Alcohol and Drug Abuse Diagnosis and Treatment Flashcards

Question

Narcotics: Withdrawal Syndrome

Answer 1

watery eyes, runny nose, yawning, cramps, loss of appetite, irritability, nausea, tremors, panic, chills, sweating

Answer 2

scars (tracks) caused by injections, constricted pin-point pupils, loss of appetite, sniffles, watery eyes, cough, nausea, lethargy, drowsiness, nodding, syringes, bent spoons, needles, etc. (weight loss or anorexia)

Answer 3

Dependence (Physical/Psychological): high/mod Use: oral Duration: 1-16 hours

Answer 4

Dependency (Physical/Psychological): high/high Use: oral Duration: 4-8 hours

Answer 5

Dependency (Physical/Psychological): high/high Use: oral Duration: 4-8 hours

Answer 6

Dependency (Physical/Psychological): mod/mod Use: oral Duration: 5-8 hours

Answer 7

Dependency (Physical/Psychological): high/mod Use: oral Duration: 4-8 hours

Answer 8

drugs used medicinally to relieve anxiety, irritability, tension high potential for abuse, development of tolerance produce state of intoxication similar to that of alcohol combined with alcohol, increase effects, multiple risks

Answer 9

-Sensory alteration, anxiety reduction, intoxication -Small amounts cause calmness, relaxed muscles -Larger amounts cause slurred speech, impaired judgement, loss of motor coordination -Very large doses may cause respiratory depression, coma, death -Newborn babies of abusers may show dependence, withdrawal symptoms, behavioral problems, birth defects

Answer 10

-Shallow respiration -Clammy skin -Dilated pupils -Weak and rapid pulse -Coma -Death

Answer 11

-Anxiety -Insomnia -Muscles tremors -Loss of appetite -Abrupt cessation or reduced high dose may cause convulsions, delirium, death

Answer 12

-Behavior similar to alcohol intoxication -Staggering, stumbling, lack of coordination, slurred speech -Falling asleep while at work, difficulty concentrating -Dilated pupils

Answer 13

Dependence (Physical/Psychological): possible/high Use: sniffed, smoked, injected Duration: 1-2 hours (high lasts 5-20 minutes)

Answer 14

Dependency (Physical/Psychological): possible/high Use: oral, injected Duration: 2-4 hours

Answer 15

Dependence (Physical/Psychological): possible/high Use: oral, injected Duration: 2-4 hours

Answer 16

Dependency (Physical/Psychological): possible/high Use: oral, injected Duration: 2-4 hours

Answer 17

Dependency (Physical/Psychological): possible/mod Use: oral, injected Duration: 2-4 hours

Answer 18

Dependence (Physical/Psychological): possible/high Use: oral, injected Duration: 2-4 hours

Answer 19

Dependence (Physical/Psychological): high/high Use: smoked, oral injec., inhaled Duration: 4-14 hours

Answer 20

drugs used to increase alertness, relieve fatigue, feel stronger and more decisive, used for euphoric effects or to counteract the "down" feeling of tranquilizers or alcohol

Answer 21

-Increased heart and respiratory rates -Elevated blood pressure -Dilated pupils and decreased appetite -High doses may cause rapid or irregular heartbeat, loss of coordination, collapse, may cause perspiration, blurred vision, dizziness, a feeling of restlessness, anxiety, delusions

Answer 22

-Agitated behavior -Increase in body temperature -Hallucinations -Convulsions -Possible death

Answer 23

-Apathy -Long periods of sleep -Irritability -Depression -Disorientation

Answer 24

-Excessive activity, talkativeness, irritability, argumentativeness or nervousness -Long periods without sleeping or eating -Euphoria -Cocaine, while classified under the Controlled Substance Act (CSA) as a narcotic, is also discussed as a stimulant

Answer 25

Dependence (Physical/Psychological): unknown/high Use: smoked, oral Duration: up to days when injected

Answer 26

Dependence (Physical/Psychological): none/unknown Use: oral Duration: 8-12 hours

Answer 27

Dependence (Physical/Psychological): none/unknown Use: oral, injected, smoked, sniffed Duration: variable

Answer 28

Dependence (Physical/Psychological): unknown/unknown Use: oral, injected, smoked Duration: variable

Answer 29

drugs that produce behavioral changes that are often multiple and dramatic no known medical use, but some block sensation to pain and use may result in self-inflicted injuries "designer drugs", made to imitate certain illegal drugs, are often many times stronger than drugs they imitate

