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55 Cards in this Set
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- Back
Substance Dependence
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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 |
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Substance Abuse
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One + 12 month period:
* failure to fulfill obligations * Use when unsafe (driving) * Legal problems * Social problems * Never met criteria for dependence |
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Most common age of onset of substance use disorders
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Teens and early 20s
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Types of pharmacologic tx
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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) |
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Psychosocial treatments shown effective with substance use disorders
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1) CBT
2) Behavioral therapies 3) Psychodynamic/Interperosnal therapies 4) Group & family 5) Self-help groups |
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Determining least restrictive setting for substance abuse treatment
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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 |
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When is hospitalization appropriate in the treatment of substance use disorders?
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* 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 |
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When is residential tx appropriate?
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lives/social life focus on use; lack the social/job skills; no drug free supports for OP setting
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Alcohol detoxification
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* 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 |
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Cocain intoxication
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Hypertension, tachycardia, seizures, paranoid delusions
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Cocain detoxification
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Following cessation of use, depression and craving are common
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Presentation of Opiod Use
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Mild-moderate does not require specific tx
Severe opiod overdose - marked by respiratory depression can be fatal and requires tx in hospital/inpatient setting |
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Tx of Opiod Withdrawal
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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 |
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Treatment goals
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* Cessation/reduction of use
* Repairing disrupted relationships * Reducing impulsivity * Developing social and vocation skills *Obtaining/maintaining employment |
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Strategies to increase motivation
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* 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 |
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Relapse Prevention
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cognitive behavioral techniques used to develop greater self control to avoid relapse
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Operant Behavioral Therapy
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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 |
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Contingency Management
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positive/negative consequences to reward abstinence or punish drug related behaviors
* Neg consequences- tell courts, employer, family |
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Preferred mode of psychotherapuetic treatment for substance dependent clients
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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 |
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Substances associated with aggression
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Cocaine, hallucinogens, PCP and alcohol
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Substances with withdrawal sx associated with violence include
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Alcohol, opioids, hypnotic sedatives
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Common drug combos
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Cocaine & alcohol
Cocaine & heroin Heroin and benzos |
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Narcotics- Definition & Common drugs
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*Used to relieve pain
* High potential for abuse * Relaxation w/ immediate rush * Restlessness and nausea Opium, Morphine, Codeine, Heroin, Methadone |
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Narcotics- Sx of overdose
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Slow, shallow breathing
Clammy skin Convulsions Coma |
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Narcotics- Withdrawal syndrom
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Watery eyes, runny nose
Yawning, cramps Loss of appetite, Irritability Nausea, Tremors, Panic Chills, Sweating |
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Narcotics- Indication of possible misuse
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Tracks/scarring from injections
Pin point pupils loss of appetite sniffles, watery eyes, cough Naseau, Lethargy, drowsiness Syringes, bent spoons, needles |
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Depressants- Definitions & Common Drugs
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*For anxiety, irritability, tension
* High abuse/dev. of tolerance * Intoxication like alcohol Barbiturates, Tranquilizers |
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Depressants- Possible Effects
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* 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 |
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Depressants- Sx of overdose
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Shallow respiration, clammy skin, dilated pupils, weak and rapid pulse, coma, death
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Depressants - Withdrawal syndrome
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Anxiety, insomnia, tremors, loss of appetite
Abrupt cessation or reduced high dose may cause convulsions, delirium, death |
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Depressants- Indications of possible misuse
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Behavior similar to alcohol w/o odor
Staggering, stumbling, lack of coordination, slurred speech Falling asleep whiel at work, difficulty concentrating Dilated pupils |
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Stimulants- Definitions and common drugs
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Used to increase alertness, relieve fatigue, feel strong and more decisive
Cocaine, amphetamines, methamphetamine, methylphenidates, Ice |
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Stimulants - Possible effects
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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 |
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Stimulants - Possible effects
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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 |
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Stimulants- Withdrawal syndrome
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Apathy, long periods of sleep, irritability, depression, disorientation
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Stimulants- Indications of possible misuse
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Excessive activity, talkativeness, irritability, argumentativeness, or nervousness
Long periods without sleep/eat Euphoria |
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Hallucinogens- Definitions and common drugs
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* Cause big behavior changes
* No known medical uses * Can block pain sensation; risk of self inflicted injuries PCP, Angel dust, LSD, Acid, Peyote, Ecstacy |
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Hallucinogens- Possible effects
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*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 |
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Hallucinogens- Sx of overdose
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Longer, more intense trip episodes, psychosis, coma, death
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Hallucinogens- Withdrawal syndrome
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None known
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Hallucinogens- Indications of misuse
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Extreme changes in behaviors/mood, trance-like states, appearing fearful
Chills, irregular breathing, sweating, trembling |
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Cannabis- Definitions and common drugs
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Hashish is the resinous secreition ofthe cannabis plant
Marijuana is a tobacco-like substance |
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Cannabis- Possible effects
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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 |
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Cannabis- Sx of overdose
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Fatigue, lack of coordination, paranoia
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Cannabis- Withdrawal syndrome
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Insomnia, hyperactivity, somtimes decreased appetite
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Cannabis- Indications of misuse
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Animated behavior, loudtalking, followed by sleepiness
Dilated pupils, bloodshot eyes Distortions in perception, hallucinations Distortions in depth and tiem perception, loss of coordination |
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Alcohol- Possible effects
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Intoxication, sensory alteration, anxiety reduction
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Alcohol- Sx of overdose
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Staggering, odor on breath, loss of coordination, slurred speech, dilated pupils
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Alcohol- Withdrawal syndrome
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Sweating, tremors, altered perception
Psychosis, fear, auditory hallucinations |
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Alcohol- Indications of misuse
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Confusion, disorietnation, loss of motor nerve control
Convulsions, shock, shallow respiration Involuntary defecation, drowsiness |
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Steroids- Definition
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synthetic compounds
closely related to male sex hormone, testosterone Moderate potential for abuse |
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Steroids- Possible effects
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Inc in weight, muscle mass & strength
Enhanced athletic performance, increased physical endurance |
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Steroids- Sx of overdose
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Quick weight adn muscle gains
Extremely aggressive behaviors severe skin rashes imptence, reduced sex drive development of irreversible masculine traits in females |
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Steroids- Withdrawal syndrome
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Significant weight loss, depression, behavioral changes, trembling
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Steroids- Indications for misuse
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Increased combativeness/aggression
Jaundice Purple or red spots on body, unexplained darkness of skin PErsistent unpleasant breath odor Swelling of feet/legs |