Diane Year Female Explained for Students (Easy Guide)
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Original Question
Diane is a 36 year old female who was referred for assessment and treatment by her place of employment. Diane was caught stealing oxycodone from the hospital pharmacy where she is currently employed as a registered nurse. Diane was placed under disciplinary action including random drug testing, restricted access to medications at work and mandated therapy. Diane reported that she is embarrassed over the entire situation and wants to remain drug free so she can continue to pursue her dream of becoming a nurse practitioner (NP). If Diane follows the corrective action plan for 12 months she will be returned to “normal” status and will be eligible to apply to the NP program that is associated with her hospital. Diane was involved in an automobile accident two years ago and broke a disc in her back. She had surgery but the pain did not subside. After the accident Diane was prescribed oxycodone for pain. She took the medication as prescribed for 10 months. At the 10 month mark her doctor refused to continue prescribing the medication, so she began going from doctor to doctor to get enough medication to keep the “cravings” at bay. She was taking 3-4 days per month off work for doctor’s appointments and would run out of the medication before the next prescription was available. At one point she was seeing six different doctors monthly and getting a prescription from each one. She attempted twice to cut back but found herself taking more than before the cut back. She also attempted to stop taking the medication four times. Each time she experienced significant symptoms including feeling like she had the flu, nausea, vomiting, diarrhea, shaking, inability to sleep and increased pain. She got two warnings at work for excessive absences due to doctor’s appointments. She also stopped socializing all together for the past six months. Three months ago four of the doctors stopped prescribing for Diane and she had to start buying opiates off the street and stealing them from work. After being caught at work she was sent to detox and has been opiate free for two weeks. She reported a strong desire to begin taking opiates again, even though she knows it can result in the loss of her job and future dreams and desires. What is the diagnosis with rationale?
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