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Substance Abuse and Addiction: A Comprehensive Overview, Exams of Advanced Education

A comprehensive overview of substance abuse and addiction, covering various types of drugs, their effects, and treatment approaches. It delves into the stages of addiction, withdrawal symptoms, and medication-assisted treatment options. The document also explores different types of drugs, including opioids, stimulants, depressants, and hallucinogens, providing insights into their mechanisms of action and potential risks. It is a valuable resource for understanding the complexities of substance abuse and addiction.

Typology: Exams

2024/2025

Available from 12/08/2024

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LCAS Exam – NC with complete questions and answers 2025

Methadone - the only long-acting full opioid agonist approved for treatment, at this time. It provides a range of effects similar to those of short-acting opitates like Heroin and Morphine, surpressing withdrawal symptoms and avoiding cravings as the opioid is eliminated from the body. Dose needed for cross-tolerance depends on client's level of tolerance for the drug(s). Trauma-informed treatments - This treatment approach should minimize the risk of re- traumatization or replicating prior trauma dynamics. Ex: Clients may express feelings of powerlessness or being trapped if they are not active involved in treatment decisions or if providers mirror specific behaviors/dynamics from client's past traumatic experiences. Screening - The first two steps in in this process are to determine whether the client as a history of trauma and whether he/she has trauma related symptoms. Screening - Often the first contact between client and treatment providers, this interaction can set the tone of treatment and being the relationship with the client. Assessment - When a client screens positive for substance abuse, trauma-related symptoms, or mental health disorders, the counselor should follow up with a comprehensive


Assessment - This process should reoccur throughout treatment, to provide valuable information and details as client's trust in staff members grow and progress occurs. CBT - Most PTSD and SA models involve ________________ that integrates cognitive and behavioral theories by incorporation two ideas: that thoughts mediate between situational demands and one's attempts to effective respond and that behavioral change influences acceptance of altered cognition about oneself or a situation and establishment of newly learned patterns

Cognitive Processing Therapy - a manualized 12-session treatment approach which can be administered in group or individual practice, which involves Exposure Therapy. Exposure Therapy - This type of therapy asks clients to directly describe and explore trauma- related memories, objects, emotions, or places. Intense emotions are evoked, but decrease, desensitizing clients through repeated encounters with traumatic material. Experimental and Social Use of Drugs and Alcohol (stage 1) - occasional - perhaps a few times monthly, usually on weekends or at parties with friends. May use when alone. Little to no behavioral changes, occasional, moderate hangover. Abuse of Drugs and Alcohol (stage 2) - regular use - up to several times a week. may begin use during the day. may be using along rather than with friends. There are behavioral indicators in this phase of addiction, such as a decrease in activities, declined in school or work performance, and greater interest in use. May use to manipulate emotions in this phase. May sell drugs or keep supply for personal use. Dependency/Addiction Phase (Stage 3) - daily use, continuous. will take serious risks to obtain drugs/alcohol, potentially including criminal behavior. Drugs/Alcohol help client to feel normal. Behavioral indicators can include changes in weight, health issues, poor appearance, memory loss, volatile mood swings, employment loss, possible overdoses, lack of concern about being caught. Chronic relapsing disorder in his phase. Alcohol - The most widely used and accepted drug, past and present. A depressant, similar to the anesthetic drug ether. The only non-medical drug taken "only" orally. It slows heart rate and slows breathing. It depresses the brain. This is the only drug with which a large number of those who use it do not become physically dependent on it. An estimated 10% of those who use it become dependent.