Answer 30

-Rapidly changing feelings, immediately and long after use -Chronic use may cause persistent problems, depression, violent behavior, anxiety, distorted perception of time -Large doses may cause persistent problems, depression, violent behavior, anxiety, distorted perception of time -May cause hallucinations, illusions, dizziness, confusion, suspicion, anxiety, loss of control -Delayed effects - "flashbacks" may occur long after use -Designer drugs - use may cause irreversible brain damage

Answer 31

longer, more intense "trip" episodes, psychosis, coma, death

Answer 32

no known withdrawal syndrome

Answer 33

-Extreme changes in behavior and mood; person may sit or recline in a trance-like state -Client may appear fearful -Chills, irregular breathing, sweating, trembling hands -Changes in sensitivity to light, hearing, touch, smell and time -Increase in blood pressure, heart rate and blood sugar

Answer 34

Dependence (Physical/Psychological): unknown/moderate Use: smoked, oral Duration: 2-4 hours

Answer 35

Dependence (Physical/Psychological): unknown/moderate Use: smoked, oral Duration: 2-4 hours

Answer 36

Dependence (Physical/Psychological): unknown/moderate Use: smoked, oral Duration: 2-4 hours

Answer 37

Dependence (Physical/Psychological): unknown/moderate Use: smoked, oral Duration: 2-4 hours

Answer 38

-Hemp plant from which marijuana and hashish are produced -Hashish consists of resinous secretions of the cannabis plant -Marijuana is a tobacco-like substance

Answer 39

-Euphoria followed by relaxation -Increased appetite, impaired memory, concentration, knowledge retention, loss of coordination; more vivid sense of taste, sight, smell, hearing -Stronger doses cause fluctuating emotions, fragmentary thoughts, disoriented behavior -May cause irritation to lungs, respiratory system; may cause cancer

Answer 40

fatigue, lack of coordination, paranoia

Answer 41

-Insomnia -Hyperactivity -Sometimes decreased appetite

Answer 42

-Animated behavior, loud talking, follow by sleepiness -Dilated pupils, bloodshot eyes -Distortions in perception; hallucinations -Distortions in depth and time perception; loss of coordinationAl

Answer 43

Dependence (Physical/Psychological): possible/possible Use: oral Duration: 1-4 hours

Answer 44

Dependence (Physical/Psychological): possible/possible Use: oral Duration: 1-4 hours

Answer 45

-Liquid distilled product of fermented fruits, grains and vegetables -Used as solvent, antiseptic and sedative -High potential for abuse -Small to moderate amounts taken over extended periods of time have no negative effects and may have positive health consequences

Answer 46

-Intoxication -Sensory alteration -Anxiety reduction

Answer 47

-Staggering -Odor of alcohol on breath -Loss of coordination -Slurred speech, dilated pupils -Coma, respiratory failure -Fetal alcohol syndrome (in babies) -Nerve and liver damage

Answer 48

-Sweating, tremors, altered perception -Psychosis, fear, auditory hallucincations

Answer 49

-Confusion, disorientation, loss of motor nerve control -Convulsions, shock, shallow respiration -Involuntary defecation, drowsiness -Respiratory depression, possible death

Answer 50

Dependence (Physical/Psychological): possible/possible Use: oral Duration: days - wks

Answer 51

Dependence (Physical/Psychological): possible/possible Use: oral Duration: days - wks

Answer 52

-Synthetic compounds available legally and illegally -Drugs that are closely related to the male sex hormone, testosterone -Moderate potential for abuse, particularly among young males

Answer 53

-Increase in body weight -Increase in muscle mass and strength -Enhanced athletic performance -Increased physical endurance

Answer 54

-Quick weight and muscle gains -Extremely aggressive behavior or "Roid rage" -Severe skin rashes -Impotence, reduced sexual drive -In females, development of irreversible masculine traits

Answer 55

-Significant weight loss -Depression -Behavioral changes -Trembling

Answer 56

-Increased combativeness and aggressiveness -Jaundice -Purple or red spots on body; unexplained darkness of skin -Persistent unpleasant breath odor -Swelling of feet or lower legs

Answer 57

1. Assessment Phase 2. The treatment of intoxication and withdrawal when necessary 3. Development and implementation of an overall treatment strategy

Answer 58

-Drug free -Substitution, use of alternative medications that inhibit the use of illegal drugs -Harm reduction

