Jerry has been a daily heroin user for the last 7 years. He is HIV positive and has recently been diagnosed with
hepatitis C. Jerry believes that both of these illnesses were contracted through the use of shared needles. As a
condition for treatment of hepatitis C with interferon, Jerry must agree to undergo treatment for his heroin
addiction. He is considering the “methadone cure,” which includes daily doses of methadone to replace the
heroin. He is not sure that he is willing to give up his heroin use. In fact, he used immediately before coming to
his most recent counseling session. Jerry feels torn, but he knows that his life depends on this choice. What
might be some compelling information for a client in this situation to know? What is your role as a mental health
professional in advocating for treatment?
An explanation of the factors that indicate the appropriateness of the medication in potentially treating the
client’s substance abuse
An explanation of the expected side effects of the medication and the mental health professional’s role in
monitoring these side effects
A justification of the medication to advocate for its use to encourage the client to continue with treatment
Required Readings
Lichtblau, L. (2011). Psychopharmacology demystified. Clifton Park, NY: Delmar, Cengage Learning.
Chapter 7, “Neurobiology of Addiction” (previously read in Week 2)
Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology for therapists
(8th ed.). Oakland, CA: New Harbinger.
Chapter 14, “Substance-Related Disorders” (pp. 153-160)
Volkow, N. D., Frieden, T. R., Hyde, P. S., & Cha, S. S. (2014). Medication-assisted therapies—tackling the
opioid-overdose epidemic. New England Journal of Medicine, 370(22), 2063-2066.
Document: Substance Abuse Case Studies (PDF)
Use this document to guide you as you complete this week’s Assignment.
Optional Resources
MSW home page
Use this link to access the MSW home page, which provides resources for your social work program.
Substance Abuse Case Studies
Constantine is a 28-year-old Turkish immigrant. He has been told that he must stop drinking or his life will be in
jeopardy. Constantine moved to the United States at 18 to study economics. During his first year of college, he
tried alcohol for the first time and was quickly “hooked.” He drinks nightly and cannot recall how many drinks he
has had. Constantine says that he drinks, “at least a bottle of scotch” every night. Over the past 10 years, he
has come to realize that he has a problem. This was not an urgent issue until recently, when he developed
pancreatitis. His doctor informed him that his drinking has already caused some damage to his liver, which is
very “fatty.” In fact, there are some areas of his liver that may never recover, even if he stops drinking. If he
does not stop, though, he will eventually either need to have a liver transplant or he will die from complications
of cirrhosis.
Constantine decided to take his doctor’s advice and will be participating in a day- treatment program at your
counseling clinic. He tried to quit drinking once in the past, and his blood pressure skyrocketed. Constantine
worries that this might happen again.
Case 2: Joey
Joey is a 30-year-old Italian-American graduate student studying counseling at an online university. He was
drawn to the program in hopes of learning more about himself. Joey eventually wants to help others after he
first figures out how to help himself. He considers himself to be a “partier.” He began using ecstasy and
cocaine during college. Joey considers his college years to be the best times of his life. Later, though, he tried
heroin. He first snorted it but eventually agreed to “mainline” it (shoot it directly into his veins). He describes
this event as singular in his life—nothing after it would ever be the same. At that point, everything was in the
context of when he would use the drug next and with whom. He plans his most extravagant parties for
weekends, but it seems that he is always “on the nod” now.
Joey is worried about a trip that he has coming up. He will be attending a counseling program “residency” in a
city across the country. How will he score? He has to take the drug. He’ll get sick otherwise. In light of this, he
decides it might be time to try to quit. But how? He doesn’t even know how to cut back. Joey is planning to take