Substance Use Disorders

1. Substance Use Disorders

2. Substance Use Disorders Substance Dependence Axis I: ___________________ Substance Abuse Axis I: ___________________

3. Substance Dependence: Diagnostic Criteria At Least 3 Of 7 Symptoms Are Present Over A 12 Month Period __________________ Withdrawal (e.g., Alcohol -> Delirium Tremens) _____________________________ Persistent Desire Or ____________________ To Reduce Or End Substance Use Extensive Time Devoted To ________________________ ______________________ From The Substance Giving Up Social Or Occupational Opportunities In Favor Of The Substance Continued Use Of Substance Despite Perception That It Has Caused ___________________________

4. Substance Abuse: Diagnostic Criteria At Least 1 Of 4 Symptoms Are Present Over A ____ Month Period Substance Use Impairs Ability To ____________________ (i.e., Good Parent, Spouse, Worker) Recurrent Use Of Substance In _____________________ ______________________ Recurrent Legal Problems Related To The Substance Use Recurrent ________________________ Stemming From The Substance Use

5. Alcohol Alcohol Is A ____________________ Incidence Of Alcohol Use Disorders 1994 National Comorbidity Study About _________________________ Could Be Diagnosed With ______________________ Or Alcohol Abuse Based On Their Current Or Past _________________________ Gender Difference Males: ________________ Females: ______________

6. Physical Consequences Of Excessive Alcohol Use Cirrhosis Of The Liver Enlargement And Abnormal Vascularization Of The Liver _______________________ Increased Risk Of Some Cancers _______________________ Mental Retardation __________________ If Heavy Drinking Occurred During ____________________

7. Physical Consequences Of Excessive Alcohol Use Disorders Of Thiamine (Vitamin B) Deficiency _______________________ __________ (Disorientation And Impaired Attention) _______________________________ Deterioration Of Peripheral Nerves High Doses Of Thiamine ______________________ _________________________ A Permanent Dementia (Cognitive Deterioration) With Prominent _____________________________ Anterograde Amnesia: Inability To __________________ Retrograde Amnesia: _____________________________

8. Alcohol Use Disorders: Biological Factors __________________ Of Alcohol-Dependent Persons Experience Alcohol Dependence Themselves At A Rate ___________________ Greater Than That Of The General Population Twin Studies Suggest That The Heritability Of Alcoholism Is ____________________

9. Alcohol Use Disorders: Psychological Factors Negative Affect (__________________________) Alcohol (Substance) Abusers Experience Greater Rates Of Negative Affect Negative Affect Increases The ____________________ Expectancy Model A Cognitive-Behavioral Model Of Substance Use/Relapse That Involves: Abstinence-Related _________________ Abstinence-Related __________________ Expectations About _________________________

10. Expectancy Model Abstinence-Related Coping Skills _________________ _________________ _________________ Abstinence-Related Self Efficacy (ARSE) Person�s Confidence In His/Her Ability To Stay Sober High ARSE Comes From Staying _________________________ Low ARSE Comes From Losing Sobriety In High Risk Situations Positive Beliefs About The Substance e.g., �A Drink Will Relax Me� e.g., �People Like Me More When I Drink� __________________________________ When Persons With Rigid Beliefs About The Dire Consequences Of Substance Use Lose Their Sobriety, They Become Depressed (Other Negative Emotions) Which Increases The Likelihood That They Will Continue To Use The Substance

11. Expectancy Model

12. Treatment Of Substance Use Disorders 12 Step Model ___________________ Narcotics Anonymous _____________________ _________________ Empirically Based

13. 12 Step Model Historical Context Two Alcoholic Physicians Wrote �____________________� (�The Big Book�) In The 1930s Prior To The Big Book, Most Persons Felt Moral Weakness Caused Substance Abuse Elements Of The 12 Step Model Disease Focus �Alcoholism Is A Disease, Not Simply The Result Of Moral Weakness� Powerlessness �____________________________________________� ______________________ �Only With The Help Of My Higher Power, I Can Stay Sober�

14. 12 Step Model Elements Of The 12 Step Model (Cont.) _____________________ �_________________� (Possibly Multiple Sponsors) � As A Sponsor� � Helps Maintain Sobriety Hotline: Someone To Drive You To A Meeting ________________________ Meetings Available 24 Hours �40 In 40� � First 40 Days Of Recovery _____________________ The Abstinent Alcoholic Should Consider Himself Or Herself To Be In A Never-Ending State Of Recovery (Never Cured) The Abstinent Alcoholic Should Be Constantly Vigilant For Precursors Of Relapse _____________________ No Distinction Between Relapse And Slip All Use Is Relapse Active Ingredients Of The 12 Step Model ____________________________

15. Possible Shortcomings Of The 12-Step Model ___________________ Many Persons Have Issues With Religion And Spirituality ___________________ Much Of The Benefit Of A 12-Step Program Stems From One�s Ability To �Fit In� And Form Relationships Socially Avoidant Persons Or Persons With Poor Social Skills Are Less Likely To Reap The Benefits Of A 12-step Program ____________________ Persons With Internal Locus Of Control May Object

16. Relapse Prevention Model Acknowledges That ______________________ In Addiction (50 � 90 Percent) Psychoeducation _______________________ Relapse Vs Slip ________________________________________ Relapse Severe Interpersonal, Financial, And Vocational Consequences Slip Brief _____________________ That Does Not Involve Severe Interpersonal, Financial, And Vocational Consequences Contingency Planning To Prevent A Slip From Becoming A Relapse Although Abstinence Is Emphasized, The Therapist Also Emphasizes That, Should The Client Slip, The Client Should ________________________________

