Substance Abuse: Cause And Treatment (Final Review)

Front 1

According to the DSM, what is "substance use"?

Back 1

occasional use of alcohol or other drugs without developing tolerance or withdrawal

Front 2

According to the DSM, what is "substance dependence"?

Back 2

when an individual displays significant signs of a dependent relationship with a psychoactive drug (has to display tolerance, withdrawal, unintentional overuse, persistent desire or unsuccessful efforts to stop using the drug, preoccupation with the drug)

Front 3

According to the DSM, what is "substance abuse"?

Back 3

when an individual continues to take psychoactive drugs despite the fact that the drug-taking behavior creates specific problems for the individual

Front 4

Schedule 1 drugs

Back 4

-high potential for abuse
-has no current medical use
-no prescription can be written
-examples: ecstasy, GHB, marijuana (FDA has approved "marinol", which is THC in a pill form and is not a Schedule 1 drug), payote (legal on a Native American reservation)

Front 5

Schedule 2 drugs

Back 5

-high potential for abuse
-has accepted medical use, but abuse of the drug can lead to psychological or physical dependence
-need a prescription
-examples: morphine, cocaine, ridolin, oxicodone

Front 6

What are the major effects/symptoms of opiates/narcotics?

Back 6

pain relief, euphoria, respiratory repression, sedation/drowsiness, constriction of pupils, sense of itching, constipation, needle marks

Front 7

What are the major effects/symptoms of depressants/downers/sedatives-hypnotics?

Back 7

lowers inhibitions, memory loss, drowsiness, talkativeness/slurred speech, impaired judgement and performance, confusion

Front 8

What are the major effects/symptoms of stimulants/uppers?

Back 8

excited, euphoria, talkativeness, a lot of energy, self-confidence, increases body temperature, irritability

Front 9

What are the major effects/symptoms of hallucinogens?

Back 9

visual and auditory hallucinations, expanded consciousness, inspiration, confusion, aggression, dilated pupils, slurred speech

Front 10

What are the major effects/symptoms of marijuana?

Back 10

paranoia, relaxation, drowsiness, dry mouth, hunger, impaired short term memory, altered states of time and space

Front 11

What are the major effects/symptoms of inhalants?

Back 11

poor motor coordination, impaired vision, abusive behavior, lightheadedness, slowed thought, headache

Front 12

What are 5 models of addiction?

Back 12

1) medical model (brain disease)
2) psychodynamic model (maladaptive coping strategy for unconscious conflicts)
3) social model (learned behavior)
4) moral model (a choice)
5) biopsychosocial model

Front 13

What are 8 treatment modalities?

Back 13

1) inpatient (TC and 28 days)
2) MICA (Mentally-Ill and Chemically Addicted)
3) intensive out-patient
4) outpatient
5) halfway house
6) pharmacological/drug treatment (methadone)
7) detox
8) self-help/mutual-help

Front 14

What are the top 5 most intense treatment modalities (in order)?

Back 14

1) inpatient (TC)
2) inpatient (28 days)
3) MICA (Mentally-Ill and Chemically Addicted)
4) intensive out-patient
5) outpatient

Front 15

What are the 5 treatment levels according to the American Society of Addiction Medicine?

Back 15

-outpatient services
-intensive outpatient services/partial hospitalization
-residential inpatient services
-medically managed intensive inpatient services (detox)
-self-help/mutual-help

Front 16

What are 8 categories of drugs and examples of each?

Back 16

1) stimulants (cocaine, adderall/ritalin, nicotine, methamphetamine, crystal meth, caffeine)
2) hallucinogens (ecstasy, PCP, LSD, shrooms, special K, marijuana)
3) club designer/designer drugs (GHB, ecstasy, special K, rufinol)
4) depressants/downers (barbiturates, alcohol)
5) opiates/opioids (percocets/oxicodone, methadone, oxycontin/synthetic heroine, vicodin, morphine, natural heroine)
6) sedatives-hypnotics (tranquilizers, benzodiazepines/sleeping pills)
7) inhalants (nitrous oxide, gasoline, magic marker)
8) steroids

Front 17

What are the 5 roots of administration from fastest to slowest?

