Reggie is a 42-year-old African American male recently referred for outpatient psychotherapy by his PCP. While he is in relatively good health, he admitted to his doctor that he has been drinking alcohol excessively again over the last three months. Reggie had a problem with alcohol when he was in his twenties, but with the help of AA and his first male partner, he was able to cease drinking for the last 19 years. Reggie admits that it has not always been easy for him to abstain, but he is committed to trying again. He has attended AA meetings but has not been able to maintain complete sobriety. On average, he has one or two drinks nearly every evening. His partner, Bob, has a zero-tolerance policy for Reggie’s drinking and has moved in with a friend rather than deal with Reggie’s promises to stop. Reggie is worried that Bob may not come back. Reggie does not want to end up like his father, who drank himself to death at the age of 56. His father and mother divorced when Reggie was only 15. Reggie’s only sister had a serious addiction to benzodiazepines and spent 28 days in a rehab center. She is clean now but also abuses alcohol on occasion.
Questions
- Summarize the clinical case.
- What is the DSM5 diagnosis? Identify the rationale for your diagnosis using the DSM5 diagnostic criteria.
- According to the clinical guidelines, which one pharmacological treatment is most appropriate to prescribe? Include the medication name, dose, frequency and rationale for this treatment.
- According to the clinical guidelines, which one non-pharmacological treatment would you prescribe? (exclude psychotherapy modalities) Include the risk and benefits of the chosen rationale for this treatment.
- Include an assessment of medication’s appropriateness, cost, effectiveness, safety, and potential for patient adherence.
- Use a local pharmacy to research the cost of the medication. Use great detail when answering questions 3-5.
