Gambling disorder and alcohol use disorder.

Given Mrs. Perez’s diagnosis of both gambling disorder and alcohol use disorder, it is important to create a comprehensive treatment plan that will address both issues simultaneously in order for her to develop lasting sobriety and also a healthy relationship with gambling. As such, I would suggest the following course of treatment:
Vivitrol (naltrexone) injection – 380 mg intramuscularly in the gluteal region every 4 weeks; this medication blocks opioid receptors which can reduce cravings for alcohol as well as gambling;
Antabuse (disulfiram) 250 mg orally daily; this medication produces an unpleasant reaction if drinking occurs which serves as a deterrent from drinking;
Campral (acamprosate) 666 mg orally three times/day; this acts to decrease withdrawal symptoms associated with cessation of drinking; and
Cognitive Behavioral Therapy, 1-2 sessions per week in order to help Mrs. Perez explore any underlying issues that may be contributing to her struggles with alcohol or gambling, provide further information on how addiction works, psychoeducation regarding managing one’s thoughts and feelings related to urges or cravings, methods for improving problem solving skills when faced with difficult situations or decisions involving substances or money management. By providing Mrs. Perez with medications plus CBT she should have some very concrete tools at her disposal to help manage symptoms in all areas so that she has more control over any future relapse attempts.