Franklin/ Grand Isle
Community Addiction Workshops
Patient #1: Michael Test
May 24, 2020
Hx: Sept 24, 2019: This 26-year-old male is a high school graduate from MVU in Swanton, VT after being a highly regarded football player. After graduation Michael and his best friend joined the Air Force to become mechanics. After his 4 year service he returned home and was hired part-time as a mechanic for a regional airline working in Burlington VT. One year after starting his job he injured his back lifting heavy engine parts at his friend’s home garage. He was still under his father’s health insurance coverage and had an MRI that showed he had a herniated lumbar disc in his back. Michael was unable to continue his work as a mechanic, and found a job as a part-time manager at a local brewery. His primary care physician, Dr. Jones initiated physical therapy, placed Michael on Percocet opioid medication to help with his pain, and referred him to the Orthopedist, Dr. Bones.
Oct. 24 2019: Michael lifting some heavy kegs of beer at work and reinjured his back. He went to Dr. bones, the orthopedist, who ordered an MRI of his back. He was given a note to be off of work, referred to physical therapy, and given a prescription for a muscle relaxer and Dilaudid, a stronger opioid medication for pain. He is very limited in his activity and is basically at home, resting and using a cane when he needs to go out.
Jan. 24, 2020: Michael continues to have severe back pain that radiates down his right leg. He has had 2 injections with only temporary relief. The MRI of his lower back found that he has a herniated disc. He must use a cane to walk, and has not worked since his injury. Dr. Bones feels he may ultimately need surgery. Michael has needed to take extra pain meds, and Dr. Bones is concerned that he may be abusing his meds. Michael has even taken a few of his step mother’s pain meds that she keeps in the medicine cabinet at home without her knowing about it. Celeste has been laid off for the winter, and is no longer working. Celeste’s ex-boyfriend is not paying the child support as he is unemployed. At this point they are unable to afford the rent so Michael has asked his father, Harry to pay the rent until they are back to work. Michael celebrated his 27th birthday, and is no longer able to get health insurance coverage through his father. Harry noted he would pay for his health care for the time being. Michael is applying for Medicaid. Celeste found out in November that she is pregnant, and she has had a hard time with morning sickness. Further, Michael’s tooth is really starting to act up, and he has had to go to a dentist. Luckily his insurance covered about half of the cost, but he no longer has dental insurance coverage. He will need a root canal to save the tooth.
May 24, 2020: Michael has had surgery on his back, and continues to have pain. Dr. Bones continues to prescribe opiate pain meds, but is increasingly concerned that Michael is abusing his medications. Dr. Bones is referring Michael to the Pain Clinic in Burlington for help. Jerry, Michael’s friend from Boston, is visiting the area. At a recent party in Burlington, Michael was offered some heroin. Reluctantly, Michael snorted a few lines, and found that it relieved his back pain, and made him feel better than he has in many months. Celeste is now 7 months pregnant and is still unable to work. Money is getting tight and they have decided to sell Michael’s car, as they cannot afford the car payments and insurance. They still have Celeste’s car if needed, but they need to get tires soon as they have had 2 flat tires in the last month. Celeste’s parents live in Florida, and have not communicated with her since they found out about Celeste’s addiction to Vicodin years ago. Michael’s father, Harry is starting to have difficulty paying for their rent and other expenses. He also is starting to question Michael’s use of pain meds, as Shelly is suspecting that Michael is taking some of her pain medications as well. She has started to keep her meds in her purse to be safe. Michael’s tooth continues to act up, but he has already used up his yearly $300. dental allowance from Medicaid. He is glad that his dentist is prescribing some pain meds to cover his dental pain. His dentist is unaware of Michael receiving pain meds for his back.
BIO/ PSYCHO/ SOCIAL/ SPIRITUAL MATRIX
A. Required Program Elements:
* ALCOHOL / DRUG COUNSELING: Sept 24, 2019: He does not participate in any counseling at this time.
* URINE TESTING: Sept 24, 2019: No required testing at this time.
