Substance-related and addictive disorders

A 17-year-old girl asks for help to stop vaping. She has used a disposable device every day for two years, now wakes at night to use it, and has failed three at…

Pre-internship · middle twist

A 34-year-old man who came to Australia from Somalia six years ago is reviewed by his general practitioner for a depressive episode. After eight weeks of sertra…

Pre-internship · niche

A 19-year-old man is admitted with a four-week history of persecutory beliefs and voices commenting on his actions. He has used methamphetamine most days for a…

Clinical rotations · middle twist

A 24-year-old man is brought to the emergency department at 2 am by police. He has been using methamphetamine for three days, and is pacing, sweating and shouti…

Pre-internship · middle twist

A 19-year-old man is brought to the emergency department by friends two hours after a party. He is frightened, is convinced the other guests were laughing at hi…

Clinical rotations · common

A 63-year-old woman has taken slow-release morphine for eighteen months for pain from vertebral metastases, prescribed and reviewed monthly by her oncologist. S…

Pre-internship · niche

A 68-year-old woman is admitted after a fall at home. She says she takes 'a sleeping tablet now and then' and drinks 'a small sherry before bed'. Her speech is…

Clinical rotations · middle twist

A 27-year-old man attends a community drug and alcohol service at 9 am asking to start buprenorphine. He has injected heroin daily for four years and last injec…

Pre-internship · middle twist

A 41-year-old woman stabilised on methadone 80 mg daily for opioid dependence has had open reduction and internal fixation of an ankle fracture. Four hours late…

Pre-internship · middle twist

A 29-year-old man who has injected heroin daily for six years has completed a seven-day inpatient withdrawal. He is medically well and has declined both methado…

Pre-internship · middle twist

A general practitioner in a regional town is asked to run a drug and alcohol education session at the local secondary school. Media coverage over the past year…

Clinical rotations · common

A 29-year-old man presents two days after running out of prescribed oxycodone, which he had been taking in increasing amounts for a year. He is yawning, restles…

Clinical rotations · common

A 34-year-old woman presents with anxiety, poor sleep, nausea and a sense that people are watching her. She stopped taking alprazolam 72 hours ago after using 6…

Clinical rotations · common

A 27-year-old man with no previous psychiatric history is brought to hospital by his family after two weeks of little sleep, expansive business plans and increa…

Clinical rotations · common