* IC&RC study guide

Buspirone Interactions

DON'T INTERACT WITH PSYCHOTIC DISORDERS! may interact with drugs called monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane) which are used in psychotic disorders. Interaction with these drugs can cause increased blood pressure.

6 Steps for Ethical Decision Making (6)

Decide the best course of action and take it

6 Steps for Ethical Decision Making (2)

Define potential issues

Parkinson's disease

Degenerative neurological disease involving damage to dopamine neurons.

Mania Disorder Social or interpersonal symptoms

Demonstrate marked annoyance, intolerance, anger, aggression, talkativeness, extreme actions, and rudeness.

Attending

Demonstration of counselors concern and interest in the client by eye contact, body posture, and accurate verbal following.

Attending

Demonstration of the counselor's concern for and interest in the client by eye contact, body posture, and accurate verbal following (listening skill) Encourages the client to continue to express his/her ideas and feelings freely Listening and observing and then communicating to the client that listening and observing is going on Counselor stays attuned to what the client is expressing verbally and nonverbally Attentiveness is conveyed through eye-contact, posture, and accurate verbal following ("Oh", "yes", "Uh huh")

Attending

Demonstration of the counselors concern for and interest in the clt by eye contact, body posture and accurate verbal following

Name the two fibers which extend from the neuron

Dendrites (send impulse toward body) and axons (send away from cell body)

Core function of orientation

Describing and introducing the nature and goals of the program to the client

3. Orientation

Describing to the client the following: general nature and goals of the program; rules governing client conduct and infractions that can lead to disciplinary action or discharge from the program; in a nonresidential program, the hours during which services are available; treatment costs to be borne by the client, if any; and client rights.

Screening Definition

Determines likelihood of co-occurring substance use and mental disorders or that client is presenting signs, symptoms, or behaviors may be influenced by co-occurring issues. Formal process, typically brief and occurs soon after client presents for services.

Thalamus

Determines sensations as painful vs pleasurable. Sensory and motor signal relay that regulates consciousness and sleep.

Addiction Severity Index

Developed by McLellan. Addresses 7 problem areas and is a one hour face to face interview.

Barbiturates

Developed in 1868 from barbiturate acid, and currently make up over 2,500 diverse compounds, typically used until the 1970's medically as a sedative hypnotic or an anticonvulsant. Function by interrupting impulses to the reticular activating system. Highly addictive and regular use of them leads to tolerance and severe withdrawal symptoms. Sudden withdrawal can lead to coma.

2 general categories of Crises are?

Developmental: One that occurs as a person experiences life, such as entering adolescence, getting married, having a baby, mid-life changes, retirement or the death of a spouse from natural causes in old age. Disturbing Event: accident, divorce, deaths, crime, financial losses, natural disasters or serious injuries.

Most commonly abused BZ (depressant)

Diazepam or Valium includes: Valium (diazepam) Halcion (triazolam) Xanax (alprazolam) Ativan (lorazepam) Klonopin (clonazepam)

Cultural diversity

Differences in race, ethnicity, nationality, religion, gender, SES, physical ability, etc.

Amphetamines and Methylphenidate action (stimulant)

Direct neuron release of dopamine and norepinepherine and blockade of catecholamine re-uptake produce euphoric effects. Various toxic effets on the sympathetic nervous system.

Existential Factors

Discovering that life can have meaning. Group member owns responsibility for own thoughts, feelings, and behaviors

Etiological Models

Disease/medical model CBT model Biological Model Moral Model Psychodynamic Model Family Systems Model Biopsychosocial Model

AXIS II determination

Do these patterns tend to cause trouble in intimate relationships, in social relationships and/or in work relationships? What developmental issues are present? • Is development arrested? • Are developmental issues currently presenting difficulty? Are any lifelong maladaptive patterns seen?

Advantages of Clonidine over Methadone

Does not produce opioid intoxication and is not reinforcing. Not classified as having abuse potential detox occurs w/o opioids no special licensing is required.

Drugs highjack the reward pathway, increasing _____________ in the user's brain, causing the high.

Dopamine

Median effective dose

Dose required to produce a specific effect in 50 percent of test subjects

Opiate W/D

Drug craving, dysphoria, anxiety, yawning, perpiration, sleep difficulties, fever, chills, gooseflesh, abdominal cramps, nausea, diarrhea, muscle cramps, bone pain tears.

___________ can also be used to rule out the presence of certain categories of drugs, thereby reducing the costs of testing for all possible substances

Drug recognition techniques

Pseudoaddiction

Drug-seeking and other behaviors that may look like addiction but is the result of inadequate pain relief. Once pain is adequately treated, the person no longer abuses the medication.

Inhalation

Drugs absorbed into the bloodstream after passing through the lungs have been taken by

rectal administration

Drugs are administered by inserting them into he body through the rectum and are absorbed through the intestinal lining.

Club Drugs

Drugs associated with use at all-night dance parties, known as "raves," held in dance clubs, abandoned warehouses and increasingly in more nightclubs. Drugs: MDMA (ecstasy), GHB, Rohypnol

Schedule V

Drugs in this category are considered to be at low risk for either physical dependence or psychological dependence, and with current indications for medical use. Includes medical mixtures using small amounts of opium or codeine.

