substance abuse

Substance Abuse
Name
Institution

Author’s Name

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Direct Care Project Part 1
Substance Use Assessment and Diagnosis Template
Introduction
Substance abuse also termed as drug abuse refers to the use of drugs in amounts which are considered as harmful to others, it can also be defined as to the harmful/hazardous use of different psychoactive substances such as alcohol and illicit drugs such as heroin and cocaine or drugs prescribed for medical purposes such as oxycodone and hydrocodone (Mclellan, 2017). Over the years, substance abuse has been associated with a wide range of health problems such as addiction and social related problems. In the contemporary world, substance use disorders affect millions of people annually and has been associated with other problems such as crimes, injuries, motor vehicle crashes, injuries, reduced quality of life as well as many deaths. Concerning this, in the US, research indicates that substance misuse/use resulted in estimated $442 billion annually in lost productivity, healthcare costs as well as criminal justice costs (Mclellan, 2017). This paper explores substance abuse as a major nursing problem and explores nursing diagnosis, interventions and best practices.

Name: Date:

Online Data Collection

1. Community Information
(U.S. Census Bureau, 2020).

Your Community Data
Name of city or town and state Homestead, Florida
Population Population estimates is 69, 523 (as of 1st July 2019).
Nature of this community (rural, suburban, urban) Suburban community
Describe your community in 2-3 sentences Homestead is a suburban of Miami located in Miami-Dade County in the U.S. state of Florida; a major agricultural area with a population of 68,424 with approximately 3,996.8 people per square mile; hence, densely populated (U.S. Census Bureau, 2018). The community is largely made up of Hispanic populations which comprise of approximately 66.6% of the population. The area can also be considered a relatively high poverty area with approximately 23.8% persons living in poverty, with households having a median income of approximately $47,508 median household income (U.S. Census Bureau, 2018).

2. Community Demographics
i. Compare the county, state, and US data
Homestead city is located in Miami-Dade county in the state of Florida the US (U.S. Census Bureau, 2020).

County Data/Miami-Dade County State Data/Florida U.S. Data
Population total 2,716,940 21,477,737 328,239,523
Male (subtract female % from 100) 48.6% of total population 48.9% of total population 49.2% of total population
Female 51.4% of total population 51.1% of total population 50.8% of total population
Persons under 5 5.8% 5.3% 6.0%
Persons over 65 16.7% 20.9% 16.5%
Race and origin data
County Data State Data U.S. Data
White alone 79.0% 77.3% 76.3%
Black or African American alone 17.7% 16.9% 13.4%
American Indian and Alaska Native alone 0.3% 0.5% 1.3%
Asian alone 1.6% 3.0% 5.9%
Native Hawaiian and other Pacific Islander alone Value greater than zero but less than half unit of measure shown 0.1% 0.2%
Two or more races 1.3% 2.2% 2.8%
Hispanic or Latino 69.4% 26.4% 18.5%
White alone, not Hispanic or Latino 12.9% 53.2% 60.1%
Significant population characteristics
County Data State Data U.S. Data
Veterans 48,104 1,440,338 18,230,322
Foreign born persons 53.7% 20.7% 13.6%
Housing overview
County Data State Data U.S. Data
Housing units 1,040,666 9,673,682 139,684,244
Owner-occupied housing unit rate 51.2% 65.4% 64.0%
Median selected monthly owner costs with a mortgage $1,825 $1,503 $1,595
Median selected monthly owner costs without a mortgage $627 $505 $500
Median value of owner-occupied housing units $289,600 $215,300 $217,500
Median gross rent $1,328 $1,175 $1,062
Family and living arrangements
County Data State Data U.S. Data
Households 883,372 7,736,311 120,756,048
Persons per household 3.0 2.65 2.62
Living in same house 1 year ago 88.0% 84.5% 85.8%
Language other than English spoken at home 74.9% 29.4% 21.6%
Computer and Internet Use
County Data State Data U.S. Data
Households with a computer 89.9% 91.5% 90.3%
Households with broadband internet subscription 76.9% 83.0% 82.7%
Education
County Data State Data U.S. Data
High school graduate or higher 81.4% 88.2% 88.0%
Bachelor’s degree or higher 29.8% 29.9% 32.1%
Health
County Data State Data U.S. Data
With a disability under age 65 years 5.8% 8.6% 8.6%
Persons without health insurance under age 65 years 19.5% 16.3% 9.5%
Economy
County Data State Data U.S. Data
Civilian labor workforce ages 16+ 62.6% 58.5% 63.0%
Transportation-mean travel time to work (minutes) 32.8 27.8 26.9
Income and poverty
County Data State Data U.S. Data
Median household income $51,347 $55,660 $62,843
Persons in poverty 15.7% 12.7% 10.5%

3. Community Epidemiological Data
(County Health Rankings and Roadmaps, 2020).

County Data/Miami-Dade State Data/Florida
Health Outcome Rank 6 N/A
Length of life rank 2 N/A
Premature death 5,300 7,300
Low birth weight 9% 9%
Adult smoking 16% 16%
Adult obesity 22% 27%
Physical inactivity 25% 26%
Excessive drinking 16% 17%
Alcohol impaired deaths 12% 23%
STIs 445.7 476.5
Teen births 17 21
Drug overdose deaths 12% 23%
Uninsured 20% 16%
Unemployment 3.9% 3.6%
Children in poverty 23% 20%
Violent crime 602 484
Air pollution 7.2 8.2
Drinker water violations No No
Long commutes 56% 42%