Back 17

1) smoking
2) injection (IV)
3) snorting
4) absorption through the skin
5) orally

Front 18

What are 3 types of injections?

Back 18

-intravenous
-intramuscular
-subcutaneous (just under skin)

Front 19

What is a drug's "half-life"?

Back 19

amount of time it takes to get half of the effective dose out of your system

Front 20

What are 5 things that affect the drug experience?

Back 20

-tolerance
-drug toxicity
-other drugs currently on
-set, setting, and expectations you have of the drug
-height/weight/age

Front 21

What are 6 types of tolerance?

Back 21

-functional tolerance
-dispositional tolerance
-protracted tolerance
-behavioral/learned tolerance
-cross tolerance
-reverse tolerance

Front 22

What is "functional tolerance"?

Back 22

acute tolerance that's built after one time of use

Front 23

What is "dispositional tolerance"?

Back 23

inherited tolerance

Front 24

What is "protracted tolerance"?

Back 24

tolerance that is built up after many times

Front 25

What is "behavioral/learned tolerance"?

Back 25

brain learns to compensate for the drug, seen in chronic users

Front 26

What is "cross tolerance"?

Back 26

mixing different drugs within the same class builds your tolerance

Front 27

What is "reverse tolerance"?

Back 27

a tolerance is never built, an intolerance

Front 28

What is the "set" and "setting" when taking a drug?

Back 28

set is the psychological state of mind and setting is the physical environment

Front 29

Addiction is an "__________" and is ___________

Back 29

affliction; progressive

Front 30

What are the 6 progressive stages of addiction?

Back 30

non-use> initial contact> experimental use> integrated use> excessive use> addiction

Front 31

Which 3 of the progressive stages of addiction can one bounce between before shifting into the final stage of addiction?

Back 31

experimental use, integrated use, and excessive use

Front 32

What is "delirium tremens"?

Back 32

a severe form of alcohol withdrawal that involves sudden and severe mental or nervous system changes that can ultimately be lethal

Front 33

What is an "effective dose"?

Back 33

minimum dose of a drug necessary to produce the effective intent of the drug

Front 34

What is a "synergistic effect"? Give an example.

Back 34

When the interaction causes an increase in the effects of one or both of the drugs, valium+alcohol= 3 or 4

Front 35

What is an "antagonistic effect"?

Back 35

when the interaction causes a decrease in the effects of one or both of the drugs

Front 36

What is an "agonist"? Give examples.

Back 36

drugs are those that work to mimic the effect of a neurotransmitter in the brain; heroine, oxycodone, morphine

Front 37

What is an "antagonist"? Give examples.

Back 37

drugs that block neurotransmitters in the brain; naltrexone, antibuse

Front 38

What does "CAGE" stand for?

Back 38

-Cut-back: have you ever tried cutting back?
-Annoyed: have your friends/family annoyed you about how much time you abuse substance?
-Guilt: have you experienced guilt?
-Eye-opener: is it the first thing you do when you open your eyes?

Front 39

Screening

Back 39

-a quick-snap shot of who the client is
-to determine if client is is eligible/appropriate for type of treatment

Front 40

What is "R/O SCIZ" and when does this occur?

Back 40

"rule out schizophrenia" and during the assessment

Front 41

What are the Three C's?

Back 41

1) Compulsion (obsessive-compulsive behavior with the drug)
2) Control (inability to stop using the drug)
3) Consequence (continuing to use drug despite negative consequences such as DWI, losing child, etc.)

Front 42

What are 6 examples of screening and assessment tools?

Back 42

-CAGE
-Three C's
-Michigan Alcohol Screening Test (MAST)
-Drug Use Screening Inventory
-Cocaine Screening Questionnaire
-Marijuana Screening

Front 43

What is primary drug prevention?

Back 43

stopping them before they've even touched drugs

Front 44

What is secondary prevention?

Back 44

experimentation and the person has been introduced to the drug, but no problem of addiction or abuse

Front 45

What is tertiary prevention?

Back 45

too late, there is already a problem, it was missed and now they need to go to treatment

Front 46

What is physical dependence defined by?

