COUN 501 - Intro to Substance Use Final Exam

PECTS: response has to do with the environment the substance is taken, such as whether the individual is drinking alone versus at a party, the person might be more depressed when drinking alone but more social at the party (Mack et al., 2016).

socioemotional

What are specific treatment considerations for Polysubstance Treatment? (3*)

*Motivational Interviewing (MI)* which is considered to be an essential element in both engaging the polysubstance-using patient in treatment and promoting treatment. Individuals may also have *behavioral treatment* as well as some *pharmacotherapy treatments.* For example, an heroin and alcohol dependent person may have to use methadone and benzodiazepines to treat them (Mack et al., 2016).

What are the lens: ADME

A.D.M.E. refers to processes a drug goes through which is used to categorized the drug such as it's absorption, distribution, metabolism, and excretion.

is how the drug goes into the body, bloodstream, and tissue for example cannabis can be _________ by smoking it.

Absorption

*Which Model?* has to do with how the substance use is related to genetics and chemicals in our brains. For example, an individual with opioid use disorder may be predisposed to it if one of their parents or relatives also developed an opioid use disorder. In this case, the individual may have a genetic connection. In addition, the individual's brain may produce chemical imbalance that may result in the individual cravings for the opioid. In this model, treatment is focused on treating the person's chemical imbalance through medication such as methadone, which assists with an individual's withdrawal symptoms, craving, and side effects that can be the products of the brain not producing neurotransmitters normally (Mack et al., 2016).

Biological Model

*Which Drug?* also reduces craving and withdrawal symptoms and is relatively safer than methadone due to the not having an increasing effect in higher doses, which makes it harder to become dependent on it.

Buprenorphine

PECTS: response to substances is our thoughts, for example with cannabis our thought process can be slowed down.

Cognitive

*Which approach?* is an approach that involves client receiving incentives for going to meetings and reaching behavioral goals. It based on operant conditioning, which allows the individual to receive positive reinforcement for their specific goals such as not using a substance for two weeks. An individual with opioid use disorder may provided the clinic with an opioid free urine example, in which their reward would include the ability to take home methadone dosages and not having to come daily to the clinic. Not only does it provide positive reinforcement for the individual's action, but also a sense that they are trustworthy to themselves (Mack et al., 2016).

Contingency Management therapy

is how drug is shared throughout the body and how fast it gets to our brain, for example nicotine is ______ quickly in that it takes 15 seconds to get to our brain.

Distribution

TRUE OR FALSE The first "Benzo" used in clinical practice was introduced in 1934.

False *1961*

PECTS: has to do with our senses such as the drowsiness individuals experience when taking hypnotics.

Physically

*Which Drug?* Kit Kat and Vitamin K is also a NAHs like PCP and is considered to be a schedule III drug. It's street name is likely to be a play on words from ________ (as well as it's role for club users). - popular at circuit parties is typically available in powder and liquid form. It can be snorted or injected (intramuscularly or intravenously). It has a half life of 3 to 4 hours, which is much shorter than PCP, which results in less chance of experience psychiatric and medical toxicity as compared to PCP (Mack et al., 2016).

Ketamine

is how the substance or drug is broken down such as alcohol is mostly ____________ but the enzyme ADH breaks it down in the stomach and on an empty stomach alcohol is __________ (breaks down) slower.

Metabolism

What are lens: PECTS?

P.E.C.T.S. refers to different ways individuals respond to substances, which stands for physical, emotional, cognitive, theoretical, and socioemotional.

is focused on the effects the drug has on neurotransmitters, the synapse, and receptors, for example how hypnotics affect the GABA receptors (Mack et al., 2016).

Pharmacodynamics

is what the body does to the drug, basically how it is absorbed, the drug's peak time, and the amount of duration it stays in the body.

Pharmacokinetics

is related to research based evidence on how the drug affects the body, such as how the drug can be linked to certain diseases.

Pharmacology

_________ drugs referred to substances that is used to treat mental disorders such as antidepressants.

Psychotherapeutic

TRUE OR FALSE: A counselors ability to explore substance abuse based in P's, A.D.M.E., and P.E.C.T.S provide a therapeutic lens to identify norms and expectations in SUDs.

TRUE

TRUE OR FALSE: Sedatives, Hypnotics, and Benzo's (SHBs) are widely used in medical practice in the treatment of Anxiety, Insomnia and Epilepsy.

TRUE

TRUE OR FALSE: The "Mesoblimbic" reward system is central to clinical consequences of Chronic Drug use.

