Fran S. was arrested for prescription fraud when she tried to obtain prescription painkillers at a pharmacy with a fake prescription. You have been asked to assess her situation and make treatment recommendations to the court.
Fran S. is a 32-year-old employee at a local bank. She was briefly hospitalized after a car accident 14 months ago and sustained injuries to her neck and back. Her doctor prescribed painkillers for these injuries. He told her that she should only take the painkillers for a few months, but Fran found that she liked the feelings of calm and relaxation that the painkillers produced. Even though the pain from her neck and back went away, she kept telling her doctor that she was in pain so that he would continue prescribing the drugs. When her own doctor told her that he would no longer prescribe the painkillers for her, she found it difficult to go for more than a few days without the painkillers (she reported feeling anxious, irritable, and “not herself” when she stopped taking them) and found another doctor who would prescribe her painkillers.
Fran told herself that the painkillers helped her get through her day, but she started missing deadlines at work and repeatedly coming in late, putting her job in jeopardy. Her husband also reported a difference in her behavior, saying that she was detached, much more irritable and likely to start arguments over minor issues, which had not been a problem in the past. Fran started taking larger doses of the painkillers because she had stopped feeling their effects at the smaller doses. Her second doctor became suspicious of how frequently she needed prescriptions and refused to prescribe her any more drugs. Fran tried again to stop using the painkillers but found that she was experiencing problems, such as headaches, blurred vision, and anxiety, when she was not taking the painkillers. She could not find another doctor to prescribe her the painkillers, so Fran started submitting fake prescriptions to the pharmacy.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) lists the criteria for assessing whether a person has a substance use disorder, which it divides into three levels of severity: mild, moderate, or severe. Use your available resources to research the DSM-5 criteria for this disorder.
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