Below is a fictional character in for treatment. MY ASSIGNMENT: I am to compare my treatment plan with those of OTHER substance abuse counselors and compare them, based one the available data from the fictional character below.

What would your general treatment plan look like for this man?
If he had an AXIS II: 301.70 Antisocial Personality Disorder – would that change your approach?

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Ok, so I just graduated high school at the top of my class. I made really good grades, did well in sports, won tons of awards blah blah blah. Basically, If everyone didn’t know that I abused drugs on a daily basis, no one would suspect anything because it doesn’t affect my life in a public way. Its a little strange that I abuse substances so frequently because I have absolutely no family history of substance abuse and my two older brothers were golden children who never even drank in high school and only drank in college in party situations. However, I unquestionably have a substance abuse problem. I smoke weed everyday, usually multiple times. I drink close to everyday, probably 4-5 times a week (not always with my friends). I do cocaine fairly regularly. I literally have to take Adderall if I have a lot of school work I need to do (during the school year about once a week). And I mix other drugs in with those occasionally too. While my abuse started out with partying, I now do drugs or drink all the time (before school, before work, before any time I have to spend with my family and of course at parties). My parents really don’t know that I have a problem, they know I’m a little wild but only suspect me of drinking occasionally. The problem is I would never ask my parents to send me to rehab plus I’m going to the University of Virginia in about a month. What I’m most scared about is that I will go absolutely out of control in college where substances are even more present than they are in my life now. UVA is pretty well known for alcohol, marijuana and most notably cocaine. I know I’m going to end up screwing my life up but I just can’t stop. I know I have a lot of things that could be worked out if I saw a therapist but I don’t know how I would do that either. I pretty much feel stuck and I don’t know where to turn anymore.
Oh, I also wanted to add that I’m not an addict(yet). The problem isn’t that I would suffer withdrawals because not using a particular substance doesn’t really affect me at all because I switch up the drugs that I abuse. I know if I continue on this path I’m going to have alot of problems but I don’t have any fun when I’m not high on something. Life without substances seems so much more strenuous and boring and I’ve abused drugs since I was 12 or 13. I can’t even imagine being sober at college and I honestly don’t really think that thats an option. I just want to be able to drink socially and moderately but it seems so crazy and unrealistic to me.

Friend for 30yrs is ill(got into Rx & street drugs & alcohol.Her liver/kidneys are failing.Shes attempted suicide. Never like that in school; even thru her 1st marriage.She & husb div over other issues/remarried;had a child.They split(he was in the closet I think). She remarried 3rd time,had a child.Somewhere in this time she got into drugs/battled depression.Lost her job, got a 3rd div& lost custody of both kids.She’s been to rehab countless x’s & her fam is just as bad.This is going to sound awful-publicly Im afraid to be seen/assoc w/her b/c of her rep.I feel bad for not “being there” Ive sent cards/flowers,but only called a few x’s. I feel guilty.One of my parents died of sub abuse- I can relate.Do I jeopardize my reputation & my kid’s rep? I sought advise from fam who said stay clear b/c of her drug prob(didnt want to give police wrong idea about my fam).My kids & I arent into drugs at all. How do I help w/o involv my fam?Should I worry what others think?She looks awful;like death
thank you everyone for answers. Ive tried intervention,& like Amy said it brought tons of drama to the house. That was before kids…. Now Im afraid for my kids to be involved; even indirectly. It was different then. Shes asked for help & but never commits. Im struggling w/guilt-but I wont forgive myself if my kids become involved in anyway. I’ll reach out to her again. I did recently go to a funeral to be w/her when another young mem of her fam overdosed. She knows she doesnt have much longer if she continues. I contacted all our friends to reach out to her & let them know we all love her. Most everyone tried in some way but she refused everything except a few phone calls. I have some ideas from the answers. I’ll contact one of the support groups to see whats available I can do. Anyone out there who believes in the power of prayer, I ask you pray for my friend, she was always so sweet to everyone, she never hurt anyone in life, (until now herself and her kids) It’s just so pitiful.

My sister and here husband have been married 5 yrs, but have always seem to abuse alcohol, pills, weed, and whatever else they have done. She has confided in me about there relationship, and she says she wants to get help, but never follows through. I just tell her you need to worry about yourself. The two of you can’t fix this alone. I suggest she leaves and seeks her own treatment if he isn’t into getting help.
The big kicker they have a 2 yr old son together and i feel like i should step in, i don’t want him to grow up in that enviroment.

