy frequently tricked youngsters under his work to his home, persuading them to place themselves in cuffs, and assaulting and tormenting them before choking them (Cahill 169-170). A large portion of Gacy’s killings occurred somewhere in the range of 1976 and 1978, the first of this time occurring in April 1976. A large number of the adolescents that were killed during this time were covered in a slither space under Gacy’s home. For the rest of the homicides, Gacy confessed to losing five bodies the I-55 extension into the Des Plaines River; be that as it may, just four of the bodies were ever recuperated (Linedecker 152). In December 1978, Gacy meets Robert Jerome Piest, a 15-year old kid working at a drug store and extends to him an employment opportunity at Gacy’s firm. Piest educates his mom regarding this and neglects to restore that night. The Piest family documents a missing individual’s report and the drug specialist advises police that Gacy would in all probability be the man that Jerome addressed about a vocation. When addressed by the police, Gacy denied any association in Piest’s vanishing. Be that as it may, the police were not persuaded, and Gacy’s history of sexual maltreatment and battery incited the police to look through his home. Among the things found at Gacy’s home were a 1975 secondary school class ring with the initials J.A.S., numerous driver’s licenses, cuffs, attire that was unreasonably little for Gacy, and a receipt for the drug store that Piest had worked at. Through the span of the following hardly any days, agents got different calls and tips about Gacy’s rapes and the puzzling vanishings of Gacy’s representatives. The class ring was inevitably followed back to John A. Szyc, one of Gacy’s exploited people in 1977. Futhermore, after looking at Gacy’s vehicle, specialists found a little bunch of strands taking after human hair, which were sent to the labs for additional investigation. That equivalent night, search hounds were utilized to distinguish any hint of Piest in Gacy’s vehicle, and one of the canines showed that Piest had, truth be told, been available in the vehicle. On December 20, 1977, under the pressure of steady police reconnaissance and examination, Gacy admits to more than 30 killings and illuminates his legal counselor and companion where the bodies were covered, both in the creep space and the waterway. 26 exploited people were found in the creep space and 4 in the waterway. Gacy is captured, indicted for 33 killings, and condemned to death by deadly infusion. He endeavored a craziness supplication yet was denied, and was executed on May 10, 1994. There were a few criminological pointers that examiners used to attach Gacy to the killings. A portion of these include fiber examination, dental and radiology records, utilizing the decay procedure of the human body, and facial remaking in recognizing the people in question. Specialists discovered strands that took after human hair in both Gacy’s vehicle and close to the creep space where the bodies were covered. Notwithstanding these hair tests, specialists likewise discovered strands that contained hints of Gacy’s blood and semen in a similar zone. Blood having a place with the unfortunate casualties was found on a portion of the filaments, which would later legitimately attach Gacy to the wrongdoings. The filaments in Gacy’s vehicle were broke down by scientific researchers and coordinated Piest’s hair tests. Moreover, the pursuit hounds that confirmed that Piest had been in Gacy’s vehicle showed this by a “demise response”, which told agents that Piest’s dead body had been within Gacy’s vehicle. Out of Gacy’s 33 known exploited people, just 25 were ever convincingly recognized. A significant number of Gacy’s exploited people had comparable physical depictions and were in this manner difficult to recognize by absolutely asking the general population. To recognize the people in question, specialists went to Betty Pat Gatliff, a pioneer in scientific science and facial reproduction. Facial reproduction is the way toward reproducing the facial highlights of a person by utilizing their remaining parts. Certain facial highlights, for example, facial structures, nasal structure, and in general face shape can be helpful in recognizing an unfortunate casualty even long in the afterlife. By utilizing these highlights, and with the assistance of program, measurable specialists can make a picture of an individual’s face, which is instrumental in recognizing exploited people after their bodies have rotted. Facial remaking should be possible in a few measurements. Two-dimensional facial recreations is utilized with skull radiographs and depend on pre-demise photos and data. In any case, this isn’t really perfect on the grounds that cranial highlights are not constantly obvious or at the correct scale (Downing). So as to get a practical and increasingly exact delineation of the unfortunate casualty’s face, a craftsman and a legal anthropologist are generally essential (Downing). Three-dimensional facial reproduction is finished by models or high goals, three-dimensional pictures. PC programs can make facial reproductions by controlling examined photos of the remaining parts and use approximations to reproduce facial highlights. These will in general produce results that don’t look counterfeit (Reichs and Craig 491). At times, specialists will utilize a strategy called superimposition as a procedure for facial reproduction. Shockingly, it’s anything but a usually utilized strategy, as it expects agents to have some information about the personality of the remaining parts they are managing. By superimposing a photo of a person over the skeletal remains, agents can check whether the facial highlights line up with the anatomical highlights, permitting them to distinguish an injured individual. On account of John Wayne Gacy’s exploited people, specialists had the option to utilize facial remaking to recognize nine of the bodies found in the creep space. The accompanying realistic shows the facial reproductions of these nine exploited people: Since facial remaking was insufficient to recognize the entirety of the people in question, agents got DNA profiles from every one of the unidentified exploited people and effectively searched out DNA tests from guys over the United States who had been accounted for missing somewhere in the range of 1970 and 1979 (Cook County Sheriff’s Office 3). The rest of the unfortunate casualties were recognized utilizing dental and radiology records. Since dental polish is harder than bone, teeth outlive tissue and once in a while bone when the body decays. Teeth are entirely dependable in distinguishing exploited people, as they will in general uncover propensities about the individual, for example, nail gnawing, crushing and weight propensities, lip gnawing, and grasping (Ryan 254). Besides, the top of the mouth, which frames a curve, is remarkable to every person fit as a fiddle, size, and shape. Teeth likewise have singular attributes that are one of a kind to every individual in that the relationship of teeth to each other fluctuates, alongside size and state of the jaws and sense of taste (Ryan 255). So as to recognize an individual utilizing dental records, criminological dental specialists must secure the dental records of the person in question or perished. In cases including numerous passings, criminological dental specialists get a rundown of potential people and afterward contrast records with the teeth (Freeman standard. 2). By and large, X-beams are viewed as progressively solid and give the best correlations, yet these are not constantly accessible to legal agents. When the dental records have been obtained, legal specialists at that point take a gander at the individual tooth size, shading, and shape, curve sizes and types, and the connection between the jaws, which is utilized to help characterize facial sorts (Ryan 256). In spite of the fact that John Wayne Gacy’s latest unfortunate casualty was Robert Piest in 1978, specialists in Cook County are as yet looking for distinguishing proof for the rest of the bodies. The most as of late distinguished unfortunate casualty, William Bundy, was convincingly recognized in 2011. The Cook County Sheriff’s area of expertise declared that year that they were reestablishing their endeavors to recognize the staying seven of Gacy’s unfortunate casualties. In any case, nobody has since approached to indisputably recognize them, and their names stay obscure. John Wayne Gacy was one of America’s most productive sequential executioners. With an unfortunate casualty include of 33 youngsters in a three-year length of time, Gacy was condemned to death by willful extermination for his violations. Criminological researchers and specialists had the option to attach Gacy to the killings by utilizing dental and radiology records, facial recreation, and DNA proof. Without the utilization of criminological innovation and the exertion set forth by the agents, Gacy would have kept submitting murders and a considerable lot of the unfortunate casualties would have gone unnoticed. While the case has been cold for a long time, specialists are as yet attempting to distinguish the rest of the exploited people so as to give bit of brain to the groups of the expired. John Wayne Gacy has stood out forever for his wrongdoings, yet his unfortunate casualties will never be overlooked. About Essay Sauce>
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