A nurse is caring for a client who reports frequent social use of alcohol. The client tells the nurse that they have been reprimanded at work for being late several times after they had been out late drinking. Which of the following statements by the client might indicate that the client has developed a substance use disorder?

A. Impaired ability to regulate body temperature: This condition is not characterized by jerking movements and twitching of the face and tongue. Impaired temperature regulation is more associated with conditions like neuroleptic malignant syndrome but does not specifically relate to the movements described.
B. Neuroleptic malignant syndrome: Neuroleptic malignant syndrome is a serious and potentially life-threatening condition that includes symptoms such as muscle rigidity, fever, autonomic instability, and altered mental status. While it can occur in patients taking antipsychotic medications, the movements described do not fit this diagnosis.
C. Extrapyramidal symptoms: Extrapyramidal symptoms (EPS) refer to a range of movement disorders caused by antipsychotic medications, including tremors, rigidity, and bradykinesia. However, the specific symptoms of jerking movements and twitching of the face and tongue are more characteristic of tardive dyskinesia rather than general EPS.
D. Tardive dyskinesia: Tardive dyskinesia is a condition often seen in individuals taking first-generation antipsychotic medications for an extended period. It is characterized by involuntary, repetitive movements, particularly in the face, tongue, and extremities. The client's symptoms of jerking movements and twitching align with this diagnosis.

A. To treat pain and ease anxiety: The client has a history of chronic back pain due to a gymnastics injury and a previous diagnosis of anxiety. It is common for individuals with chronic pain conditions to be prescribed opioids for pain relief. Additionally, those experiencing anxiety may misuse opioids to self-medicate and achieve temporary relief from their symptoms, leading to the development of an opioid use disorder.
B. To promote sleep and rest: While some individuals may use opioids in an attempt to promote sleep, this option does not directly address the client's specific history of chronic pain and anxiety. It is less likely to be a primary reason for starting opioid use compared to treating pain and anxiety.
C. Because they witnessed their parents using drugs or alcohol to cope: Although witnessing parental substance use can influence a person's behavior, there is no indication in the provided information that the client has this background. Therefore, this is not a clear underlying reason for the client's opioid use.
D. To treat hallucinations and perform better at work: There is no mention of the client experiencing hallucinations, and the context suggests that the client is struggling academically rather than seeking to perform better at work. This option does not align with the client's situation or history.