Any advice on what i should do or what? I just want to help my sister and my nephew before its to late.
I completely understand the child is 1, and know it def. a tough love situation. Its so frustrating because she has been with him for a total of 10 yrs and she was so much better before him. She had so much potential for a great future , and i understand she still can.
Thats why our parents are seeking some type of guardianship for her son.
Enough is enough.
I love her to death, and don’t want anything to happen to her or my nephew.

Im applying for a residency and have been prescribed Naltrexone for alcohol dependence… to reduce cravings. They ask a question stating “have you been treated for chemical dependency or substance abuse?” Am I required to say yet? I have not been in rehab etc but I have been medically treated for it. I’d rather not put it down because I don’t want to jeopardize my future or opportunities.

my brother chocked me the other day and grabbed my arms really hard and dragged me around the house saying how he was gonna hit me until my sister stopped him, this isn’t the only time this happened, i have scratch marks in my neck and arms and my stomach is sore from him making me hit it, also i get punched, because i didn’t bring the phone down as soon as they told me to.

everyday literally there’s always a argument or fight in my house, i get told im ugly stupid dumb and a lot of other things by my mom and sister(my dad’s in rehab for alcohol). i want to get help, but is my situation bad enough to get help?

How do you think your beliefs about the various users of certain drugs like Meth, Cocaine, Marijuana and Alcohol affect the treatment outcome of these individuals?

what adive would you give to someone who deals with visual triggers to use alcohol or drugs. for example, one of my clients lives in an area where when he walks down the street he sees people on patio bars and this triggers him. MOVING IS NOT AN OPTION – this is where the treatment facility is located. traveling a different route is not an option for the most part. what are some effective coping skills he may utilize?
please no more ridiculous responses.

I use to live in home filled with verbal abuse, hatred, and alcohol. It caused a lot of pain and anger. I had no way of expressing it and no one to talk to. I attempted suicide, several times and began cutting. I never actually became anorexic, but I only ate like once, maybe twice a day. I was so miserable and scared. The only person, I felt gave me a reason to live was my younger brother. I moved on from cutting and began to OD, about once or twice a week. Now I live with some friends and haven’t cut or OD-ed since October. I still eat very small amounts, but have gotten a lot better. Everything in my life has changed for the good. I’m making good grades, have a job, and am starting to make friends and open up to people. My personality has finally returned, but right now, I’m really afraid of losing control and returning to the dark place, I once suffered in. Yesterday, in my church small group, I was told one of the members was put in a mental facillity. She’s 18 and has been fighting anorexia for like 6 years. She’s on a feeding tube and was in a eating disorder rehab program. Though the program was created to help her gain weight, she continued to lose massive amounts. On Saturday, a classmate committed suicide. He was a senior and the exboyfriend of some one really close to me. I haven’t spoken to her yet, because her phone is broken. About a week ago, the dad of one of my closest friends died from a disease he suffered for basically her whole life. Another friend of mine has been dealing with physical abuse from her father for several years and there’s nothing any one can do about it. On top of all of that, I’m not allowed to speak to my brother, who is my best friend, because my dad and his wife don’t want me to talk to my siblings. I have so many triggers right now and I’m trying to fight them off, but it’s really hard. I feel so helpless, as I watch every one around me sit in the same dreadful position, I sat in, just several months ago and can’t do anything about it. I’m trying so hard to push my emotions away and focus on every one else, but I don’t know how long I can do it. I don’t want to turn back to self-harm or get stuck in the cycle of not eating and not being able to sleep. I’ve been praying all day, but still don’t know what to do.

So I was hospitalized last week with pancreatitis and diabetic ketoacidosis after collapsing at my sister’s wedding reception. Anyway, the doctors ran some tests and it turns out that I have elevated liver enzymes and show signs of advanced liver disease.

The doctor advised that I quit drinking and even referred me to several addiction treatment facilities. The thing is, not drinking isn’t an option. Drinking to excess is a very important part of my lifestyle and my professional image. Is there something I’m doing wrong? Is there a safer way to drink? Are there any multivitamins or herbal supplements I can take to lessen the damaging effects of alcohol on my liver?

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