Which situations would the nurse interpret as indicating the client has a true substance dependence problem rather than a substance abuse issue?

Question

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. At every clinical visit the client initiates a discussion about her need to stop using drugs.
2. The client reports, "I'm going back to my plan of drinking only on weekends."
3. The client states, "I'm trying to quit using sleeping pills but I can't do it. Without them I'm awake all night."
4. The client reports that his parents have "kicked me out of the house" for repeatedly coming home drunk.
5. The client was arrested for shoplifting cigarettes at a convenience store.

Answer 1

1,2,3
Rationale 1: People with substance dependence spend a lot of time either trying to obtain the substance or trying to cut down or schedule their use.
Rationale 2: People who are dependent on a substance often try to control the dependence by scheduling when they will use it.
Rationale 3: One of the hallmarks of dependence is the inability to withdraw from the substance.
Rationale 4: Neither of the hallmarks of dependence (tolerance and withdrawal) is demonstrated in this statement. The client has encountered an adverse social consequence, which indicates abuse.
Rationale 5: Neither of the hallmarks of dependence (tolerance and withdrawal) is demonstrated in this statement. The client has encountered an adverse consequence, which indicates abuse.