Blake is a 26 year old heroin addict. He has all the symptoms of withdrawal. He has a runny nose, stomach cramps, dilated pupils, muscle spasms, chills despite the warm weather, elevated heart rate and blood pressure, and is running a slight temperature. Aside from withdrawal symptoms, this man is in fairly good physical shape. He has no other adverse medical problem and no psychological problems. At first he is polite and even charming to you and the staff. He's hoping you can just give him some "meds" to tide him over until he can see his regular doctor. However, he becomes angry and threatening to you and the staff when you tell him you may not be able to comply with his wishes. He complains about the poor service he's been given because he's an addict. He wants a bed and "meds" and if you don't provide one for him you are forcing him to go out and steal and possibly hurt someone or he will probably just kill himself "because he can't go on any more in his present misery." He also tells you that he is truly ready to give up his addiction and turn his life around if he's just given a chance, some medication, and a bed for tonight.

-Do you believe that Blake is interested in remaining sober? Please explain your thoughts and provide examples.

-In thinking about the Stages of Change, where would you place Blake and why?

-What do you think as a human service provider you can do to help Blake "progress" through the NEXT stage?

-What do you think you can do to help Blake progress to the Termination stage in your work with him?