Answer 59

-Major public health problem, costing society in excess of $300 billion annually, including the costs of treatment, related health problems, absenteeism, lost productivity, drug-related crime and incarceration, and efforts in education and prevention -The motivation for using any psychoactive substance is, in part, related to the acute and chronic effects of these agents on mood, cognition, and behavior -In some individuals the subjective changes that accompany substance intoxication are experienced as highly pleasurable and lead to repetitive use -About 15 percent of regular users become psychologically dependent in that they come to believe that they are unable to function optimally in social, work, or other settings without experience some degree of substance intoxication

Answer 60

1. A maladaptive pattern os substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following occurring at any time in the same 12-month period (look below) 2. Tolerance, as defined by either of the following: (a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect; (b) markedly diminished effect with continued use of the same amount of the substance 3. Withdrawal, as manifested by either of the following: (a) the characteristic withdrawal syndrome for the substance; (b) the same (or closely related) substance is taken to relieve or avoid withdrawal symptoms 4. The substance is often taken in larger amounts or over a longer period than was intended 5. There is a persistent desire, or unsuccessful efforts to cut down or control substance use 6. The individual's activities are disproportionately dedicated to acquiring the substance, use the substance, or recover from its effects 7. Important social, occupational, or recreational activities are given up or reduced because of substance use 8. The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance

Answer 61

1. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period: a. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home b. Recurrent substance use in situations in which it is physically hazardous c. Recurrent substance-related legal problems d. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance e. The symptoms have never met the criteria for substance dependence for this class of substance

Answer 62

1. Physiological dependence 2. Without physiologic dependence 3. Clients may be variously classified as currently manifesting a pattern of abuse, or dependence, or as in remission

Answer 63

-Four Categories: full, early, partial, sustained, and sustained partial-on the basis of whether any of the criteria for abuse or dependence have been met and over what time frame -The remission category can also be used for clients receiving agonist therapy or for those living in a controlled drug-free environment

Answer 64

-Clients presenting for treatment of a substance use disorder frequently manifest signs and symptoms of substance-induced intoxication or withdrawal -The clinical picture varies with the substance used, its dosage, the duration of action, the time elapsed since the last dose, the presence or absence of tolerance, and/or other clinical emotional factors -The expectations of the client, his or her styles or response to states of intoxication or physical discomfort, and the setting in which intoxication or physical discomfort, and the settings in which intoxication or withdrawal takes place also play a role -Clients experiencing substance-induced intoxication generally manifest changes in mood, cognition, and/or behavior

Answer 65

-Mood-related changes may range from euphoria to depression, with rapid mood changes in response to, or independent of external events -Cognitive changes may include shortened attention span, impaired concentration, and disturbances of thinking and/or perception -Behavioral changes may include wakefulness or somnolence, lethargy, or hyperactivity -Impairment in social and occupational functioning is also common in intoxicated individuals

Answer 66

clinical disorders commonly found in such clients include conduct disorder in children and adolescents, depression, bipolar disorder, schizophrenia, anxiety disorders, eating disorders, pathological gambling, antisocial personality disorder, PTSD, and other personality disorders

Answer 67

-Cardiac problems resulting from acute cocaine intoxication, respiratory depression and coma in severe opioid overdose and alcohol abuse, and hepatic cirrhosis after prolonged heavy drinking -General medical conditions frequently associated with opioid-dependent individuals who administer opioids by injection include bacterial infections, HIV, and hepatitis -Clients whose substance dependence is accompanied by poor self-care and/or high levels of risk-taking behavior are at increased risk of malnutrition, physical trauma, and HIV infection

Answer 68

-Long history of repeated episodes of intoxication and withdrawal interspersed with attempts to remain substance free -Episodes of intoxication may be sporadic and brief, rarely requiring general medical or clinical intervention -Repeated episodes of intoxication lasting weeks or months, interrupted by voluntary or involuntary periods of self-managed, or medically managed, withdrawal -Partial or complete withdrawal from abused substances may be followed by variable periods of self-imposed or involuntary abstinence, often ending in relapse to substance use and, eventually, resumption of dependence

Answer 69

-Replacement of one form of substance dependent by another may occur -Many individuals who abuse alcohol or illicit substances maintain their ability to function in interpersonal relationships and in the work setting -Peer relationships often focus extensively on obtaining and using illicit drugs or alcohol -The risk of accidents, violence, and suicide is significantly greater than for the general population

