FINALS Chapter 15

examples of harm reduction strategies

-Change of diet -Speed limits -Wearing seat belt -Sunscreen -Helmets

Principle of harm reduction

-Protect rights of people who use drugs -Commitment to evidence -commit to social justice -avoid stigma

Transtheoretical Model of Change

1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance 6. Termination

Hunt, Barnett, and Branch (1971) showed that __________% of the individuals treated for alcohol, tobacco, or heroin abuse in abstinence-oriented programs had returned to their primary substance use three months after treatment.

70

_________ is a pharmacotherapy for alcoholism that affects the NMDA receptor and the metabotropic glutamate receptors.

Acamprosate

__________ is a self-help group for alcohol abusers that was founded by Dr. Bob and Bill W.

Alcoholics Anonymous (AA)

________ differs from AA in that there is no emphasis on spirituality or a higher power.

All of these are correct

The __________ model is the foundation for Alcoholics Anonymous (AA).

American disease

Intensive Outpatient

An *alternative to partial hospitalization* is an intensive outpatient program (IOP).

Which of the following drugs has FDA approval for treatment of alcohol-use disorders?

Antabuse

Drug Checking

Better inform users of the content of what they're using (name, lab, onsite)

5. Maintenance of change

Changed their behavior; working on there goal and maintained goal for 6 months

__________ involves the medical management of alcohol withdrawal symptoms.

Detoxification

6. Termination of change

Experience a lot of barriers but do a lot with it, do not discontinue to active change old habits are no longer a problem

Principles of MI

Express empathy Develop discrepancy Roll with resistance Support self-efficacy

A person who takes disulfram and then has an alcoholic drink will soon experience life-threatening symptoms such as an excessively rapid heartbeat.

False

According to the opponent process theory, the individual's self-efficacy to cope with high-risk situations determines whether or not they will relapse.

False

Alcohol and drug treatment that most people receive today is consistently supported by research evidence.

False

Alcoholics Anonymous (AA) has been shown to be, by far, the most effective treatment for alcoholism.

False

Harm reduction programs stress abstinence as the only way to reduce the harmful consequences of alcohol abuse to society.

False

In order to be cost effective, a person with a substance use disorder must remain in outpatient treatment for at least three months.

False

One limitation of Alcoholics Anonymous (AA) is that it is appropriate only for those holding Judeo-Christian beliefs.

False

Recent research has demonstrated that telehealth methods are ineffective for treating substance use disorders.

False

Recent research has shown that acamprosate in combination with behavioral treatment produces better outcomes than the same behavioral treatment paired with a placebo.

False

There does not seem to be any connection between alcohol or drug abuse and psychological disorders.

False

Individuals with genetic polymorphism in the _____ receptor tend to be more responsive to naltrexone's effects on alcohol use.

GABA

Why is methadone used in the treatment of heroin abuse?

It blocks the addict's craving for heroin.

Why is levo-alpha-acetylmethadol sometimes used as a substitute for methadone?

It has longer-lasting effects.

S.M.A.R.T.

Leads beliefs that can be irrational and hinder a persons beliefs to stop what they need to stop

3. Preparation Stage of change

Made a committment to change behavior and accepted responsibility

__________ is the last stage of the stages of change model.

Maintenance

___________ is a non-medical treatment for alcohol use disorders in which verbal psychotherapy is used to encourage the individual to move forward in the stages of changing alcohol-use patterns.

Motivational enhancement

__________ are people working in direct patient care without a formal degree.

Paraprofessionals

MI Spirit 1.) Collaboration (vs Confrontation)

Partnership with therapist and client (client is an expert, therapist plays a supporting role)

residential treatment

Patients that need intensive and comprehensive psychiatric treatment on a long-term basis are treated

needle exchange programs

People can exchange used needles for cleaned ones

1. Pre-contemplation Stage of change

Person does not recognize the problem to be the substance use (instead small isolated instances)

Safe injection sites

Place where people can safely use drugs

Which of the following self-help movements stopped holding meetings in 1999 and now condemns the self-help movement?

Rational Recovery

2. Contemplation Stage of change

Recognizes the problem ; desires/considers change, but does not invest effort to change

Naloxone distribution

Reduces Overdoses

The focus of _________ is on four key areas: motives, beliefs, emotions, and behavior.

SMART

__________ is a self-help group that is purported to be based on methods that are scientifically validated and is led by a coordinator who has maintained a period of sobriety or has never had an alcohol problem.

SMART

The Sobriety Priority Program is the philosophy that underlies __________.

Secular Organizations for Sobriety (SOS)

__________ is an approach in which a person's withdrawal is monitored by professional staff in a treatment setting, but no drugs are administered.