Other Sedative-Hynotics - sedative and hypnotic agents which are non-barbiturate or non- benzodiazepines, including Quaaludes, Ambien (Zolpidem), and Lunesta (Eszopiclone). Narcotics or Opiates/Opioids - Drugs that cause sedation and euphoria by causing depression of the central nervous system. Narcotics or Opiates/Opioids - Used medically to relieve pain, suppress cough and control diarrhea, as well as some anxiety relief. Narcotics or Opiates/Opioids - Overdose can cause death by respiratory depression Semi-synthetic Opiates - Hydromorphone (Dilaudid), Oxycodone, Heroin Synthetic Narcotics - Demerol, Methadone, Buprenorphine, Propoxyphene (Darvone) Pentazocine (Talwin), OxyContin Opiate Agonist - These drugs can be substituted for the drug of abuse to provide a more controllable form of addiction. Using them alleviates many withdrawal symptoms. It acts similarly to opiates, and bonds with an opiate receptor to trick the brain and take the place of an opiate. Substitution Therapy. Ex. Methadone, Clonidine. Opiate Antagonist - A drug which occupies the same space in the receptor, but does not produce the same effects. This type of drug blocks the opiate receptor so that it blocks the effects of opiates. Non-addictive. Example. Naltrexone (Revia, Vivitrol), Naloxone, and Buprenorphine is a partial agonist can act as both agonist and antagonist Inhalant - Solvents, aerosols, gases, and nitrates which can act as Central Nervous System depressants. Can create similar effect to alcohol intoxication. Can cause physical and

psychological dependence. Risk of immediate death. OTC so tend to be abused by adolescent population. Marijuana - Most frequently used illicit drug in the United States. THC potency has increased dramatically since the early 1960s. Depressant stimulant, analgesic, and sometimes hallucinogenic effect. 4-10 times the tar and carcinogens than found in cigarettes. Can cause physical and psychological dependency. The buds of the female plant contain the highest concentration of THC. Cannabis Sativa - Marijuana is derived from the hemp plan called this Cannabinoids - Chemical compounds found only in marijuana are referred to as _____________. The primary one being THC. Hallucinogens/Psychodelics - This class of drug alters mood, thought, and perception, cause CNS depression and, at times, stimulation. No physical dependence, but can cause a psychological dependence. In large quantities, can be fatal. LSD and PCP - the only hallucinogens which are not naturally occurring. Naturally occurring hallucinogens - Mushrooms, Peyote, Morning Glory Seeds, Nightshade, DMT, Nutmeg and Mace LSD - One of the most potent drugs and one of the few which can be absorbed directly through the skin. PCP (phencyclidine) - A dis-associative anesthetic, which causes stimulation, depression, analgesia and hallucinations. Can cause death by overdose. Unpredictable length of effect. May illicit drugs on the streets are actually this.

Designer drugs - Includes MDMA (Ecstasy, Molly) and Synthetic Marijuana (K2, Spice), these are synthetic products chemically manufactured to be similar to other drugs. Can be highly dangerous and unpredictable. Alters activity of neurotransmitters. Can interfere with body's ability to regular temperature, heart rate, and blood pressure. Caffiene - Most widely used central nervous system stimulant. Produces tolerance as well as withdrawal symptoms. Nicotine - A powerful Central Nervous System stimulant. Highly addictive - more so than cocaine and heroin. 60 mg can be fatal. Amphetamines - Strong CNS stimulant. (ex. Bath Salts, Ice, Meth, Adderall) Can be legally prescribed by physician typically to treat ADHD. Increase alertness and sense of well-being, but can lead to increased anxiety, malnutrition, paranoia, and even death. People with high blood pressure, heart issues, diabetes, thyroid or urination issues, should not take. Causes physical and psychological dependence. Can harm developing fetus. Lowers white blood count - decreases resistance. Ice - smokable methamphetamine. pure with few additives. colorless and odorless. less expensive than crack. highly addictive. adverse impact occurs more quickly than with other amphetamines. high can last up to 30 hours. Cocaine (White, Crystalline Powder) - Most Powerful Naturally occurring CNS stimulant. Short- lived sense of euphoria. Physically and psychologically dependence causing. Can increase risk of infectious diseases due to reduction of white blood cells with use. Can cause damage to heat and neurological functioning even with short term use. Impairs judgement, decreases ability to concentrate, and impairs motor coordination, as well as vision.