TRUE

What's the Epidemiology of Polysubstance Dependence? (7)

The development of an SUD increases the chances of having additional SUD diagnoses. more than 40 percent of individuals with alcohol dependence also had a co-occuring drug abuse or dependence. Polysubstance dependence is especially found in cocaine dependent individuals, whom have a higher risk than any groups with a SUD to also develop an alcohol use disorder. Adolescents are at a high risk of polysubstance dependence, especially female adolescents are a higher risk. can be underdiagnosed especially in clinical settings. For methadone patients, roughly 90% of individuals are nicotine dependent. Additionally, Heroin injection drug users are also more likely to use multiple drugs such as nicotine, alcohol, and benzodiazepines (Mack et al., 2016).

PECTS: response such as our expectations may influence our experience. We might have an expectation of alcohol being really great and that it make us more confident, thus when we take it we begin to act overly confident such as flirting with one's crush.

Theoretical

TRUE OR FALSE LSD is among the most potent SHs.

True

What type of approach is Polysubstance Treatment considered to be? in which it uses evidence-based approaches where available. A good example would be using methadone for opioid dependent individuals which is heavy evidence based as compared to using methadone for an individual with alcohol dependence (Mack et al., 2016).

a bottom up approach

Special populations that have a higher increase to polysubstance use includes (5)

adolescents especially in clubs, women, heroin injection drug users, individuals with antisocial personality disorder, and those with personality traits such as impulsivity and novelty seeking (Mack et al., 2016).

MDMA, ketamine, GHB, cocaine, methamphetamine, and alcohol can be consider .... usually popular in large gatherings, especially with those who identify as gay men. Many individuals say that these drugs enhance their socializing, dancing experience, relieves inhibitions, and improves sex. However, it is also linked to depressed mood, anxiety, social isolation, and living with HIV disease or AIDS. The higher risk of HIV disease or AIDS is associated to the higher chance of participating in unprotected sex and risky behaviors (Mack et al., 2016).

club drugs.

which is how the substance exits the body such as alcohol exiting through a person's urine

excretion

*which Drug?* Bananas is a semi-synthetic opioid that comes from a naturally occurring opioid such as morphine. It is a prescription opioid to help with pain and make an individual feel pleasurable and good. The high that is experienced involves an increase of energy (which may be related to street name) and improvement of sleep. Just as other opioids, it can be taken orally, snorted, inhaled, smoked and injected. It does have a rapid delivery to the brain which is related to it's abuse potential as well as it's rapid tolerance. Likewise, it does also have a short half life, in which may be metabolized quickly resulting in multiple use daily. It can stay in the body for several days, mainly exited through the urine (Mack et al., 2016).

hydrocodone

What are the Lens: P's (6)

pharmacokinetics, pharmacology, psychopharmacology, pharmacodynamics, psychotherapeutic drugs, psychostimulants.

is the term used to describe the use of two or more substances. This unfortunately makes it more difficult to assign symptoms to multiple substances without making multiple independent substance disorders diagnoses. This multiple substance use can be either simultaneously or use different substances at different times (Mack et al., 2016). very common in circuit parties

polysubstance

is how the drug may affect the brain or person's behavior such as the drug being associated with brain damage or impairment in cognition.

psychopharmacology

are substances that excites the body such as the central nervous system or body tissues.

psychostimulants

*Which Drug?* Juice and Stackers the street name is also for alcohol(juice), however, it can also be referring to these as well. are a human growth hormone (HGH) usually used by athletes to improve their performance. It can be called juice due to giving athletes an extra push or "juice" to enhance their performance. It can be taken orally or injected, which results in a rapid delivery to the brain. it has a rapid onset and overall has a short duration of action It is metabolized in the liver, which may result in failure to medical treatment if overused. It is detected through urine since metabolite exits through there (which is how many athletes are tested). are ban from all legitimate sports organization, however, athletes have a wide availability to them (Mack et al., 2016).

steroids

*Which Drug?* Juice is absorbed orally by drinking it, which is related to why it may be referred as juice. It is distributed through the body by an individual's body water, which is why women achieve a higher blood _____ concentration (BAC) since they have less body water. It is metabolized by the enzyme ____ dehydrogenase (ADH) in the stomach, which also contributes to why women have a higher BAC since they have less ADH. If taken with food, it is absorbed slower and a small amount of _____ is left unmetabolized which is exited through the urine. It can be detected in urine for up to 3 to 5 days after absorbing it (Mack et al., 2016).

