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55 Cards in this Set

  • Front
  • Back
Substance Dependence
Three + in 12 month period:
* Tolerance
* Withdrawal
* Lgr amts, longer periods than intended
* Desire/unsuccessful efforts to cut down
* Focus on getting substance
* Activites red. due to use
* Use despite knowing prob caused/worsened by cont. use
Substance Abuse
One + 12 month period:
* failure to fulfill obligations
* Use when unsafe (driving)
* Legal problems
* Social problems
* Never met criteria for dependence
Most common age of onset of substance use disorders
Teens and early 20s
Types of pharmacologic tx
1) Treat intoxication and withdrawal states
2) Dec. reinforcing side effects
3) Discourage use through unpleasant consequences w/ drug-drug interaction
4) Agonist substitution therapy (methadone maintenence)
Psychosocial treatments shown effective with substance use disorders
1) CBT
2) Behavioral therapies
3) Psychodynamic/Interperosnal therapies
4) Group & family
5) Self-help groups
Determining least restrictive setting for substance abuse treatment
1) Ability to cooperate/benefit
2) Need for structure/support
3) Ability to refrain from use
4) Ability to avoid risk behaviors
5) Need for a specific tx limited to certain settings
When is hospitalization appropriate in the treatment of substance use disorders?
* OD unsafe in OP setting
* Risk of complicated withdrawal
* GMC making ambulatory detox unsafe
* hx of not engaging/benefiting from less intensive tx
* MH impair ability to participate in/benefit from other tx
* Danger to self or others
When is residential tx appropriate?
lives/social life focus on use; lack the social/job skills; no drug free supports for OP setting
Alcohol detoxification
* Sx begin within 4-12 hrs of cessation/reduction of use
* Sx intensity peaks during second day of abstinence
* Sx resolve in 4-5 days

Complications include seizures, hallucinations, delirium
Cocain intoxication
Hypertension, tachycardia, seizures, paranoid delusions
Cocain detoxification
Following cessation of use, depression and craving are common
Presentation of Opiod Use
Mild-moderate does not require specific tx

Severe opiod overdose - marked by respiratory depression can be fatal and requires tx in hospital/inpatient setting
Tx of Opiod Withdrawal
Goal to safely ameliorate acute sx and facilitate entry into a long term tx program

* Methadone substitution with gradual tapering
* Abrupt dc of opiods, use of meds to suppress withdrawal sx
* Important to monitor other substance use- concurrent use of or withdrawal from other substances can complicate the tx of opiod withdrawal
Treatment goals
* Cessation/reduction of use
* Repairing disrupted relationships
* Reducing impulsivity
* Developing social and vocation skills
*Obtaining/maintaining employment
Strategies to increase motivation
* Self help w/ others in recovery
* Drug free peer group/lifestyle
* Drug free experiences/roles
* No major life changes that inc. chance of relapse
* Learn cues
* self monitor feeling/thinking
* Contingency contracts
* Desensitization/relaxation
* Alternative coping responses
Relapse Prevention
cognitive behavioral techniques used to develop greater self control to avoid relapse
Operant Behavioral Therapy
Involves operant rewarding or punishing for desirable/undesirable behaviors

For example, voucher for a clean UA that can be exchanged for something already agreed upon such as movie tickets
Contingency Management
positive/negative consequences to reward abstinence or punish drug related behaviors

* Neg consequences- tell courts, employer, family
Preferred mode of psychotherapuetic treatment for substance dependent clients
Group therapies because they are supportive, therapuetic, and educational
They offer the client the opportunity to identify with others
Understand the impact of substances on their lives
And learn about own feelings, others' feelings and reactions
Substances associated with aggression
Cocaine, hallucinogens, PCP and alcohol
Substances with withdrawal sx associated with violence include
Alcohol, opioids, hypnotic sedatives
Common drug combos
Cocaine & alcohol
Cocaine & heroin
Heroin and benzos
Narcotics- Definition & Common drugs
*Used to relieve pain
* High potential for abuse
* Relaxation w/ immediate rush
* Restlessness and nausea

Opium, Morphine, Codeine, Heroin, Methadone
Narcotics- Sx of overdose
Slow, shallow breathing
Clammy skin
Convulsions
Coma
Narcotics- Withdrawal syndrom
Watery eyes, runny nose
Yawning, cramps
Loss of appetite, Irritability
Nausea, Tremors, Panic
Chills, Sweating
Narcotics- Indication of possible misuse
Tracks/scarring from injections
Pin point pupils
loss of appetite
sniffles, watery eyes, cough
Naseau, Lethargy, drowsiness
Syringes, bent spoons, needles
Depressants- Definitions & Common Drugs
*For anxiety, irritability, tension
* High abuse/dev. of tolerance
* Intoxication like alcohol

