Amelia has inadvertently overdosed on heroin two times this past year, has been fired from 2 jobs because she was too sick to come to work. She reports that she doesn't even feel high when she uses now and just uses heroin to feel normal. She is now selling her common household items for cash and occasionally trading sex for drugs or housing. She doesn't feel like she any friends or family she can lean on b/c she has burnt so many bridges. Amelia lost her dog and house to a kitchen fire last year because she left the house when she was high and did not realize she left the stove on. What is the current situation of Amelia?
1. Amelia is experiencing severe heroin use disorder with multiple negative consequences.
2. Amelia is displaying signs of chronic substance dependence.
3. Amelia is at high risk for substance abuse but does not meet the criteria for dependence.
4. Amelia is likely facing challenges but does not show clear signs of substance use disorder.