Case Study 2

Joseph is a 55-year-old First Nations man on Ontario Disability Support Program due to a physical back injury in the factory he worked in. Despite his injury, he still receives work health benefits and is able to perform some amount of activities of daily living. Due to his chronic back pain, his doctor has prescribed Oxycodone which he uses occasionally (prn), as prescribed. However, he also uses marijuana daily because it makes him feel more in control. He is recently divorced, lives alone and is finding it hard to cope with this loss. Joseph presents at the clinic reporting of increasing pain. During your conversation you discover that he is gradually increasing the amount of marijuana he is using to combat his pain and feelings of isolation.

Student questions:

• What are your next steps with Joseph?
• How would you conduct a motiva-tional interview?
• What do you suggest talking about with Joseph at his next appointment?
• What strategies could you provide that would support a recovery oriented approach?
• What strategies could you provide that assist with harm reduction?

Educator elaborations

Change the ethnicity of Joseph and layer in cultural nuances. Pose questions that teach cultural competency.

Discussion Topics

• Culture and diversity as it relates to mental health
• The relationship between addiction and mental health
• Grief and loss