IC&RC Examination Test: Substance Abuse and Addiction, Exams of Public Health

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marking scheme

How is drug tolerance best described? - Correct Answer Decreased sensitivity to a drug over time

What is the most common symptom of Wernicke's encephalopathy? - Correct Answer Confusion

Which 3 conditions does alcohol induce? - Correct Answer 1. Steatosis

2. Hepatitis
3. Cirrhosis

Formication - Correct Answer a sensation like insects crawling over the skin.

What organ is most damaged by cocaine abuse? - Correct Answer The Heart

What are 3 basic chemicals of amphetamines? - Correct Answer 1. Amphetamine Sulphate

2. Dextroamphetamine
3. Methamphetamine

What is the most difficult drug to quit? - Correct Answer Nicotine: only 7% succeed, 1/ of all heart disease deaths linked to smoking

Convergence Theory - Correct Answer Rates of substance abuse among women are converging with those of men

Alcohol Abuse ranks _____ in psychiatric disorders in the elderly - Correct Answer Third

Alcohol Use Disorder 3 Subcategories in the elderly include: - Correct Answer 1. Late- onset alcoholism

2. Delayed-onset alcoholism
3. Late-onset exacerbation drinking

First requirement at an initial meeting with a client - Correct Answer Establish rapport

What does Motivational Interviewing primarily involve? - Correct Answer Supportive persuasion

What % of Dual Dx clients received tx for only their mental illness? - Correct Answer 32.9%

What does the acronym GATE stand for? - Correct Answer Gather information Access supervision Take responsible action Extend the action (i.e. to evaluate suicidal ideation/behavior)

Which is the MOST important introductory statement/question to ask in a suicidality evaluation? - Correct Answer I need to ask you a few questions about suicide

What is the purpose of screening? - Correct Answer To determine the need for placement or referral

What is the primary purpose of SUD assessment? - Correct Answer To determine the severity of the substance problem

Who should create a treatment plan? - Correct Answer Collaborative team with the client

How must 'assessment information' be handled to be the Most effective? - Correct Answer Converted into goals and objectives

What 3 key elements bolster a client's desire to complete the program? - Correct Answer 1. Knowledge of the benefits of tx

2. Understanding of the tx process
3. Fully assuming the patient role

How many levels of tx placement are recognized by the American Society of Addiction Medicine (ASAM)? - Correct Answer Four levels of treatment placement

How many Assessment Dimensions are recognized by the American Society of Addiction Medicine (ASAM)? - Correct Answer Six assessment dimensions

"Drug Use Trajectory" refers to? - Correct Answer Individual drug use patterns over the lifespan

Circumstances, Motivation, Readiness, and Suitability (CMRS) Scales are used for what purpose? - Correct Answer Assessing client readiness for treatment

When is a client fully prepared to enter treatment? - Correct Answer A client accepts the need for treatment

Guiding principles in treatment planning are identified by which acronym? - Correct Answer MATRS:

What are the 7 learning styles? - Correct Answer 1. Aural

2. Visual
3. Verbal
4. Physical
5. Logical
6. Social (interpersonal)
7. Solitary (intrapersonal)

What is the influence of family on treatment outcomes? - Correct Answer Treatment outcomes can improve OR worsen depending on health of the family

How many levels exist in the substance abuse continuum of care, according to the American Society of Addiction Medicine (ASAM)? - Correct Answer Five levels of care

How many sequential stages must outpatient clients work through, regardless of the level of care at which they enter treatment? - Correct Answer Four stages

What are the 4 Stages of treatment according to the American Society of Addiction Medicine (ASAM)? - Correct Answer 1. Treatment Engagement

2. Early Recovery
3. Maintenance
4. Community Support

Individual vs. Group Therapy - Correct Answer Equal in Effectiveness

What are 3 types of IOT groups? - Correct Answer 1. Psychoeducational groups

2. Skills development groups
3. Interpersonal process groups

What was the original CIWA-Ar scale designed for? - Correct Answer Evaluation of alcohol withdrawal risk

Adjunctive Therapies include: - Correct Answer 1. Stress Management

2. Meditation
3. Acupuncture

What is the sandwich technique? - Correct Answer An (intake interviewing) technique

What are the 3 most effective screening tools for SUDs? - Correct Answer 1. The CSAT Simple Screening Instrument

2. The Alcohol Dependence Scale (ADS) and the Addiction Severity Index (ASI) - Drug Use Subscale Combined
3. The Texas Christian University Drug Screen

What is the SDSS designed to measure? - Correct Answer Drug use disorder severity over time

What is the primary purpose of the Texas Christian University Drug Screen (TCUDS)? - Correct Answer To identify those WITH vs. those WITHOUT issues of drug dependency

What is physiological dependence determined by? - Correct Answer Tolerance or symptoms of withdrawal

Early Remission is? - Correct Answer No criteria being met: 3 but less than 12 months

