Brenda was born in New Jersey. She is the middle child in a family of four, born to an African American father and Hispanic mother. Her father owned his own limousine business while her mother stayed at home with the children. The children were supported and encouraged to explore their talents. For Brenda, this was dancing. At a young age, she enrolled in ballet and quickly found success. In middle school, she became involved with a hip-hop dance group. She immediately became lead, and her group became nationally awarded. In high school, she continued with the hip-hop dance group and joined the cheerleading squad. During this time in her life, she received many awards and was scouted by internationally acclaimed institutions including Juilliard, which had always been her dream school. She was accepted early in her senior year and committed herself to working even harder to make a great impression when she began school. Unfortunately, toward the end of senior year, Brenda injured herself during a dance competition, dislocating her knee. The experience was extremely painful and came with a projected recovery time lasting into her first several months of college. Her doctor prescribed Vicodin to help with the pain. She was initially provided with 60 pills to take no more than twice daily over the first month. At first, she only took one per day. However, after one particularly bad day, she took three in a night. Brenda loved the way she felt. It also helped her begin to dance some again. Because she could not renew her prescription within a month, she decided to take two pills every night, which gave her a bit of a buzz and continued to help her knee feel better than it did when she took just one. After the first month, she convinced her doctor to refill her prescription. Again, she was given 60 pills to last the month. After a week of continuing to take two pills per night, she then progressed to taking three. A week later, she took four. Having done this on a daily basis, she ran out of medication early. She requested an appointment with her doctor. They met early. After Brenda explained that she finished the pills early, her physician became worried and refused to refill the prescription. Frustrated and worried about her future with dancing, Brenda sought another doctor who would prescribe her painkillers. This time, she found one who prescribed 30 OxyContin pills for the month. Again, she ran out early, and the physician refused to renew her prescription. After trying to shop for more doctors, she could not find anyone who would prescribe her anything as strong as OxyContin. She did, however, find two different doctors who each prescribed her a three-month supply of hydrocodone. This time, the six-month total supply of pills ran out in a month. Brenda was at the point of taking 10 to 15 pills per day. She was sleeping in late, missing class, withdrawing from family, barely eating, and feeling apathetic toward her life’s dream of graduating from Juilliard. Growing increasingly concerned, Brenda’s mother recommended that Brenda see someone.
Case Study Client – Brenda
Full Answer Section
Precipitating Factors- Injury: The knee injury was a significant physical and emotional setback, leading to pain, frustration, and a sense of loss.
- Introduction to Opioids: The prescription of Vicodin for pain management was the initial gateway to opioid addiction.
- Reinforcement: The euphoric effects of the opioids provided temporary relief from pain and emotional distress, reinforcing drug-seeking behavior.
- Tolerance and Dependence: As Brenda increased her opioid dosage, she developed tolerance, requiring higher doses to achieve the desired effects. Physical dependence also developed, leading to withdrawal symptoms when the drug was not available.
- Doctor Shopping: Brenda's inability to obtain prescriptions from her original doctor led her to seek out other providers, perpetuating the cycle of addiction.
- Isolation and Neglect: As the addiction progressed, Brenda withdrew from her social support system, exacerbating feelings of loneliness and despair.
- Detoxification: A medically supervised process to manage withdrawal symptoms.
- Medication-Assisted Treatment (MAT): Using medications like methadone or buprenorphine to reduce cravings and prevent relapse.
- Psychotherapy: Addressing underlying emotional and psychological issues to prevent relapse.
- Support Groups: Connecting with others in recovery can provide encouragement and accountability.
Sample Answer
Brenda's story is a tragic example of how a promising young woman's life can be derailed by opioid addiction. Several factors contributed to her downward spiral:
Predisposing Factors
- Age and Developmental Stage: Adolescence and young adulthood are periods of heightened vulnerability to substance abuse.
- Personality: Brenda's driven and competitive nature might have contributed to her tendency to push herself beyond limits, both physically and psychologically.
- Family History: While not explicitly stated, a family history of substance abuse could be a potential risk factor