Crack Cocaine (Cocaine with baking soda and water) - Freebased, more potent than powder form of drug. One of most highly addictive drugs known. Absorbed within seven seconds of being smoked. Harms developing fetus. Long-term adverse effects of crack cocaine - weight loss, dehydration, constipation, tooth decay, urinary tract issues, chronic sore throat, lung congestion, hacking cough, lung damage and black discharge. Detoxification (Detox) - The purpose of this process is to help the client stabilize physically and psychologically until the body becomes free of drugs or the effects of alcohol. Signs of depressant withdrawal - tremor, hyperreflexia, agitation, HTN, tachycardia, insomnia, nausea, vomiting, excessive perspiration, cognitive impairment (memory loss, difficulty concentrating), seizures, weakness, anorexia, irritability, anxiety, restlessness, headache, muscle ache, depression, tinnitus, paranoid delusions, hypersensitivity to light and sound. Medication Assisted Treatment (MAT) - The use of approved medications with medical supervision. Goals of this treatment include reduction of substance use, reduction of criminal activity, improvement of social behavior and improvement of psychological well being. Subutex - Buprenorphine monotherapy. Bupe is a mixed agonist and antagonist agent. It is long-active and blocks the effects of other opiate drugs. Suboxone - Buprenorphine/Naloxone combo, used for treatment for opioid addiction. The combination is designed to decrease the potential for abuse by injection. Antabuse (disulfiram) - An antidipsotropic drug which creates an adverse physical reaction when the person consumes the substance of abuse. This drug is used to treat alcohol addiction to prevent relapse.

Naloxone - NARCAN. Sold under the brandname Narcan among others, is a medication used to block the effects of opioids, especially in overdose. Naltrexone - Revia, Vivitrol. Opioid Antagonist which blocks effects of opioids. It helps a client deal with alcohol cravings by blocking the chemical responses that make alcohol rewarding. Behavior Modificatoin - Increases rewards for positive, pro-social behaviors. Unpleasant responses or rewards withheld for negative or anti-social behavior may help to extinguish unwanted behavior. Aversive Conditioning - Providing negative rewards to extinguish unwanted behavior Screening - The process by which a client is determined appropriate and eligible for admission to a particular program. Generally determined by the focus, target pop, and funding requirements of the program/agency. This process may include collection of client's age, sex, place of residence, legal status, veteran status, income level and referral source. Diagnostic criteria may be utilized. Eligibility is influences by agency's environment and treatment modality. Presenting problem will be collected along with previous treatments, outside supports, and stage of change. Rapport will begin to be established. Intake - The administrative and initial prodedures for admission to a program including completion of required documentation, intake sheet, appropriate releases, collection of financial data, signing consent for treatment, etc. Orientation - Describing to the client the nature and goals of the program, any rules governing client conduct, hours of services, schedule, treatment costs if any, client rights. Any questions, concerns or fears client has about treatment can be discussed.

Assessment - The procedure by which a counselor or program identifies and evaluates an individual's strengths, weaknesses, problems, and needs for the development of a treatment plan. This process should be multidisciplinary and ongoing. It should include psychological, physiological, behavioral, family, economic, environmental, sociological, interpersonal, and addiction information. Collection of a verbal history and establishment of rapport for diagnosis and treatment planning. Group Counseling - The central factor in making this treatment modality effective is denial. Peer support and peer pressure can be effective in breaking through denial. Denial - the one therapeutic factor with the most profound effect in eliminating ______ is universality - recognizing that he or she is not alone. This helps to eliminate the isolation and possible demoralization that the person could be feeling. Yalom's 12 factors that help group members to change. - Instillation of Hope; Universality; Imparting information; Altruism; Corrective recapitulation of one's family (learning healthier ways to behave); Development of socializing techniques; Imitative behavior; Interpersonal Learning; Noticing new Interpersonal Skills; Group cohesiveness; Catharsis; Existential factors. Stages of group development - p. 308 Treatment Planning - Based on the assessment; The process by which the counselor and client identify and prioritize problems, establish agreed upon immediate and long-term goals, and decide on treatment methods and resources to be used. Psychology - the study of people - understanding why they think, feel and behave as they do. Psychodynamic/Psychoanalytic Theory - Sigmund Freud is the founder of this theory, including Id (impulses), Ego (reasoning), and Super Ego (conscience). By the time a child is five, their personality is already formed. The rest of life is acting out unresolved conflicts.