17. Relapse Prevention Model Developing Coping Skills _________________ _________________ _________________ Qualities Of A Good Support Person Someone Who Knows You And Cares About You Someone Committed To Your Sobriety Someone Available To You 24 Hours A Day Increase Awareness Of _____________________ Thoughts, Emotions, Persons, And Situations That Have Led To Substance Use In The Past _____________________ Situations That Increase The _____________________________

18. Relapse Prevention Model �__________� Anything You Do That Makes It ___________ That You Will Use A Substance When Confronted With A High Risk Situation Increase �__________________� Pleasurable Activities That Are Good For You, i.e. Activities That ______________________

19. Medication Treatment Of Alcohol Abuse ____________ (Disulfiram) Administered Daily About 30 Minutes After Alcohol Consumption, The Patient __________________________Reaction That May Include ___________ ___________ Headache Chest Pain Weakness ___________ What Are Two Weaknesses Of Antabuse?

20. The Neurophysiology Of �Getting High� Mesolimbic Dopamine System The Brain�s �_________________� Upper _____________ (Upper Brainstem) -> Nucleus Accumbens (Limbic System) -> Frontal Cortex Evolutionary Adaptive ________________________ Many Substances Stimulate The Dopaminergic Neurons In The _________________________

21. Stimulants Cocaine Almost 1% Of Persons Use Cocaine At Least Once Monthly Snorted, Smoked, Or Intravenous (IV) Compared To Amphetamines, The Stimulating Effects Of Cocaine Are _______________________________ Moderate Doses _______________________________ Higher Doses ____________________________________ Risk Of Tachycardia And Heart Attack Withdrawal ________________________________________________

22. Stimulants Amphetamine (�_________�) Oral and Intravenous (IV) Administration ______________________________________________ Tolerance Within ___________________ Psychotic Symptoms May Develop ________________ ________________ Bugs Crawling On Skin Withdrawal Sxs (�Crashing�) For 2 Weeks ________________ ________________ ________________ Disturbed Sleep

23. Cannabis Active Substance In Cannabis THC (Delta-9-Tetrahydrocannibol) Forms Of Cannabis _______________ From The Dried Leaves Of The Marijuana Plant _______________ From The _____________________________________ Contains Higher Levels ____________ Administration MJ May Be _________________________ When MJ Is Smoked Peak Levels ______________________ Subjective Effects ________________________________ After Smoking High Lasts For ______________________

24. Cannabis Metabolites Of THC Remain In The Body For 8 Or More Days �High� Produced By MJ ___________________ Heightened ______________________ Increased Awareness Of _______________________And Internal Stimuli Negative Consequences Of MJ ________________ Risk Of Cancer (Lung Cancer) __________________________

25. Hallucinogens Cause Unusual Perceptual Experiences, _______________, _________________________________ Sometimes Auditory Hallucinations And Auditory Illusions Can Produce Negative Psychological Changes _______________ _______________ Ideas Of Reference _______________ _______________ Post-use Psychosis Hallucinogen Persisting Perception Disorder (DSM-IV) ________________________________________ ________________________________________

26. Hallucinogens Types Of Hallucinogens Lysergic Acid Diethylamide (�LSD�, �Acid�) ________________________ Produces Hallucinations And Euphoria __________________________ Psilocybin (In Hallucinogenic Mushrooms) _________________________________________ ____________ (Peyote) STP (Serenity, Tranquillity & Peace) _____________________________ PCP (�Angel Dust�; Phencyclidine) ____________________________________ In Low Doses: ____________________________________ In High Doses: ______________________________ And The Environment Sometimes Leading To Aggressive And/Or Irrational Behavior ________________________________________________________________________________________________________________

27. Opioids Types Of Opioids Naturally Occurring Opioids (Opium And Morphine) Come _____________________________ Semisynthetic Opioids (Heroin) Are Produced By _______ ___________________________________ Synthetic Opioids (___________________________) Are Chemically Manufactured To Have __________________ Heroin _____________________________________________ _______________________ Fatal And Near Fatal Overdoses Are Common Due To Variability In The Potency Of The Heroin Immediate Euphoria Can Be Accompanied By ______________________________________________ ______________________________________________

28. Opioids Withdrawal From Heroin Begins ______________________________ ______________________________________________________________________________ Treatment For Heroin Addicts Methadone and LAAM Neither _________________________ When Correctly Prescribed Reduce The Euphoric Rush Caused By ____________ Duration Of Therapeutic Effect __________________________________ __________________________________

29. Sedatives-Hypnotics-Anxiolytics __________________________________________________________________________________ ____________________ All Have ______________________ Intoxication On Sedatives, Hypnotics, or Anxiololytics _____________________________________ ______________________ ______________________ Slurred ___________ Unsteady Gait Impaired ____________________ ______________________

30. Sedatives-Hypnotics-Anxiolytics Withdrawal From Sedatives, Hypnotics, or Anxiolytics Shakiness ______________ ______________ Sweating Psychomotor Agitation ______________ Transient Illusions Or Hallucinations ___________________ Anxiolytics _____________________________________ Produce Relaxation By Increasing ________________ Withdrawal Symptoms ____________________ ____________________ Irritability ____________________ Muscle Tension ____________________