Answer 70

1. Initial experiences with substance use usually occur before puberty; casual users who go on to develop a substance use disorder are generally indistinguishable from their peers with respect to the type and frequency of substance use 2. Early or regular use of "gateway" drugs, such as alcohol, marijuana, or nicotine, and early evidence of aggressive behavior, intra familial disturbances, and associating with substance use and the subsequent emotional and mental health problems 3. In adolescents, growing preoccupation with substance use, frequent episodes of intoxication, use of drugs with greater dependence liability, and a preference for routs of administration that result in quicker onset of drug effects and for more rapidly acting preparations presage the development of substance dependence -In most cases, the onset of substance abuse occurs in the teens and early 20s, some individuals settle on a "drug of choice" early on

Answer 71

-Current fashion, availability, peer influences, and individual biological and psychological factors -Gender-specific differences in drug preference have diminished somewhat over the last two decades -Familial predisposition to disorders that predispose individual memebers -Genetic factors are associated with alcoholism, particularly in males with biological male relatives who are also alcoholic and, to a lesser extent, in females with strong gamily histories of the disorder

Answer 72

-Some individuals can abstain for long periods without formal treatment -Abstinence or periods of greatly reduced substance use are more likely when there is active participation in regular treatment and/or self-help groups -Clients who experience a severe life crisis are generally more motivated to seek treatment, but most still require external support to maintain their motivation to continue in treatment beyond the initial stages

Answer 73

-Many experience several cycles of remission and relapse before they acknowledge that "controlled" substance use is not possible for them -Frequency, intensity, and duration of treatment participation are positively correlated with improved outcomes

Answer 74

-Majority of clients (up to 70 percent in some studies) are eventually able to stop compulsive use and either abstain from abused substances entirely or experience only brief episodes of substance use that do not progress to abuse or dependence -Only a minority of clients exhibit a pattern of chronic relapse requiring repetitive intervention -Of those who remain abstinent for 2 years, almost 90 percent are substance free at 10 years have a very high likelihood of being substance free at 20 years -Prolonged abstinence, accompanied by improvement in social and occupational functioning, is more apt to occur in those who have lower levels of psychopathology, demonstrate the ability to develop new relationships, and consistently make use of self-help groups

Answer 75

Yes approximately one-third of hospitalized mentally ill clients manifest associated nonnicotine substance use disorders

Answer 76

foundation of treatment for clients with substance use disorders

Answer 77

1. Establishing and maintaining a therapeutic alliance 2. Monitoring the client's clinical status 3. Arranging and monitoring services and programs for the individual and the family 4. Assessing the client's need for continued services and monitoring their effectiveness 5. Providing direct clinical social work services 6. Remaining alert to intoxication and withdrawal states 7. Facilitating adherence to a treatment plan 8. Preventing relapse 9. Providing education about substance use disorders 10. Insuring the availability of medical care to reduce the morbidity and sequelae of substance use disorders

Answer 78

combined with specific treatments carried out in a collaborative fashion with professionals of various disciplines at a variety of sites, including community-based agencies, clinics, hospitals, detoxification programs, vocational rehabilitation and residential treatment facilities

Answer 79

-Medications to treat intoxication and withdrawal states -Medications to decrease the reinforcing effects of abused substances -Medications that discourage the use of substances by inducing unpleasant consequences through a drug-drug interaction or by coupling substance use with an unpleasant, drug-induced condition -Agonist substitution therapy -Medications to treat associated clinical conditions

Answer 80

-Essential components of a comprehensive treatment program -Studies few in number and have major design limitations -The following are effective for substance abuse treatment: CBT, behavioral therapies, psychodynamic/interpersonal, group and family therapy, participation in self-help groups

Answer 81

-Clinical Management -A strategy for achieving abstinence or reducing the effects or use of illicit substances -Efforts to enhance ongoing compliance with the treatment program, prevent relapse, and improve functioning -Additional treatments necessary for clients with associated conditions

Answer 82

vary with regard to the availability of specific treatment modalities, the degree of restriction to access to substances that are likely to be abused, the availability of medical, psychiatric and social work care, and the overall milieu and treatment philosophy

Answer 83

-Hospitals -Residential Treatment Facilities - Partial Hospital Care -Outpatient Programs