Ego Defenses - Repression, Projection, Displacement, Reaction formation, Regression, Rationalization, Intellectualization. Client-Centered Therapy - Carl Rogers is the founder. Goal of therapy is self healing through self-discovery and self-acceptance. Techniques of treatment include Genuineness, Empathy, Unconditional positive regard Gestalt - Fritz Perls was the founder. Goal of therapy is to integrate experiences into a whole personality. The client does the changing and integrating. Therapist is a catalyst and guide providing a safe environment and analysis in the "here and now" and providing exercises that force client to experience rather than just talk about him or herself (empty chair). Rational-Emotive Therapy - Albert Ellis is the founder. Goal of therapy - teaching a client to analyze his/her belief system and correct the irrational distortions. Techniques including engaging in active dialogue with client and identifying client's irrational belief. Reality Therapy - William Glasser is the Founder. Goal of therapy: helping the individual get back in touch with objective and moral reality by making responsible choices. This process involves a plan for change, good rapport, focus on the present, and work on getting one's needs met within reality. Transactional Analysis - Eric Berne is the Founder. Each person has three ego states that are continuously functioning - parent, adult, and child. These ego states interact with the ego states of another person and this exchange is called a "transaction". Goal of Therapy: To identify the types of transactions in which the person participates. The transactions are interpreted in light of the client's script. Games are identified. Role in script is defined. Client is helped to function from the rational adult position whic is considered the healthiest place.

Behaviorism - Pavlov and Skinner are founders. This therapeutic approach focuses only on observable behavior and not the inner being. All people are subject to "conditioning". Goal of therapy: Client learns new responses to old stimulus. Techniques: Behavior modification, Contracting, Systemic desensitization, Modeling Extinction - A particular behavior is weakened by the consequences of not experiencing a positive condition or stopping a negative condition. Part of behavior modification. Systematic Desensitization - Because it is difficult to feel both pleasant and anxious at the same time, this technique is aimed at teaching an individual to relax and behave in some way that is inconsistent with anxiety while in the presence of anxiety-producing stimulus. Involves repeated exposure to stimulus. Aversion Therapy - Modifying an undesirable behavior by the "old fashioned method" of punishment. Existential Therapy - Viktor Frankl; Rollo May are founders. Goal of Therapy: To provide conditions for maximizing self-awareness. Removal of blocks to fulfillment of full potential. To help clients discover and use freedom of choice by expanding self-awareness and enable them to be free and responsible for the direction of their own lives. Cluster A Personality Disorders - Odd or Ecentric Behavior including paranoid, schizoid and schizotypal. Cluster B Personality Disorders - Dramatic, emotional or erratic including antisocial, borderline, histrionic, and narcissistic. Cluster C Personality Disorders - Anxious, fearful behavior including avoidant, dependent, and obsessive-compulsive types

Motivational Interviewing - A counseling style based on the assumption that ambivalence about change is normal and can be resolved by working with client's intrinsic motivations and values. The alliance between client and counselor is a collaborative partnership to which you each bring important expertise, and an empathetic, supportive, yet directive counseling style provides conditions under which change can occur. Stages of Change - Precontemplation, Contemplation, Preparation, Action, and Maintenance. OTP - opioid treatment program Naturally Occurring Opiates - Morphine, Codiene 12 Core Functions - Screening, Intake, Orientation, Assessment, Treatment Planning, Counseling, Case Management, Crisis Intervention, Client Education, Referral, Record Keeping, Consultation