Nadia is a 42-year-old Caucasian woman who has been coerced into treatment by her wife and children. When you meet her she explains that she feels as if her family has ganged up against her just because she likes to have a good time. Nadia works as an executive in a prestigious law firm and uses cocaine and drinks alcohol at work events. She says she has no desire to stop using cocaine but acknowledges that it is negatively affecting her relationships with her wife and children. She adds that while she has tried to stop a few times before, she was unable to, and thinks its because she doesnt really want to. And while she only ever plans to do a line or two, she acknowledges that she sometimes ends up using much more. Nadia adds that she was recently diagnosed with a stomach ulcer which her doctor thinks is related to her cocaine use. She explains that it is part of her work culture which is very testosterone-driven and she is concerned that if she stops, she will no longer be seen as one of the boys which may mean she wont make partner at the firm. When you ask her if she uses other substances, Nadia says that she usually drinks alcohol whenever she uses cocaine. You ask Nadia about her family history of substance misuse and she says that both of her parents were heavy drinkers when she was growing up.
What DSM-5 diagnosis might you give Nadia? Include the type and level of severity. (2)
What is the evidence in this passage for this diagnosis i.e., which of the DSM-5 criteria does she meet? (4)
Using the biopsychosocial model, what factors do you hypothesize may have led Nadia to become addicted? (3)
Give an example of the type of question you might ask Nadia to find out more about her substance (mis)use? (1)
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