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Flashcards in Prevention Deck (47)
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1
Q

What do prevention programs involve?

A

one or more intervention to reduce or deter specific or predictable problems, protect the current state of well-being, or promote desired outcomes or behaviours

2
Q

What can be influential in helping to prevent addiction and reduce substance abuse?

A

Messages that parents, doctors, teachers, the media and others in the community send to children and teens about the dangers of tobacco/nicotine, alcohol and other drug abuse

3
Q

What is the preventure program?

A

Examined how children’s temperament drives their risk for drug use, indicating different pathways to addiction. Since most teenagers who try addictive substances (e.g., alcohol, opioids or methamphetamine) dont become addicted, the program focuses on what’s different about the minority who do. Personality testing can help identify most of the highest risk children before their risky traits cause problems

4
Q

What 4 personality traits may lead to or foster the development of addiction?

A

impulsivity, sensation seeking, hopelessness, anxiety sensitivity

5
Q

How does the preventure program work?

A
  1. An intensive two- to three-day training is given for teachers—a crash course in therapy techniques proven to fight psychological problems.
  2. When the school year starts, middle schoolers take a personality test to identify the outliers. Months later, two 90-minute workshops—framed as a way to channel students’ personalities toward success—are offered to the whole school, with only a limited number of slots.
  3. The workshops teach students cognitive behavioral techniques to address specific emotional and behavioral problems.
6
Q

What components of the preventurre programme intervention are incorporated using manuals?

A

psycho-educational
motivational enhancement therapy (MET)
cognitive–behavioural therapy (CBT)
and include real-life ‘scenarios’ shared by local youth with similar personality profiles.

7
Q

What is the goal of the preventure programme?

A

Goal is to provide participants with the tools to moderate the cognitive and behavioural tendencies stemming form their personality that contribute to their difficulties in life

8
Q

Is the preventure programme effective?

A

The evidence is promising

Two RCT’s show reduced alcohol consumption and initiation among at risk adolescents

9
Q

What is the goal of prevention in general?

A

The goal of prevention is to identify and help those at high risk to not develop behavioural addictions

10
Q

What Is motivational interviewing?

A

Among people engaging in addictive behaviours, motivational interviewing (MI) can be used to help them think about and pursue behaviour change
The goal of MI is to evoke the client’s own reasons for change (and his/her ideas bout how change should happen)

11
Q

What are the five principles of MI?

A
  1. Express empathy for the client
  2. Develop discrepancy between the client’s goals and values and their current behaviour (i.e., behavioural addiction)
  3. Avoid argumentation and direct confrontation
  4. Roll with client resistance, instead of fighting it
  5. Support the client’s self efficacy, or their belief that they can change
12
Q

What is an understudied element of MI?

A

People become more ready to change and actually attempt to change through nostalgia (gambling, alcohol and cannabis)
Longing for the past is an understudied aspect of MI
Finding that it actually has utility in trying to motivate change

13
Q

What is the spirit of MI?

A

The MI spirit represents an egalitarian relationship characterized by:

  • Unconditional acceptance and positive regard
  • Compassionate and empathetic understanding (no confronting)
  • A stance of evoking (versus installing) ideas, goals and deep wisdom
14
Q

What are the Do’s of MI?

A

MI Do’s: Emphasize and respect client’s autonomy, actively collaborate with them, elicit their perspective, ideas, concerns, and demonstrate non-judgmental acceptance while conveying empathy

15
Q

What are the Dont’s of MI?

A

Asserts authority about what is best for the client, pursues own agenda in the session, mandates specific goals, provides unsolicited feedback, confronts or threatens client with negative consequences if change does not occur

16
Q

What are the four processes of MI?

A

Engaging, focusing, evoking, planning

17
Q

What is the nature of addictive behaviours and changing them?

A

Addiction has been conceptualized as a chronic relapsing disorder or chronic disease. Although changing an addictive behavior is difficult, maintaining change is even more challenging. Relapse means failure to maintain behavioral change

18
Q

What was treatment outcome once believed to be?

