PSYC FPX 4300 Assessment 3 I’ve Got you Pegged Treatment Plan

Student Name

Capella University

PSYC FPX 4300 Introduction to Addiction Treatment

Prof. Name

Date

PSYC FPX 4300 Assessment 3 I’ve Got you Pegged Treatment Plan

Melissa’s case indicates problematic daily Xanax (alprazolam) use that warrants a comprehensive substance use assessment and professional intervention. Her reported use of four to five pills per day, daily frequency, increasing tolerance, secrecy surrounding her drug use, and exposure to peers who also misuse Xanax are important clinical concerns. Her parents’ divorce, limited parental attention, concerns about revealing her sexual orientation, and other adolescent stressors may also contribute to her substance use. Because Melissa is a minor, treatment should address both her substance use and the emotional, family, social, and developmental factors surrounding it.

Substance Use History

Melissa’s primary substance of concern is Xanax, the brand name for alprazolam, a prescription benzodiazepine. According to the case information, she reports taking approximately four to five pills per day and has used Xanax every day during the past month.

There is no indication that Melissa used Xanax during an earlier period or that she has combined it with other substances. The available case information also does not identify a specific physical complication associated with her Xanax use. However, the absence of reported physical symptoms does not mean that her pattern of use is safe. Regular benzodiazepine use can result in tolerance, physical dependence, and withdrawal-related complications.

Pattern and Frequency of Xanax Use

Melissa’s reported pattern of taking four to five Xanax pills every day represents a significant concern, particularly because she is an adolescent. Her continued daily use suggests that Xanax has become an established part of her routine.

The case also indicates that Melissa obtains Xanax by deceiving her physician. This behavior is clinically significant because obtaining a controlled medication through deception can indicate problematic substance use and increases the risk of inappropriate dosing or unsafe medication use.

Consequences of Substance Use

Physical Consequences

The case does not identify significant physical consequences directly attributed to Melissa’s Xanax use. She reportedly experiences positive feelings after taking the medication. However, benzodiazepines can produce sedation, impaired coordination, cognitive impairment, and other adverse effects. The risks can become particularly serious when benzodiazepines are combined with other central nervous system depressants.

Because Melissa is taking several pills each day, a healthcare professional should evaluate her for tolerance, physical dependence, adverse effects, and withdrawal risk.

Psychological and Emotional Consequences

Melissa’s substance use occurs within a complex emotional environment. She hides her Xanax use from her parents and school because she is afraid of getting into trouble. This secrecy may prevent adults from recognizing the severity of her substance use and connecting her with appropriate support.

Her parents’ divorce also appears to be contributing to emotional distress. Melissa feels that her parents are neglecting her while they deal with the divorce. In addition, she is keeping her sexual orientation hidden because she is concerned about how her parents may respond because of their religious beliefs.

These circumstances may contribute to stress, isolation, anxiety, or other emotional difficulties. A comprehensive assessment should therefore explore whether Melissa is using Xanax as a way to cope with difficult emotions or stressful circumstances.

Environmental and Social Factors

Melissa’s home and peer environments are important factors in understanding her substance use.

Following her parents’ divorce, Melissa lives primarily with her mother and visits her father every other weekend. Her parents appear to be focused on the divorce, which may reduce the amount of attention and emotional support available to Melissa and her brother.

Her peer group is another significant risk factor. Melissa’s friends also use Xanax and reportedly share or sell the medication among themselves. Easy access to a substance within a peer group can normalize drug use and make it more difficult for an adolescent to stop using.

Family History

Melissa’s family history includes some substance use. Her parents reportedly consume alcohol moderately, while her older brother uses marijuana and has been suspended from high school because of marijuana use.

There is also a family mental health concern involving Melissa’s mother, who is receiving therapy following the divorce. The case suggests that her mother’s difficulties may involve anxiety or depression, although no specific diagnosis is provided.

Family circumstances should be considered during treatment because family conflict, parental stress, substance use within the household, and limited communication can influence adolescent substance use.

Educational, Financial, and Legal Considerations

Melissa is in her final year of middle school and is preparing to transition to high school. This developmental transition may introduce additional academic and social stressors.