Answer 84

-Clients with drug overdose who cannot be safely treated in an outpatient or emergency room setting -Clients at risk for severe or medically complicated withdrawal syndromes -Clients with general medical conditions that make ambulatory detoxification unsafe -Clients with a level of mental health problems that would markedly impair their ability to participate in, comply with, or benefit from treatment or whose associated disorder would by itself require hospital-level care -Clients manifesting substance use or other behaviors that constitute an acute danger to themselves or others; or clients who have not responded to less intensive treatment efforts and whose substance use disorder(s) poses and ongoing threat to their physical and mental health

Answer 85

indicated for clients who do not meet the clinical criteria for hospitalization, but whose lives and social interactions focus predominantly on substance use, and who lack sufficient social and vocational skills and drug-free social supports to maintain abstinence in an outpatient setting residential treatment of 3 months or more is associated with better long-term outcome in such clients

Answer 86

clients who require intensive care but have a reasonable probability of refraining from illicit use of substances outside a restricted setting clients who are leaving the hospital or residential settings and who remain high risk for relapse clients who are thought to lack sufficient motivation or social and familial supports to continue in treatment, clients with severe mental illness and/or a history of relapse to substance use in the immediate post hospital or post residential period, and those returning to high-risk environments who have limited psychosocial supports for remaining drug free partial hospital programs are also indicated for clients who are doing poorly in intensive outpatient treatment

Answer 87

clients whose clinical condition or environmental circumstances do not require a more intensive level of care monitoring for substance use should be intensified during periods of high risk of relapse, including early stages of treatment, times of transition to less intensive levels of care, and the first year following cessation of active treatment

Answer 88

-Reflect consideration of associated mental and general medical conditions, gender-related factors, age, social milieu and living environment, cultural factors, and family characteristics -High prevalence of associated mental illness and the diagnostic distinction between substance use symptoms and other disorders should receive particular attention, and specific treatment for associated disorders should be provided

Answer 89

-Clients with alcohol withdrawal must be detoxified in a setting that provides for frequent clinical assessment and the provision of any necessary treatments -Some outpatients settings can accommodate these requirements and may be appropriate for clients deemed to be at low risk of a complicated withdrawal syndrome -Those who have a prior history of delirium tremens, whose documented history of very heavy alcohol use and high tolerance places them at risk for a complicated withdrawal syndrome, who are concurrently abusing other drugs, who have a severe associated general medical or mental health disorder, or who repeatedly fail to cooperate with, or benefit from, outpatient detoxification are more likely to require a residential or hospital setting that can safely provide the necessary care -Clients in severe withdrawal require treatment in a hospital setting -Most treatments for clients with alcohol dependence or abuse can be successfully conducted outside of the hospital -Client who are unlikely to benefit from less intensive or less restrictive alternatives may need to be hospitalized at times during their treatment

Answer 90

-Effective treatments are not well established -Naltrexone may attenuate some of the reinforcing effects of alcohol, but there are limited data regarding the long-term efficacy for clients with alcohol use disorders -Disulfiram is an effective adjunct to a comprehensive treatment program in reliable, motivated clients whose drinking may be triggered yb events that suddenly increase alcohol craving -Clients with impulsive behavior, psychotic symptoms, or suicicdal thoughts are poor candidates for disulfiram treatment -In clients with clearly established associated mental illness, treatment specifically directed at these disorders is indicated

Answer 91

-CBT -Behavioral Therapies -Psychodynamic/Interpersonal Therapies -Brief Interventions -Marital and Family Therapy -Group Treatment -Participation is self-help groups, such as Alcoholics Anonymous, is frequently helpful

Answer 92

-Monitored and maintained in a safe environment -Alcohol withdrawal typically begins within 4-12 hours after cessation or reduction of alcohol use, peak in intensity during the second day of abstinence, and generally resolve within 4-5 days -Serious complications include seizures, hallucinations, and delirium

Answer 93

treatment of pregnant women with alcohol use disorders is complicated by the risk of fetal alcohol syndrome and the corresponding urgency of minimizing the intake of alcohol

Answer 94

clinical and research experience suggests that intensive outpatient treatment, in which a variety of treatment modalities are simultaneously used and in which the focus is maintenance of abstinence, is effective for most clients with cocaine use disorders

Answer 95

those who fail to respond to psychosocial treatment may be considered for treatment with medications

Answer 96

treatments focusing on abstinence are effective for most clients regular participation in self-help groups may improve the outcome for selected clients with cocaine use disorders

Answer 97

-Hypertension -Tachycardia -Seizures -Paranoid Delusions -Depression -Cravings

Answer 98

pregnant women with cocaine use disorders is complicated by increased risk of prematurity, low birth weight, stillbirth, and sudden infant death syndrome and the corresponding urgency of minimizing the intake of cocaine

