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Hayley is a 30-year-old married female who is experiencing generalized anxiety disorder and has developed a problem with prescription pain pills. She describes herself as always worrying excessively. This problem increased when she got married two years ago. She experienced a serious fall down a flight of stairs a little over a year ago and suffered several injuries. She was prescribed oxycontin for the pain, which originally reduced her suffering. The pain persisted, so she continued to return to her physician for medication refills. She found that the medications were not as effective as when she first began taking them. She also experienced a relief in her anxiety when she took the oxycontin. Her doctor became concerned that Hayley was misusing her medications and indicated that he was going to gradually reduce her prescriptions. Her anxiety intensified as she became desperate to find more of the medication. She began buying prescription opioids over the internet and increased her consumption over time. Her husband became concerned when Hayley seemed to be isolating herself and calling in sick for work. He eventually insisted that she go see a psychiatrist to get some help for her anxiety and misuse of prescription medications. The psychiatrist suggested that she start taking buprenorphine. He also suggested that after careful monitoring and stabilization on buprenorphine, that the anxiety issues be reassessed to see if they are still prevalent. If so, then medication and counseling options for anxiety will be considered. These are Hayley’s concerns: “Why do I have to take drugs if I am trying to get off of drugs?” “How will medications for my anxiety issues work?” “Are there any concerns with taking buprenorphine and a medication for anxiety?” “Will I continue to see you as well as the medication provider?” “So, if I see you, what will we do that will help me with a substance use disorder and my anxiety?” 700- to 1,050-word transcript of your responses. Validate the client’s concerns and provide accurate information about their situation. Anticipate at least 3 more questions that the client might ask about their medications and how you would respond. Explain the biological factors affecting the client’s mental health and their influence on behavior. Explain your response to each question in your own words. Use professional language that is culturally sensitive and understandable to this client. Support your replies with citations from the text and research from peer-reviewed sources.
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