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27 Cards in this Set

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Substance Dependence Criteria?

Polysubstance Dependence Criteria?
The 3 or more sxs in past 12mon period:
- tolerance
- withdrawal
- progression in amount
- taking substances over a longer period than intended
- desire to reduce
- spending a great deal of time obtaining the substance
- impairment in social, interpersonal,or occupational functioning
-continued use despite consequences

- 3+ groups (eg opiod, sedative) w/ none predominating.
Substance Abuse Criteria? (4)
1+ over a 12 mon period
- failure to fulfill obligations
- repeated use in physically hazardous situations.
-mulitple legal problems
-recurrent social and interpersonal problems

Substance never met crit for SD.
What is the life time prevalaence of alcohol dependence?

What is the prevalence at any given point in time?

Male to Female?
-15%

- 5%

-5:1,

18 to 24 years is the highest prevalency
Race/ethnicity in alcohol dependence
equal in black and white
- Latin: higher in males, lower in L females
- lowest in Asians
- highest in Native Americans
What are the six specifiers for Substance Dependence?
1. Early Full Remission
2. Early Partial Remission
3. Sustained Full Remission
4. Sustained Partial Remission
5. On Agonist Therapy
6. In a Controlled Environment
What is meant by the Substance Dependence Specifier:

Early Full Remission?
1+ month, but >12 months w/ no criteria for Dependence or Abuse being met.
What is meant by the Substance Dependence Specifier:

Early Partial Remission?
1+ month, but >12 months w/ 1+ but not 3 criteria for Dependence or Abuse being met.
What is meant by the Substance Dependence Specifier:

Sustained Full Remission?
12+ months w/ no criteria for Dependence or Abuse being met.
What is meant by the Substance Dependence Specifier:

Sustained Partial Remission?
12+ months w/ 1+ but not 3 criteria for Dependence or Abuse being met.
What is meant by the Substance Dependence Specifier:

On Agonist Therapy?
individual is on a prescribed agonist medication, and no criteria for Dependence or Abuse have been met for that class of medication for at least the past month (except tolerance to, or withdrawal from, the agonist). This category also applies to those being treated for Dependence using a partial agonist or an agonist/antagonist.
What is meant by the Substance Dependence Specifier:

In a Controlled Environment?
individual is in an environment where access to alcohol and controlled substances is restricted, and no criteria for Dependence or Abuse have been met for at least the past month. Examples of these environments are closely supervised and substance-free jails, therapeutic communities, or locked hospital units.
Diagnostic Criteria for Alcohol Intoxication?
B. inappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social or occupational functioning

C. One (or more) of the following signs, developing during, or shortly after, alcohol use:
(1) slurred speech
(2) incoordination
(3) unsteady gait
(4) nystagmus
(5) impairment in attention or memory
(6) stupor or coma
Diagnostic Criteria for Alcohol Withdrawal?
B. Two (or more) of the following, developing within several hours to a few days after Criterion A:
(1) autonomic hyperactivity (e.g., sweating or pulse rate greater than 100)
(2) increased hand tremor
(3) insomnia
(4) nausea or vomiting
(5) transient visual, tactile, or auditory hallucinations or illusions
(6) psychomotor agitation
(7) anxiety
(8) grand mal seizures
Diagnostic Criteria for Amphetamine Intoxication?
B. euphoria or affective blunting; changes in sociability; hypervigilance; interpersonal sensitivity; anxiety, tension, or anger; stereotyped behaviors; impaired judgment; or impaired social or occupational functioning

C. Two (or more) of the following, developing during, or shortly after, use of amphetamine or a related substance:

(1) tachycardia or bradycardia
(2) pupillary dilation
(3) elevated or lowered blood pressure
(4) perspiration or chills
(5) nausea or vomiting
(6) evidence of weight loss
(7) psychomotor agitation or retardation
(8) muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias
(9) confusion, seizures, dyskinesias, dystonias, or coma
Diagnostic Criteria for Amphetamine Withdrawal?
B. Dysphoric mood and two (or more) of the following physiological changes, developing within a few hours to several days after Criterion A:

(1) fatigue
(2) vivid, unpleasant dreams
(3) Insomnia or Hypersomnia
(4) increased appetite
(5) psychomotor retardation or agitation
Diagnostic Criteria for Caffeine Intoxication?
A. Recent consumption of caffeine, usually in excess of 250 mg (e.g., more than 2-3 cups of brewed coffee).

