NURS 687 MAT Questions

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8 Hour MAT Waiver Training Case Discussion

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Case Study

Lawyer, Beginning to Use Daily

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Clinical Management

A forty–year-old man who comes to your office asking to be treated with buprenorphine. He is a criminal defense attorney in private practice, and he knows about buprenorphine because you are treating some of his clients. His goal is to use buprenorphine during the week and occasionally use heroin (by snorting) on the weekend. He has used heroin for the past 5 years.

Lawyer, Beginning To Use Daily

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He describes that for the past 6 months, he has continued to use heroin primarily on the weekends, but is concerned because he has begun to use small amounts of heroin daily. If he doesn’t do this, he has loose stools, becomes irritable, and has difficulty getting and staying asleep. He has no desire to completely stop heroin use, but he doesn’t want to use it during the week.

His passion is playing jazz and he has organized a band. He says that heroin use is common in the club where his band plays. All the members of the band use heroin and many of his friends who come to the club also snort or inject heroin. He rarely buys heroin, as his friends usually give it to him.

Lawyer, Beginning To Use Daily

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His only other drug use is marijuana and alcohol (3-6 drinks/night on the weekend), again primarily used on the weekend. He has never been arrested or had significant medical consequences from his heroin use. He is not married. He has a 14-year-old son who he has supported and sees often.

 What is the diagnosis?

 Is this patient a candidate for treatment with buprenorphine?

 What are the treatment goals?

 What is the initial treatment plan?

Lawyer, Beginning To Use Daily

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