Essay Analysis

Stephanie is a 24-year-old college graduate. Stephanie used marijuana infrequently during her high school
years and had tried ecstasy about three times during her senior year of high school while beginning to frequent
clubs. During her college years Stephanie did not use drugs but during her junior year she became concerned
about her alcohol abuse and met with a therapist in the college counseling center. He recommended attending
Alcoholics Anonymous, however Stephanie attended about ten meetings, sporadically, and although she
stopped drinking she did not identify herself as an alcoholic. She did however, admit to being very bored and
began to isolate. Six months after completing college Stephanie injured her back in a skiing injury. She was
prescribed Percocet and slowly started to use it more frequently then prescribed as well as using it long after
the pain diminished. She began to have difficulty filling her prescriptions, as she finished her medications
before the next refill. Stephanie started to seek additional doctors in an effort to obtain more of the drug. As this
process became more expensive, a friend she met at a club introduced her to using heroin intra-nasally. This
was less expensive and while Stephanie experienced euphoria, she rationalized that the drug use would help if
the back-pain returns. About 6 months later, she was using approximately 3 bags of heroin daily. Her daily use
was now interfering in many life areas. Her only socialization was that of her connections to buying heroin. She
started to be late for work and miss alternative employment opportunities. She lived home with her parents,
who remained uneducated regarding her drug use and necessary treatment. She also continued to drink more
heavily during this time. Stephanie was arrested for driving under the influence (alcohol) and possession of
marijuana, while her parents were unaware of her heroin use. As a result of her pending legal involvement,
Stephanie was recommended for drug treatment. She completed a psychosocial evaluation, which included
urinalysis testing. Stephanie admitted using heroin and marijuana daily, she did not identify herself as an addict
and continued to lie to her parents about her heroin use. She justified not being addicted stating she “could
stop at any time”, had a college degree and was gainfully employed. She supported her denial by stating she
does not use IV and was initially prescribed the medication for pain by a doctor. She minimized her marijuana
use, often referring to it as ‘legal and often used for medicinal purposes.” While her parents were supportive,
they remained in denial about the severity of her use and were limited in setting clear boundaries and
consequences. Stephanie continued to attend treatment to satisfy her legal status, but continued to struggle to
remain completely abstinent and remained only minimally engaged in the treatment process. Her primary
counselor, along with the multidisciplinary team introduced that Stephanie explore options of medication
assistance treatment in order for her to become more engaged and educated regarding substance use
disorders and assist her in gaining insight into her addictive behaviors.
Discussion Topic: After reviewing the attached Medication Assisted Treatment PowerPoint, and the following
web links:
Medication Assisted Treatment
M.A.T. Pros & Cons
Painkiller abuse treated by sustained buprenorphine/naloxone
Describe why you would or would not consider Stephanie to be a good candidate for Medication Assisted
Treatment. Please support your position using the references provided or related references.