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Adv Cell Bio > D&K Exam 3 > Flashcards

D&K Exam 3 Flashcards

(103 cards)

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1
Q

To treatments reach everyone?

A

No! less then 10% of adolescents and 94% of people ages 12 or older with substance disorder

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2
Q

Which age range doesnt get the treatment?

A

18-25

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3
Q

Barriers to treatment

A

The stigma, lack of problem of recognition, mental disorders

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4
Q

Public opinion on treatments

A

Most people dont want a heavy drinker as a neighbor

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5
Q

External barriers to treatments

A

Cost, time conflicts, lack of availability

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6
Q

Do treatments work?

A

No evidence but its better than nothing

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7
Q

Consideration for treatments

A

Their age (brain development), their life goals, limited life experience, labeling

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8
Q

Public health approach

A

Minimize the problems associated with use

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9
Q

Safe injection sites

A

Opened in 2003, allowed people to use drugs on sights with no prosecutions

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10
Q

Safe injection sites stats

A

Visited by 7k people; heroin, methadone, and cocaine were used; Budget of 500k; Trusted burse and staff was present (95% rated good); 76% of residents showed support

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11
Q

Safe injection sites results

A

Decreased needle sharing and reuse of needles; fewer people injecting in public, and less syringes in public areas; No increase in police reports and new imitate of drug use; Number of years saved 1,175

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12
Q

E-cigs pros

A

Better than tobacco (harm reduction); helps with smoking cessation; Less chemicals (only 5 vs 9k); no significant risk to bystanders; Lower risk for cancer; lower nicotine delivery

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13
Q

E-cigs cons

A

High carcinogens level; low quality control; false ads on no nicotine; unknown level of nicotine level; other harmful chem; 42% people age 20+ complained of vomiting…

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14
Q

E-cigs in teens

A

Aggressively marked towards teens (58% of 12-17 were reached); Celebrity endorsement; Renormalization of smoking; Teens are more likly to smoke when they use, they are an addition to cigs (76% use both)

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15
Q

Medically Supervised Withdrawal (detoxification)

A

Carried out in a hospital setting, allows medical people to monitor and treat withdrawal symptoms; 80% of them use medications

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16
Q

Agonist

A

You know

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17
Q

Antagonist

A

Binds and blocks the physiological effecs
You know

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18
Q

Methadone

A

Opioid agonist, schedule 2, normal dose = no high, only one time a day; used to prevent withdrawal symptoms

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19
Q

Naltrexone

A

Opioid Antagonist, you must be clean for 7 day to use, prevents releases after withdrawal; Can lead to a reduced tolerance = increase risk of overdose; daily (oral) or monthly (injectable)

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20
Q

Naloxone

A

Brand name of Narcan; Opioid antagonist; used to treat opioid overdose; not addictive, side effects are rare; withdrawal symptoms can onset after use; all 50 states allow + DC

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21
Q

Buprenorphine

A

Opioid partial agonist; Used to help people withdraw from heroin and methadone and treat severe pain; Schedule 3 drug, requires waver; Has many methods of administering

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22
Q

Stander drinking amount

A

12 oz beer = 8-9oz malt = 5 oz wine = 1.5 shot

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23
Q

Disulfiram

A

When combined with alcohol produces vomiting and headaches (etc…) or even worse shock and/or death; Brand name Antabuse; Given daily; Ideal for people who are committed to abstinence and willing to take

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24
Q

Acamprosate

A

Decreases the cravings and urges to use alcohol; Restore naturally occurring neurotransmitters; Doesnt help with withdrawal symptoms (for people who already detoxed/abstinent); 3x a day