Alcohol

*Which assessment?* is also a brief assessment that was created by the World Health Organization (WHO), which is comprised of a list of drugs but not including prescription or over the counter medications. It is available in English, French, German, Hindi, and Portuguese and takes roughly 17 minutes to complete. This allow health providers to screen patients for alcohol or substance use and allows them to provide a treatment plan such as the recommendation of AA meetings (Nitzburg & Vadhan, n.d.; Mack et al., 2016). Nitzburg, G. C., & Vadhan, N. P. (n.d.). Identification and brief treatment approaches for substance use disorders [Powerpoint Slides]. Care Transitions Network. file:///C:/Users/maria/Downloads/Identification-and-Brief-Treatment-Approaches-for-Substance-Use-Disorders.pdf

ASSIST

*Which Approach* involves the individual being drug free and actively preventing relapse. This can be achieved through CBT in which the individual works with a counselor to address their negative thoughts that may cue their cravings for the substance while also teaching the individual to replace their habit of using substance as a coping skill with a more adaptive one. Likewise, contingency management may also be beneficial in producing ____________ such as rewarding an individual for their ___________. This may also involve medications to help the individual's withdrawal symptoms. For example, an individual with opioid use disorder may use methadone to reduce their withdrawal symptoms and cravings, while also participating in contingency management and being rewarded for their _______. CBT may also be received by the individual to help develop more beneficial skills such as keeping a journal during stressful situations (Nitzburg & Vadhan, n.d.; Mack et al., 2016).

Abstinence

*Which drug?* Ethanol is the active ingredient in _________ drinks, that comes from the fermentation of grain, grapes, and/or wheat. It is metabolized in the liver, usually peaking after 30 minutes of consuming it. The effects it has on the body includes: improving mood, experiencing mild euphoria, and increasing sociability. It has been reported that it may also produce sleepiness in certain people. It is distributed through body water, for this reason women receive higher blood __________ concentration since they have less body water. is metabolized by the enzyme __________ dehydrogenase which is located in the stomach and since it is absorbed through the stomach if an individual eats a meal, then it is absorbed slower. __________ use disorder is diagnosed depending on the number of criteria met, whether it is mild, moderate, or severe over the past 12 months. There are several screening test in which several questions are asked to the individual to determine whether they may have __________ use disorder, one is CAGE and the other is TWEAK which is similar to CAGE but more appropriate for women. After determining whether the individual may have ___________ use disorder, the clinician may turn to the DSM5 but also to the client's history, signs, and symptoms to determine their disorder and severity. __________ use disorder may also occur with other drug use disorders, mood disorders, and anxiety disorder. likely to feel withdrawal symptoms six to eight hours after the last drink and it may produce nausea, vomiting, insomnia, decreased appetite, tremors, and an increase in heart rate. For more severe cases hallucinations may occur, and withdrawal symptoms intensifies in the following 48 hours which includes: anxiety, irritability, agitation, and headaches. it is a commonly used drug in which it is shown in 17.8 percent of Americans. More common for males, whites, and Native Americans. Treatments include emphasizing abstinence, educating about alcohol use, receiving psychotherapy such as CBT, and medication such as diazepam to treat withdraw symptoms (Mack et al., 2016).

Alcohol

*Which drug?* are also known as downers, z-bars, and/or xanax, which help produce sleep and sedation. Likewise to sedatives and hypnotics, it also is used to treat anxiety and insomnia. affect the GABA receptors by binding to them and exciting them to release more GABA neurotransmitters, while also depressing the CNS. Basically "taming" the body and calming it down. It can be taken orally or crushed up and inhaled. To feel euphoria, an individual must take a high dose and when abused is usually with other drugs such as alcohol and stimulants to reduce the unpleasant effects of the other drugs. The more common ___________ that is abused is diazepam and when taking it with other drugs increases the risks of coma and death. are associated with memory loss, personality change, and cognitive function impairment. Although overall discontinuation is not considered dangerous but it is distressing. In higher doses, it may result in withdrawal seizures. It does have a rapid tolerance as well as a rapid onset, meaning that it is can be quickly absorbed in the body which is related to it's abuse potential. Although ___________ are not overprescribed as many may assume, roughly 1.6% of the population are chronic users. However, there is an increase of emergency department incidents relating to ___________. There are five characteristics that may determine whether ______________ are being abused such as the intent of the using it such as medically or not, the effect it may have on the person's life, whether it is known by a physician, whether it is legal, and what is the pattern of the substance meaning where and how is it being consumed. To be considered to have an Substance Use Disorder (SUD), the person must meet DSM5 critieria in the past 12 months, and depending on the amount of criteria met would determine the severity of the disorder. Likewise to sedatives and hypnotics, severity depends on the amount of criteria met. Some treatments that may be used for those abusing __________ are switching to another sedative/hypnotic to help treat withdrawal symptoms as well as anxiety and panic attacks symptoms the individual may also be experiencing (Mack et al., 2016).

