Counselor Name: dh biggs Clients Name: Jack Smith A. SUBSTANCE ABUSE HISTORY A diagnostic summary was completed on 10/6/96; Jack Smith is a 41-year-old white male currently living in a small community in southern Ohio. Jack came into the agency involuntarily; his involvement with the agency is a requisite of probation for assault and domestic violence. He was arrested for assaulting his wife during an alcoholic blackout; he was placed on probation for one year on the condition he participates in substance abuse counseling. This is Jack's second involvement with this agency as a result of his alcohol abuse. His first encounter was in 1985, when he underwent after-care counseling with an agency counselor who no longer is employed at this facility. The apparent symptom's of chemical dependency were: 1) Loss of Control - Jack had made several attempts at controlling the amounts of alcohol he consumed, but those times when he was able to abstain from alcohol were when he substituted marijuana and / or other drugs.

2) Blackouts - these began occurring almost daily as a result of his alcohol and marijuana use. 3) Family History of Alcohol / Drug Usage - Jack's natural and adoptive parents, as well as three natural brothers and three natural sisters have used alcohol and / or drugs heavily. 4) Changes in Tolerance - when Jack began drinking at age 15, he soon developed a high tolerance for beer; by age 18, he was drinking six-to nine beers per occasion, and had begun smoking marijuana on these occasions. Before he stopped using marijuana in 1985, he was smoking one-two marijuana joints daily through the week, and five-six joints daily on weekends, as well as drinking the equivalent of a 12-pack of beer daily, occasionally chasing it with whiskey during the week, and on weekend, consuming the standard 12-pack of beer in addition to half of a fifth of whiskey mixed with soft drinks. 5) Physiological Symptomolog - Jack was diagnosed with bleeding ulcers shortly after he began drinking at age 15; when he entered his second treatment program in 1985, he was diagnosed with alcoholic hepatitis; currently, his flushed / tarnish -looking skin and bloated appearance (edema) are indicative of further liver dysfunctions which can be attributed to his continued alcohol consumption..