Substanceuse disorder is a medical condition in which the application of oneor more drugs leads to an impairment or distress that is clinicallysignificant. In some cases, the disorder is also known as drug usedisorder. Many people have misused drugs and as a consequence, theyhave developed this disorder. The disorder in DSM-5 combines thecategories of substance dependence and abuse into a unitary disordermeasured on a range from minor to severe. Each specific drug isaddressed as a distinct use disorder. An example of this is thestimulant use disorder and alcohol use disorder among others. Nevertheless, almost all substances are diagnosed basing on a similarpredominant criterion. The current paper seeks to explore on thedisorder majoring on the criticism directed to The Wolf of WallStreet basing on the memoirs of the actual life of Jordan Belfort.The brief moment of sobriety of Jordan is hardly figured as positive.

CaseStudy: Jordan Belfort, Wolf Of Wall-Street

JordanBelfort is a white male American citizen aged 57 years. He is afather of two children Chandler Belfort and Carter James Belfort whowas born with a hole in his heart. Belfort is married to Duchess. Hehas two residents, one on the 30thStreet Heliport in midtown Manhattan and the other one in OldBrookville, Long Island. He is a business person and initially owneda company that dealt with manufacturing, processing and supply ofmeat and sea foods. Mr. Belfort left this business to look foremployment after it closed down when he continuously incurred losses.The business had very many debts which made Belfort stressed andevasive. The business owed banks, and other financial service firmslike American Express. Many bills were on the neck of thisbusinessman including the NYNEX phone bills. Mr. Belfort was forcedto ditch this business for employment as a secretary in a brokeragecompany located in Wall Street on May 4 1987. He made great profitsin this company and rose through ranks to become a sales man. In thecourse of his day to day activities in Wall Street, he met Mr. MarkHanna who introduced him to the use of drugs like alcohol, tobaccoand cocaine. Belfort later left the company to start StrattonOakmont, his brokerage firm before he attained age thirty (Jordan,2007). He is diagnosed with serious back pains which may be anindication of DSM disorder. Availability of money, pressures fromhome and the surrounding environment were the major causes of drugaddiction and multi sexual activities that led to adverse effectslike loss of sexual urge and intensive back pains which made him toundergo back surgery on October 15 1995.

RecommendedTreatment Approaches

Patienthistory information indicates that Mr. Jordan Belfort is adverselyaddicted and affected by the use of cocaine, tobacco and alcohol.Anglis and Hser (1992) suggest that to effectively treat thispatient, a combination of interventions in a comprehensive treatmentframework shall be applied. Since drug addiction is abio-psychological disease, pharmacotherapy and psychologicaltreatments shall be used as discussed below.


Comprehensivetreatments for drug addiction particularly caused by intake ofalcohol, heroin and cocaine require the use of pharmacologic agents.In this case, agonists can be used as substitutes for abused drugsand substances to aid detoxification. In a similar way, thistreatment shall be used as an act of maintenance. The use ofmethadone is a good substitute for the use of cocaine. According toMorgensteern et al (2001), antagonists or partial agonists have thetendency of competing with abused drugs and substances preventing theinteraction of psychoactive substances when they come into contactwith receptors of nerve cells. For instance, naltrexone can be usedas an antagonist while buprenorphine can be used as a partial agonistfor alcohol, heroin and cocaine in the opioid receptors of the brain.The urge to consume drugs can also be prevented through the use ofaversive agents. Abuse (2010) explains that these substances bringunpleasant effects in their victims if they continue taking the drugwhile undergoing treatments. In situations where metabolism ofalcohol, cocaine and heroin goes to completion, disulfiram can beused. Anti-craving agents can then be recommended to cut down cravingfor drugs and substances. Some psychopharmacologic agents have theability to solve problems with both psychiatric and addiction roots. This addiction patient under consideration has a history ofunderutilizing pharmacotherapy. This could be attributed to the factthat Mr. Belfort has been experiencing traumatizing situations in hismarriage.