Benzodiazepines

*Which Approach?* is lowering the craving and euphoria of the drug, as result reducing it abuse potential (Nitzburg & Vadhan, n.d.). An individual would receive a medication that blocks the effect of the desired substance and does not allow the substance to be reinforced. This may lessen the association between drug cues that trigger cravings and drug use. For example, an individual with opioid use disorder may receive naltrexone that blocks the reinforcing properties of opioids and does not allow them to feel euphoria (Mack et al., 2016). Nitzburg, G. C., & Vadhan, N. P. (n.d.). Identification and brief treatment approaches for substance use disorders [Powerpoint Slides]. Care Transitions Network. file:///C:/Users/maria/Downloads/Identification-and-Brief-Treatment-Approaches-for-Substance-Use-Disorders.pdf

Blocking therapy

*Which assessment?* is a brief assessment to identify alcohol use disorder, which includes two screener and four follow up yes and/or no questions. It is beneficial for clinics and primary care that are busy and it is available in English and Spanish. takes roughly one minute to complete, and allows the health providers to identify an individual's alcohol use disorder. This allows the individual to begin their treatment process such as health providers recommending AA meetings and medication to reduce their withdrawal symptom such as benzodiazepines (Nitzburg & Vadhan, n.d.; Mack et al., 2016). Nitzburg, G. C., & Vadhan, N. P. (n.d.). Identification and brief treatment approaches for substance use disorders [Powerpoint Slides]. Care Transitions Network. file:///C:/Users/maria/Downloads/Identification-and-Brief-Treatment-Approaches-for-Substance-Use-Disorders.pdf

CAGE-AID

*Which Drug?* Weed and Aunt Mary is considered to be a schedule I drug since the 70s. It consists of dried leaves, stems, and seeds of the hemp plant which is related to why it is referred as weed. It's active ingredient is THC, which can be smoke and ingested. It passed through the brain blood barrier quickly due to being lipid soluble, especially when smoked, and peaks roughly 15 to 30 minutes. May last two to three hours depending on the amount consumed. It has the half life of 19 hours and its elimination is impacted on whether it is taken by food. However, can be exited through the urine as well (Mack et al., 2016).

Cannabis

*Which Drug?* comes from a plant that was used for medicine and religious purposes. It later became cultivated and sold, which lead to its taxation and later to be considered a schedule I drug. THC is the active ingredient in it, which can be smoked and ingested. It is the most widely used illicit drug in the United States with 5.7 million people using it daily. It takes 15-30 minutes to peak and lasts roughly two to three hours. Its' effects the body by calming down the person, slowing down their perception of time as well as affecting their visual perception as well. It may also result in depression, anxiety, and paranoia. Some negative effects it may on body is that it is linked to impairment in memory, impairment in executive functioning such as cognitive functions, reduction in brain volume, and is associated with psychosis such as development of schizophrenia in those who are predisposed. _________ use disorder is diagnosed similar to other drugs in which certain criteria must be met in the past 12 months and depending on the number of criteria met depends on the severity. It also requires the stopping of use and within the first week three withdrawal symptoms must be present to be considered _______ dependent. Unfortunately, there are no FDA approved medications for it, but individuals may find Motivational Interviewing (MI), 12 steps programs, and Cognitive Behavioral Therapy (CBT) useful (Mack et al., 2016).

Cannabis / Marijuana

*Which Drug?* Flake and Scrabble which is a water-insoluble cocaine base (freebase) form of cocaine that is processed with baking soda and water and then heated to remove the hydrochloride. As a result, this allows the substance to be smoked. The name ______ came from the crackling sounds that is heard when it is smoked. When it is smoked it allows for a rapid absorption into the bloodstream towards the brain, this increases its' abuse potential. effects last roughly five to ten minutes It is distributed rapidly towards the brain, but there is a shorter duration of action meaning the "high" does not last as long. It is metabolized to produce two inactive metabolites such as benzoylecgonine and ecgonine methyl este, however, when taken with alcohol cocaine interacts with ethanol (alcohol) which causes the metabolism process to slow down. It exits the body through urine usually being able to be detected for roughly four days (Mack et al., 2016).

Crack

PECTS: response to substances may include how we feel for example the calming and relaxation individuals may feel with cannabis.

Emotional

TRUE OR FALSE: Pharmacological treatments don't interact constructively with Social factors to facilitate recovery.

FALSE *can* interact constructively..

TRUE OR FALSE: Peyote buttons are a non-sacramental substance in the Native American Church.

FALSE ...are a *sacramental* substance...

TRUE OR FALSE: The weight of the Human Brain is approximately 1lbs

False *3 pounds*

TRUE OR FALSE Diazepam has been used unsuccessfully in prevention of "Night Terrors" that occur in stage 4 sleep.

False *successfully*

TRUE OR FALSE Volatile solvent types typically are found from only outside of the household.

False ... are found *within* household

TRUE OR FALSE The majority of Hallucinogens are not included in the Scheduled 1 category as defined orinally in the Controlled Substances Act of 1975.

False ...*are included* in the schedule 1

TRUE OR FALSE Caffeine is an opioid derivative.

False Caffeine *is not* an opioid derivative

TRUE OR FALSE Inhalants do not cause long-term damage to the CNS.

False Inhalants *do cause* long-term harm to the CNS.

