Assignment: Evaluating Substance Abuse Client Cases

Respond to two of your colleagues’ posts that posted to a different case study than you by: 

o   Extending your colleague’s Discussion with additional support for the factors that indicate the appropriateness of the medication

o   Providing a different perspective on the role of the mental health professional in monitoring side effects

o   Refuting the use of the selected medication and providing evidence to support your stance from the Learning Resources and other scholarly sources


Colleague 1: Kendra


he scenario that I chose is the case scenario of Angela. Angela is 41 years old and resides in Durham, NC.  Angela has been smoking cigarettes for as long as she can remember.  Angela’s friends have all quit smoking, but she has continued to smoke. Lately, Angela’s friends have quit coming around and she believes it’s because she continues to smoke.  Angela has decided that it is time for her to quit smoking. Despite her many years of smoking, Angela does not consider herself to be an addict.  She doesn’t consider herself to be an addict since she does not use drugs, drink alcohol, or take pills. Angela smokes on average two to three packs of cigarettes a day. Previously she tried to quit smoking by using the nicotine patch but was unsuccessful.  Since the nicotine patch was unsuccessful Angela is interested in cognitive behavioral treatment.  She has admitted that in order for her to quit she has to have her mind off of smoking and focused on quitting.  As Angela’s worker I would not recommend the nicotine patch since she has already tried it.

I would however recommend Nicotine Replacement Therapy also known as NRT.  NRT works by making it easier to abstain from tobacco by partially replacing the nicotine previously obtained from tobacco.  There are at least 3 mechanisms by which NRT could be effective: reducing general withdrawal symptoms, thus allowing people to learn to get by without cigarettes, reducing the reinforcing effects of tobacco-delivered nicotine, and exerting some psychological effects on mood and attention states.  According to Lande (2017), “Nicotine replacement medications should not be viewed as standalone medications that make people stop smoking; reassurance and guidance from health professionals are still critical for helping patients achieve and sustain abstinence.” Along with the NRT I would recommend a prescription of Varenicline tartrate (Chantix).  Chantix is a medication that recently received FDA approval for smoking cessation. This medication may help people quit by easing withdrawal symptoms and blocking the effects of nicotine if people resume smoking. Side effects of Angela being on Chantix include nausea, stomach pain, indigestion, constipation, gas, vomiting, headaches, weakness, and tiredness. According to Stoppler (2017), “Chantix is not addictive and is not a controlled substance; however, some patients may experience irritability and sleep disturbance if Chantix is abruptly discontinued. Patients may experience psychiatric symptoms such as behavioral changes, agitation, depressed mood, and suicidal behavior while using Chantix.”



Lande, G. (2017, June 27). Nicotine Addiction Treatment & Management. Retrieved July 25, 2017, from

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of clinical psychopharmacology for therapists (8th Ed.). Oakland, CA: New Harbinger. Chapter 14, “Substance-Related Disorders” (pp. 153-160).

Stoppler, M. (n.d.). Common Side Effects of Chantix (Varenicline) Drug Center. Retrieved July 25, 2017, from