Kaplan & Sadock’s Synopsis of Psychiatry, 12th
Edition – Chapters 1 & 4
Final Exam High-Yield Summary for Substance Use Disorders
Definitions
• Behavioral Dependence: Compulsive drug-seeking, craving, continued use
despite harm.
• Substance Use Disorder: ≥2 symptoms within 12 months (craving, loss of
control, tolerance, withdrawal, impairment).
• SUD Severity: Mild (2–3), Moderate (4–5), Severe (6+).
• Substance Intoxication: Reversible syndrome causing
behavioral/psychological changes after substance use.
• Substance Withdrawal: Substance-specific symptoms following cessation;
can be life-threatening (alcohol, benzodiazepines).
Screening Tools – SBIRT
• Screening: Identifies risky substance use.
• Brief Intervention: Motivational interviewing.
• Referral to Treatment: Connect patient to formal treatment services.
• Scoring Meaning: Higher score = greater need for treatment.
CIWA (Clinical Institute Withdrawal Assessment for
Alcohol)
• Components: Nausea, tremor, sweats, anxiety, agitation,
tactile/visual/auditory disturbances, headache, orientation.
• Scoring: 0–8 mild, 9–15 moderate, ≥16 severe.
• Actions: Mild = observe; Moderate = PRN benzodiazepines; Severe =
scheduled benzos, possible admission.
CAGE Screening
• Components: Cut down, Annoyed, Guilty, Eye-opener.
• Scoring: ≥2 indicates problematic drinking.
