CASE: Amy Dunn
During an assessment of a person who is inquiring about substance abuse treatment, the Amy states she is feeling very discouraged and tells you she has been using heroin (intravenously) for many months and she requires more, more often, to feel comfortable and at ease. She has become more withdrawn from her friends and family. Her career is now suffering. She is worried that if she goes into a residential "rehabilitation" program again she will be fired from her job. She states that she cannot stop using at all.
Amy is an executive at a large corporation and has gone through their Employee Assistance Program one time. Nobody knows that she is using once again. She has had very little success attempting to cut back or quit. After a short period of time, she is using again and this time using more than she used to before she tried to quit. She can never really quit completely. She is hopeful that your outpatient program can help her. She wants to know what her best options are for getting clean and while still being able to maintain her job.
1. What evidence is presented in order to make a diagnosis of either heroin abuse or heroin dependence? Note the differences between each and support your decision.
2. What other information could be useful in order to complete her evaluation? What does she need and how would you go about helping her reach her goals?
3. Which treatment options would you recommend? Psychological, addiction, or medical treatment (or all or some of those options) and why would choose to do so?