| Course | PA 505 Behavioral Medicine I |
|---|---|
| Week | 6 |
| Paper type | Substance use history brief |
| Length | About 830 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 505 Week 6
Substance Use History Brief: Whiskey by the Glass, a Caffeine Headache Tablet by the Day and a Spouse's Leftover Pain Pills, Asked One Substance at a Time
Student Name
Chamberlain University
PA 505: Behavioral Medicine I
Instructor Name
Month Day, Year
Substance Use History Brief: Whiskey by the Glass, a Caffeine Headache Tablet by the Day and a Spouse's Leftover Pain Pills, Asked One Substance at a Time
Purpose and Setting
This brief sets out the substance use questions for W.T.'s third clinic visit, a week after discharge from the hospital stay for pneumonia and delirium. Each question is written as I would say it, with the shape of a recordable answer beside it. The aim is a history that a second clinician could read three weeks later and use, which means numbers, units, dates and routes rather than words such as "social" or "some."
The Screening Questions First
Alcohol: "How many times in the past year have you had four or more drinks in one day?" Answer shape: a number of days. The federal alcohol research institute recommends this one question; in a primary care validation it was about 82% sensitive and 79% specific for unhealthy alcohol use, with five as the threshold for men and four for women (Smith et al., 2009). For a patient of 68, the clinic uses four, the lower figure.
Other drugs: "How many times in the past year have you used a street drug, or a prescription medicine in a way it was not prescribed?" Answer shape: a number. The single question was fully sensitive for a drug use disorder in its validation sample (Smith et al., 2010). I ask it about prescriptions as much as street drugs, because that is where this patient's risk sits.
One Substance at a Time
Alcohol, in detail. "On a usual evening, what do you drink, and in what glass?" Answer shape: type, glass size, number poured. W.T. answered at the second visit, "Whiskey and water, the tall glass, three, sometimes four." "When did you last have a drink?" Answer shape: a date and time. In the hospital this answer, Saturday evening, set the window for possible withdrawal. "Has anyone told you that you drink too much, or have you tried to cut down?" Answer shape: yes or no, with who and when.
Tobacco. "Do you use tobacco in any form, including chew?" Answer shape: product and amount per week. W.T. uses about one can of moist snuff a week, unchanged for forty years.
Cannabis. "Have you used marijuana in any form, including edibles or oils from a store?" Answer shape: product, route, days per month. Asked separately because the state permits adult sales and patients often do not count store products as drugs.
Caffeine. "How many cups of coffee or cans of soda in a day?" Answer shape: a number and a cup size.
The Over-the-Counter Pass
"What do you take for the headaches, and can you show me the bottle?" Answer shape: product name, tablets per dose, days per month. W.T. brought a bottle of a combination tablet with acetaminophen, aspirin and caffeine and said two tablets "most mornings," which the headache calendar later put at 18 days in the last month. Regular use of a combination analgesic on 10 or more days a month for more than three months is part of the international criteria for medication-overuse headache (Headache Classification Committee of the International Headache Society, 2018), so the count of days is the number that matters. "Anything else from the store, for sleep, colds or your stomach?" Answer shape: product and frequency.
The Prescribed Pass
"Which medicines do you have a prescription for, and how do you take each one?" Answer shape: name, dose, how often, missed doses. W.T. takes lisinopril each morning. Then the question patients rarely expect: "Are there any medicines in the house that were prescribed for someone else?" W.T. said there was "a bottle of her pain pills, the hydrocodone, about half full," left from the spouse's last months, and that two had been taken "for my back, in the summer." The state's prescription monitoring report shows the bottle as the spouse's, filled in November, and no controlled prescriptions in W.T.'s own name.
Keeping the Attribution
Every answer above is recorded as W.T.'s report, in W.T.'s words where possible, except the pharmacy record, which is recorded as the monitoring report, and the day count, which is recorded as the calendar. The brief does not turn "three, sometimes four" into "four drinks nightly" or into "moderate use." A later reader needs to know which numbers came from the patient, which from a record and which from a calendar the patient kept.
What the Brief Leaves for Later
The brief gathers the history. Whether the drinking meets criteria for a disorder, and what to do about the tablets and the leftover pills, are questions for the assessment and plan, and are not answered here.
