1.4: Case Study- Jake
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WCC 285
Case Study Bio
Jake is a 30 year old biracial (father is Caucasian, mother is Latina from Nicaragua) male referred for substance use disorder assessment by the local county court. Jake was charged with DUI following a serious car accident 3 months ago, for which he was hospitalized for 1 month. He stated he took a deferred prosecution so that is why he is agreeing to do the assessment although he doesn’t think he has a big problem with it. When asked about the accident and his DUI, Jake reported he had been at a friend’s birthday party and drank a little more than he had planned on without eating dinner. He also reported he didn’t really felt drunk when he left the party, only a little bit of a “buzz”. Jake reported that he was the only person in the car and when coming around a curve in the road he lost control suddenly and hit a tree. Jake reported that he sustained several injuries from the accident including a broken elbow, a broken wrist, several broken ribs, and a head injury when his head hit the steering wheel. Jake reported he did not have airbags in his vehicle as it is an old Mustang. He lost consciousness at the scene and woke up in the hospital. Jake reported the police report states his blood alcohol level was 1.81 at the time of his test in the hospital. He also reported that there was some marijuana in his system but he didn’t know what levels. Jake reported this is his first DUI.
Jake is the youngest child of 4. Jake denied having a significant other. He reported his parents were legally married but divorced when he was 13 years old following an incident of domestic violence. Jake became very teary at this point during the assessment. He then asked this writer if he had to answer questions about his family life. It was explained to Jake the importance of gathering family history. This writer offered to let him take a break but he wanted to continue. He then stated, “I think it broke everyone’s heart, especially my mother’s because even though they fought sometimes there was also a lot of love when my dad wasn’t drunk.” Jake reported his father was 10 years older than his mother and he used to drink heavily and “was a mean drunk” so would beat his mother and sometimes all the kids, “sometimes for no reason accept he was angry about life.” He reported that his mother is always there for him because he is the baby. He reported he knows he has been a big disappointment for his mother and his troubles make her worry. Jake reported his mother always allowed him to live with her but recently kicked him out because he would not get a job and would not stop using. She was concerned that he was sleeping most of the day, not doing anything to look for a job, doing drugs and drinking like his father when she has her grandkids at the house. Jake reported that his mother stays home and watches his sister Mandy’s kids all day while she is at work. He reports not feeling close to anyone in his family but his mother because his older siblings are “always on my case about how I am living my life.” He added, “They are always saying I am killing my mom.” According to Jake he has not seen his father since he was 14 years old. He stated once his mother and father divorced his dad remarried very quickly and the step mother does not like any of the father’s kids and they had two of their own, very close together right after they were married. Both of those half-siblings are now in high school and he has only met the oldest child once when she was a baby. Jake described his relationship with his family as “messed up.” Jake reported that he was sent to counseling as a teen when the school contacted his mother to report Jake was getting in trouble with teachers while in class, skipping classes, and appeared to be going “down the wrong road”. He reported that he thinks the counselor said he was depressed and had anxiety and they put him on some kind of drugs. He reported he took the drugs for only month but they made him feel “weird” so he stopped taking them.
Jake reported that he is currently homeless and has been for nearly a year since his mother kicked him out and he lost his last job. He stays with friends off and on but mostly lives out of his car.
He mostly “hangs out” with friends and drinks either at their house or at bars. When asked if he has a best friend, Jake reported yes, my friend Johnny. He reported he and Johnny have been friends since grade school. He reported that Johnny is a big drinker and he thinks Johnny probably has a drinking problem. When asked if what he thinks about his use of alcohol and drugs, he stated, “I know I do it more than I should but I don’t think I am addicted or anything. I can quit if I want to on my own.”
Jake currently drinks about once a week with about 4 drinks at a time, sometimes more if he is there for longer. He states he tried marijuana and he didn’t really like it at first. He said he would occasionally smoke weed with friends but not if alcohol was available. He said he currently only smokes marijuana when his pain is too much because it is the only thing he can use and still function okay. He reported that he probably smokes 10 bowls a day. The most he has ever smoked in one sitting was about 27 bowls in a day. He reports his last use of marijuana was about 2 weeks before the accident. Jake denies use of opioids in all forms. He reported he tried mushrooms once when he was about 17 and didn’t like them “because they didn’t do anything.” He reported trying cocaine for the first time in the past year when he was at a party and a friend had laid down 3 lines and encouraged him to try some. He reported he didn’t really like how it made him feel because it made him feel really “hyped up and anxious”. He stated he has never tried it again. However, the hospital discharge summary states that he had alcohol, marijuana and cocaine in his system. Jake states he can’t drink now since he has the DUI charges. He said he doesn’t think that will be a problem though. He reported he thinks it shouldn’t matter if he does drink since he doesn’t have a problem with drinking but that is the law.