No information is provided about employment or financial concerns, which is understandable given Melissa’s age. There are also no reported legal problems at this time.

Despite the absence of legal or financial problems, her substance use may place her academic performance, relationships, physical safety, and future educational development at risk.

Motivation for Treatment

Melissa does not appear to be actively seeking treatment for her Xanax use. However, she does have personal and emotional concerns that could provide an opportunity for therapeutic engagement.

Treatment should avoid relying solely on confrontation. A supportive, developmentally appropriate approach can help Melissa explore why she uses Xanax, identify her concerns, and develop healthier coping strategies. Motivational interviewing may be useful for helping her recognize the relationship between her substance use and the problems occurring in her life.

Recommended Assessment

A comprehensive assessment should explore the reasons behind Melissa’s Xanax use rather than focusing only on the number of pills she takes.

The assessment should consider:

• The circumstances surrounding her first use and progression to daily use.
• Her reasons for using Xanax and the effects she expects from it.
• Tolerance and possible physical dependence.
• Withdrawal symptoms or previous attempts to stop.
• Access to prescription medications and how she obtains Xanax.
• Use of alcohol, marijuana, prescription medications, or other substances.
• Anxiety, depression, trauma, suicidal thoughts, or other mental health concerns.
• Family relationships and the impact of the divorce.
• Peer relationships and social pressure.
• Academic performance and school-related concerns.
• Her willingness to participate in treatment.

Because Melissa is an adolescent, assessment should also consider developmental needs and involve appropriate family or caregiver participation while maintaining confidentiality within applicable legal and ethical requirements.

Clinical Assessment and Diagnostic Considerations

Melissa demonstrates several indicators of problematic benzodiazepine use, including daily consumption, a relatively high reported quantity, tolerance, concealment of her use, and obtaining Xanax through deception.

However, a formal diagnosis should not be assigned solely from the limited case information. The DSM-5-TR uses the diagnosis of sedative, hypnotic, or anxiolytic use disorder rather than the older terminology of “Xanax abuse.” A qualified clinician would need to determine whether Melissa meets the required diagnostic criteria and severity level.

Her daily use and reported tolerance are particularly important findings, but tolerance alone does not establish a substance use disorder. A complete clinical assessment should identify additional symptoms such as unsuccessful efforts to reduce use, cravings, continued use despite problems, hazardous use, or impairment in important areas of functioning.

Factors Supporting Clinical Concern

Several factors increase concern about Melissa’s substance use:

• Daily Xanax consumption.
• Reported use of four to five pills per day.
• Development of tolerance.
• Concealment of substance use.
• Obtaining Xanax through deception.
• Peer access to and use of Xanax.
• Stress associated with parental divorce.
• Feelings of parental neglect.
• Concerns about family acceptance of her sexual orientation.
• Lack of current motivation to seek substance use treatment.

Together, these factors suggest that Melissa needs a comprehensive evaluation rather than simply being advised to stop taking Xanax.

Treatment Plan for Melissa

Treatment should address both Melissa’s substance use and the underlying circumstances that may be contributing to it. Because benzodiazepine withdrawal can be medically significant, Melissa should not be advised to abruptly discontinue regular Xanax use without medical supervision.

A treatment plan may include several stages, including assessment, stabilization, rehabilitation, and ongoing maintenance or relapse prevention. The appropriate level of care should be determined by a qualified healthcare professional after evaluating the severity of her substance use and withdrawal risk.

Individual Therapy

Individual therapy can provide Melissa with a confidential and supportive environment to discuss her substance use, family circumstances, identity-related concerns, and emotional difficulties.

Cognitive behavioral approaches may help her identify unhealthy thought patterns and develop healthier coping strategies. Motivational interviewing can also help strengthen her willingness to consider treatment and reduce substance use.

Family-Based Support

Family involvement may be beneficial because Melissa’s parents’ divorce and limited attention appear to be important environmental factors.

Family therapy can help improve communication, establish appropriate boundaries, increase parental support, and address conflicts that may contribute to Melissa’s emotional distress.

