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After seeing Howard and performing the appropriate screening tools, and a urine drug screen, he admits to you that he does have a problem with opioids due to his back injury. He states he has been admitted to an inpatient detox and twenty-eight day rehabilitation unit previously and was able to quit using for 3 months, but relapsed due to his pain. He states for the last 6 months he has been unable to get opioids from physicians since there is a record of him being prescribed a large amount over a short period of time. Due to this, he has started buying heroin from an acquaintance who he went to high school with. His wife is very tearful and states she is concerned that eventually Howard will end up killing himself.

 
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