Drugaddiction patients are very sensitive to side effects brought bymedication. In most cases side effects have a resemblance of feelingswhich are uncomfortable especially during periods of withdrawal anddetoxification. For instance, antidepressants have a stimulating sideeffect which is a reminiscent of agitating psychomotor aspects andanxiety during withdrawal. According to Beatty and Tamara (2014),clinical physicians dealing with treatment must begin their patientswith lower doses then gradually increase these doses to therapeuticlevels. It is advisable to aim for maintenance doses that are lowerthan usual. In pharmacotherapy, it is at times important to employmultiple medications for patients with refractory dual diagnosis.Since recovering drug addicts are prone to serious consequences likeviolence and suicide, medical officers should be encouraged to usethe safest treatments on their availability to curb this problem.


Mchellan,Luborsky, Woody and O’Brien (1980) propose that patients of drugaddiction should be exposed to varied modalities of psychologicaltreatments. Modalities of treatment include individual, couples,family, group, couples, network and vocational therapies. Further, avariety of treatment approaches can be used for these modalities.These treatments include psychodynamic, cognitive, behavioral, andpsycho educational. The proposed programs are only fellowship innature and are not supposed to be used as formal treatments despitethe fact that they have good therapeutic effects. As a way ofensuring affectivity, interventions which are pharmacological innature are integrated with psychological treatments to have improvedoutcomes. Belfort should be put on recovery training self-help andmodified dynamic group therapy. These methods of treatment areconsidered to be more effective if they are to be compared to grouptreatment modalities.


Toeffectively treat Mr. Jordan Bretford, high priority evidence basedtreatment practices shall be put into consideration. This will be athree step process in a care continuum which will include screening,diagnosis and evaluation as the first step, continuous activetreatments which range from stabilizations, early recovery treatmentsand timely management of conditions like co-morbidities as the secondstep and a continuous engagement by each party concerned as a longterm care plan for this patient as the final step.

Step1. Screening

Thepatient will be screened to determine the level of alcohol abuse andmisuse using methods that are individual specific. According toHubbard, Mardsen and Racholl (1989), one effective way of doing thiswould be opportunistic screening which is greatly recommended forpatients who have periodically abused drugs in a continuous manner.In clinical settings, this practice this routine is so far known tobe less extensive.

Step2. Initial Brief Intervention

Ifthe patient’s results in step 1 are positive, he will be referredto a well-trained medic in this technique. This will include anevaluation follow up care with referrals to services of specialty.Mr. Belford will then be exposed to systematic monitoring activitiesas required.

Step3. Prescription for Treatment Services

Mr.Jordan Belford will be given a written dosing recommendation in whichhis plan for treatment shall be defined and described in an explicitway. This is an intensive process in which the assigned healthcareprovider will systematically reevaluate and match the problems of thepatient with services appropriate for his condition. If a need isidentified, the patient will be advised for a new prescription.

Step4. Psychosocial Intervention

Inthis step, the patient will be taken through motivational interviews,therapies of motivational enhancement, contingency management, atwelve step facilitation therapy and cognitive behavioral therapies.

Step5. Pharmacotherapy

Sincethe patient under consideration has a history of alcohol and opioiddependence, a pharmacotherapy which agrees with the prescribedpsychosocial treatments will be prescribed. This shall then befollowed with a comprehensive recovery management strategy in whichthe people surrounding the patient will be encouraged to support andmonitor his recovery. Other treatments that deal with back pains willalso be administered.


Abuse,S. (2010). Mental Health Services Administration. (2009). Resultsfrom the 2008 national survey on drug use and health: Nationalfindings.

Anglin,M. D., &amp Hser, Y. I. (1992). Drug abuse treatment. In Drugabuse treatment(pp. 1-36). Humana Press

Hubbard,L., Marsden, E., &amp Racholl, V. (1989). Drugabuse treatment.Chapel Hill: The Univ. of North Carolina press.

JordanB. (2007).The Wolf of Wall Street: Bibliography.Bantam Dell Publishers New York, New York

McLellan,A. T., Luborsky, L., Woody, G. E., &amp O`BRIEN, C. P. (1980). Animproved diagnostic evaluation instrument for substance abusepatients: The Addiction Severity Index. TheJournal of nervous and mental disease,168(1),26-33.

Morgenstern,J., Morgan, T. J., McCrady, B. S., Keller, D. S., &amp Carroll, K.M. (2001). Manual-guided cognitive-behavioral therapy training: Apromising method for disseminating empirically supported substanceabuse treatments to the practice community. Psychologyof Addictive Behaviors,15(2),83.