Sustained Remission is? - Correct Answer No criteria being met: 12+ months

To establish rapport and trust with a new client, what would you do first? - Correct Answer Ask the client's permission to address the subject of change

Four Steps to give client feedback about assessment results - Correct Answer 1. Express appreciation for client effort in responding

2. Ask client whether they had problems w/testing
3. Ask client how testing affected their perceptions
4. Encourage client to ask questions

For minority group clients, culturally competent tx is best achieved through? - Correct Answer Services integrating community partners

What is a key element of effective referrals? - Correct Answer Collaboration

Case Management - Correct Answer 1. Gives clients continuity by providing a single contact point

2. Is community based in all approaches, but the extent varies by agency

For Case Management to be Culturally Sensitive - Correct Answer The case manager must do cultural self-assessment to be culturally competent

Stages of Change - Correct Answer 1. Precontemplation

2. Contemplation
3. Preparation
4. Action (6 months)
5. Maintenance (7+ months)

Research has found what to be true about ethnic minority client in SA/MH settings? - Correct Answer Studies found fewer community resources and access to specialty treatment for ethnic minorities

How to SA clients file complaints when they've experienced discrimination? - Correct Answer Cases may be filed in state or federal court, or a suit filed by the U.S. Attorney General

Medulla Oblongata - Correct Answer Lowest part of the brain/brainstem that controls vital life-sustaining involuntary functions such as heartbeat, breathing, blood pressure, and digestion.

Pons - Correct Answer Connects brain stem and midbrain Allows communication b/w cerebrum, cerebellum, and spinal cord

Midbrain - Correct Answer A small part of the brain above the pons that integrates sensory information and relays it upward Psychedelics act here and cause hallucinations

Limbic System - Correct Answer neural system (including the hippocampus, amygdala, and hypothalamus) located below the cerebral hemispheres; associated with emotions and drives. Tranquilizers calm

Hypothalamus - Correct Answer A neural structure lying below the thalamus; it directs several maintenance activities (eating, drinking, body temperature), helps govern the endocrine system via the pituitary gland, and is linked to emotion and reward. Many psychoactive drugs work here

Cerebellum - Correct Answer A large structure of the hindbrain that controls fine motor skills.

Thalamus - Correct Answer the brain's sensory control center, located on top of the brainstem; it directs messages to the sensory receiving areas in the cortex and transmits replies to the cerebellum and medulla

Subthalamus - Correct Answer located beneath the thalamus interacts with the cerebellum to control motor activity

Cerebrum Lobes - Correct Answer frontal, parietal, occipital, temporal

Frontal Lobe - Correct Answer A region of the cerebral cortex that has specialized areas for movement, abstract thinking, planning, memory, and judgement

Occipital Lobe - Correct Answer A region of the cerebral cortex that processes visual information

Parietal Lobe - Correct Answer portion of the cerebral cortex lying at the top of the head and toward the rear; receives sensory input for touch and body position

Temporal Lobe - Correct Answer A region of the cerebral cortex responsible for hearing and language.

Cerebral Cortex - Correct Answer outer region of the cerebrum, containing sheets of nerve cells; gray matter of the brain

What are the 3 General Stages of SUD? - Correct Answer 1. Experimental and Social Use

2. Abuse
3. Dependency/Addiction (incurable at this stage)

5 Stages of SUD - Correct Answer 1. Experimentation

2. Regular Use
3. Problem Use
4. Dependence
5. Addiction

7 Stages of Alcohol Intoxication - Correct Answer 1. Subclinical

2. Euphoria
3. Excitement
4. Confusion
5. Stupor
6. Coma
7. Death

3 Stages of Alcohol Withdrawal - Correct Answer 1. Beginning Withdrawal

2. Withdrawal
3. Severe Withdrawal

Blood Alcohol Content (BAC) - Correct Answer a measure of the percentage of alcohol found in a person's blood Legal limit = 0.08%

Substance Use vs. Abuse vs. Disorder - Correct Answer 1. Occasional Drug Use = some behavioral changes, some physical symptoms

2. Drug Abuse = behavioral signs
3. SUD = physical, health, and behavioral symptoms

Alcohol Use vs. Abuse - Correct Answer 1. Tolerance

2. Loss of Control

Metabolization of Alcohol - Correct Answer takes about 2 hours to metabolize a single 1/2 oz of 200 proof alc, 1.5 oz of 80 proof, 12 oz of beer, 6 oz of wine Detoxification only in liver Broken down into acetaldehyde then acetic acid

CNS Depressants - Correct Answer *Sedative/hypnotics *Barbiturates *Minor tranquilizers

Motivational Interviewing - Correct Answer a collaborative, person-centered form of guiding to elicit and strengthen motivation for change

Patient Confidentiality can be disclosed when? - Correct Answer 1. Client's written consent

2. Medical emergency
3. Threatened harm to program, property, personnel
4. If info needed to assess functioning of program
5. If a court order is present

Screening vs. Assessment - Correct Answer Screening: to determine if there's a problem Assessment: to identify extent of problem, areas of dysfunction, impact of drug use on functioning

