Case Study Report: 5

Opening Statement: Despite side effects which the patient attributed to the medication that he experienced on a daily basis (mild nausea, mild headache), the patient took naltrexone regularly for 24 weeks. During these 24 weeks, the patient did not relapse to alcohol or other substances.

Patient Background Information: The patient was a 31 year-old white, male college graduate. He was divorced and employed full-time as a special education teacher. He reported 13 years of heavy drinking; at intake, he drank alcohol on a daily basis. on average, he drank six standard drinks daily. The patient reported a history of chronic sinus infections, jaundice as a child, irritable bowel with intermittent diarrhea, knee surgery, hypoglycemia, allergy to cats, hay fever, insomnia, depression, and childhood physical abuse by his parent. At intake, the patient reported no concomitant meds other than occasional OTC pain medication for headaches. During the course of treatment at Matrix, the patient was diagnosed with clinical depression by a private psychiatrist and was treated successfully. At discharge, the patient was taking paroxetine (Paxil) and trazodone (Desyrel) daily, prescribed by his private psychiatrist. The patient reported a history of cocaine abuse, a history of marijuana abuse, as well as a significant history of hallucinogen abuse (patient reported taking LSD over 100 times). The patient's family history for alcoholism and age at onset of problem drinking are unknown. The patient had one brief prior substance abuse treatment episode while enlisted with the Marine Corps. He stated that this treatment was not successful in reducing his use of alcohol and other substances. The patient reported that for many years he has used alcohol to help him cope with his life stress. The patient's use of alcohol also affected his ability to keep his commitments in his interpersonal relationships.

Naltrexone Treatment and Results: The patient took medication for 24 weeks and complained of mild nausea and mild headache as well as intermittent insomnia for the entire duration of study. The patient took medication at 50 mg daily for the first 2 weeks. Dosage was then reduced to 25 mg daily due to patient's complaints of nausea, headaches, and insomnia. The dosage remained at 25 mg daily until study completion. The patient stated that he felt that the medication helped reduce his alcohol craving. The patient participated actively in the intensive Matrix treatment model and attended a weekly AA meeting. Currently, client remains substance and alcohol free and continues to attend AA meetings as well as a weekly social support meeting at the Center.

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