Ask him more about substance use

You probe for details about his drinking, smoking and other drug use using a Kindle document you carry on your smart phone. (Nice to be able to use the Kindle reader for more than just fiction.)

You use the NIDA Screening questionnaire for drug use in general medical settings info and get some further information about his patterns:

6 beers prior to fight & often drink after work 

Smokes a pack/day, started smoking at age 10

No access to prescription drugs

He reports that he has played around with a lot drugs depending on what was available. He admits to using pot on a daily basis. He has tried coke, speed (his favorite), ecstasy, and mushrooms. When specifically questioned, he does admit to shooting drugs a few times.

He has used most of these within the last 3 months, although he has not been able to afford coke for the last 6 months. He didn’t like the way mushrooms made him feel so decided it was not for him. He doesn’t see anything wrong with using pot and denies any problems at home or work because of his daily use. Although he craves speed most days it is hard to find so he only uses once a month. He last dropped E at a party last weekend because it was the only drug available but it is not his favorite and he can live without it. Although he lives at home, his parents are not aware of his illegal drug use and all of his friends use the same amounts so he is not concerned and neither are they. He usually snorts speed when he takes it but has injected it on a few occasions but as far as he can remember he used a new needle. 

What do you want to ask now?

 

Ask what triggers his drug and alcohol use?
Ask if he thinks drug & alcohol use is a problem for him
Warn him about risk for health, work and relationships

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