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Substance Use History
| Drug | First Use: Yes or No | Pattern of use over time? | Frequency of use in past month? | Date/Amount of most recent use? |
|---|---|---|---|---|
| Alcohol | No | Yes | Every day | Every day, drinks until passing out |
Diagnostic Criteria Checklist
| Criteria | Yes | No | Criteria | Yes | No |
|---|---|---|---|---|---|
| Was the substance taken in larger amounts or over a longer period of time than intended? | X | Were important social, occupational, or recreational activities given up or reduced because of substance use? | X | ||
| Is there a persistent desire or unsuccessful efforts to cut down or control substance use? | X | Has the substance been used recurrently in physically hazardous situations? | X | ||
| Was a great deal of time spent in activities necessary to obtain or use the substance, or recover from the substance? | X | Has use continued despite knowing of having a persistent or recurrent physical or psychological problem that is caused or exacerbated by substance use? | X | ||
| Have they continued to use the substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the substance use? | X | Has recurrent use of the substance resulted in a failure to fulfill major role obligations at work, school, or home? | X | ||
| Is tolerance present? | X | Is withdrawal present? | X | ||
| Is there a craving or strong desire or urge to use the substance? | X |
DSM-5 Diagnosis: Alcohol Use Disorder
DSM-5 Diagnostic Code: 303.90
Basis of Diagnosis
Tommy is a 22-year-old male who has recently returned from a tour in Iraq. His military experience has left him feeling angry and reliant on alcohol to numb those feelings. He spends his nights at a local bar with friends, drinking until he passes out. He frequently experiences flashbacks of traumatic events from Iraq, using alcohol as a means to escape these memories. Tommy does not perceive his behavior as problematic and believes that using alcohol is justified to cope with his war-related issues.
Applicable Theory
Tommy exhibits Alcohol Use Disorder, characterized by a tolerance developed through prolonged daily use. He utilizes alcohol to avoid confronting the traumatic memories from his time in Iraq. He perceives this behavior as normal and fails to recognize the harm it causes to himself and his family.
Sociocultural Factors
Tommy served in the military and was deployed to Iraq for one year, where he witnessed the murder of friends and colleagues, resulting in significant mental trauma. After returning home, he suffered a concussion that prevented him from resuming military service. During this period, he began drinking to alleviate his emotional pain and the distressing memories from his deployment.
Tommy does not drink alone; he socializes with friends at the bar who also served in Iraq, providing him with a sense of camaraderie and understanding. However, their method of socializing—drinking daily to escape their pain—is unhealthy. He feels more at ease with these friends, as they can share silent moments together. In contrast, he feels judged by his family and others, leading him to seek solace in the bar where he feels accepted.
Motivation for Change and Relapse Prevention
Tommy’s primary motivation for seeking treatment is his wife, who is concerned about his anger and excessive drinking, especially with their young child in the picture. Although he has attempted to seek treatment in the past, waiting lists have hindered his progress. While he does not believe he has a problem, he is open to speaking with someone due to his wife’s encouragement. Tommy views drinking as a beneficial coping mechanism, making him more reluctant than eager to pursue help.
(Based on NAADAC code of ethics.)
Confidentiality
A client’s personal information must remain confidential and shared only between the therapist and the patient, unle
+1 (206) 350-4565
support@nursingstudyhub.com