TRUE OR FALSE Sedatives and Hypnotics are divided into 4 groups, Barbiturates, Benzo's, Ecstasy, and Cocaine.

False They are divided into *three* groups: *barbiturates, other sedatives and hypnotic, and benzodiazepines*

TRUE OR FALSE Benzo's produce surgical anesthesia, coma or death at low doses, except when administered with other agents that suppress respiration.

False benzos *do not* produce these unless with other agents

TRUE OR FALSE: Within the "Change Set Point" model of SUDs, there is a minimal variant based on a herd Neurobiology of DA neurons in the VTA and NA neurons in the LC during early phase of withdrawal and abstinence.

False has *several* variants (not minimal)

TRUE OR FALSE Suicidal ideation does not commony occur with use of inhalants.

False suicidal ideation *does* commonly occur with use of inhalants

TRUE OR FALSE Tolerance is typically slow building to the Sedative and Euphoric effects Benzo's on repeated oral administration, and in inconsistent dose level if only used for a few days.

False tolerance is *rapid*

*Which Drug?* China girl is a synthetic opioid that is considered to be chemically different from morphine, but have similar mechanism and cross tolerance. may be injected, inhaled, snorted, smoked, or transdermal. It is a short acting opioid, meaning it results in multiple daily use. The onset of the drug is relatively rapid as well, and may last up to roughly six hours similar to heroin (Mack et al., 2016).

Fentanyl

*What Drug?* G is classified as a sedative and commonly used as a club drug. is a depressant of the central nervous system, and that is used illicitly to produce sedative and euphoric effects and is a known date rape drug that some also use recreationally to cause impairment. It is usually taken orally but can be crush and/or inhaled. Likewise to many sedatives, it does had a rapid onset and a relatively short duration of action. In addition, it also has a rapid tolerance, thus more _____ is needed to feel the effects

GHB

*Which drug?* Brown Sugar and Hero a synthetic opioid that came from morphine. It can look like a white or brown powder (which is why it may be referred to as brown sugar) or as a black sticky substance that is called "black tar _____". It can be injected, inhaled, snorted, or smoked. It has a quick delivery to the brain regardless of which route of administration the individual may use. Just as other opioids, it is associated to be quickly metabolized resulting in multiple daily usage, such as every 6 to 12 hours. It can be exited through the body by an individual's urine, but a portion of _____ may stay unmetabolized (Mack et al., 2016).

Heroin

*Which drug?* are also used to treat anxiety, insomnia, and epilepsy. They produce drowsiness and promote sleep. They also act on GABA receptors and depress the CNS, which also induces the drowsiness that takes over. Likewise to sedatives, it is usually taken orally or broke down and inhaled. it also has an affect on the melatonin receptors in our brains, which melatonin is a hormone that is produced to regulate our sleep. Just as sedatives, they are also more likely to be abused by those who are alcoholics or those who abuse other drugs to increase the effects or euphoria of the drug. It is also likely to be given to an individual who suffers from anxiety disorders and/or panic attacks. Withdrawal experiences are similar to those of sedatives in that if there is an abrupt discontinuation, then it may result in seizures, coma, or death. Other withdrawal symptoms are also anxiety, tremors, insomnia, hypertension, nausea, vomiting, illusion, and hallucinations. Nonmedical use is on a steady decline, in which roughly one percent of Americans use it illicitly. Benzodiazepines are also used to help an individual who is dependent on ________ drugs. Likewise to sedatives, in order to diagnose someone with ___________ use disorder they must meet DSM5 criteria in the past 12 months. Additionally, depending on the amount of criteria met, depends on the severity of the disorder (Mack et al., 2016).

Hypnotics

*Which Drug?* Huff and Honey Oil is considered to be a group of volatile solvents, aerosols, gases, and nitrates. These are usually found in household and industrial items such as paint thinners, glues, correction fluid, sprays , and even in whipped cream dispensers. can be a reference to how the substance is absorbed. are absorbed commonly by inhaling as evident in it's name. It is distributed rapidly towards the brain and it's intoxication lasting a few minutes. it does have a short duration of action, which result in multiple daily use It can result in permanent brain damage, suffocation, coma, and choking. It also can cause damages to the central nervous system (CNS), especially after long exposure, since when absorbed it quickly targets the CNS. It may also result in disorders of mood, psychosis, and anxiety (Mack et al., 2016).