Answer 99

-Standard treatment settings -Therapeutic communities

Answer 100

maintenance on methadone or LAAM is appropriate for clients with a prolonged history (>1 year) of opioid dependence naltrexone is an alternative treatment strategy whose utility is often limited by lack of client compliance and low treatment retention

Answer 101

-CBT -Behavioral therapies -Psychodynamic Psychotherapy -Group and Family Therapies -Self-Help Groups

Answer 102

-Methadone substitution with gradual tapering -Abrupt discontinuation of opioids, with the use of medications to suppress withdrawal symptoms -Monitoring for the presence of other substances is essential because the concurrent use of or withdrawal from other substances can complicate the treatment of opioid withdrawal

Answer 103

-Treatment of mental health issues and substance abuse can be difficult -Those who use opioids are at a higher risk of medical complications from bacterial endocarditis, hepatitis, HIV infection, and tuberculosis -Treatment of pregnant women with opioid use disorders is complicated by the increased risk of low birth weight, prematurity, neonatal abstinence syndrome, stillbirth, and sudden infant death syndrome and the corresponding urgency of minimizing the intake of opioids

Answer 104

1. Assessment phase 2. Treatment of intoxication or withdrawal 3. Development and Implementation of an overall treatment strategy 4. Treatment strategy may emphasize the individual's need to remain drug-free, or substitution of a safer drug

Answer 105

-Reduction in the use and effects of abused substances -The achievement of abstinence -Reduction in the frequency of relapses, and rehabilitation

Answer 106

-May be an intermediate goal of treatment since abuse is chronic and subject to relapse -Help clients to identify situations that place them at high risk for relapse -Develop responses to stress other than substance use

Answer 107

craving physiologic responses to the substance and, for some, interpersonal or social situations constitute risk factors

Answer 108

-Degree of associated intoxication -Severity of associated withdrawal syndromes -Time elapse since most recent use -The mode of onset -Pattern of use -General medical and mental illness history, including a complete physical and mental status examination, to ascertain the presence or absence of general medical or mental disorders, as well as signs and symptoms of intoxication or withdrawal -In some cases, psychological or neuropsychological testing may be indicated -History of prior treatment (if relevant) -Qualitative and quantitative blood and urine screening for drugs of abuse and laboratory tests for abnormalities that may accompany acute or chronic substance use -Screening for infectious and other diseases often found in substance-dependent persons

Answer 109

1. Setting, context, modalities used, compliance, duration, and short (3-month), intermediate (1-year), and longer-term outcome as measured by subsequent substance use 2. The level of social and occupational functioning achieved, and other outcome variables 3. Prior efforts to control or stop substance use outside of a formal treatment setting should be discussed, as well as the client's attitudes toward his or her previous treatment experiences 4. Complete family, social, and substance use history including: familial substance use disorders or other mental illness, familial factors contributing to the development or perpetuation of substance use disorders 5. School or vocational adjustment, peer relationships, and financial or legal problems 6. Impact of the client's current living environment

Answer 110

-Establishing and maintaining a therapeutic alliance -Monitoring the client's clinical status -Managing intoxication and withdrawal states -Developing and facilitating adherence to a treatment plan -Preventing relapse -Providing education about substance use disorders -Reducing the morbidity and sequelae of substance use disorders

Answer 111

-Obtains necessary diagnostic and treatment-related information -Gains the confidence of the client and significant others -Important in time of crisis -Strength of the therapeutic alliance is a significant predictor of outcomes

Answer 112

-Ongoing evaluation of safety is critical -Important to monitor for emergence of suicidal or homicidal thoughts, or of treatment-emergent side effects -Need to monitor clinical status to ensure that client is receiving appropriate treatment -Relapse is common and is inconsistently self-reported by clients -Laboratory monitoring through breath, blood, saliva, and urine testing for drugs of abuse -Need to monitor validity and reliability of results

Answer 113

-Participation in self-help or professionally led groups that include recovering individuals -Encouraging the development of a substance-free peer group and lifestyle -Helping the client develop techniques to improve interpersonal relationships in family, work, and social settings -Encouraging the client to seek new experiences and roles consistent with a substance-free existence -Discouraging the client from instituting major life changes that might increase the risk of relapse -Helping clients anticipate and avoid drug-related cues -Training clients in self-monitoring affective or cognitive states associated with increased craving and substance use -Contingency contracting -Teaching desensitization and relaxation techniques to reduce the potency of drug-related stimuli and modulate craving intensity -Helping clients develop alternative, nonchemical coping responses to uncomfortable feelings and situations -Providing coping and social skills training to help clients become involved in satisfying drug-free alternative activities