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25
Vaccines
To aid nicotine, cocaine, and heroin addicts; Causes the immune system to create antibodies that attack substance; Only use after addiction is developed; Most data found in animals not human; Block drug from entering the brain
26
Contingency Management (CM)
They see drugs as a special case of behavior maintained by reinforcing effects and provides rewards for evidence of abstinence (pee test)
27
CM strategy
To build positive reinforcement from non drug use; Abstinence = rewarded, drug use = immediate loss of reinforcement; rewards are given immediately
28
CM target behavior
Choose the most important behavior to change, must be quantifiable, and must occur frequently
29
CM choose reinforcers
Must be seen as desirable by adolescents and has be chosen by adolescent
30
CM reinforcement fix rate
All targeted behaviors receive the same rewards
31
CM reinforcement progressive rate
The more targeted behaviors the higher the reward gets, if you fail the rewards are set back to first round
32
CM reinforcement Variable rate
The level of reward is unpredictable, meant to create long-term behavioral change
33
CM priming
A reward is giving first to show how the reward is earn and to spark interest
34
CM effectivness
Effective in reducing smoking adults but people return once the rewards are withdrawn; Works on adolescents and decreases in marijuana, opioid, and cocaine use; Increased attendance in treatments
35
CM works best...?
...when paired with other treatments; CBT + CM (58%) > CM (0%) school based in 4 weeks; Group CM > standard; CBT + CM parent based > CBT + parent education on marijuana; Boost abstinence rate but HIGH relapse rates
36
CM concerns
High rewards work better than low; cost of treatments; cash vs. gift cards
37
Juvenile Drug courts
Almost 3k across the US, Juvenile = 433, Family treatment = 303; Monitor progress (checked in with judge regularly); Individuals who are convicted with substance use
38
JDC Post Adjudication Model
Most common; sentence of incarceration is suspended till a program is completed (plead guilty and then complete the program); Gives court more authority over youth
39
JDC Components
Substance abusing youth are referred; Drug court team (judge, prosecutor, public defender, probation officer, coordinator and treatment provide); this teams makes comprehensive treatment plan to address substance abuse; collaborates with family for treatment; team monitors youth progress
40
Functional Family Therapy (FFT)
Targeted at risk youth aged 10-18; Meant to target delinquency, substance, and violence; Used across the US and internationally; 1 of the 4 model programs from seriously delinquent youth
41
FFT overview
Short term based on risk and protective factors; 2 person term and max than 26 sessions for 2-4 months; wide range of interventionists; Office and clinic based; 1.6k- 5k for 12 home visit
42
FFT goals
Help family and youth replace maladaptive behaviors with adaptive behaviors; Reduce or eliminate with substance use and/or behavior in the family; Focus on changing the family function
43
FFT Engagement
Goal is for family members to show up at least to one session; Maximize the family's expectation of positive change
44
FFT Motivation
For the blame and negativity to decrease, increase expression of hope; To create motivation for long term change
45
FFT Relational Assessment
To identify bad patterns in family, and relational functions in the family hierarchy
46
FFT Behavior Change
To observe changes and increase patterns that reduce problem behaviors, to build skill; Facilitate individual and relational change
47
FFT generalization
Maintain and expand the positive change; Anticipate and plan for future stressors in the family; Improve bonding and social support in school
48
FFT support
Effectively treats adolescents with disorders and violence history; Lower long-term reduction in re-arrests and re-offending; Reduces sibling involvement in high risk behaviors; Positive effect on family conflict and communication; Low drop out rates
49
Brief Strategic Family Therapy
Made for Cuban immigrant in 1970s, based on understanding culture and values of the community to address the issues
50
BSFT Goal
to recognizes the complex relationships in the family system and understand behaviors under context in the family
51
BSFT overview
Short-term (3 months); Ask the family to enact discussion of the problem; Focus is on the relationships within the family
52
BSFT Components
Joining/ engaging family members; Diagnosis family interactions; Restructuring family
53
BSFT support
Need more follow up studies; decrease problem behaviors, and marijuana use and improved family function; Higher levels of engagements compared to community-based treatments
54
Motivational Interviewing (MI)
Ambivalence is a normal step towards change (people can be stuck here), they want work through this
55
MI Spirit
Collaborating with the therapist, acceptance the person decision, compassion towards each other, and evocation (active listening)
56
MI principles
Express empathy, develop discrepancy, respond to sustaining talk and discord, and support self-efficacy
57
Change vs. sustain talk
Sustain talk: Person is talking about change but not doing it Change talk: Person is doing the change
58
MI processes
Engage (build relationship), Focus (set agenda), Evoke (draw out reason for change), Plan (set goal)
59
MI skills
OARS: Open ended questions, Affirmations, Reflections, summarizing
60
MI and adolescents
