Models Of Addiction, Tx; Addiction Pharm

Front 1

What is the Disease model of addiction?

Back 1

Presumes addiction has a biologic basis, runs a chronic course with relapses and remissions, there is no cure, but it's treatable and meds may help to improve outcomes.

Front 2

What is the Genetic model of addiction?

Back 2

Liability for substance use disorder aggregates in families.

Genetic factors play an important role.

Front 3

What are environmental factors for addiction?

Back 3

Accessibility - need access to drug and the opportunity to use. Availabiltiy and cost an issue.

Front 4

T/F The shorter-acting or more potent the drug, the more reinforcing.

Back 4

T

Front 5

What is the Self-medication model of addiction?

Back 5

Use of mood-altering substances is to ameliorate underlying negative psych symptoms.

Front 6

What is the Moral/volitional model of addiction?

Back 6

Addiction if for weak-willed people and is a personal choice.

There is no research to support this model.

Front 7

There are sustained remission rates of up to _____% in addiction treatment, lending evidence that it works.

Back 7

60

Front 8

Contingency Management: defn

Back 8

A behavioral therapy for addiction that's been shown to be effective.

Basically, paying addicts to stay clean. It's a voucher-based system to give positive rewards for staying in treatment and giving urine samples that are negative for drugs.

Exchange vouchers for items that encourage healthy living.

Drug-free lifestyle goals eventually replace need for vouchers as rewards.

Front 9

Cons of Contingency Management

Back 9

Expensive (but cheaper than the costs of addiction to society)

Prize-based (lottery tickets) is less expensive than vouchers.

Front 10

Naloxone: MOA

Back 10

μ opioid antagonist

Front 11

Signs and Sx of Benzo overdose

Back 11

Physical: slurred speech, impaired attn, or memory, coma, stupor, incoordination, ataxia, nystagmus

Psych signs: mood lability, impaired judgment,inappropriate behavior

Front 12

Tx of Benzo OD

Back 12

1) Secure airway, breathing, circulation

2) Activated charcoal

3) Flumazenil: Benzo antagonist

Front 13

Which classes of drugs show withdrawal syndromes with gross physical symptoms?

Back 13

Sedative-hypnotics; Opioids, Marijuana, Nicotine

Front 14

What occurs in the first 48 hours of alcohol withdrawal?

Back 14

1) Elevated vital signs
2) Tremors
3) Mild diaphoresis
4) Disorientation
5) Hallucinations
6) Seizures

Front 15

What occurs after 48 hours of no alcohol use in physically dept. person?

Back 15

Delirium tremens:

Diaphoresis
Nausea/vomiting
Rapid, severe fluctuations in vital signs
Hallucinations
No seizures

Front 16

If an alcoholic is going to have withdrawal seizures, when will they occur?

Back 16

Within 48 hours

Front 17

Treatment of severe alcohol withdrawal

Back 17

Meds:
Benzos, Barbiturates

Giving rapid-onset med

Then substitute long-acting sedative-hypnotic to prevent recurrent of alcohol withdrawal symptoms

Taper long-acting med by 10-20% per day over 5-10 days

Front 18

Treatment of opioid withdrawal

Back 18

Any cross-dept opioid.

Short-acting for severe withdrawal - Morphine

Methadone is preferred bc it's long acting

Taper it over several days

Front 19

What is given in opioid withdrawal for anxiety and autonomic symptoms

Back 19

Clonidine : α2 agonist

Front 20

blocks acetaldehyde dehydrogenase

Back 20

disulfiram

Front 21

generally inhibitory to glutamatergic system in CNS

Back 21

acamprosate

Front 22

blocks opioid receptors, reducing craving and reducing alcohol slips

use for alcohol and opiates

Back 22

naltrexone

Front 23

Nicotine replacement therapy should always be combined with what?

Back 23

a behavioral therapy program

Front 24

nicotine partial agonist

Back 24

varinicline

Front 25

3 important drugs to treat alcohol addiction

Back 25

1) Disulfiram

2) Acamprosate

3) Naltrexone

Front 26

What are maintenance therapy approaches for opioid addiction?

Back 26

Long acting meds in controlled setting

Access to counseling and social services

Avoid withdrawal and craving

Reduce disease and crime

Front 27

What is methadone used for?

Back 27

Long-acting pure opioid agonist

Available for opioid addiction treatment in federally licensed programs

Requires daily clinic visits

Front 28

What is buprenorphine used for?

Back 28

Long acting opoid partial agonist/antagonist

Office based opoid addiction tx

Schedule III

Low risk of OD

Front 29

6 month prevalence of serious mental illness in ____%

Back 29

19

Front 30

Lifetime prevalence of Axis I andII disorder is ___%

Back 30

33

Front 31

Prognosis for successful treatment of depression and anxiety

Back 31

80%

Front 32

What percent of patients with personaltiy disorders treatment for 1.3 years will no longer meet diagnostic criteria?

Back 32

33-50%

Front 33

Day 1 to 2 years: what is the psychological development hurdle?

Back 33

Trust (oral stage)

Front 34

What is the anal stage?

Back 34

around age 2, conflicts concerning child's autonomy and independence vs. self-control is one of many conflicts which may arise. Bowel control is one of the many conflicts that may arise.

Autonomy vs. shame and doubt.

Front 35

What is the initiative vs. guilt stage?

Back 35

Ages 4-7. Child begins testing the role in triangle with mother and father.

Front 36

What is fixation?

Back 36

when pathological experiences take place at a stage of development, an over-investment in that stage may occur. Person may regress to the fixated stage.

Front 37

Explicit memory is aka ____ memory

Back 37

declarative

Front 38

Memory most likely mediated through the medial temporal lobe and hippocampus

Back 38

explicit memory

Front 39

Type of memory experienced through emotional and bodily sensations

Back 39

implicit memory

Front 40

person's capacity for objective evaluation and judgment of the external world. individual uses memory, reasoning, and perceptive organs of hearing, seeing, and touch

Back 40

reality testing

Front 41

diffuse, unpleasant, often vague feeling of apprehension, accompanied by one or more bodily sensation that characteristically recur for the same person

Back 41

anxiety

Front 42

effortless, automatic processes whereby ideas, impulses or feelings which are distasteful or anxiety-laden are transferred out of conscious awareness into the unconscious.

Back 42

repression/denial

Front 43

complex, multi-faceted defense mechanism whereby unacceptable feelings, ideas or perceptions are split-away from elements normally associated with them

Back 43

dissociation

Front 44

what occurs in phobias?

Back 44

the idea causing the fear is split away from the feeling (fear) leaving fear to be attached to another idea

Front 45

Re-channeling of a socially unacceptable impulse into a socially acceptable area

Back 45

sublimation

Front 46

unconscious process in which behavior/attitudes are adapted that are the exact oposite of the impulses which the individual can't express directly

Back 46

reaction formation

Front 47

emotional conflicts are unconsciously converted into their intellectual problems and are thereby divested of their personal meaning and feelings

Back 47

intellectualization

Front 48

process of neutralizing an uncomfortable feeling or thought

Back 48

undoing

Front 49

feelings and ideas which belong to an external referent are taken in and seen as a feature of the self

Back 49

introjection (opposite of projection)

Front 50

process of expressing a conflict through action rather than thoguht, feeling, and understanding

Back 50

acting out