self-report inventories
instruments used for diagnostic purposes, they can be useful, but are not meant to be used in isolation from other assessment data
components of a psychosocial history
AOD use history, family history, social history, legal history, educational history, occupational history, medical history, and psychological and behavioral problems
referral programs
refer to a program that conducts objective assessments, has proper licensing, credentialed counselors
misuse
when a person experiences negative consequences from the use of AOD
substance abuse
the continued use of alcohol or other drugs in spite of negative consequences
addiction or dependence
is the compulsive use of AOD relgardless of the consequences
Early Full Remission
if the client has been in recovery for 1 to 12 months and none of the criteria for dependence or abuse are met
Early Partial Remission
if one or more criteria are met but the client cannot be diagnosed as substance dependence- does not meet three or more of the criteria
Sustained Full Remission
period of recovery is 12 months or longer without slips
Sustained Partial Remission
period of recovery is 12 months or longer but had slips but not full-blown relapse
On Agonist Therapy
client has a low probability of use due to external circumstances
In a Controlled Environment
if client is in prison or a supervised enviroment without AOD
Minnesota Model
4 components- 1- belief that client can change attitutude, 2- adheres to the disease concept of addiction, 3- long-term treatment goals- personal growth, 4- principals of AA and NA in treatment
Aversive conditioning techniques
using unpleasant stimuli to reduce desire - nause, apnea, electric shock
Heroin withdrawal medications
methadone, suboxone
treatment modalities
individual, group, and family counseling, support groups, lifestyle changes, education and aftercare
treatment settings
inpatient and residential settings, partial hospitalization, day treatment, intensive outpatient, and outpatient treatment
Drug Abuse Prevention and Control Act
was passed by congress in 1970. As part of this law, drugs are placed in one of five shcuedules with requirements assoicaited with each schedule.
Schedule I drugs
have a high potential for abuse- they have no currently accepted medical use in treatment in the US and a lack of a safe level of use under medical supervision- heroine, quaalude, LSD and marijuana
Schedule II drugs
high abuse potential and can lead to psychological or physical dependence- can be used in medical treatment- morphine, PCP, cocaine and methamphetamine
Schedule IV drugs
Valium, Xanax- related to public policy- can have same abuse potential
Benzodiazepines
most widely prescribed drugs, valium, xanax, ativan, klonopin, serax, librium sometimes used for the treatment of panic attacks
Benzos
most widely abused, fat soluable, 1/2 life, xanax and valuim- most widely abused
Barbituates
prescribed for sleep, used for seizure control- phenobarbital, seconal, quaaludes
Opiods
prescribed as an alangesic- pain relief, vicadan olycontin, percocet methadone- could cause respiritory depression
alchohol
most commonly used intoxicant- affect GABA/inhibition of stimulation, blocks panic and anxiety
Beer
3%-6% alcohol
Wine
11%-18% alcohol
Liquor
25% or more alcohol
CNC- central nervous system depressants
sedates, relaxes and calms- downers
Nicotine
causes more deaths than alcohol, most widely used
Cocaine
most addictive, smokeable form crack- rapid high intense crash, high 20 minutes to an hour
swallowing pills
takes 15-30 minutes to get absorbed into the bloodstream
snorting
takes 5-7 minutes to produce a high
IV use
takes 15-30 seconds to produce a high
smoking
takes 8 seconds to produce a high
Methamphetamine
speed, crank, meth, crystal- can be snorted or smoked, synthetic, high up to 4 hours, pschomotor stimulation, allertness, mood elevation, withdrawal is not medically dangerous, but psychologically devastating (cocaine too)
Hallucinogens
escape reality, LSD, mushrooms, morning glory, marijuana- can cause panic reactions, injuries to self/others, flashbacks- could last for years
Marijuana
most widley used illegal drug, active ingredient THC, gateway drug, amotivational drug- "Careless drug
alchohol overdose
common- being drunk- staggering, slurred speech, extreme disinhibition, blackouts, stomach spasms- vomit, rapid ingestion may result in coma or death
overdose
depress the central nervous system- 10-15 times the therapeutic dosage- barbituates often used in suicides
accidental overdose
combination of alcohol and benzos- xanax, ativan
inhalants
produces euphoria- nitrous oxide, poppers, white out, could result in hallucinations, brain paralysis, or coma
anabolic steroids
used to improve athletic perfromance- muscle mass- infertility, baldness, aggression
club drugs
ecstasy- MDMA, special K, pohypnol- date rape drug, GHB- diminishes inhibitions- enhances sexual experiences
central nervous system depressants
alcohol, minor tranquilizers
central nervous system stimulants
cocaine, mehtanphetamine
Impaired Model
no addicts are this way by nature- prognosis: death due to use
Dry Moral Model
maintain complete abstinence or it's a sin- based only on willpower, uses guilt and remorse, religious conversion
Wet Moral Model
advocates for controlled drinking, supports self-will, goal- drink responsibly
Psychoanalytic Model
use is due to an underlying personality disorder, most expensive and most popular
Family Interaction Model
focus on family- successful with intervention, pronosis: poor without full family involvement
AA Model
