四周后，病人来进行第一次随访，并报告感觉良好。她也赞成注射后不喝酒，离开医院。她说她去赌博的冲动已经减少了，但她去的时候仍然在花很多钱。她似乎无法戒烟，这让她很担心。安定被确定为一个选择药物治疗酒精戒断,这是因为安定、利眠宁大的半衰期意味着他们可以工作天数治疗提供一个简单的路径没有反弹的迹象,如癫痫发作与后期经历了撤军(巴拉et al ., 2012)。将病人转诊给专门从事赌博的顾问是至关重要的，但目前时机还不成熟。她仍然需要处理她的焦虑和烟瘾。她担心的任何恶化都可能导致她赌博或饮酒的增加。Chantix可以帮助戒烟，但解决她的焦虑是重要的，因为这可能是她吸烟的原因。我的计划是让病人继续使用目前的剂量，目标是在两周内停止使用，因为病人不再出现早期症状。即使客户继续要求增加安定，我认为这在目前是不合适的。安定通常被认为是安全的，但如果滥用就会有害。这里的考虑是，患者有药物滥用史。安定的即时作用使它有价值的使用，为医生短期使用和作为PRN。随着她症状的减轻，由于她的赌球问题，我支持心理治疗。我也会选择让病人服用他目前的剂量，因为安定不被认可长期使用，因为有滥用的倾向。长期使用安定会导致化学依赖和成瘾。
After four weeks the patient comes for her first follow up appointment and reports feeling alright. She also endorses not drinking since getting the injection and leaving the hospital. She reports her urge to go gambling has decreased but she is still spending and lot of money when she goes. She cannot seem to stop smoking which is worrisome to her. Valium is identified as one of the chosen drugs for treating alcohol withdrawal, this is because diazepam and chlordiazepoxide have greater half-life meaning they can work for a number of days providing an easy path of treatment free from rebound signs such as seizures that is experienced with late withdrawal (Bharadwaj et al., 2012). It is vital that the patient be referred to a counselor that specializes in gambling,but the time is not right currently. She still needs to deal with her anxiety and smoke addiction. Any worsening of her concern may result in an increase in her betting or alcohol consumption. Chantix can be helpful in the treatment of smoking cessation, but addressing her anxiety is important as this may be the reason for her smoking.My plan is to continue the patient on her present dose, with the aim of discontinuing it in 2 weeks, since the patient was no more showing her earlier symptoms. Even though the client continues to ask for increased Valium, I do not think that this will be appropriate currently. Valium is seen as being usually safe when taken as prescribed for the treatment of a disorder but becomes harmful if it is abused. The consideration here is that patient has a history of substance abuse. Valium’s immediate effect action makes it valuable to use by the doctors, for short-term use and as PRN. With the decrease of her symptoms I would endorse psychotherapy because of her betting problems. I will also choose to keep patient on his present dose since Valium is not endorsed for long-term use because of the tendency of abuse. The use of valium on long term bases can result in chemical dependency and, addiction .