A

once thought to be binary: “Either you have it or you don’t, and there is nothing in between”. Categorizes treatment outcomes as either abstinent or non-abstinent. Then means that relapse Implies failure, weakens, and shame, which are unhelpful value judgments and barriers to change

19
Q

What are some factors that should be considered when assessing relapse?

A

Threshold (the amount of substance use)
Window (the period of time judged)
Reset (the period of abstinence required before a person can be considered to have relapsed)
Polydrugs (the types of substance use that constitute a relapse)
Consequences (behaviors and consequences associated with substance use required before a person can be considered to have relapsed)
Verification (self-report or collateral reports).

20
Q

What is a relapse versus a prolapse?

A

Lapse – an initial setback (a slip)/Relapse – a return to pre-treatment use
Prolapse – recovering from a relapse by making positive behavior changes
Others use quantitative cut-offs to distinguish between lapse and relapse. These terms may not equally apply to all addictive behaviors (e.g., having 1 beer vs. injecting heroin)

21
Q

What is the client centered definition of relapse?

A

Severity of problem not quantity of consumption

  1. the person’s progress toward treatment goals, including substance use, psychosocial or other goals
  2. The personal and social consequences related to alcohol or other drug use (e.g., fight with partner)
  3. The person’s return to the addictive behaviour
22
Q

What is Marlatt’s relapse prevention model?

A

Cognitive-behavioral model of relapse
Two-stage process, where the precipitants of substance use are distinct from the factors that prolong or sustain such use over time. Relapse occurs as a result of a person’s lack of coping skills to successfully avoid drinking or using drugs in certain challenging situations

23
Q

What 8 risk situations or relapse determinants did Marlatt propose?

A
Unpleasant emotions
Physical discomfort
Pleasant emotions
tests of personal control
Urges and temptations
Conflict with others
Social pressure to use
Pleasant times with others

Marlatt’s approach focuses on Providing coping skills training for the risk situations that are particular to each client

24
Q

What are some limitations of Marlett’s prevention model?

A

Relapse determinants are multidimensional and can interact in complex ways. Does not account for structural factors (e.g., living n substandard housing, poor access to health care) which can affect behaviour change. As can motivation and ambivalence. The negative experience of relapse may solidify the motivation to change for some people
Does not take into account the powerful role of neurobiology and craving on relapse risk.

25
Q

What are the revisions to Marlett’s model?

A

Revised to capture the complex and dynamic interplay of factors that may predict vulnerability to relapse. Includes high-risk situations which have been called tonic processes (primarily stable) and phasic processes (primarily fluctuating) that are somewhat overlapping. Tonic: underlying level of risk (e.g., family history, craving, self-efficacy, social support) and physical withdrawal (the individual differences that put people at risk). Phasic: represent dynamic precipitants to relapse and can also include cognition and withdrawals as well as coping behavior, substance use and perceived effects (factors that change and develop in individuals environment).

26
Q

What is the biological perspective of relapse?

A

vulnerable biological systems due to neuroadaptations from long-term drug use (changes in brain structure particularly in brain’s executive functioning and reward system) and genetics

27
Q

What are the psychological perspectives of relapse?

A

personality factors (e.g., impulsivity, anxiety sensitivity, hopelessness), ineffective coping

28
Q

What are the social factors of relapse?

A

of people in social support network (protective) and attachment to circle of support. Those who engage in addictive behavior (risk), living alone, and chronic life stressors

29
Q

What are the socio-cultural factors of relapse?

A

neighborhood factors (e.g., crime rate), level of education, access to safe stable housing, access to meaningful and stable opportunities, substance availability,

30
Q

What are the spiritual factors of relapse?

A

Spiritual growth through treatment, prayer, relying on a higher power, findings deeper meaning in life

31
Q

How does AA support recovery?

A

Alcoholics Anonymous (AA) supports recovery through helping members cultivate spirituality and related practices as a new way of living and it helps facilitate social network changes (e.g., by helping people drop heavy drinkers from their social networks and adopt abstainers and recovering people into their social network). AA boosts peoples confidence in their ability to stay sober when faced with high risk situation or negative emotions. Finally AA reduces craving and impulsivity.

32
Q

What is the social identity theory?