B. Five (or more) of the following signs, developing during, or shortly after, caffeine use:

(1) restlessness
(2) nervousness
(3) excitement
(4) Insomnia
(5) flushed face
(6) diuresis
(7) gastrointestinal disturbance
(8) muscle twitching
(9) rambling flow of thought and speech
(10) tachycardia or cardiac arrhythmia
(11) periods of inexhaustibility
(12) psychomotor agitation
Criteria for Cannabis Intoxication?
B. impaired motor coordination, euphoria, anxiety, sensation of slowed time, impaired judgment, social withdrawal

C. Two (or more) of the following signs, developing within 2 hours of cannabis use:

(1) conjunctival injection
(2) increased appetite
(3) dry mouth
(4) tachycardia
Criteria for Cocaine Intoxication?
B. euphoria or affective blunting; changes in sociability; hypervigilance; interpersonal sensitivity; anxiety, tension, or anger; stereotyped behaviors; impaired judgment; or impaired social or occupational functioning

C. Two (or more) of the following, developing during, or shortly after, cocaine use:

(1) tachycardia or bradycardia
(2) pupillary dilation
(3) elevated or lowered blood pressure
(4) perspiration or chills
(5) nausea or vomiting
(6) evidence of weight loss
(7) psychomotor agitation or retardation
(8) muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias
(9) confusion, seizures, dyskinesias, dystonias, or coma
Criteria for Cocaine Withdrawal?
(1) fatigue
(2) vivid, unpleasant dreams
(3) Insomnia or Hypersomnia
(4) increased appetite
(5) psychomotor agitation or retardation

C. The symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.
Criteria for Hallucinogen Intoxication?
B. marked anxiety or depression, ideas of reference, fear of losing one's mind, paranoid ideation, impaired judgment, or impaired social or occupational functioning

C. Perceptual changes occurring in a state of full wakefulness and alertness (e.g., subjective intensification of perceptions, depersonalization, derealization, illusions, hallucinations, synesthesias) that developed during, or shortly after, hallucinogen use.

D. Two (or more) of the following signs, developing during, or shortly after, hallucinogen use:

(1) pupillary dilation
(2) tachycardia
(3) sweating
(4) palpitations
(5) blurring of vision
(6) tremors
(7) incoordination
Criteria for Inhalant Intoxication?
B. belligerence, assaultiveness, apathy, impaired judgment, impaired social or occupational functioning

C. Two (or more) of the following signs, developing during, or shortly after, inhalant use or exposure:

(1) dizziness
(2) nystagmus
(3) incoordination
(4) slurred speech
(5) unsteady gait
(6) lethargy
(7) depressed reflexes
(8) psychomotor retardation
(9) tremor
(10) generalized muscle weakness
(11) blurred vision or diplopia
(12) stupor or coma
(13) euphoria
Criteria for Nicotine Withdrawal?
B. Abrupt cessation of nicotine use, or reduction in the amount of nicotine used, followed within 24 hours by four (or more) of the following signs:

(1) dysphoric or depressed mood
(2) Insomnia
(3) irritability, frustration, or anger
(4) anxiety
(5) difficulty concentrating
(6) restlessness
(7) decreased heart rate
(8) increased appetite or weight gain
Criteria for Opioid Intoxication?
B. initial euphoria followed by apathy, dysphoria, psychomotor agitation or retardation, impaired judgment, or impaired social or occupational functioning

C. Pupillary constriction (or pupillary dilation due to anoxia from severe overdose) and one (or more) of the following signs, developing during, or shortly after, opioid use:

(1) drowsiness or coma
(2) slurred speech
(3) impairment in attention or memory

Specify if:
With Perceptual Disturbances
Criteria for Opioid Withdrawal?
B. Three (or more) of the following, developing within minutes to several days after Criterion A:

(1) dysphoric mood
(2) nausea or vomiting
(3) muscle aches
(4) lacrimation or rhinorrhea
(5) pupillary dilation, piloerection, or sweating
(6) diarrhea
(7) yawning
(8) fever
(9) Insomnia
Phencyclidine Intoxication?
B. belligerence, assaultiveness, impulsiveness, unpredictability, psychomotor agitation, impaired judgment, or impaired social or occupational functioning

C. Within an hour (less when smoked, "snorted," or used intravenously), two (or more) of the following signs:

(1) vertical or horizontal nystagmus
(2) hypertension or tachycardia
(3) numbness or diminished responsiveness to pain
(4) ataxia
(5) dysarthria
(6) muscle rigidity
(7) seizures or coma
(8) hyperacusis

Specify if: With Perceptual Disturbances
Criteria for Sedative, Hypnotic, or Anxiolytic Intoxication?
B. nappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social or occupational functioning

C. One (or more) of the following signs, developing during, or shortly after, sedative, hypnotic, or anxiolytic use:

(1) slurred speech
(2) incoordination
(3) unsteady gait
(4) nystagmus
(5) impairment in attention or memory
(6) stupor or coma
Criteria for Sedative, Hypnotic, or Anxiolytic Withdrawal?
Same as alcohol