Substance Use Education

Melissa and her caregivers should receive age-appropriate education about Xanax, including the risks of tolerance, dependence, impaired judgment, overdose, and withdrawal.

Education should also address the dangers of combining benzodiazepines with alcohol, opioids, or other sedating substances.

Rehabilitation and Relapse Prevention

Rehabilitation should focus on helping Melissa replace substance use with healthier coping mechanisms. Treatment can include strategies for managing stress, dealing with peer pressure, improving communication, and handling difficult emotions.

Relapse-prevention planning should identify situations that increase her desire to use Xanax and develop specific alternatives for responding to those situations.

Ethical and Confidentiality Considerations

Because Melissa is a minor, confidentiality must be handled carefully. Healthcare professionals should explain the limits of confidentiality at the beginning of treatment and follow applicable laws, professional standards, and institutional policies regarding parental involvement and disclosure.

Confidentiality does not necessarily mean that all information must be withheld from parents or guardians. The specific rules governing adolescent consent and confidentiality vary according to jurisdiction, the type of treatment, and the circumstances involved. Information concerning an immediate safety risk may also require disclosure.

Therefore, clinicians should clearly explain to Melissa what information can remain confidential and what circumstances may require information to be shared.

Overall Clinical Perspective

Melissa’s case demonstrates how adolescent substance use can develop within a combination of individual, family, social, and developmental stressors. Her daily Xanax use, tolerance, secrecy, access through peers, and emotional difficulties require careful clinical attention.

The most appropriate approach is a comprehensive, adolescent-centered treatment plan that addresses substance use while also considering family relationships, mental health, peer influences, school adjustment, and coping skills. Early intervention can help reduce the risk of continued benzodiazepine misuse and support Melissa’s transition into high school and later developmental stages.

Frequently Asked Questions

What is the main substance use concern in Melissa’s case?

The primary concern is Melissa’s daily use of Xanax (alprazolam), reportedly at a rate of four to five pills per day. Her tolerance, secrecy, and access to Xanax through peers are additional warning signs requiring professional assessment.

Does daily Xanax use mean Melissa has a substance use disorder?

Daily use is a significant clinical concern, but frequency alone does not establish a DSM-5-TR substance use disorder diagnosis. A qualified clinician must evaluate the full set of diagnostic criteria, including impairment, loss of control, continued use despite problems, cravings, and other symptoms.

Why is Xanax use particularly concerning for an adolescent?

Adolescents are still undergoing significant neurological, emotional, and social development. Misusing benzodiazepines can contribute to sedation, impaired judgment, dependence, and other health and safety concerns.

What factors may be contributing to Melissa’s Xanax use?

Several factors may be involved, including her parents’ divorce, perceived lack of parental attention, concerns about family acceptance, peer substance use, and difficulties associated with adolescence and the transition to high school.

What treatment is recommended for Melissa?

Treatment should begin with a comprehensive clinical and substance use assessment. Depending on the findings, treatment may include individual therapy, family-based interventions, substance use education, medically supervised management of benzodiazepine dependence, and relapse-prevention strategies.

Should Melissa stop taking Xanax immediately?

She should not abruptly discontinue regular Xanax use without professional medical guidance. Benzodiazepine withdrawal can be serious, and a qualified healthcare professional should determine the safest approach to reducing or discontinuing use.

How can Melissa’s family support her recovery?

Her family can provide consistent emotional support, improve communication, establish appropriate boundaries, monitor safety, and participate in family-based treatment when clinically appropriate. Addressing the stress associated with the divorce may also help reduce factors contributing to her substance use.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787

Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating addiction: A guide for professionals (2nd ed.). Guilford Press. https://www.guilford.com/books/Treating-Addiction/Miller-Forcehimes-Zweben/9781462533374

PSYC FPX 4300 Assessment 3 I’ve Got you Pegged Treatment Plan

National Institute on Drug Abuse. (2024). Benzodiazepines and other prescription medications. National Institutes of Health. https://nida.nih.gov/research-topics/prescription-drugs/benzodiazepines

Substance Abuse and Mental Health Services Administration. (2023). Treatment considerations for youth and young adults. https://www.samhsa.gov/