Reference no: EM133503790

Michelle is an 18-year-old Caucasian student completing her second semester of college. Throughout her life she has lived in a small rural town approximately 3 hours away from the university she attends. Going away to college was always a dream of hers, but she did not anticipate the lifestyle changes that came with moving away from the comforts of her hometown. Michelle is one of the only students from her high school to pursue a college education.

Michelle's father is a police officer and her mother is an elementary school teacher. She was raised with strict rules, to which she diligently adhered. She graduated as the valedictorian of her high school class last summer, and is described by those who know her as an "over-achiever." She received a full scholarship to her university upon graduation. Michelle has a younger brother, Michael, who she has a very close relationship with; however, since beginning college, making time to visit or video chat with each other has been difficult. Michelle feels somewhat disconnected from her friends from home, because she feels that they do not understand her goals for the future. Many of these friends have been starting families, and Michelle feels that she cannot relate.

Michelle is planning on double-majoring in Chemistry and Biology, and dreams of becoming a veterinarian in her home town. Michelle reported that she enjoyed the initial sense of freedom after moving away from the strict rules and routines of home life. While she was nervous about being away from home, she began to make new friends in her dorm, and became involved in many on-campus groups. Michelle began to experiment with alcohol at parties, and tried smoked marijuana once. Prior to these experiences, Michelle had never consumed alcohol other than when she was receiving Communion at her church.

Michelle's grades have begun to drop, and while she still maintains A's and B's, this is a marked difference from her usual academic performance. She has been missing classes more frequently due to feeling "hungover" or going to local bars to drink during the day, where she uses a fake driver's license to buy alcohol. Michelle has been visiting home less often, and her parents have become worried. They have even threatened to make Michelle drop-out of school "until she gets her act together." Michelle believes that her family is "trying to punish me for living my life and not doing what everybody expects me to do." She shared that she wants to drink more often to "stick it to them."

Michelle stated that she feels that she might have a problem with using alcohol, but is afraid that if she does not continue to drink she "won't have anything in common with my friends here and I will be too shy to talk with others at parties." She has decided to attend counseling at her university clinic after a Resident Assistant (RA) in her dorm approached her about having knowledge of alcohol in her room and her underage drinking. Michelle is worried that if she is reported for her alcohol use, she will lose her scholarship and be unable to continue attending the university. After talking with the RA, Lori, she found out that the two had much in common. Lori is also from a small town that coincidentally is not far from Michelle's hometown, and has offered to share rides to visit home.

Questions:

1. Based on the information provided, identify at least one biological, psychological, social, and sociocultural factor that may have contributed to Michelle's current substance use.

2. After having learned about the signs and symptoms of substance use disorders, do you believe Michelle has a substance use disorder? Explain why or why not.