* PCP / MEDICAL / ED VISITS: Sept 24, 2019: His primary care physician is Dr. Jones. He has an appointment with the Orthopedic Specialist, Dr. Bone within the next 2 weeks to continue to evaluate his back pain.
Oct. 24, 2019: Michael lifting some heavy kegs of beer at work and reinjured his back. He went to Dr. Bones, the orthopedist, who ordered an MRI of his back. He was given a note to be off of work, referred to physical therapy, and given a prescription for a muscle relaxer and Dilaudid, a stronger opioid medication for pain. He is very limited in his activity, and is basically at home, resting, and using a cane when he needs to go out.
Jan. 24, 2020: Michael continues to have severe back pain that radiates down his right leg. He has had 2 injections with only temporary relief. The MRI of his lower back found that he has a herniated disc. He must use a cane to walk, and has not worked since his injury. Dr. Bones feels he may ultimately need surgery. Michael has needed to take extra pain meds, and Dr. Bones is concerned that he may be abusing his meds. Michael has even taken a few of his step mother’s pain meds that she keeps in the medicine cabinet at home without her knowing about it.
May 24, 2020: Michael has had surgery on his back, and continues to have pain. Dr. Bones continues to prescribe opiate pain meds, but is increasingly concerned that Michael is abusing his medications. Dr. Bones is referring Michael to the Pain Clinic in Burlington for help.
* VPMS: Sept 24, 2019: No irregularities were noted by Dr. Jones at
the time of prescribing Percocet opioid pain medication.
B. Priority Life Elements:
1. TRANSPORTATION: Sept 24, 2019: Owns his own car paying $215./mo in car payments. He currently has insurance coverage on his father’s policy. He has no SR 22 insurance requirements. Car is registered and he has an unrestricted license. His new 2016 Camero needs the brakes repaired and his muffler has a hole in it. His girlfriend, Celeste has a 2002 Toyota Camry that runs well, but needs new tires. She pays $80./mo. for insurance.
May 24, 2020: Money is getting tight and they have decided to sell Michael’s car, as they cannot afford the car payments and insurance. They still have Celeste’s car if needed, but they need to get tires soon as they have had 2 flat tires in the last month.
2. HOUSING: Sept 24, 2019: He recently moved out of his father’s place and moved into an apartment in Swanton with his girlfriend and her daughter. They are currently paying $800./mo for rent.
Oct. 24, 2019: Michael reinjured his back at work, and is longer to work. This has put more pressure on his girlfriend, Celeste to keep up with the rent, and other payments.
Jan. 24, 2020: At this point, they are unable to afford the rent so Michael has asked his father, Harry to pay the rent until they are back to work.
May 24, 2020: Michael’s father, Harry is starting to have difficulty paying for their rent and other expenses.
3. EMPLOYMENT: Sept 24, 2019: Michael is working as a PT manager at the Red Spruce Brewery in St. Albans. His girlfriend, Celeste works as a waitress at Pearl’s Restaurant in St. Albans.
Oct. 24, 2019: Michael reinjured his back lifting some heavy kegs at work. He is no longer able to work at the brewery for now. He has no income until he returns to work.
Jan. 24, 2020: The MRI of his lower back found that he has a herniated disc. He must use a cane to walk, and has not worked since his injury.
4. FINANCES: Sept 24, 2019: His finances are tight, but is helped by his girlfriend’s income and her child support payments.
Oct. 24, 2019: Michael reinjured his back lifting some heavy kegs at work. He is no longer able to work at the brewery for now. He has no income until he returns to work.
Jan. 24, 2020: Celeste has been laid off for the winter, and is no longer working. Celeste’s ex-boyfriend is not paying the child support as he is unemployed. At this point, they are unable to afford the rent so Michael has asked his father, Harry to pay the rent until they are back to work.
May 24, 2020: Money is getting tight and they have decided to sell Michael’s car, as they cannot afford the car payments and insurance.
