Addiction and Substance Abuse: A Comprehensive Guide for Students, Exams of Advanced Education

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Dependency - occurs when a drug user experiences physical or psychological distress upon discontinuing use of the drug.

Addiction - implies compulsive use, impaired control over using the substance, preoccupation with obtaining and using the drug, and continued use despite adverse consequences.

Five Critical Components of Effective Treatment - Assess Patient-Treatment Matching (individualized) Comprehensive Services Relapse Prevention Accountability

DSMV removed what distinction? - The distinction between abuse and dependence.

Substance Use Disorders Have _____ Criteria... including ______ and _______. - 11 including tolerance and withdrawal.

Once addiction reaches dependency, it is now a _____________. - Chronic and relapsing disorder.

Medical View of Addiction - Disease Model

Criminal View of Addiction - Protect Public

Process of Stimulus and response - Sensory, Interconnection, Motor Responses

Two Major Structures in the Nervous System - Central Nervous System and Peripheral Nervous System

Two Parts of the Peripheral Nervous System - Autonomic and Somatic systems

Psychoactive drugs majorly affect this - synapses

Alcohol affects what part of the Nervous System - CNS

Two key issues that separate alcohol use from alcohol abuse - Tolerance and loss of control

Sedatives-Hypnotics - Barbiturates

Inhalants are - CNS Depressants

Marijuana has - Depressant, stimulant, analgesic and hallucinogenic effects

CNS Stimulants - Caffeine, Nicotine, and Amphetamines

Disease means - an involuntary disability

treatment approaches - Medical, Biopsychosocial, social, clinical

Three substances that require detox - Alcohol and CNS Depressants, Opiates, Cocaine

12 Core Functions - 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. Record Keeping
12. Consultation

Invented Psychodynamic Theory - Sigmund Freud

Invented Client-Centered Therapy - Carl Rogers

Invented Rational-Emotive Therapy - Albert Ellis

Invented Transactional Analysis Therapy - Eric Berne

Invented Gestalt Therapy - Fritz Perls

Invented Reality Therapy - William Glasser

Types of Behaviorism - Classical Conditioning and Operant Conditioning

Inventor of Classical Conditioning - Pavlov

Inventor of Operant Conditioning - BF Skinner

Four Parts of Operant Conditioning - Positive Reinforcement Negative Reinforcement Punishment Extinction

3. Preparation
4. Action
5. Maintenance

Cultural Sensitivity - being open to working with issues of culture and diversity

Cultural Competence - Examine and understand nuances and exercise full cultural empathy

Cultural Proficiency - working to advance the field through leadership, research, and outreach.

ASAM Criteria: 3 Types of Programs for People with COD - Addiction only services, Co- Occuring capable, Co-Occuring enhanced

Basic example of a system - SAMSHA

Comprehensive Continuous Integrated Systems of Care - Model to bring the mental health and substance abuse treatment systems into an integrated planning process to develip a compmrehensive, integrated system of care

Four Quadrant Model - A valid model for service planning

Screening - A process for evaluating the possible presence of a particular problem

Assessment - A process for defining the nature of that problem and developing specific treatment recommendations for addressing the problem

Psychoactive - the ability of certain medications, drugs, and other substances to cause acute psychomotor effects and a relatively rapid change in mood or thought

Twin Epidemics - AOD abuse and HIV

Prevention and treatment of AOD abuse and HIV disease require - a multidisciplinary approach that relies on the strengths of a variety of providers and treatment settings to provide a comprehensive range of effective services

Most important features of any program providing care to HIV-infected patients - minimal barriers to access and a "user friendly" environment

1993 Substance Abuse Block Grant recipients must create a waiting list to give preferential treatment to - 1. Pregnant IDU

2. Pregnant SA
3. Other IDU
4. All Others

Crucial to the Recruitment and retention of HIV-infected AOD abuse patients in treatment - Cultural sensitivity and competence

Ethics - The discipline dealing with what is good and bad and with moral duty and obligations - ethics are the principles of conduct governing an individual or group.

Primary justification for breaking confidentiality - when a person is a danger to self or others

Basic Principle of Confidentiality - No information divulged by patients in the course of treatment (inlcuding the fact that the patient is in treatment) may be revealed to an outside source without the written consent of the patient when they are rational & drug-free.

Consent forms must specify - what information will be disclosed, to whom, and for how long

Privilege - A legal term that refers to an individual's right not to have confidential information revealed in court or other legal proceedings.

Grounds for breaching confidentiality - Suicide, child abuse, elderly abuse, neglect

MDMA - Combo drug with stimulant qualities Predominant action on the CNS is one of depression associated with extreme physical fatigue Interferes with the body's ability to control temperature Increases heart rate and blood pressure

Gold Standard for Urinalysis - GC/MS

Basic Steps of Assessment - Information, Data analysis, and Treatment Plan Development

Validity - accurately measure what it intends to measure

Reliability - produces stable results

Standardized Interview - Limits the interviewer to a prescribed style and list of questions. May be more credible than structured interview.

Treatment Plan Development includes - Problems, goals/objectives, resources, persons responsible, time frame, benefits

Maslow's Hierarchy of Needs - Physiological, Safety, Belonging/love, Esteem, and Self- Actualization

Termination - A stage in the counseling process

Three Stages of Drug/Alcohol Treatment - Medical, Psychosocial, Aftercare

Commits suicide more frequently - Men commit suicide more frequently than women, although women attempt it more often.

Client informs counselor they have a suicide plan - 1. Notify supervisor

2. Formulate protective plan

Making a disclosure to the courts - subpoena, search warrant, or arrest warrant alone are not sufficient to permit a program to make a disclosure

Court Order for release of records - 1. program and patient whose records are sought must be given notice of application

2. program and individual have opportunity to make an oral or written statement to the court about the application

Criteria for court order to be issued - 1. Crime is extremely serious

2. Records sought must contain significant information to prosecution of crime
3. No other feasible way to obtain the information
4. The public interest in disclosure outweighs any harm to the patient, doctor-patient relationship, and agency
5. Program has opportunity to represented by independent counsel when law enforcement personnel seek the order

Search Warrant - may not be used to allow law enforcement to enter

Arrest Warrant - permit entry to search for client who committed/threatened crime on program premises or against personnel. Unless arrest warrant is accompanied by a court order, the program cannot cooperate with a search for a patient who committed a crime elsewhere.

Duty To Warn - activated when a client makes a threat of physical harm to an identified

individual or individuals. Threat of harm is deemed imminent.