Inhalants

*Which Drug?* Blue Heaven discovered in 1943 and similar to endogenous psychotic states (psychotomimetic) Most potent Serotonergic Hallucinogens (SHs) produces altered states of consciousness such as hallucinations, thought disorder, and delusions They activate prefrontal areas, while decreased activities in areas that are related to information processing and somatosensory areas It seems it does not possess the properties to maintain dependence such as the lack of affect on dopamine activity and lack of withdrawal syndrome Can result in "bad trips" that include anxiety, panic, paranoid ideation, and fear usually do response to verbal reassurance but can lead to dangerous behaviors Can provoke psychosis in vulnerable people and Hallucinogen Persisting Perception Disorder (HPPD) in which flashbacks occur spontaneously or triggered by stress, exercise, or use of another drug and caused distress and function impairment National Institute on Drug Abuse does not considered this category of drugs as "addiction" since they do not produce compulsive drug-seeking behavior Available as a liquid, ingested on "blotter paper", microdots, or other materials such as sugar cubes that are contained with ___ solution. Effects begin roughly at 30-45 minutes, peaking around 1.5 to 2.5 hours, lasting to 6-10 hours elimination of half-lie is roughly 4 hours and is extensively metabolized allowing less than 1% to appear in the urine. this use disorder is one of the most rare use disorder and least likely to be associated with addiction usually beginning adolescence Posses low toxicity and supportive psychotherapy is found useful

LSD

*Which Drug?* Molly- is considered to be a hallucinogen drug but not a "classical" hallucinogen, because unlike the other hallucinogen drugs it does not act as an agonist in serotonin 2A receptor nor does it produced psychosis. is typically used in a pill form, thus being usually taken orally. However, it can be absorbed by snorting or injecting. It has a rapid onset in that it take roughly 20 to 40 minutes after it is taken and can easily cross blood brain barriers getting to the brain rapidly. It can be metabolized by two ways either involving O-demethlenation or a minor pathway way involving N-Demethylation. Through the minor pathway, the half life is roughly 16 to 40 hours. half life for elimination is 7 to 8 hours, allowing individuals to come down from their rush after 3 to 6 hours (Mack et al., 2016).

MDMA

*Which assessment?* is a brief assessment for substance use including 16 questions that involve prescription and over the counter medications. It is commonly used in correctional facilities, but can also be used in other populations. It is available in English, Chinese, Creole, Korean, Russian, and Spanish. It takes roughly ten minutes to complete it. For an individual with opioid use disorder, this would allow the counselor to identify their substance use such as using Oxycontin. it would allow them to detect the SUD in an outpatient clinic and begin treatment process such as receiving methadone to help with the individual with their withdrawal symptoms ( Nitzburg & Vadhan, n.d.; Mack et al., 2016). Nitzburg, G. C., & Vadhan, N. P. (n.d.). Identification and brief treatment approaches for substance use disorders [Powerpoint Slides]. Care Transitions Network. file:///C:/Users/maria/Downloads/Identification-and-Brief-Treatment-Approaches-for-Substance-Use-Disorders.pdf

MSSI-SA

*Which drug* is antagonist, that helps opioid dependent individuals by reducing their cravings and withdrawal symptoms.

Methadone

*Which Approach?* in which the focus is to produce an internal motivation to change in the individual usually involving their substance use and other problems.

Motivational Interviewing (MI)

is referred to having two or more formal SUD diagnoses, meeting criteria for substance abuse, or meeting the criteria at a reasonable proxy.

Multiple SUDs

is defined as meeting formal or reasonable proxy criteria for two or more substance dependence disorders (Mack et al., 2016).

Multiple substance dependence

*Which Drug?* blocks the effect of opioids, not allowing the individual to receive the pleasure effects if they do use illicit drugs (Mack et al., 2016).

Naltrexone

*Which drug?* is the active ingredient in tobacco, which is widely used around the world and in the United States about one in every five person is a smoker. It is responsible for many medical conditions that may result in death such as cardiovascular disease, pulmonary disease, various cancers, respiratory disease, and even gum disease. Those who smoke are at a higher risk for morality, but if they quit it leads to improvements on their health and risk of morality lowers. Additionally, the risks on certain diseases such as cardiovascular and various cancers drops as well. Roughly 40 to 50 percent of people with psychiatric disorder are smokers, in which certain disorders are more likely than others to smoke including: bipolar disorders, schizophrenia, and alcoholism. Smoking also may result in certain antipsychotic and antidepressant medications to be taken in higher doses since tobacco accelerates the metabolism of these medications. It is usually inhaled and it has a rapid absorption, which takes roughly 15 seconds to reach the brain. Withdrawal symptoms occur, in which depending on the how fast withdrawal symptom appears depends on the severity of the addiction. Treatments include ___________ replacement treatment (NRT) that can come in transdermal patches (skin patches), gum, lozenge, nasal spray, and inhaler that can be combined as well. These allow the individual to quit smoking by reducing their cravings and withdrawal symptoms such as headaches, fatigue, irritability, depressed mood, and increased appetite. There are also medications approved such as bupropion slow release and varenicline that reduce cravings, decrease the reward of smoking, and help with withdrawal symptoms. Counseling is also useful in helping smokers quit. Although many smokers say they want to quit, only roughly 30 percent of smokers are ready to do so (Mack et al., 2016).