5. RELATIONSHIPS: Sept 24, 2019: His father lives in Swanton VT. He is a part time manager at Barry’s Ice Cream factory in St. Albans. He gets along with his father very well, and is very supportive of him. His father remarried after his mother died of ovarian cancer about 3 years ago. His current mother in law is named Shelly and is supportive of him as well. She has chronic pain with her arthritis and is on anti inflammatory and pain meds for that. Shelly has a 17 year old daughter, Rebecca who is attending her senior year at MVU high school. He has a girlfriend named Celeste, who now lives with him in their new apartment. She has a history of severe opioid use and is currently in a Suboxone Treatment Program in St. Albans . Celeste has a 6 year old daughter named Zoie, and receives $130./mo. for child support. Zoie’s biological father is named Frank who lives in St. Albans, and is currently unemployed.
Oct. 24, 2019: Michael reinjured his back at work, and is longer to work. This has put more pressure on his girlfriend, Celeste to keep up with the rent, and other payments.
Jan. 24, 2020: Celeste has been laid off for the winter, and is no longer working. Celeste’s ex-boyfriend is not paying the child support as he is unemployed. At this point, they are unable to afford the rent so Michael has asked his father, Harry to pay the rent until they are back to work. Celeste found out in November that she is pregnant, and she has had a hard time with morning sickness.
May 24, 2020: Jerry, Michael’s friend from Boston, is visiting the area. At a recent party in Burlington, Michael was offered some heroin. Reluctantly, Michael snorted a few lines, and found that it relieved his back pain, and made him feel better than he has in many months. Celeste is now 7 months pregnant and is still unable to work. Celeste’s parents live in Florida, and have not communicated with her since they found out about Celeste’s addiction to Vicodin years ago. Michael’s father, Harry is starting to have difficulty paying for their rent and other expenses. He also is starting to question Michael’s use of pain meds, as Shelly is suspecting that Michael is taking some of her pain medications as well. She has started to keep her meds in her purse to be safe.
6. INSURANCE: Sept 24, 2019: He is currently covered by his father’s health insurance policy through his employment. He has car insurance as well and pays $110./mo.
Jan. 24, 2020: Michael celebrated his 27 th birthday, and is no longer able to get health insurance coverage through his father. Harry noted he would pay for his health care for the time being.
May 24, 2020: Michael’s tooth continues to act up, but he has already used up his yearly $300. dental allowance from Medicaid.
7. LEGAL / CRIMINAL JUSTICE STATUS / DCF: Sept 24, 2019: Both Michael and Celeste have no history or current relationship with the legal system at this time.
8. EDUCATION: Sept 24, 2019: He has a high school diploma and is currently interested in taking some small business classes part time at CCV in St. Albans.
9. DIET / FOOD / NUTRITION: Sept 24, 2019: They currently feel they have enough food, and do not require additional support.
10. CLOTHING: Sept 24, 2019: They currently feel they have enough clothing, and do not require additional support.
11. PERSONAL ACTIVITIES / EXERCISE / PLEASURE: Sept 24, 2019: Michael is currently limited in his activities due to back pain. He does enjoy going to auto races at Thunder Mountain race track in New York. He knows several drivers, and helps them prepare their cars for races.
12. MENTAL HEALTH STATUS / COUNSELING: Sept 24, 2019: He does not suffer from any mental health concerns at this time.
13. SPIRITUAL AFFILIATION / ACTIVITY: Sept 24, 2019: He was raised as a stout catholic but does not attend services with any regularity.
14. PROGRAM ACTIVITIES: Sept 24, 2019: He is not currently involved with any Addiction Treatment Programs.
15. DENTAL NEEDS: Sept 24, 2019: He has several cavities that need repair, however, does not have a current dentist.
Jan. 24, 2020: Michael celebrated his 27 th birthday, and is no longer able to get health insurance coverage through his father. Harry noted he would pay for his health care for the time being. Michael is applying for Medicaid. Michael’s tooth is really starting to act up, and he has had to go to a dentist. Luckily his insurance covered about half of the cost, but he no longer has dental insurance coverage. He will need a root canal to save the tooth.
May 24, 2020: Michael’s tooth continues to act up, but he has already used up his yearly $300. dental allowance from Medicaid. He is glad that his dentist is prescribing some pain meds to cover his dental pain. His dentist is unaware of Michael receiving pain meds for his back.