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II. Type (and sub-types, as applicable) of substance.- for example, antidepressant, tricyclic. – If drug of abuse, how scheduled by the FDA.
III. Development. – How was the compound discovered or developed? It is lab-synthesized or naturally occurring (like an element or an ingredient of a plant)? What was the original goal for the substance and is it still used that way today?
IV. FDA Indication, common off-label use and, if abused, reason why abused (effect sought). Additional issues to address in this part: -How will you know which of your clients may benefit for refferral for this or similar medication? What counseling techniques would you use to obtain this information from the client? How would you go about making a referral? What are the barriers to a successful referral and how can these be overcome? How will you know which of your clients may be abusing this substance? How will you intervene/collaborate with other professionals to address this?
V. Route(s) of administration, usual, dosages, etc.- Where applicable, make sure to separetely discuss routes of administration and dosages for desired effects when used medicinally and when abused. For each route of administration provide the usual dose range.
VI. Intended populations- Whith what specific population is the drug commonly used (on or off label)? How does the drug use difer in various populations based on age, ethnopsychopharmacological considerations, etc.? In what levels of mental health service delivery (inpatient, outpatient, partial hospitalization, aftercare, etc.) are you most likely to encounter clients who use (or abuse) this drug?
VII. Pharmacokinetics (makes sure you discuss all 4 phases). Additional issues to address in this part: -Is this subsance particularly prone to drug-drug interactions? Are there practical considerations stemming from these pharmacokinetics that may adversely impact client compliance? for Drugs of abuse, are there particular aspects of pharmacokinetics that impact the abuse potential of this substance?
VIII.Pharmacodynamics -Which parts of the brain are involved in creating the psychoactive effects? Which specific brain changes are connected with specific desired and adverse effects? For drugs of abuse, are there particular aspects of pharmacodynamics that impact the abuse potential of this substance?
IX. Desired effects. Issues to address in this part: -As a counselor, how do you hope this medication will help your client? how will you know the medication is working? what counseling techniques would you use to obtain this information from the client? How will you document that in the client’s treatment records? How will you help empower your client to address with the prescriber if the medication is not working as it should? If drug of abuse, what are the specific effects sought by those who abuse this substance? Can desired effects of abuse of this drug mimic or exacerbate psychological disorders? How can you tell a client is abusing this substance, and if so, what can you do as a counselor?
X. Adverse effects. Issue to address in this part: -How will you recognize potential adverse effects? What counseling techniques would you use to obtain this information from the client? How will you document that in the client’s treatment records? How will you know which are especially dangerous and what those dangers are? How will you help your client attend to these? Are there barriers to addressing these adverse effects, and if so, how will you help your client overcome them? Can adverse effects of abuse of this drug mimic or exacerbate psychological disorders? How can you tell a client is abusing this substance, and if so, what can you do as a counselor?
XI. Research of effects. -For medicinal use, review studies that provide evidence of efficacy for each use listed earlier in the paper. -For abuse, review studies that show evidence of the effects of this drug.
XII. Conclusions – For medicinal use, weigh benefits and potential harm. – For drug abuse, discuss relative risk as compared with other drugs of abuse, comment on whether FDA scheduling accurately reflects those risks, comment about steps needed to enhance prevention and treatment of the abuse of this substance.
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