Addiction

Question 1

What are some comorbidities of addiction?

Answer 1

• Wernicke’s encephalopathy is a degenerative brain disorder caused by the lack of vitamin B1. It may result from: Alcohol abuse.
• Korsakoff syndrome is a memory disorder that results from vitamin B1 deficiency and is associated with alcoholism.
• fetal alcohol spectrum disorder

Question 2

What is the social theory of addiction? and treatment?

Answer 2

• Availability: How easy is it to acquire the substance or engage in the behavior
• Acceptability: Peer pressure, Honor the notion of “private”
• Values and Beliefs: People have choices
• treatment: legal consequences

Question 3

What is the psychological theory of addiction? and treatment?

Answer 3

• Addiction is influenced by an individual’s psychological make-up
  -Consider attachment theory
• Impact of personality traits leaves the person vulnerable and at risk for using substances to eliminate pain or negative feelings
• Treatment: Therapy

Question 4

What is the biological theory of addiction? and treatment?

Answer 4

• Addiction is a disease
• In an addicted brain there are structural and functional changes from a non-addicted brain
• Treatment: Abstinence

Question 5

Define substance use

Answer 5

Consumption is infrequent; may be described as experimental, casual or social; minor consequences

Question 6

Define physical dependence

Answer 6

Physiological changes that result from a pattern of regular use (substances) or engagement (gambling) that increase tolerance and withdrawal symptoms

Question 7

Define psychological dependence

Answer 7

The emotional and/or mental need to continue taking a drug or gambling to feel normal and to cope.

Question 8

Define craving. What neurotransmitter is it related to?

Answer 8

• A strong and intense desire.
• Cravings are related, in part, to dopamine levels in your brain

Question 9

Define abuse

Answer 9

A maladaptive pattern of use indicated by … continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use [or by] recurrent use in situations in which it is physically hazardous

Question 10

Define intoxication

Answer 10

A condition that follows the administration of a psychoactive substance and results in disturbances in the level of consciousness, cognition, perception, judgement, affect, or behaviour, or other psychophysiological functions and responses

Question 11

What are the cardinal signs and symptoms of addiction?

Answer 11

• Loss of Control
• Compulsion
• Craving
• Use despite consequences

Question 12

What is the CAGE assessment?

Answer 12

screen for alcohol abuse

C: have you ever felt you should Cut down on your drinking?

A: have people Annoyed you by criticizing your drinking?

G: have you ever felt Guilty about your drinking?

E: Have you ever had a drink as an Eye-opener first thing in the morning to steady your nerves or help a hangover?

Question 13

What are the stages of readiness to change?

Answer 13

• precontemplation
• contemplation
• preparation
• action
• maintenance
• relapse
• termination

Question 14

What is the precontemplation stage?

Answer 14

unaware, no knowledge of change needing to be made

Question 15

What is the contemplation stage?

Answer 15

thought of change, some information is gathered

Question 16

What is preparation stage?

Answer 16

planning for change, finding resources and creating course of action

Question 17

What is the action stage?

Answer 17

taking steps for change, utilizing resources

Question 18

What is the maintenance stage?

Answer 18

results are achieved and behaviour becomes a part of lifestyle

Question 19

What is the relapse stage?

Answer 19

A relapse is a form of regression to an earlier stage. It is not a stage in itself, but a failure to maintain the existing position in behavioral change, either as a result of inaction (e.g., stopping physical activity) or the wrong activity (e.g., beginning smoking again.)

Question 20

What is the termination stage?

Answer 20

The client has zero temptation, and their self-efficacy is 100%.

Question 21

What are examples of primary prevention for addiction?

Answer 21

alcohol labelling policy

cigarette taxation

Question 22

What are examples of secondary prevention?

Answer 22

harm reduction practices (supervised injection sites, managed alcohol program)

relapse prevention support

Question 23

What are examples of tertiary prevention?

Answer 23

detox and recovery/rehabilitation programs

Question 24

What are the 5 principles of motivational interviewing?

Answer 24

• Express empathy: key component is reflective listening

-Develop discrepancy between clients’ goals or values and their current behaviour

-Avoid arguments/power struggles and direct confrontation

-Support self-efficacy and optimism

• Roll with resistance

Question 25

How can resistance be identified?

Answer 25

Resistance can be identified by 4 basic behaviours:

• Arguing, interrupting, denying, ignoring

Question 26

What are the goals of motivational interviewing?

Answer 26

• Process Goal: for the patient to his/her own voice to express concerns, and recognize the argument for change
• Outcome Goal: to have the patient resolve ambivalence and increase his/her motivation and commitment to change

Question 27

When would you use CIWA-A?

Answer 27

When there is a likelihood of alcohol withdrawal

Question 28

When would you stop monitoring CIWA-A?

Answer 28

• When the score is <10 for three consecutive assessments
• Continue to monitor informally for re-emergence of symptoms

Question 29

What are treatment options for addiction?

Answer 29

• Benzodiazepines: Ativan and Valium - for anxiety and seizures
• methadone: Used for opioid addiction, Suppress withdrawal symptoms, Relieve cravings

-tobacco: Nicotine replacements, Bubroprion (Wellbutrin) - antidepressant, Varenicline (Champix) - smoking cessation medication

Question 30

What is a concurrent disorder?

Answer 30

used to refer to co-occurring addiction and mental health problems.