Nicotine

*Which drug?* are divided into three categories including: naturally occurring, semisynthetic, or synthetic. Naturally occurring __________are __________ that come from the opium plant such as morphine, while semisynthetic __________ are the _______ that comes from the naturally occurring ______________such as hydrocodone. The last category is the synthetic ______________ that are made in the lab and are more potent such as methadone. can be taken orally, snored, injected, or smoked. Prescription _________ are the most commonly initiated drugs second to marijuana and there is an increasing usage of heroin in which 1.6% of Americans have at least tried heroin once. Many people that are prescribed _________ turn to heroin because it is cheaper. Just as other drugs, to be diagnosed with an _______ use disorder with the DSM5, an individual must meet the criteria in the past 12 months and depending on the number of criteria met depends on the severity. The human immunodeficiency virus (HIV) along with Hepatitis is common with _______ use, especially if the individual use contaminated needles. Withdrawal symptoms includes anxiety, muscle aches, insomnia, sweating, abdominal cramping, diarrhea, nausea, and vomiting. Although it is uncomfortable, withdrawal is usually not life threatening. Medications to treat withdrawal symptoms include benzodiazepines while treatments to help reduce cravings and the usage of illicit drugs include methadone, buprenorphine, and naltrexone.

Opioids

*Which Drug?* Dipper is categorized as a NMDA antagonist hallucinogen (NAHs) that are known for their ability to disconnect mental from somatic processes. It is a schedule I drug and usually seen as a tablet, powder, liquid, and liquid sprayed onto plant materials (related to why it is called dipper). Thus, they can be taken orally, snorted, injected, and smoked. They have a wide range of reaction in that it has a half life of roughly 7 to 46 hours and the effects can continue for days after absorbing. It can result in psychotic state of minds as well (Mack et al., 2016).

Phencyclidine (PCP)

*Which Model?* relates substance use with issues in learning, thinking, or emotion regulation (AllCEUs Counseling Education, 2017). This usually includes behavioral approaches involving Motivational Interviewing (MI) This may also require assessing the individual's stage of change in which counselors may recognize the individual's motivation from not seeing that there is a problem (precontemplation) to knowing there is a problem and weighing the pros versus the cons (contemplation). may also involve cognitive behavioral approaches that include social learning theories and operant conditioning. This approach involves understanding their substance use and training the individual to develop other skills to replace their usage. An individual with opioid use disorder may receive MI to assess their motivation to change, and if they are ready to take the step towards change, then they may also receive CBT to help improve their negative thoughts that may trigger their usage while also replacing their habit of using substance with a more adaptive skill (Mack et al., 2016). AllCEUs Counseling Education (2017, November, 4). 187 Models of treatment for addiction: Addiction counselor training series [Video]. Youtube. https://www.youtube.com/watch?v=eQkA0mIWx8A&feature=youtu.be

Psychological model

*Which drug?* are drugs that lowers one's excitement and calms the person down. Thus, the drug depresses the Central Nervous System (CNS), which results in that calming effect the awake client may feel. also affects the GABA system, in releasing more GABA neurotransmitters which is also associated with that relaxation effect. However, depending on the dosage of the drug, it may also result in unconsciousness, coma, and surgical anesthesia. It is usually is taken orally but may be crushed and inhaled. The drugs are given to those who are diagnosed as having anxiety, insomnia, and epilepsy. It is similar to other drugs should only be prescribed for serious illness, in lower doses, and for a short duration. The withdrawal is similar to other drugs that also affect the GABA system in which if it is an abrupt discontinuation, then it may result in seizures or death. However, other withdrawal symptoms tend to include anxiety, insomnia, tremors, hypertension, nausea, vomiting, and tachycardia. To treat someone who is abusing the specific drugs, they may use benzodiazepines under medical supervision to reduce withdrawal symptoms. It does have a rapid tolerance, in which an individual's body would quickly get use to the the dose being consumed and need more drugs to receive the same effect. It was shown that the use is on a decline, although in did resurface in mid-2000, it continues to be on the decline. Roughly being 0.1% of the population that that continues to use it. diagnosed someone with a __________ use disorder, they must meet DSM 5 criteria in the past 12 months. Meeting two or three criteria is mild SUD, four to five is a moderate SUD, and six or more is severe (Mack et al., 2016).