Social detoxification

__________ refers to the resolution of a problem without the use of formal treatment.

Spontaneous remission

4. Action stage of change

Taking steps and understanding they are responsible for creating change in their lives

Why is it difficult to assess the effectiveness of Alcoholics Anonymous?

The members are anonymous.

Which of the following is not true of AA?

The program is only appropriate for those who accept Western religious beliefs

MI Spirit 2.) Evocation

Therapist is Drawing out rather than imposing ideas on the client

Which of the following is not true about self-help groups?

They are led by group leaders who have recovered.

According to the 2015 NSDUH survey, more people were admitted to drug treatment for abuse of pain relievers than for any other nonalcohol drug.

True

According to the disease model of alcohol use disorder, complete abstinence from alcohol should be the only valid goal of treatment.

True

Antabuse is thought to be effective because it creates a learned aversion to alcohol.

True

Brief interventions tend to be most effective for individuals with mild to moderate alcohol problems.

True

Halfway houses are usually designed as milieu treatment.

True

In inpatient settings for substance abuse, the organization of patient care is similar to that given to people hospitalized for physical problems.

True

Naltrexone, an opiate antagonist, is an approved pharmacotherapy used in alcohol treatment.

True

Substance-use problems in women tend to develop faster than they do in men.

True

Temposil is an alcohol-sensitizing drug that is not available in the United States.

True

The biopsychosocial model is a new viewpoint attempting to account for the three major variable domains known to influence behavior.

True

The primary goal of detoxification is to manage withdrawal symptoms.

True

harm reduction is strategies reducing negative consequences for safe use

True

MI Spirit 3.) Autonomy (vs Authority)

Up for individual to follow through with making change for themselves

MI Spirit

Way of being rather than set of rules/steps to follow

Which term describes therapeutic services that follow a person's completion of a formal treatment program?

aftercare

What is typically the first step in the substance abuse treatment process?

assessing the client

Which of the following results have been reported in research conducted on the effectiveness of therapeutic communities?

associated with a more productive life after discharge if stay is long enough

The urges and cravings model states that relapse of substance use occurs because these two experiences are ________.

automatic

To increase the potential for successful outcomes, many believe that treatment of polysubstance abusers must address which of the following?

behavior patterns

The treatment most clearly implied from the __________ model is to advise at-risk people of their risk for developing a substance use disorder and perhaps to counsel them to avoid alcohol or drugs.

biological

From a formal perspective, a person who has successfully completed an alcohol abuse treatment program is advised to stay out of bars to avoid ________.

cues

The _________ model is especially important because of its prevalence in the United States.

disease

Which of the following is an alcohol-sensitizing drug?

disulfiram

Which of the following terms best reflects a person who is addicted to meth and has an anxiety disorder?

dual-diagnosis

Under the Affordable Care Act, treatment for substance use disorders is categorized as a(n) ________ service.

essential

Drug therapeutic communities are most often run by __________.

ex-addicts

Which of the following played a key role in the expansion of drug treatment services during the 1980s?

growth of crack cocaine use

In a recent study in Canada, heroin addicts who failed in methadone treatment were successful when prescribed _________.

heroin

In __________ there is considerable attention given to the medical aspects of alcohol problems.

inpatient hospital treatment

Halfway houses are an example of a(n) __________.

intermediate setting

When did treatment of substance use disorders shift from applying a "one size fits all" strategy?

late 1980s

Decriminalization of drugs

legalization of drugs (reduce the harm of drugs used)

According to the __________ model, treatment consists of spiritual or legal intervention.

moral

In the _________ model, individuals are seen as personally responsible for problems they incur from their drug and alcohol use.

moral

__________ is an opiate antagonist that may help in recovery from alcohol dependence.

naltrexone

Narcotics Anonymous evolved with a concentration on ________

opiates

Outpatient

person who requires health care services but does not need to stay in an institution for those services

Which term best reflects overall activities intended to treat substance use disorders?

planned

According to the stages of change model, individuals in the __________ stage often have not acknowledged a problem.

precontemplation

Individuals in the __________ stage are typically on the edge of taking action to change.

preparation

Which term best reflects the treatment that occurs in self-help groups for substance use disorders?

reciprocal

In Alcoholics Anonymous (AA), the beginning of recovery occurs when the alcoholic __________.

recognizes his/her powerlessness over alcohol

According to the __________ model, treatment includes arranging a person's environment so that nonabuse of psychoactive substances is reinforced.

social learning

Taxation of alcoholic beverages would be an example of an intervention based on the __________ model.

sociocultural

More people resolve their substance abuse problems through ___________ than any other way.

spontaneous remission