A

Part of people’s self-concept is derived from their membership in social groups

33
Q

What benefits can being a member of a group have?

A

The nature of MHOs like AA fits well with the major themes of the social identity approach to behavior change (e.g., social support from similar others, knowledge-base of coping resources)
People who used MHOs indicate that they valued the identification and belongingness they developed with others and feelings of hope.

34
Q

What is the theorized role of social identity in behaviour change?

A

Look for new social role models and social groups that can offer hope of change and recovery. When someone stopping substance use it is unachievable without outside support and help (MHOs).By observing and interacting with others at MHOs, membership becomes associated with positive outcomes (contented sobriety and happiness) because people are motivated to reduce subjective uncertainty in their lives, those new to MHOs may identify with their MHO and MHO members to reduce this uncertainty and to enhance their own self-concept

35
Q

What is the “all or nothing” service delivery approach?

A

Require abstinence prior to receiving treatment. Rooted in belief that change is motivated by the experience of negative consequences from substance use.Continued substance use is a sign that that the person is unmotivated to change. Providing service to persons who have no abstained would delay their commitment to abstinence and thus change

36
Q

What are the limitations of the all or nothing approach?

A

Deprives people who are not interested in cessation, but want to remain healthy
Deprives people who have problems controlling one addictive behavior, but not other addictive behaviors
Limits the right to self-determination
Harm reduction policies, programs, and approaches deal with these limitations

37
Q

What is the Harm reduction approach?

A

Harm reduction approaches involve policies, programmes and practices that aim primarily to reduce the adverse health, social and economic consequences of engagement in addictive behaviors without necessarily reducing engagement in the addictive behavior.

38
Q

Who does harm reduction benefit?

A

Harm reduction benefits people who engage in addictive behavior, their families, and their community and · Helps people who have not benefited form the traditional treatment system

39
Q

How did harm reduction star?t

A

with injection drug use (injection practices continuum)

40
Q

What is the prevalence of injecting drugs, HIV and death?

A

In 2014, 0.3% of the Canadian population inject drugs. People who inject drugs are 59 times more likely to get HIV . 14.3% of all new HIV infections in Canada may have been acquired through injection drug use (incidence). Unsupervised drug injection can lead to overdose death

41
Q

What country is a leader in HR policy and practice?

A

Canada, · One of the first needle exchange programs to open in North America was initiated in Vancouver in 1988. HR is part of the federal government’s response to illicit drug use

42
Q

What are some limitations of the needle exchange program?

A

People may continue to inject in public spaces thus increasing their risk of overdose death
Injecting in public may also cause users to inject as quickly as possible, thus increasing the risk for local tissue damage and infection
Supervised injecting facilities (SIF) overcome these limitations

43
Q

What did they find at an extensive evalutation of a SIF that opened in Vancouver

A

Attracted drug users at higher risk of acquiring HIV and having an overdose
After the facility opened, public injecting in the neighborhood around the facility decreased. Less risk of acquiring HIV, such as less syringe sharing and increased use of sterile water
Lower drug use: refer users to withdrawal management services and subsequent addiction treatment and Lower risk of death from overdose

44
Q

What is the methadone Maintenance treatment?

A

Most widely studied and most effective treatment for opioid addiction. Helps deal with problems related to withdrawal and intoxication
MMT has a long history in Canada. The first Canadian methadone program started in Vancouver in 1959

45
Q

When prescribed within the context of appropriate services, What benefits does MMT leads to for patients and the community?

A
reduced use of other opioids
reduced use of other drugs 
improved mental and physical health 
reduced illegal activity and incarceration 
reduced risk of acquiring HIV infection 
improved outcomes of pregnancy
improved quality of life
46
Q

What is heroin assisted treatment?

A

Prescribing individualized doses of pharmaceutically pure heroin, which the patient self-administers under nursing supervision up to three times daily
Reserved for people who have injected opioids long term, and not benefited from other treatment options

47
Q

Many of the harms associated with heroin injection arise not because of the drug itself, but the context of drug use, what are they?

A

an illicit source resulting in unknown purity;
an illegal market driving costs, and resulting in criminal activity for obtaining drugs
unsafe injection practices