Question 42: A 29 year old married male presents to the inta…
Question 42: A 29 year old married male presents to the intake department at a community mental health center, seeking treatment of a severe cannabis use disorder. Aside from using ½ can of tobacco “dip” per day, he denies using other addictive substances. His breathalyzer is negative and urine immunoassay is positive only for cannabinoids. Medically, he has hyperlipidemia and mild obesity (BMI=31.2). He has a history of childhood-onset ADHD, inattentive type, for which he stopped medication several years ago. He periodically experiences “anxiety attacks” which reportedly trigger him use cannabis. Otherwise he denies any psychiatric issues. He is employed at a small local insurance agency for the past 8 years. He has never sought help for this problem before. His wife, who does not use drugs, is very supportive of his efforts to get help and wants him to quit. His brother-in-law, who also smokes cannabis, has been sleeping on the couch in the living room for the past 5 weeks but plans to move out “real soon.” The patient verbalizes apprehension about treatment and has financial strain. He has already used up most of his vacation/sick leave, and definitely does not want to do anything to jeopardize his job. With respect to substance treatment, the most appropriate level of care is: