Brief History and Identified Problem Sandra is a 32-year-old female of Caucasian descent. She has been using drugs and alcohol since the age of 15. She presents into inpatient rehabilitation appointed by court order after receiving a DUI (driving under the influence). She is in denial of needing any type of drug rehabilitation or treatment. She is an adult child of an alcoholic and has a limited family support system at this time. She will need detoxification from alcohol abuse and will need to attend 28 days of inpatient rehab. A full psychological evaluation will follow after detox to determine any potential dual dx. She will be referred to sober living after her first 28 days in inpatient Rehab. Out-patient detoxification with AA/NA,1;1, and family therapy will follow. Sandra grew up with parents who were preoccupied with their own lives. Although some of her basic needs like shelter, food, and education were provided, there was a lack of emotional and family support. Her parents were alcoholics so that by the time she was fourteen, she already had her first smoke and by the time she got a little older, she was drinking alcohol. Soon enough, friends and schoolmates have seen her hanging with a crowd that was involved in other substances, or drugs aside from cigarettes and alcohol. Before she was eighteen years old, Sandra left home and tried to live on her working on fast foods and whatever may come along. At the same time, she has stopped schooling but continued to hang around with the crowd that introduced her to vices. Sandra has had other interests in life, such as moving to a better neighborhood. She crashes in with her friends’ flat and would sometimes share with the rent. But as there are a lot of conflicts they have to address, such as overcrowding at some nights or days, Sandra would stay from one friend’s place to another until it has become a habit. However, her case has worsened when she was apprehended by the police for driving under the influence. She had been recommended for rehabilitation but right from the start, Sandra has refused and denied she ever needed one. There are several reasons why people like Sandra fell for abusing substances or drugs. It has been identified that her own family, specifically her parents were alcoholics. Alcohol is one of the more prevalent substances that are openly abused, or very acceptable in society, aside from nicotine or cigarette use. Other reasons include environmental influence, peer pressure, and the need to personally address conflicts. The American Psychiatric Association defined substance abuse as First, a maladaptive pattern of substance use that leads to clinical impairment or distress manifested by one of the following:   * Recurrent use of a substance that fails to fulfill obligations at work, school, or at home. In the case of Sandra, she has escaped or walked away from home as well as stopped schooling altogether. She has looked for ways to earn but this is to support her vice, and just to keep on living.   * Repeated substance use has become physically hazardous such as her being caught driving under the influence.   * Presence of substance-related legal problems or her arrest.   * Persistence of substance use despite the presence or repetition of social or interpersonal