Back 46

the appearance of characteristic withdrawal symptoms when the substance is suddenly discontinued

Front 47

What is psychological dependence?

Back 47

dependency of the mind, and leads to psychological withdrawal symptoms (such as cravings, irritability, insomnia, depression, anorexia, etc)

Front 48

What was the precursor of the FDA?

Back 48

The Pure Food and Drug Act of 1906

Front 49

What act made marijuana illegal?

Back 49

The Marijuana Tax Act of 1937

Front 50

In what act was marijuana labeled as a Schedule 1 drug?

Back 50

The Controlled Substance Act of 1970

Front 51

What is a "psychoactive drug"?

Back 51

effects the functioning of the brain

Front 52

What is a "psychotropic drug"?

Back 52

effects the structure/functioning of the body

Front 53

5 notes on guest lecturer on TC

Back 53

-people can get to a place where its "good enough" that they can move on
-the "working through" process (we're always working through something)
-structure breeds security
-a "pull up"- immediate identification without judgement
-the issues of my past should not be an excuse for my behavior today

Front 54

What is a development to work against a resistant and unmotivated attitude to change?

Back 54

motivational interviewing

Front 55

What are the 5 stages of change?

Back 55

1) pre-contemplation
2) contemplation
3) preparation
4) take action
5) maintenance

Front 56

What is the "sixth" stage of change for some people?

Back 56

relapse

Front 57

What is most important when moving a client through the stages of change?

Back 57

the therapeutic alliance

Front 58

What is heroin sold in?

Back 58

bags

Front 59

How many bags of heroin is a "bundle"?

Back 59

10-12 bags

Front 60

Who makes the treatment plan?

Back 60

counselor and client collaborate on it

Front 61

When should treatment plans first be done?

Back 61

within 10 days of being admitted

Front 62

How often are treatment plans reviewed/revised?

Back 62

AT LEAST every 90 days

Front 63

What are 4 things to be addressed under each "life area" on a treatment plan?

Back 63

-problem identified
-long term goal
-short term objective
-specific activities,experiences and/or therapies toward goal attainment

Front 64

On a treatment plan, short term objectives need to be ________ and __________

Back 64

specific; measurable

Front 65

What is "enabling"?

Back 65

doing for someone what they can and should be doing for themselves

Front 66

What is the rule of record-keeping?

Back 66

if it's not documented, it didn't happen

Front 67

Why is record-keeping important?

Back 67

if the client ends up needing to go to another treatment in the future, the records will greatly help

Front 68

What is recovery really about?

Back 68

change

Front 69

NA and AA don't have _____, they have ___________

Back 69

rules; suggestions

Front 70

What are 4 suggestions of NA/AA that we went over in class?

Back 70

-get a sponsor
-come to meetings early, stay late (make connections)
-get a commitment (greeter, make coffee)
-work with your sponsor on the 12 steps

Front 71

What is necessary for people to maintain recovery?

Back 71

to have a PROGRAM for recovery

Front 72

What are the 3 most important things that somebody needs to change?

Back 72

-people (change old social group that encouraged use; replace with positive social group)
-places (not going back to environments that encouraged use)
-things/activities (finding new things that are enjoyable to replace time/focus spent on drug use; positive outlets)

Front 73

What is a "lapse"?

Back 73

a momentary episode of drug or alcohol use following a period of recovery, which is then followed by immediate action to get back on track

Front 74

What is "relapse"?

Back 74

Having a lapse, but NOT taking action to get back on track, NOT admitting to it> failure to maintain behavior change

Front 75

When does relapse/lapse happen?

Back 75

when one starts to revert back to old behaviors and when triggers/cues are activated

Front 76

What are triggers/cues?

Back 76

stimuli that makes you want to start using again

Front 77

What are 7 examples of triggers/cues gone over in class?

Back 77

-loneliness
-stress
-boredom
-anger
-secret disappointment with the straight life
-euphoric recall
-depression

Front 78

What is "euphoric recall"?

Back 78

recalling how good it used to be and FORGETTING ABOUT THE NEGATIVE CONSEQUENCES

Front 79

What is the 8 stage relapse process, also referred to as the "relapse train"?

