CARN case studies
CARN · Put your knowledge to work in context.
The Certified Addictions Registered Nurse (CARN) credential is a specialty certification for registered nurses who provide care to people with substance use disorders and co-occurring conditions. It signals that a nurse has moved beyond generalist practice into addictions nursing: assessment, withdrawal management, medication-assisted treatment, recovery support, and the ethical and legal frameworks that shape this work. The CARN case studies are 5 cases and about 2,746 words.
1The Tremulous Admission
A 41-year-old man with a 12-year history of daily alcohol use (approximately 1 pint of vodka plus 6 beers per day, last drink 14 hours ago) is brought to the emergency department by his brother. Vital signs: HR 118, BP 162/98, temperature 37.4 C, respirations 20, SpO2 96% on room air.
545 words, about 3 min2The Pain Contract Dilemma
A 34-year-old woman with opioid use disorder (fentanyl, intranasal, daily) has been stable on buprenorphine/naloxone 16/4 mg daily for 8 months, with negative urine screens for illicit opioids for 5 months. She presents after a motor vehicle collision with an acute distal radius fracture requiring surgical fixation.
513 words, about 3 min3The Adolescent in the Exam Room
A 16-year-old boy is brought by his mother to a community clinic after she found a vape pen and a small bag of what she believes is marijuana in his backpack. He is calm, denies any problem, and says the vape is 'just nicotine.' He asks that the visit be kept private from his father, who he says 'would lose it.' The mother insists on being in the room and wants to know 'everything.' The clinic is in a state where minors may consent to some behavioral health services but not to substance use treatment without parental consent.
592 words, about 3 min4The Methadone and Benzo Question
A 52-year-old man on methadone maintenance (110 mg daily, 3 years, stable, take-home privileges) presents to his primary care clinic with 6 weeks of worsening anxiety, poor sleep, and panic attacks. He has been drinking 'a few beers' most nights to sleep and has started borrowing a friend's alprazolam 'a couple times a week.' His urine screen is positive for benzodiazepines and alcohol metabolite.
578 words, about 3 min5The Rural Telehealth Gap
A rural county of 18,000 people has one primary care clinic, no psychiatrist, and no addiction specialist. The nearest detox facility is 90 minutes away; the nearest inpatient psychiatric bed is 3 hours away.
518 words, about 3 min