An 18-Year-Old Man Comes to the Office for a Follow-Up

An 18-year-old man comes to the office for a follow-up visit.  He was seen in the emergency department 3 months ago because of panic attacks related to cocaine use.  The patient subsequently stopped using cocaine and has had no recurrent anxiety symptoms.  He graduated from high school, started a new job, and has been considering applying to community college.  At today's visit, the patient reports that he used cocaine at a friend's house this past weekend.  He says, "I really messed up.  I feel like a failure."  The patient has no history of illness.  He is in no physical discomfort.  Which of the following is the most appropriate statement by the physician at this time?

A) "Do you think using cocaine again could have a negative impact on your job and going to college?"
B) "It's hard to quit.  Let's go over the health effects of cocaine to help motivate you to stay sober."
C) "Quitting is difficult, so don't be so hard on yourself.  Let's move forward from here."
D) "Socializing with your friend probably contributed to your relapse.  Let's look at strategies to deal with peer pressure."
E) "You've been making real progress in quitting.  What can we learn from this temporary setback?"

Correct Answer:

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