Oliver Vincent never saw himself using substances. He had always been “on top of things.” At age 35, he was independently wealthy as the owner of several clothing franchises, lived with an ex-partner in a more-than-comfortable apartment in New York City, worked out every day, enjoyed the company of a group of loving friends, and, although single, had not given up on the idea of someday (preferably soon) finding the perfect man to share his life with. Mr. Vincent came out to his Irish Catholic family when he was 19. His parents had already guessed that Mr. Vincent desired male partners long before he told them, and they took the non-news fairly well. Their main concern had been that their son might be discriminated against because of his sexuality, get hurt, and live a lonely life. Nothing could be farther from the way things turned out: Mr. Vincent was “out and proud” and living it up.
When Mr. Vincent found himself utilizing substances, he addressed it the same way he had dealt with pretty much everything else: head on. For the first time in his life, he decided to see a psychiatric provider. He presented to his nurse practitioner today for an initial encounter.
Mr. Vincent described a pattern that revolved around weekend “party and play” activities. Party and play are code words for drugs and sex, respectively. The term is sometimes abbreviated PNP. On Friday and Saturday evenings—and occasionally during the week—he would go out to dinner with friends and then to a club or a private party. He tended to drink two or three cocktails and four to five glasses of wine during the evening. Without the alcohol, he found he could easily say “no” to substances, but “after a good buzz, if someone has drugs—and there is always someone around who has something to reverse the lows of alcohol—I use. And then my heart starts to race, and then I do everything I can to hook up. I used to go online, but these days, it’s all on Grindr.”
Overall, Mr. Vincent drank alcohol and reports using cocaine three to four times a week and “occasionally using xanny, tina and bath salts.” He could hardly attend Monday morning meetings, much less prepare for them, and had been trying to cut down on his cocaine use for the prior 6 months without success.
Since Mr. Vincent had started using cocaine regularly, he had lost weight and had trouble sleeping. He worried that his effort at the gym was going to waste. His business continued to succeed, but his own effectiveness had decreased. Most importantly, he did not practice safer sex when high on stimulants, and he is worried about HIV seroconversion.
His family upbringing is “normal”. He will not discuss anything from middle childhood ages 8-10 when his father’s best friend “Oliver’s uncle” stayed at his home. His first use of substances was at age 9, when he would regularly use his parent’s alcohol to sleep so he would not have nightmares.
DUE DATE: October 06th, 2022
The case study will be located in Bb and is to be completed and submitted electronically via Blackboard. Dates for submission are October 06th, 2022 at 11:59PM and will be discussed on Intensive Class days.
• Read the case study.
• Distill the salient elements that contribute to diagnosis and treatment planning of a client with complex medical issues and psychiatric complications.
• Review the evidence-based literature based upon the case data and provisional diagnosis.
• Compare and contrast the two non-pharmacologic treatment approaches that could be employed
• Propose interventions which reflect interprofessional collaboration, integrating ethical, legal social factors in clinical decision-making.
• Identify measurable outcomes expected as a result of optimizing care based upon the knowledge gained through the case, and the proposed interventions for care.