Barbiturates, Tranquilizers
Depressants- Possible Effects
* Sensory alteration, anxiety reductions, intoxication
* Small amts cause calm, relaxed muscles
* Larger amts cause slurred speech, impaired judgement, loss of motor coordination
* Newborns can show sx
Depressants- Sx of overdose
Shallow respiration, clammy skin, dilated pupils, weak and rapid pulse, coma, death
Depressants - Withdrawal syndrome
Anxiety, insomnia, tremors, loss of appetite
Abrupt cessation or reduced high dose may cause convulsions, delirium, death
Depressants- Indications of possible misuse
Behavior similar to alcohol w/o odor
Staggering, stumbling, lack of coordination, slurred speech
Falling asleep whiel at work, difficulty concentrating
Dilated pupils
Stimulants- Definitions and common drugs
Used to increase alertness, relieve fatigue, feel strong and more decisive

Cocaine, amphetamines, methamphetamine, methylphenidates, Ice
Stimulants - Possible effects
Increased heart adn respiratory rates, elevated blood pressure, dilated pupils and decreased appetite

high doses may cause rapid/irregular heartbeat, loss of coordination, collapse, may cause persspiration, blurred vision, dizziness, and feelign of restlessness, anxiety and delusions
Stimulants - Possible effects
Increased heart adn respiratory rates, elevated blood pressure, dilated pupils and decreased appetite

high doses may cause rapid/irregular heartbeat, loss of coordination, collapse, may cause persspiration, blurred vision, dizziness, and feelign of restlessness, anxiety and delusions
Stimulants- Withdrawal syndrome
Apathy, long periods of sleep, irritability, depression, disorientation
Stimulants- Indications of possible misuse
Excessive activity, talkativeness, irritability, argumentativeness, or nervousness

Long periods without sleep/eat
Euphoria
Hallucinogens- Definitions and common drugs
* Cause big behavior changes
* No known medical uses
* Can block pain sensation; risk of self inflicted injuries

PCP, Angel dust, LSD, Acid, Peyote, Ecstacy
Hallucinogens- Possible effects
*Rapidly changing feelings, immediately and much later
*Chronic use can cause depression, violent behavior, anxiety, distorted perception of time
*Cause hallucinations, illusions, dizziness, confusion, suspicion, anxiety, loss of control
Hallucinogens- Sx of overdose
Longer, more intense trip episodes, psychosis, coma, death
Hallucinogens- Withdrawal syndrome
None known
Hallucinogens- Indications of misuse
Extreme changes in behaviors/mood, trance-like states, appearing fearful

Chills, irregular breathing, sweating, trembling
Cannabis- Definitions and common drugs
Hashish is the resinous secreition ofthe cannabis plant

Marijuana is a tobacco-like substance
Cannabis- Possible effects
Euphoria followed by relaxation

Loss of appetite, impaired memory, concenrtraion and knowledge returntion
Loss of coordination, more vivid sense of taste sight smell hearing
Strong doses can cause fluctuating emotions, fragmented thoughts, disoriented behavior
Cannabis- Sx of overdose
Fatigue, lack of coordination, paranoia
Cannabis- Withdrawal syndrome
Insomnia, hyperactivity, somtimes decreased appetite
Cannabis- Indications of misuse
Animated behavior, loudtalking, followed by sleepiness

Dilated pupils, bloodshot eyes
Distortions in perception, hallucinations
Distortions in depth and tiem perception, loss of coordination
Alcohol- Possible effects
Intoxication, sensory alteration, anxiety reduction
Alcohol- Sx of overdose
Staggering, odor on breath, loss of coordination, slurred speech, dilated pupils
Alcohol- Withdrawal syndrome
Sweating, tremors, altered perception
Psychosis, fear, auditory hallucinations
Alcohol- Indications of misuse
Confusion, disorietnation, loss of motor nerve control

Convulsions, shock, shallow respiration

Involuntary defecation, drowsiness
Steroids- Definition
synthetic compounds

closely related to male sex hormone, testosterone

Moderate potential for abuse
Steroids- Possible effects
Inc in weight, muscle mass & strength

Enhanced athletic performance, increased physical endurance
Steroids- Sx of overdose
Quick weight adn muscle gains

Extremely aggressive behaviors
severe skin rashes
imptence, reduced sex drive
development of irreversible masculine traits in females
Steroids- Withdrawal syndrome
Significant weight loss, depression, behavioral changes, trembling
Steroids- Indications for misuse
Increased combativeness/aggression
Jaundice
Purple or red spots on body, unexplained darkness of skin
PErsistent unpleasant breath odor
Swelling of feet/legs