Warn him about risk for health, work and relationships

 He is not happy  that you seem to think he has a drug problem and insists he is not using more than any of his friends.

You provide him with a handout about the risks of drug use.  You consider asking him to return in another 2 weeks to check on the fracture healing and to see if he has had any further thoughts about what your concerns about substance use.

But remember that these patients are not good at follow up - you wonder whether he might come back? 

What advice could you give him now while he is here?