Substance Dependence: Case Study

Topic: Psychological Issues
Words: 604 Pages: 2


Although alcohol is classified as a depressant, it is widely consumed, and many people list increased feelings of sociability and relaxation as the primary reasons for its use. According to Feldman (2008), “the discrepancy between the actual and the perceived effects of alcohol lies in the initial effects [including] release of tension and stress, feelings of happiness, and loss of inhibitions” (p. 157). This paper aims to describe the problem from the given case study, generate a primary and differential diagnosis using the DSM-5 and ICD-10 codes, and discuss physiological and psychological processes leading to substance dependence.

Description of the Presenting Problem

The patient from the case study is a Caucasian female, aged 66, recently retired, with no history of anxiety or depression and no previous involvement in therapy. However, Jax’s increased use of alcohol throughout the past year has begun to affect her relationship with her wife, which is the primary reason for seeking help to solve the problem. The woman reports being irritable and argumentative after drinking; at the same time, she does not always recall these episodes as she sobers up. As a result of intoxication, Jax experienced two falls which resulted in bruising on both occasions and hitting her head once. The client consumes six packs of beer daily, notes the decrease in alcohol’s positive effect on her mood, and denies experiencing withdrawal symptoms.

As can be seen, the patient’s lifestyle presents significant risks for her physical and mental health and her marriage and relationship with her spouse. To formulate a diagnosis, additional information would be needed that was not provided, namely, the results of the CAGE alcohol abuse questionnaire (Durand, Barlow, & Hofmann, 2018). This test would allow for confirming or ruling out alcohol dependency based on the client’s answers to the questions.

Primary and Differential Diagnosis Using the DSM-5 and ICD-10 Codes

Based on the available data, the client from the case study can be diagnosed with an alcohol-related disorder. The signs displayed by the patient allow for generating alcohol use disorder as a primary diagnosis as per the Diagnostic and statistical manual of mental disorders (DSM-5). The following symptoms described by the American Psychiatric Association (2013) are present: alcohol is taken in larger amounts within 12 months, and alcohol use continues “despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol” (p. 491). According to ICD-10-CM, the following differential diagnoses can be named: F10.9 alcohol use, unspecified; F10.2 alcohol dependence; F10.1 alcohol abuse (“Alcohol-related disorders,” n.d.). Additional data is required to specify the disorder, such as a physical exam, lab test results, and psychological evaluations.

Physiological And Psychological Processes Leading to Substance Dependence

Substance dependence refers to a state in which one’s functionality requires the presence of a particular substance. Physiological processes leading to drug addiction include excessive consumption within a short period (binge), intoxication, withdrawal, and preoccupation with the substance (Feldman, 2008). Furthermore, the following psychological processes contribute to the development of dependence: a sense of satisfaction caused by the drug, the desire for a repeated feeling of pleasure, and the deterioration of one’s mental and physical health (Feldman, 2008). An individual experiences difficulty in stopping drug or alcohol usage and requires help.

Overall, the case study of Jax demonstrates the symptoms indicating alcohol use disorder. Drugs pose significant health risks for consumers and can result in the development of an addiction. However, even the widespread knowledge about this fact does not prevent many people from using substances. Different tools and classifications, including DSM-5 and ICD-10-CM, can be used to evaluate the patient’s symptoms and diagnose the disorder.


Alcohol-related disorders. (n.d.). Web.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). New York, NY: American Psychiatric Publishing.

Durand, V., Barlow, D., & Hofmann, S. (2018). Essentials of abnormal psychology (8th ed.). Boston, MA: Cengage Learning.

Feldman, R. S. (2008). Essentials of understanding psychology (8th ed.). New York, NY: McGraw-Hill.

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