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36-year-old male presents with insomnia

History of present illness: A 36-year-old male patient presents today for assistance with insomnia that began two years ago when he was in the middle of a divorce, but has recently worsened. He notes that he has had a lot of personal tragedy in the past two years that he reports have made him feel depressed and anxious. The patient's brother died a month ago. He was recently hospitalized for a pulmonary embolism. He is not currently in therapy because he reports that he cannot currently afford it.

Social history: Patient reports he has been prone to drinking too much but says he "has it under control." He notes a history of alcoholism in his family. His recently deceased brother died of organ failure secondary to alcoholic liver disease. He smokes marijuana once a week and takes LSD every few months. He smokes a pack of cigarettes a week. He works part-time remotely for a digital agency. He has been splitting his time between living with his sister and living with his aunt.

Medications: None.

Allergies: None.

1. What treatment(s) would you offer to this patient?

2. Do you consider this patient to have a predisposition to substance abuse? How do you factor this in to your diagnosis and prescription?