Answer 114

focuses on altering the cognitive processes that lead to maladaptive behaviors in substance users (intervening in the behavioral chain of events that lead to substance use, helping clients deal successfully with acute or chronic drug craving, promoting and reinforcing the development of social skills and behaviors compatible with remaining drug free)

Answer 115

the foundation of cognitive therapy is the belief that by identifying and subsequently modifying maladaptive thinking patterns, clients can reduce or eliminate negative feelings and behavior

Answer 116

-Help client gain better self-control -Discussing ambivalence -Identifying emotional and environmental triggers of craving and substance use -Developing and reviewing specific coping strategies to deal with internal or external stressors -Exploring the decision chain leading to resumption of substance use -Learning from brief episodes of relapse about triggers leading to relapse and developing effective techniques for early intervention

Answer 117

client-centered, systems, and social-psychological persuasion techniques are used characterized by an empathic approach in which the therapist helps to motivate the client by asking about the pros and cons of specific behaviors, by exploring the client's goals and associated ambivalence about reaching these goals, and by listening reflectively

Answer 118

involves operant rewarding or punishing of clients for desirable behaviors example: exchange clean urine sample for movie tickets

Answer 119

treatment based on the use of predetermined positive or negative consequences to reward abstinence or punish drug-related behaviors

Answer 120

based on Pavlovian extinction paradigm involves exposure of the client to cue that induce drug craving while preventing actual drug use and, therefore, the experience of drug-related reinforcement cue exposure can also be paired with relaxation techniques and drug refusal training to facilitate extinction of calssically conditioned craving

Answer 121

coupling drug or alcohol use with an unpleasant experience, is used in certain specialized facilities controlled trials have mixed results

Answer 122

sometimes used in combination with other treatment modalities clients antisocial personality disorder are poor candidates for psychodynamic psychotherapy

Answer 123

focuses on difficulties in current interpersonal functioning by using psychodynamic principles and techniques with some modifications, i.e., including limit setting and using advice and suggestions

Answer 124

-Modified Psychodynamic -Interpersonal, Interactive -Rational Emotive -Gestalt -Psychodrama

Answer 125

-Dysfunctional families are associated with poor short-and long-term treatment outcomes -Goals include encouraging family support and monitoring abstinence -Theoretical orientations include structural, strategic, psychodynamic, systems, and behavioral approaches -Interventions can be focused on the nuclear family; the client and spouse; on concurrent treatment for clients, spouses, and siblings; on multifamily groups; and on social networks -Family interventions are used when abstinence upsets a previously well-established but maladaptive style of family interaction in which members need help adjusting to a new set of individual and familial goals, attitudes, and behaviors -Couple and family therapy are useful for promoting psychological differentiation of family members, providing forum for the exchange of information and ideas about the treatment plan, developing behavioral management contracts and ground rules for continued family support, and reinforcing behaviors that help prevent relapse and enhance the prospects for recovery

Answer 126

-Generally based on the 12-step approach of AA and related groups, such as Narcotics Anonymous and Cocaine Anonymous -Rational Recovery Smart Recovery -Faith Community Supported Programs -Receive group support and repeated reminders of the consequences of alcohol or other drug use and the benefits of abstinence and sobriety

Answer 127

programs include detoxification, assessment, and treatment of general medical and mental illness conditions; groups, individual, and family therapies; psycho education, and motivational counseling

Answer 128

-Drug overdose clients who cannot safely be treated in an outpatient or emergency room setting -Client in withdrawal who are either at risk for a severe or complicated withdrawal syndrome -Clients with acute or chronic general medical conditions that make detoxification in a residential or ambulatory setting unsafe -Clients with documented history of not engaging in, or benefitting from, treatment in a less intensive setting -Clients with marked mental illness who are a danger to themselves or others

Answer 129

indicated for clients whose lives and social interactions are largely dedicated to substance use and who lack sufficient motivation and/or drug-free social supports to remain abstinent in an ambulatory setting, but who do not require hospitalization provide individual, group, and vocational counseling programs but use partial hospital or outpatient programs to supply psychosocial and psycho pharmacologic treatment