Back 79

1) beginnings of secret dissatisfaction
2) stress and conflict at home
3) boredom (i.e., lack of challenge at work)
4) reactivation of denial (i.e., "things are going great!", "im doing well", "maybe i wasnt an addict")
5) emotional drift from significant others, isolation (as opposed to loneliness)
6) anger (manifests in headaches, ulcers, etc)
7) depression
8) acted out relapse-TAKING THE DRUG is the last step in the relapse process

Front 80

What is important to keep in mind about the 8 stage relapse process?

Back 80

it is done entirely alone, don't talk to anyone about it> riding the relapse train alone

Front 81

When is a treatment plane reviewed/revised BEFORE 90 days?

Back 81

when new information comes up

Front 82

What is the pre-contemplation stage of change?

Back 82

complete denial ("it's not that bad")

Front 83

What is the contemplation stage of change?

Back 83

thinking about stopping ("maybe I do have a problem")

Front 84

What is the preparation stage of change?

Back 84

preparing to make a change (looking online for an NA meeting)

Front 85

What is the take action stage of change?

Back 85

taking action to be clean and sober (going to AA meeting)

Front 86

What is the maintenance stage of change?

Back 86

staying clean and sober (staying away from old friends)

Front 87

What are three rules in all treatment modalities?

Back 87

no sex, no violence, no threats of violence

Front 88

What 2 drugs are responsible for the most deaths in America every year?

Back 88

alcohol and cigarettes

Front 89

What model of addiction believes addiction is genetic?

Back 89

the disease model

Front 90

For drugs, what is the primary method of excretion?

Back 90

urination

Front 91

What are the two organs of the body most closely associated with excretion?

Back 91

kidneys and liver

Front 92

What are the 12 core functions of a CASAC in order?

Back 92

1) screening
2) intake
3) orientation
4) assessment
5) treatment planning
6) counseling
7) case management
8) crisis intervention
9) client education
10) referral
11) report and record-keeping
12) consultation

Front 93

What is the core function of intake?

Back 93

the administrative and initial assessment procedures for admission to a program; an extension of screening

Front 94

What is the core function of orientation?

Back 94

describing and introducing the nature and goals of the program to the client

Front 95

What is the core function of assessment?

Back 95

the procedures by which a counselor/program identifies and evaluates an individual's strengths, weaknesses, problems and needs for the development of a treatment plan

Front 96

What is the core function of treatment planning?

Back 96

the process by which the counselor and client identify and rank problems needing resolution, establish agreed upon immediate and long-term goals, and decide upon a treatment process and resources to be used

Front 97

What is the core function of case management?

Back 97

activities intended to bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals (case conferences, coordination of client care)

Front 98

What is the core function of crisis intervention?

Back 98

those services which respond to an alcohol and/or other drug abuser's needs during acute emotional and/or physical distress; safety plan

Front 99

What is the core function of client education?

Back 99

provision of information to individuals and groups concerning alcohol and other drug abuse and the available services and resources; psychoeducation; harm-reduction

Front 100

What is the core function of referral?

Back 100

the identification of the client's needs that cannot be met by the counselor or agency and assisting the client to use the support systems and community resources available

Front 101

What is the core function of consultation?

Back 101

relating with counselors and other professionals in regard to client treatment to assure comprehensive quality care for client

Front 102

Notes about movie "Down to the Bone" (things Gregg said during movie)

Back 102

-Irene went home early (only there 10-14 days)
-didn't get a sponsor right away
-no relationship in first year of recovery
-went out with guy who worked at treatment facility
-hanging out with old friends who still use
-husband is using in front of her/he is supportive of drug use
-getting in trouble at work (can't get fired for alcoholism)
-didn't tell sponsor about coming on to the counselor/worker guy or about doing drugs with him
-does coke again with husband
-eyes are pinned (pupils like pins) on heroin
-mandated to treatment through drug court

Front 103

What are 3 agencies that can mandate someone to treatment?

Back 103

Employment Assistance Program (EAP)
Drug Treatment Alternative to Prison (DTAP)
Treatment Alternative for Safe Communities (TASC)