addiction is defined as a physical allergy and mental obsession, has a support system, prognosis: fair to good
Love Model
Addict doesn't perceive themselves as sufficiently loved
Substitution Model
created by an inability to cope with anxiety due to absitinence, treat with substitute medications that could be addictive, but not the person's drug of choice, pronosis is poor
Biopsychosocial Model
looks at a variety of factors in explaining the addiction i.e. biological, psychological, environmental, and cognitive
Social Learning Model
use is the result of the environment
Old Medical Model
self-induced deterioration due to drinking, treatment- detox. and meds, treat the symptoms and let them go, implies one can drink if no medical problems exist
Disease Model
E.M. Jellninek - physiological susceptibility to disease exacerbated with continued use, requires abstinence + education, does not require psychological help, unless dual diagnosis
Dopamine
pleasure seeking transmitter
Norepinephrine
adrenaline, energy transmitter
Serotonin
mood regulator transmitter
GABA
inhibitory (Stops inhibitions) transmitter
Glutamate
It is always excitatory (GO), usually due to simple receptors that increase the flow of positive ions
Acetylcholine
plays a role in skeletal muscle movement, muscle control
Natural Opiates
andogenous opiates- endorphins help pain relief made from poppy
Opiods
man-made synthetic opiate, any synthetic narcotic that has opiate-like activities but is not derived from opium
Brain effect
Brain gets tricked with drug abuse b/c the neurotransmitters are confused with the natural neurotransmitters and are passed through the blood-brain barrier
electrical impulse
gets stimulated through drug use
Homeostasis
balances the brain- tries to find balance by shutting down or opening up more receptor sites
tolerance
as receptors are closed, a person can never get that "First High", needs to take more to get more of a high
Limbic System
pleasure and survival part of the brain
cerebral cortex
learning, judgment part of the brain
VTA Ventral Tagmental Area
rewards circuit of the brain, where dopamine is produced
Amygdala
stores emotional memories and pleasurable memories
Hippocampus
intellectual memories, learning (marijuana affects this area, pot-head can't remember)
Dopamine Depletion Hypothesis
addiction begins at this stage b/c the brain stops producing the receptors, abstinence must occur in order for the brain to start producing receptors again
reuptake
recycled, the reabsorption of a secreted substance by the cell that originally produced and secreted it, for example, affects serotonin
SSRI selective seratonine reuptake inhibitor
are a class of compounds typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders.
Alcohol disease
over time mitochondria becomes misshapened - first sign of addiction
mitochondria
parts of the cell that produce energy
esophagitis
drying of the esophagus
Liver disease
enzomatic breakdown- enzymes overactive,
hepatitis
fatty liver, liver enlarged
serosis
scarred liver, can cause cancer
bial
accumulated in body jaundice
THIQS tetrahydroisoquinenlines enzyme
enzyme that gets produced in the brain of an alcoholic, stimulates opiate receptor sites- produces euphoria
Meds to stop drinking
NTA, antobuse, naltrexone revia- used for relapse patients
naloxo
used to stop withdrawal
opiate antagonist
blocks the opiate
compral accopracy
drug taken after acute withdrawal- helps with cravings
compliance
client needs to take medication as directed
naltrexone
is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence
Functional Alcoholic
more at risk for chronic medical problems than an alcoholic
cross tolerance
addicted to one substance, tolerance is higher for other meds. in that category
cross addiction
addicted to more than one category
poly-substance dependence
abuse dependences- 3 or more categories of addiction i.e. huffing, smoking pot, and alcohol abuse
rebound effect
opposite of intoxicating effect i.e. drink a lot- sleep, blood alcohol level drops, person wakes up needs more alcohol
cocaine - high
crash withdrawal could lead to substance abuse psychosis or suicide
synergistic effect
combining 2 drugs for a better high i.e. alcohol + a Benzo= multiplied effect, can cause accidental deaths
Acute withdrawal
lasts 1-5 days
Benzo withdrawal
lasts 4-14 days, need medically managed care
Post Acute Withdrawal or Protracted Withdrawal
more psychological dependence- could take up to 2 years- inability to solve simple problems
PAW symptoms - six major types
1-an inabiltiy to think clearly 2-memory problems 3-emotional overreaction/numbness 4-sleep problems 5-physical coordination problems 6- stress sensitivity
regenerative PAW
symptoms gradually improve the longer a person stays sober, brain rapidly returns to normal
degenerative PAW
symptoms get worse the longer a person stays sober, relapse prone, person may collapse physically or emotionally- possible suicide
stable PAW
symptoms essentially remain the same, frustrating b/c people believe they should get better with sobriety, but need to learn to manage these symptoms
intermittent PAW
symptoms come and go, may have improvement then episodes that are severe, may go away, may occur periodically
Managing PAW
Stabilization, Education and Retraining, Self Protective Behavior, Nutrition, Exercise, Relaxation
CIWA- clinical institute withdrawal assessment for alcohol
scaled assessment used to dertermine Post Acute Withdrawal
Predictor of adolescent substance abuse
verbal abuse, decrease social involvement, absenteeism, truancy, stealing, involvement with peers who use