Name: Joan Age: 39 Sex: Female Family: In a relationship with a live-in girlfriend Presenting Problem: Hospitalization;

[answerhappygod]

Name: Joan
Age: 39Sex: Female
Family: In a relationship with a live-in girlfriend
Presenting Problem: Hospitalization; Potential Overdose
Case Summary: Joan was brought to the emergency room by a friendafter collapsing unconscious. According to the friend, they hadbeen partying for several hours and regularly snorting cocaine.Upon being examined, the attending physician diagnosed Joan withcocaine-induced kidney failure, though he expects her to make afull recovery. Toxicology tests showed some level of painkillers inher system, although her friend stated that they’d only donecocaine. Following hospital protocol in cases of potentialoverdose, a psychologist was called in to interview Joan about herdrug use. According to Joan, she is not a regular user of cocaine.She says that she’ll do it recreationally if she’s around otherswho are using it. When questioned about the party, she said, “Iremember tat we’d been going at it for, I don’t know, pretty muchan entire day before I passed out. We just kept doing little bumpsof cocaine to keep ourselves up, and I guess I just overloaded mysystem.” She admits that she’s had some medical problems withcocaine in the past, and that’s why she does usually do cocaine.When asked about painkillers, however, Joan reports an entirelydifferent pattern of use. About 4 years ago, she fell from a stagewhile performing and suffered extensive leg injuries. She wasprescribed OxyContin to help manage the pain, but her use quicklyescalated beyond the prescribed amount. In her words, “For a yearor so, I just went totally crazy. I was basically using more andmore every day and getting totally wasted on it.” Eventually, shewas kicked out of her band for missing shows and rehearsals. Atthat point, she “completely lost it” and went on a week’s longbinge of constantly getting high. When that ended, she decided tocut back on her use. These days, Joan claims to “dabble with”prescription painkillers. This is a considerable source of tensionbetween Joan and her girlfriend. “She’s always going on about howmuch I lost last time I got mixed up with Oxy. Every now and then,I’ll miss rehearsal or a band meeting, but isn’t that just part ofbeing a rock star? Seriously, I’ve got it mostly under controlnow.” Despite this posturing, Joan admits to having cravings forthe drug and feeling high irritable and anxious when she’s notusing. She’s often tried to stop entirely but only stays sober fora couple of weeks at most. When asked how she obtains her drugs,Joan is blunt, “I have sex with a doctor; he writes me aprescription.” She estimates that she’s had 20-25 sexual partnersover the past year but has never been tested for a sexuallytransmitted infection (STI). She says that she doesn’t botherbecause it wouldn’t stop her from using sex to obtain herdrugs.
Some of the symptoms associated with various substance-relateddisorder are listed below. Select which symptoms are clearlypresent in Gloria’s case. Check all that apply.
Symptoms of Opioid Use
Is highly troubled by current usage patterns
Experiences cravings, or strong desire to use
Recurrent use causes inability to meet major roleresponsibilities at work, school, or home.
Recent use has caused significantphysical impairment
Withdrawal symptoms are present during times of nonuse
2. Some of the symptoms associated with varioussubstance-related disorder are listed below. Select which symptomsare clearly present in Gloria’s case. Check all that apply.
Symptoms of Cocaine Use
a. Drug use causes significant physicalimpairment
Important social, occupational, or recreational activities aregiven up due to drug use.
Drug use is persistent despite significant personal distress
Unsuccessful attempts to cut down on use
Drug is regularly taken in larger amounts or for longer periodsof time than originally intended.
3.
Based on the full diagnostic criteria listed by the DSM-5 forsubstance-related disorders, Joan appears to meet the criteria fora diagnosis of _____________________
a. opioid-usedisorder only
stimulant-use disorder only
opioid-use disorder and stimulant-use disorder
neither opioid-use disorder nor stimulant-use disorder.