4. Substance Use
(Substance Abuse and Mental Health Services Administration (SAMHSA), 2019).
State Average National Average
Tobacco use 26.5% 28.9%
Marijuana 13.2% 13.9%
Marijuana use disorder 1.3% 1.5%
Heroin use 0.28% 0.33%
Misuse of Prescription pain reliever 4.2% 4.3%
Opioid use disorder 0.8% 0.8%
Illicit drug use disorder 2.6% 2.8%
Alcohol use disorder 5.6% 5.6%
Substance use disorder 7.3% 7.5%

Windshield Survey
It is recommended that you have someone drive you around your community at least 2 times, ideally at different times of day and weekend vs. weekday.
Look at the people in your community.

Did you observe: No Yes If Yes, provide number or state “many” “some” or “few”
• *pregnant women Yes 6
• *pregnant adolescents Yes Few
• *infants (under age of 1 year old) Yes Many
• *young children (1-5 years old) Yes Many
• *school-age children (6-18 years old) Yes Many
• adults (18 – 60 years old) Yes Many
• *older adults (over the age of 60 years old) Yes Many
• people exercising Yes 7
• people driving Yes Many
• people walking Yes Many
• people biking Yes Few
• people congregating in groups on the street Yes Few
• *people that had hygiene issues or were unkempt Yes 16
• people that were appropriately dressed Yes Many
• people that were physically fit Yes Many
• people that were obese Yes Many
• *people that were undernourished, thin Yes Some
• people that appear healthy Yes Many
• *people that have obvious physical disabilities, such as those using walkers or wheelchairs Yes 9
• *people with apparent mental/emotional disabilities Yes Few
• *people who appeared homeless or unemployed Yes Many
*Represents vulnerable populations
Social and Economic Conditions

Did you observe: No Yes If Yes, provide number or state “many” “some” or “few”
• housing that was run down or dilapidated Yes Few
• areas undergoing renewal Yes some
• public housing Yes few
• public transit (subway, train, buses, taxis, etc) Yes Many
• transportation to health care resources Yes Few
• landfills No
• restaurants Yes Many
• any political signs Yes Few
• any evidence of health education on billboards, advertisements, or signs No
• any efforts to improve the neighborhood’s health such as advertisements for health-related events, health fares, clinics, or lectures No
• any group efforts in the neighborhood to improve the living conditions or the neighborhood No
• churches, synagogues, and other places of worship Yes Few

Health Resources

Did you observe: No Yes If Yes, provide number or state “many” “some” or “few”
• hospitals Yes Few
• community clinics No
• family planning clinics No
• generalist doctors No
• dentist offices Yes 1
• pharmacies Yes 6
• urgent care clinics No
• skilled nursing facilities No
• mental health or counselling clinics No
• homeless or abuse shelters No
• public health department office No
• substance abuse treatment center Yes 2
• alternative medicine practices, botanicals, or herbal medicine shops Yes 1

Answer the following question:

Environmental Conditions

Did you observe: No Yes If Yes, provide number or state “many” “some” or “few”
• evidence of anything that might make you suspicious of ground, water, or air pollutants No
• poor road conditions with potholes, or poor drainage Yes Few
• adequate traffic lights, signs, sidewalks, and curbs Yes Many
• railroad crossings fitted with warnings and barriers Yes 1
• streets and parking lots well lit Yes Many
• handicapped access to buildings, sidewalks, and streets Yes Many
• recreational facilities, playgrounds, and/or facilities like the YMCA No
• children playing in the streets, alleys, yards, or parks Yes Many
• evidence of nuisances such as ants, flies, mosquitoes, or rodents, or stray animals observed Yes Many

Problem Identification: _________________
Based on data on substance abuse from the Substance Abuse and Mental Health Services Administration (SAMHSA) is marijuana use. In accordance SAMHSA, the annual average prevalence marijuana use in Florida among young adults aged 18–25 is 34.3% which is higher than the national average 33.0%.

Vulnerable Population Identification: _________________
The most vulnerable population in accordance to the Substance Abuse and Mental Health Services Administration (SAMHSA) is young adults aged 18–25 years.

Nursing Diagnosis: Increased risk for marijuana use among young adults aged 18-25 years related to lack of adequate knowledge regarding the negative effects associated with the use, demonstrated in increased county data in comparison to state/national averages.
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References
Substance Abuse and Mental Health Services Administration (SAMHSA). (2019). Behavioral health barometer, volume 5. Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/Florida-BH-BarometerVolume5.pdf
County Health Rankings and Roadmaps: Florida, Miami-Dade (DA). (2020). Explore rankings. Retrieved from https://www.countyhealthrankings.org/app/florida/2020/rankings/miami-dade/county/outcomes/overall/snapshot
U.S. Census Bureau. (2018). State and county QuickFacts: Miami-Dade County, Florida; Florida; Homestead city, Florida; United States. Retrieved From; https://www.census.gov/quickfacts/fact/table/miamidadecountyflorida,FL,homesteadcityflorida,US/PST045219
Mclellan, T.A. (2017). Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare?. Trans Am Clin Climatol Association. 128: 112–130. Retrieved From; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5525418/