PS511 Unit 9 Cannabis Use Disorder Case Study Example

Every Night Since Senior Year: A PS511 Unit 9 Case Study on Cannabis Use Disorder in a Young Adult Apprentice

[Student Name]

Purdue University Global

PS511: Chemical and Psychological Dependency Counseling

Unit 9 Cannabis Use Disorder Case Study

[Instructor Name]

[Date]

The client, his family, the clinic and every detail of the case are composite and illustrative; the sources cited are real.

Presenting Problem

Tyler is 20 and in the second year of an electrical apprenticeship with a union local that serves the mines and power plants of the Range. Minnesota legalized recreational cannabis for adults 21 and older in 2023, but Tyler is under 21, and the apprenticeship requires drug-free tests for work on industrial sites. A random test in January was positive, and Tyler was suspended from site work for sixty days with a requirement to complete an assessment and follow its recommendations. His mother drove him to intake.

History

Tyler began using cannabis at 15 with friends on weekends, and by his senior year was smoking every night "to fall asleep." He now uses high-potency vape cartridges and flower several times a day, including in his truck before shifts at a part-time job. He has tried to stop twice, once for a hockey tournament and once after the positive test, and each time spent days snapping at his mother, lying awake, skipping meals and waking from strange, vivid dreams. He failed two classes at the technical college before the apprenticeship began and says, "I can't remember things like I used to." He no longer plays in the men's hockey league he joined after high school.

Diagnosis Against the Manual

Cannabis is judged by the manual's standard list of eleven problems (American Psychiatric Association, 2022). Tyler's history supports using more than intended, especially on weekends (1); two failed attempts to stop (2); craving at night (4); failing two classes (5); giving up the hockey league (7); use before driving (8); tolerance, since he now needs stronger products for the same effect (10); and withdrawal, marked by irritability, poor sleep, low appetite and vivid dreams (11). That is eight criteria.

Diagnosis: cannabis use disorder, severe. The memory complaints should be noted but not attributed to cannabis without further assessment, since poor sleep and low mood can also affect memory.

What the Evidence Says About Risk

Volkow et al. (2014) summarized what research shows about harm from cannabis. Their estimate put the addiction rate near one user in eleven overall, about one in six for those who began as teenagers and between one in four and one in two for daily users. Regular use that begins in adolescence was linked to worse outcomes, including changes in brain development, poorer educational outcomes and, in some studies, lasting effects on cognition. The authors noted that much of the evidence is correlational and that products have become far more potent than those used in earlier studies.

Tyler fits several of these risk markers: early start, daily use and high-potency products. That information is useful for him to hear, but it is not a reason for scare tactics.

Tyler did not need to hear that cannabis is dangerous; he needed to see how it was already costing him the trade he wanted.

What the Evidence Says About Treatment

Gates et al. (2016) pooled the controlled trials of talk-based treatment for problem cannabis use. The strongest results came from two approaches, used alone or together: skills-based CBT and the brief, feedback-driven motivational enhancement format. Both lowered how often people used and how dependent they were at the early follow-ups, and a few trials did better still when vouchers for clean tests were added. They also found that few participants reached lasting abstinence and that more intensive treatment, with more sessions, tended to produce better outcomes than brief treatment.

Treatment Plan

Tyler's plan combines motivational enhancement with cognitive behavioral therapy over twelve weekly sessions. The first two sessions use motivational interviewing to explore what Tyler wants from the apprenticeship and how cannabis fits with it. In intake he said his goal was to "get back on site and be a journeyman by twenty-four," and that goal will anchor the plan.

Sessions three to ten use cognitive behavioral strategies: tracking use and triggers, which for Tyler are bedtime, boredom after work and driving with friends; planning alternatives, such as a sleep routine and rejoining the hockey league; and practicing ways to refuse offers from friends who still use. Withdrawal and sleep problems will be explained in advance so they are not mistaken for a reason to restart. A referral to his doctor will address sleep, and the memory complaints will be rechecked after six weeks without cannabis.

The apprenticeship requires a negative test to return to site work. Weekly urine tests will track progress, and with Tyler's consent the clinic will report completion of assessment and attendance to the union, as his agreement requires.

Family Involvement

Tyler lives with his mother, who is worried and has searched his room twice. One joint session will set boundaries: she will stop searching, and Tyler will keep no cannabis or vapes in the house during treatment.

Legal and Ethical Context

Tyler's case sits at an awkward point in Minnesota law. Cannabis is legal for adults 21 and older, so many of his friends use openly and in a year Tyler will be legally allowed to buy it. That makes the case for change rest on Tyler's own goals rather than on the law. It also means the long-term goal is a decision for Tyler to make: abstinence while on industrial sites is required by the apprenticeship, but whether he uses at all after 21 is his choice. I told him plainly that my role is to help him reach the goals he sets, not to enforce his mother's or the union's.

The union's agreement also raises questions of confidentiality. Tyler signed a consent allowing the clinic to report attendance and completion to the apprenticeship coordinator, and nothing else. What Tyler says in sessions about friends, driving or other drugs stays in the clinic, except where the law requires otherwise, such as a serious threat to someone's safety. Tyler said that knowing this made him willing to talk about using before driving, which he had not mentioned at intake.

Goals

Within two weeks, Tyler sets a quit date and removes products from his truck and room. Within six weeks, weekly tests show falling levels, and he reports sleeping at least six hours most nights. By the end of the sixty-day suspension, he has a negative test and returns to site work. Within three months, he has rejoined the hockey league.

Conclusion

Tyler's history meets eight DSM-5-TR criteria for a severe cannabis use disorder, and his early start, daily use and high-potency products match the risk markers Volkow and colleagues describe. Gates and colleagues' review supports a combined motivational and cognitive behavioral plan of moderate length, and anchoring that plan to Tyler's goal of becoming a journeyman electrician gives it a reason that belongs to him.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Gates, P. J., Sabioni, P., Copeland, J., Le Foll, B., & Gowing, L. (2016). Psychosocial interventions for cannabis use disorder. Cochrane Database of Systematic Reviews, 2016(5), Article CD005336. https://doi.org/10.1002/14651858.CD005336.pub4

Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. B. (2014). Adverse health effects of marijuana use. New England Journal of Medicine, 370(23), 2219-2227. https://doi.org/10.1056/NEJMra1402309