References
Headache Classification Committee of the International Headache Society. (2018). The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 38(1), 1-211. https://doi.org/10.1177/0333102417738202
Smith, P. C., Schmidt, S. M., Allensworth-Davies, D., & Saitz, R. (2009). Primary care validation of a single-question alcohol screening test. Journal of General Internal Medicine, 24(7), 783-788. https://doi.org/10.1007/s11606-009-0928-6
Smith, P. C., Schmidt, S. M., Allensworth-Davies, D., & Saitz, R. (2010). A single-question screening test for drug use in primary care. Archives of Internal Medicine, 170(13), 1155-1160. https://doi.org/10.1001/archinternmed.2010.140
PA 505 Week 6 instructions, in plain terms
Week six asks for a brief that sets out how you would take a substance use history from the patient in your case. Write each question as you would say it aloud, and beside it give the shape of a recordable answer: a number with a unit, a time since last use, a route, a year the pattern began. Cover substances one at a time rather than with one question about drugs in general. Include alcohol, tobacco, cannabis and other drugs, and give over-the-counter products and prescribed medicines their own passes, including medicines prescribed to someone else. Ask when each substance was last used. Use validated screening questions where they exist, with sources. Keep the patient's report labeled as report and records labeled as records. Do not diagnose or plan treatment in the brief.
How this PA 505 Week 6 example is built
The brief is set at W.T.'s third clinic visit, a week after the hospital stay. It opens with the single alcohol question about days with four or more drinks, with the validation figures, and the single question about drugs and prescriptions used other than as prescribed. Alcohol is then taken in detail: what is poured, in which glass, how many, and when the last drink was, a time that mattered in hospital. Moist snuff, store cannabis and coffee each get their own question. The over-the-counter pass asks to see the headache bottle and records 18 days of use in a month, the number the medication-overuse criteria use. The prescribed pass asks about medicines in the house prescribed to someone else, which brings out the spouse's half bottle of hydrocodone, checked against the monitoring report. A final section labels every answer by its source.
PA 505 Week 6 rubric: what full points look like
A brief comes apart first when its questions produce answers nobody can write down: asking how much someone drinks invites a word, and a word does not survive a second clinician reading it weeks later. Next comes a single question standing in for a whole history, which lets a patient answer honestly about one substance and leave out the rest. Further deductions follow for questions that suggest a quantity, so the answer echoes the number offered; for prescribed and over-the-counter medicines left out; for no question about when each substance was last used; and for patient report rewritten as fact. Strong briefs pair each spoken question with an answer shape, take substances one at a time, include store products and other people's prescriptions, use validated screening questions with sources and keep attribution throughout. A brief that slides into diagnosis or treatment loses points for scope.
PA 505 Week 6 help from the desk
Substance histories are often thin because the questions are too broad or too polite to produce a usable answer. With your case in hand, we can draft each question the way you would say it, attach the answer shape a later reader needs and decide the order that works for your patient. We can also help you add the passes students often miss, such as store products, caffeine and medicines prescribed to someone else in the household. Citing the validated single screening questions accurately, with their figures, is another part we can help with. Keeping report, record and calendar data labeled separately makes the brief trustworthy. The questions and their wording remain yours to adapt. If your section uses a set instrument, such as the AUDIT-C or the TAPS tool, the custom sample builds the brief around it.
Get a PA-505 Week 6 example written to your instructions
Send the assignment, the rubric, the setting your section names and any structured history it requires, because a brief written for an urgent care desk and one written for a scheduled visit share very little wording. A custom PA-505 Week 6 brief is written to those and returned inside 24-48h, with the first one free.
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PA 505 Week 6 questions, answered
The person is going to under-report. Does the brief pretend otherwise?
No, and pretending is what costs marks. A brief can say plainly that these figures are what was reported today, in this room, to somebody the person had just met, and that the numbers are a floor rather than a measurement. What it cannot do is adjust the answers upward on suspicion, which puts an invented number into a record under the writer's own authority.
Where do questions about consequences belong?
After the pattern, not before it. Asking what has gone wrong before establishing what is actually being used produces answers with nothing to attach them to, and it sets a tone that shortens every reply afterward. Keep consequences in the person's own words, attribute them, and resist converting a described argument or a missed shift into a category the record cannot support.
Can the brief say what should happen after a positive history?
One line naming that a fuller assessment follows is usually safe. Anything past that, an approach, an interval, a threshold for acting, belongs to the second behavioral course and earns nothing in this rubric. Where your section has actually set that component, send the wording it issued and that part is drafted separately rather than folded into this brief.
Where can I find a free PA 505 Week 6 sample paper?
You can read a complete PA 505 Week 6 substance use history brief, with each spoken question and its answer shape, on this page.
Why does the PA 505 Week 6 sample ask about medicines prescribed to someone else?
Because leftover prescriptions in the home are a common source of misuse; here the question brought out a spouse's half bottle of hydrocodone.