CAGE Assessment Instrument - Correct Answer Quick tool to identify alcoholism Moderate drinking = 1-2 drinks/daily, 1/older adults

C = Cutting Down A = Annoyed at Criticism G = Guilty of feeling E = Eye Opener

Screening to Brief Intervention (SBI) Assessment - Correct Answer To identify substance users, utilize brief interventions - to assess frequency of use Goal: to reduce use and risks 3 Levels: No risk, Low risk, High risk Ask MI questions to gather more info

TAPS Assessment Instruments - Correct Answer Tobacco, Alcohol, Prescription Medication & Other Substance Use (TAPS)

TAPS-1: frequency of use in last 12 months (if yes - administer TAPS-2) TAPS-2: frequency of use in last 3 months

CRAFFT Assessment Instrument - Correct Answer Children & Adolescents under 21 Acronym for screening questions

Car Relax Alone Forget Family/friends Trouble

Process Evaluation - Correct Answer Assesses if tx was appropriate, whether screening/assessment led to suitable tx

Whether client took advantage of recommended services available

Outcome Evaluation - Correct Answer Whether client accurately assessed and benefited from tx plan

Provides evidence of needs in drug tx (gaps)

Substance Use Disorders (SUDs) - Correct Answer Caused by: Drug abuse, Medication side effects, or exposure to a toxin

Intoxication & Withdrawal = behavioral, psychological & physiological sxs due to use or restriction of a substance

Substance classes: caffeine, hallucinogens, alcohol, cannabis, stimulants, tobacco, inhalants, opioids, sedatives, hypnotics & anxiolytics, and other

11 Symptoms Used to Dx SUD - Correct Answer 2+ must have occurred in past 12 months for dx

1. Tolerance
2. Withdrawal
3. Increased Amount
4. Inability to Control Use
5. Time & Effort to Obtain
6. Giving up Important Activities
7. Continued use despite ill effects
8. Craving
9. Inability to fulfill major roles
10. Physically harmful (use)
11. Use despite social problems

Level of Care: Quadrant 1 - Correct Answer Quadrant 1 = Low-Level SUD and minor mental health problems

Outpatient

Level of Care: Quadrant 2 - Correct Answer Quadrant 2 = Severe mental health, low- level SUD

treated in MH system

Level of Care: Quadrant 3 - Correct Answer Quadrant 3 = Severe SUD, MH low- moderate severity

7 SUD & MH Service Systems - Correct Answer 1. Comprehensive Continuous Integrated Systems of Care (CCISC) to integrate SUD & MH

2. Rational Recovery - educational material for self-recovery
3. Moderate Management (MM) - cut back drinking so no longer a problem
4. Women for Sobriety - female alcoholics
5. Secular Organization for Sobriety (SOS) - save our selves, get/stay sober from any substance
6. SMART Recovery - self-management & recovery training; addiction = maladaptive behavior
7. 12-Steps (AA, Minnesota Model) 60-day residential tx -- Hazelden 21-day -- 28-day version

SOAP Docmuentation - Correct Answer S: Subjective (clt's statement of problem) O: Objective (observations) A: Assessment (determination of possible causes) P: Plan (short & long-term goals, immediate plan)

PIE Documentation - Correct Answer Problem Intervention Evaluation

DAR Documentation - Correct Answer Data: about condition Action: taken by counselor Response: by client

Client Status Reports - Correct Answer Observable & Measurable

Duration, time, frequency, progress, direct observation

6 Stages of Counseling - Correct Answer 1. Information Gathering

2. Evaluation
3. Feedback
4. Counseling Agreement
5. Changing Behavior
6. Termination

Attending Skills - Correct Answer 1. Physical attending

2. Psychological attending
3. Self-attending

4. Responding

2 components = (1) listening and observing (2) ensuring client knows she's being heard

3 Components of Interpreting - Correct Answer 1. Ascertaining client's ideals & stating them (use attending, paraphrasing, reflection of feeling, and summarizing)

2. Adding counselor's ideas to client's ideas (helps to see other views)
3. Go over these ideas w/the client

Promoting Client Action - Correct Answer Role-playing Values clarification Goal setting Problem-solving Homework Advice Giving (several suggested paths w/out directing)

Transference - Correct Answer Client exhibits feelings towards counselor originally felt towards significant others (positive or negative)

Countertransference - Correct Answer Counselor exhibits feelings towards client based on unconscious reaction or response related to previous relationships or situations

*self-awareness important!

Recovery-Oriented Systems of Care (ROSC) - Correct Answer person-centered self-directed support referral to community resources

Crisis Intervention - Correct Answer establish rapport gather information arrange follow-up interview

Suicide Risk Factors: High-Risk Groups - Correct Answer Women attempt suicide more than men; men die by suicide more than women

Teenage boys Men over 50 yrs Older people in general Individuals who've suffered recent loss Individuals who're seriously ill Individuals w/out support system Individuals in unstable relationships Impulsive individuals