Answer 130

-Clients with opioid, cocaine, or polysubstance use disorders may benefit from referral to a residential therapeutic community -Programs reserved for clients unsuitable for outpatient treatment -Designed to resocialize for a drug-free lifestyle

Answer 131

provides and intensive and structured treatment experience for clients with substance dependence who require more services than those available in traditional outpatient settings

Answer 132

-Treatment should encourage and integrate self-help programs -High rates of attrition are a problem in the early phase -Intermediate-and long-term outcomes are highly correlated with retention -Efforts should be directed toward motivating clients to remain in treatment -Efforts may include the use of legal, family, or employer-generated pressure where available

Answer 133

-Risk of suicide attempts and completed suicides (incidence of complete suicide is approximately 3-4 times that found in the general population; major depressive disorder increase the suicide risk) -Risk for homicide and other forms of violence -Substances whose use may be associated with aggression include cocaine, hallucinogens, phencyclidine (PCP), and alcohol -Substances that lead to withdrawal syndromes associated with a risk of violence include alcohol, opioids, and hypnotic sedatives -Marijuana or hallucinogens can create a state of paranoia and anxiety and may inadvertently commit violent acts on the basis of their faulty perception -The diagnosis of substance use disorders in all individuals who present with a history of suicide or other form of violence

Answer 134

-Personality disorders -Increased risk for suicide

Answer 135

-Simultaneous intoxication or withdrawal from two or more drugs -Varying time frames for experiencing withdrawal symptoms in clients using multiple drugs -Need to detoxify the client from more than one drug -Potential interactions between an abused substance and medications used to treat a substance use disorder

Answer 136

-Gastrointestinal and Central Nervous System -Severe CNS injury-affect cognition, behavior and ability to comply -Increased risk of accidents and death from automobiles, suicide homicide and falls

Answer 137

-The most important of these are HIV infection, tuberculosis, hepatitis-C, and sexually transmitted diseases -Approximately 30-40 percent of inner-city intravenous drug users test positive for HIV

Answer 138

-High risk for sexually transmitted diseases, hepatitis, anemia, tuberculosis, hypertension, and preeclampsia -Woman's ability to maintain a healthy lifestyle, including proper nutrition, and obtain needed health care

Answer 139

greater than average risk for spontaneous abortions, and early and prolonged labor, in addition to complications of other general medical conditions that may be due to the substance use

Answer 140

-Some substances, including opiates, cocaine, and alcohol, are known to directly affect the health of the fetus -Health effects may occur at any stage of development, but is particularly likely during the third trimester -Fetal concentrations of abused substances average 50-100 percent of maternal blood levels can be higher; the circulation of active drug metabolites is another source of fetal exposure to potentially toxic substances -Higher risk of birth defects, cardiovascular problems, impaired growth and development, prematurity, low birth weight, and stillbirth -After delivery, the infant may suffer from withdrawal

Answer 141

some substances are associated with long-term negative effects on physical and cognitive development

Answer 142

mothers with substance use disorders are frequently in need of education and training in parenting skills, social services, nutritional counseling, assistance in obtaining health and welfare entitlements, and other interventions aimed at reducing the likelihood of child abuse or neglect

Answer 143

-Psychological and financial barriers prevent many women from seeking treatment -Women's perception of greater social stigma associated with their abuse of drugs and alcohol -Women have a higher prevalence of depressive and anxiety disorders -Many women with substance abuse disorders have a history of physical and/or sexual abuse which may influence treatment -Female clients with family responsibilities need more help with family-related problems

Answer 144

-More likely to have abuse rather than dependence disorders -Less likely to appreciate the need for entering and remaining in treatment -Assessment and treatment must take into account possible impairments in the child's cognitive, social, and psychological developmental

Answer 145

-A sense of autonomy -Ability to form interpersonal relationships -General integration into society -Emphasis on evaluating the adolescent's adaptive functioning, such as academic progress, school behavior and attendance, and social functioning with peers and family members -Treatment should also address the ability of parents to communicate and set appropriate behavioral limits

Answer 146

-Outcome studies in therapeutic communities show that individuals who enter treatment under legal compulsion stay longer and do as well as comparable clients who enter treatment voluntarily -Higher rates of treatment compliance with narcotic antagonists are reported for court-mandated clients and for professional at risk of losing their professional licenses should they fail to comply -Contingency contracting approaches are used such as not participating would be reported to a board

Alcohol and Drug Abuse Diagnosis and Treatment Flashcards

(170 cards)