Sedatives

*Which Model?* is related to how society may influence an individual substance use either through social learning, reinforcement, or socialization process culture. Treatment may include building new relationships with others not involving substance use, developing social competency, and working with the individual's cultural infrastructure (AllCEUs Counseling Education, 2017). An individual with opioid use disorder may focus on couple and family treatments such as behavioral family counseling to reinforce abstinence while also engaging with family members as collaborators in the individual's treatment process (Mack et al., 2016). Likewise, treatment may also involve going to support groups such as NA and building new relationships outside those that were created through their opioid use. AllCEUs Counseling Education (2017, November, 4). 187 Models of treatment for addiction: Addiction counselor training series [Video]. Youtube. https://www.youtube.com/watch?v=eQkA0mIWx8A&feature=youtu.be

Social Model

*Which Approach?* involves the individual receiving a drug or the drug's primary component/ medication in order to reduce harm for the individual. This would help assist the individual's withdrawal symptoms, cravings, and harmful behaviors such as sharing needles. It is considered to be controversial since many people may see it as only switching drugs and not actually helping the individual to get off the substance. An example would be an individual with opioid use disorder such as using heroin may receive methadone at a clinic to relief their symptoms and cravings (Nitzburg & Vadhan, n.d.; Mack et al., 2016). Nitzburg, G. C., & Vadhan, N. P. (n.d.). Identification and brief treatment approaches for substance use disorders [Powerpoint Slides]. Care Transitions Network. file:///C:/Users/maria/Downloads/Identification-and-Brief-Treatment-Approaches-for-Substance-Use-Disorders.pdf

Substitution therapy

TRUE OR FALSE About one in every two smokers dies of a diseased caused by smoking.

True

TRUE OR FALSE Alcoholics and Barbiturate addicts can be withdrawn under medical supervision using Benzodiazepine.

True

TRUE OR FALSE Epidemiology is the branch of medicine, which deals with incidence, distribution and possible control of diseases and other factors relating to health.

True

TRUE OR FALSE Ethyl Alcohol (Ethanol) is the psychoactive ingredient found in Alcoholic Beverage's.

True

TRUE OR FALSE Ethyl Alcohol occurs naturally as a fermentation product of fruits and grains.

True

TRUE OR FALSE HPPD involves "Flashbacks" which are triggered by stress, exercise or use of other drugs.

True

TRUE OR FALSE Nearly 70 percent of smokers want to stop smoking, and 50 percent make a quit attempt each year.

True

TRUE OR FALSE Nitrates enhance sexual activity.

True

TRUE OR FALSE Other Sedative and Hypnotics (OSHs) pharmacological properties resemble "Barbiturates" producing profound Central Nervous System (CNS) depression with little or not Analgesia.

True

TRUE OR FALSE Overall, approximately 40-50 percent of people with Psychiatric Disorders are current smokers of Tobacco products (e.g. Cigarettes).

True

TRUE OR FALSE Self-Report Instruments used to determine alcohol abuse are Mast (1971) and Audit (1997).

True

TRUE OR FALSE The FDA limits the amount of Caffeine that can be added to soft drinks.

True

TRUE OR FALSE Thiamine Deficiency is the leading nutritional cause of Brain damage in "Complicated Alcoholics."

True

TRUE OR FALSE Trimethyxanthine is found naturally in more than 60 species of plants.

True

TRUE OR FALSE Uncomplicated Alcoholics are those whose alcohol related "Brain" damage is ethanol-specific and referred to as Alcohol-Induced Persisting Dementia.

True

TRUE OR FALSE Varenicline, which is the only other approved non-nicotine-based medication for smoking cessation, reduces cravings, decreases the rewarding effects of smoking, and attenuates withdrawal symptoms.

True

TRUE OR FALSE When a cigarette is smoked, nearly 80 percent of the inhaled nicotine is absorbed by the lungs.

True

TRUE OR FALSE When a physician prescribes Benzo's for long-term use. The physician should use the Benzodiazepine Check List, to help structure decision making for treatment.

True

TRUE OR FALSE: Detoxification became prevalent in the mid 1900s and drug substitution has been a recurrent approach for treatment.

True

TRUE OR FALSE: Limited factors, both individual and environmental, predicts whether Americans who experiment with drugs will continue taking it long enough to develop an SUD.

True

TRUE OR FALSE: Substance Use Disorder (SUDs) is indeed a brain disease with Neurochemical effects.

True

TRUE OR FALSE: The structure of the Human Brain consist of 3 major parts.

True

*Which Drug?* Smoking gun is the street name for ___________, which is a product from the coca leaf and is considered to be a widely used stimulant. It can be taken through snoring, inhaled, orally, injected, and/or smoked (depending on the form). The onset of the drug may vary but it has a relatively a rapid onset, but it is more quicker when it is injected or smoked. However, the duration the drug may also vary, in which snorting it may last from 15 to 30 minutes and smoking it may only last from five to ten minutes (Mack et al., 2016).

cocaine

*Which Drug?* Blue Heavens drugs (such as alcohol, barbiturates, and opiates) that reduce neural activity and slow body functions it relaxes an individual's body and depresses their Central Nervous System (CNS). It can be consumed orally and inhaled if crushed up, and has a rapid onset due to the rapid delivery to the brain. In addition, it has a short duration of action

depressants