Brief intervention; emphasis is not on abstinence (moderation is focus); Doesn't not label; Builds independence; fosters developmentally appropriate goals
61
MI shortcomings
May not recognize current dangerous; the moderation focus may not focus with the abstinence expectations
62
MI adaptations
Using MCQ instead of open ended ones; Graphics for clarify; give personal feedback
63
MI with Adolescents supprt
Reduce risky alcohol behaviors (for 24 months) and negative behaviors (4 months); short term is a positive
64
Motivational Enhancement Interventions
Short term and cost effective; Powerful substance abuse intervention; harm reduction approach
65
ME approach
Can be direct or motivate patient for more extensive treatments; Lead by professionals ; 1 to 5 sessions (inpatient and outpatient), may be used after negative event
66
ME strategies
Non-Judgmental/confrontational; Client centered; Open ended questions, roll with resistance
67
ME FRAMES (Feedback to personal risk)
Personalized Feeback
68
ME FRAMES (Responsibility)
Emphasis on personal responsibility and freedom of choose
69
ME FRAMES (Advice to change)
Recommendations and information on drinking and drug patterns
70
ME FRAMES (Menu of options for change)
Abstained or reduction
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ME FRAMES (Empathy)
Therapist expresses caring and warmth
72
ME FRAMES (Self-efficacy)
Instilling hope that change is possible
73
Check up overview
Computer based to reduce alcohol use in college student (18-24); Using FRAMES
74
Check up outcomes
Reduced drinking by 45-55%; lower average number of drinks
75
CBT
Learned behavior maintained through the environments that cause emptions and thoughts; We can control thoughts and behaviors and emotions are connected
76
CBT features
Avg # of session is 16; Time limited therapy; Practice and homework; Collaboration between therapist and client; Structured and direct goals for each session
77
CBT thought
Help people understand that though can be controlled and that our interpretations lead to emotions leading to behaviors
78
CBT Socratic Questioning
Questions leading to a pattern seen by the person, the main problem the root
79
CBT Functional analysis
Analysis what may trigger use and know the consequences of use; Ask Why
80
CBT Targeting thoughts & emotions
Thoughts impact addiction and emotions; Thoughts are hypothesis to test; Learn to reframe and question assumptions
81
Automatic thoughts
Instantaneous thoughts, they have been so well learned
82
CBT Skill building
Self monitoring thoughts and behaviors; Reduce negative thinking; Avoiding stimulus cues; improve refusal skills; improve social, coping, and communication skills
83
CBT Evidence
Increase abstinence rates; Decrease drinking, substance, and problem related to use
84
CBT for adolescents
Develops cognitive skills, and such; Comorbidity when build; Relapse high
85
Dialectical Behavioral Therapy
Used for substance abuse AND personality disorders (less evidence of substance use); Comprehensive treatment program
86
DBT Overview
Weekly skill training in a group setting, 24/7 phone coaching; Used to help mange strong emotions (such as suicidality, family conflict... etc)
87
Four core Areas of DBT
Mindfulness, Interpersonal effectiveness, emotional regulation, and distress tolerance
88
DBT focuse
Commitment to abstinence and accepting slips as a pathway towards abstinence; Avoid shame that occur during lapses; Have a clear mind (your clean but remember your addict mind)
89
DBT Evidence
Significant less drug use and grater gains in global and social adjustment at post treatment
90
DBT Adolescents
96% in remission or improved at time of discharge (using American Indians and Alaskan Natives)
91
Relapse Prevention overview
Adolescents have a high relapse rate with 6 months after leaving treatment (2/4 to 4/5) so... CBT, 12 steps, and involvemnets of family support system are used to lower this
92
Relapse Prevention Techniques
Identify and avoid high risk situation that trigger emotion and behavior; Use distractions; Coping strategies
93
Relapse Prevention Strategies
Abstinence Violation Effects (AVE); If you throw out everything you will also get rid of the good
94
LSD
Schedule 1 drug; became illegal in 1966; potential treatment for alcoholism, depression, and patients dealing with terminal illness; Weakness the brain connections and dynamics
95
LSD evidence
Safe and decreases anxiety 12 month post treatment (77% reduction in anxiety)
96
MDMA
No approved for medical purpose; Alternative treatment for PTSD, social anxiety, and life threating illness anxiety; 8-10 sessions; Helps decrease fear and defensiveness, increases trust and affection
97
MDMA evidence
Long term (1 to 5 years) effects on rape survivors; Sustained effects in PTSD at 12 month follow up; 83% no longer received diagnosis of PTSD lasted for 3.8 years
98
Psilocybin
Activates Serotonin 2A receptors; Treats Anxiety, PTSD, and depression and substance addiction
99
Psilocybin and cancer
Reduced the anxiety and depression associated with cancer
100
Psilocybin and disorders
Reduces OCD, alcohol, and smoking discords
101
Ayahuasca
Treat substance use and other discords; Promoting personal or insightful or self-knowledge
102
Ibogain
Reduce withdrawal from opiates and eliminate substance related cravings
103
Psychedelics considerations
Needs to be in a controlled environment and administered safely; Low dosage are needed; Funding challenges; Combined with therapeutic approaches

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