For the discussion boards this term please consider the following case:
His wife brought Sam, a 66-year-old man, to treatment after his third DUI offense, in which he ran off the road and into a stop sign. He has a history of alcohol and drug use since age 15. Although neither of his parents drank, his grandfather died of cirrhosis of the liver. Sam has been in counseling previously to try to save his marriage. After the divorce, he lost his business and became extremely depressed. When Sam drank, he became belligerent and, at one point, threatened his ex-wife. During this period, he also began gambling at the local casino in an attempt to make some quick money. Sam says that he is willing to enter treatment at this time so that he does not lose his current wife and because he fears the men to whom he owes gambling debts. He knows that he will be safe in the hospital until he can figure out what to do. He does not believe that he has a problem with alcohol, drugs, or gambling and attributes his misfortunes to the ill will of others. He denies suicidal ideation at this time. Evan’s blood alcohol level on admission was 0.04%. His current lifestyle involves hunting and spending time with his wife. Assume he is your patient on an inpatient unit.
Any differential diagnoses (state why each one should be considered for the case)
Your diagnosis and reasoning. What are some unique considerations to keep in mind when treating a patient who has an addiction?
Any additional questions you would have asked to get more helpful information.
Medication recommendations along with your rationale. Always discuss side effects vs benefits vs risks in your education of a medication. Note possible side effects or issues to address if attempting to obtain consent.
Any labs and why they may be indicated (What labs could rule out some organic causes of the behaviors?)
Screener scales or diagnostic tools that may be beneficial?
Additional resources to give (Therapy modalities, support groups, activities, etc.) Always include a hotline number for the patient to call if needed.
- Choose one of the following questions.
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