Schedule IV

Drugs in this category are considered to be at low risk for physical dependence but moderate risk for psychological dependence and have a currently accepted medical use. Includes Xanax, Barbital and chloral hydrate.

Schedule III

Drugs in this category are considered to be at moderate or low risk for physical dependence, and with current reasons for medical use. Includes anabolic steroids, most barbituates and ketamine.

Schedule II

Drugs in this category are essentially similar to Schedule I, but with an accepted medical use. There are restrictions on manufacture and distribution via production quotas and import/export controls. Non-refillable meds. Include methadone, morphine, methamphetamine and cocaine.

Stimulants

Drugs in this class increase cental nervous system activity. Includes cocaine, amphetamines, methamphetamines, and methylphenidate.

Hypnotics

Drugs used to induce sleep. Barbiturates-pentobarbital(Nembutal), secobarbital(Seconal) other-chloral hydrate(Noctec,Somnos), ethchlorvynol(Placidyl).

Sedatives

Drugs used to relax, calm or tranquilize. Barbiturates - amobarbital(Amytal), butabarbital(Butisol) other-buspirone(Buspar), meprobamate(Miltown)

analgesics

Drugs used to relieve or eliminate pain

Anxiolytics examples

Drugs, such as Valium, used in the treatment of anxiety disorders. Literally, "anxiety-dissolving".

SSRI and SSNRI

EFFECTIVE TREATMENT OF GAD selective serotonin reuptake inhibitor selective serotonin and norepinephrine reuptake inhibitor

Tradition 5

Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.

Tradition 4

Each group should be autonomous except in matters affecting other groups or A.A. as a whole.

Disadvantages of group therapy

Each member receives less attention Group may scapegoat a member Counselor has less power/control

Level 0.5

Early Intervention

Tricyclic/Tetracyclic antidepressants work by?

Easeing depression by affecting naturally occurring chemical messengers (neurotransmitters), which are used to communicate between brain cells. They block the absorption (reuptake) of the neurotransmitters serotonin and norepinephrine, making more of these chemicals available in the brain. This seems to help brain cells send and receive messages, which in turn boosts mood. Most antidepressants work by changing the levels of one or more neurotransmitters.

Psychoactive

Effects on thoughts, emotions, or behavior

Dimension 3

Emotional, Behavioral, or Cognitive Conditions and Complications

3 agencies that can mandate treatment

Employee Assistance Programs (EAP) Drug Treatment Alternative to Prison (DTAP) Treatment Alternatives for Safe Communities (TASC)

6 Steps for Ethical Decision Making (5)

Enumerate consequences of various decisions

CYP450

Enzyme family most important in metabolizing drugs Always available in the liver Evolved to eliminate toxic chemicals from plants Function can be altered by alcohol & barbiturates

MAJOR DEPRESSIVE DISORDER

Episodes without a history of manic, mixed or hypomanic episodes. Two times more likely in adolescent and adult females than in males. Pre-adolescent period, this disorder affects boys and girls equally. Feel unmotivated, sad, listless and emotionally drained. Behavioral manifestations may vary from profound psychomotor retardation and withdrawal, to agitation and irritability.

Transactionional Analysis

Eric Bern is the founder of TA. View the person as three ego states: parent, adult, and child.

Transactional Analysis

Eric Berne. Focuses on interactions of ppl. Relies on Id, Ego, Superego, therapy of personality, and an organized system of interactional therapy. We make current decisions based on past premises that were at one time appropriate for our survival

Screening Purpose

Establish need for in-depth assessment, not to establish presence or specific type of disorder.

Types of alcohol

Ethyl Methyl Isopropyl Butyl Denatured alcohol

Narcotics possible effects

Euphoria, drowsiness, respiratory depression, constricted pupils, nausea

Cannabis effects

Euphoria, relaxed inhibitions, increased appetitie, disorientation,

Global Criteria: Screening

Evaluate psychological, social, and physiological signs and symptoms of alcohol and other drug use and abuse. Determine the client's eligibility and appropriateness for admission or referral. Identify any co-occurring conditions, such as medical, psychiatric, physical, etc. This will indicate the need for additional assessment and services. Abide by applicable laws, regulations, and agency policies governing alcohol and other drug abuse services.

Tradition 7

Every A.A. group ought to be fully self-supporting, declining outside contributions.

Simple Random Sample

Every member of the population has an equal chance of being selected

Systematic Sampling

Every nth element is chosen.

Global Criteria: Treatment Planning

Explain assessment results to the client in an understandable manner. Identify and prioritize problems based on client's needs. Formulate immediate and long-term goals using behavioral terms Identify the treatment methods and resources to be used as appropriate for each client.

5 principles of MI

Express empathy through reflective listening Develop discrepancy between values and behavior Avoid argument and direct confrontation Adjust to client resistance rather than opposing it directly

Mania Disorder Behavioral symptoms

Extremely talkative and sometimes very loud. They may sing, rhyme, make puns, demonstrate hyperactive or agitated behavior, have an exaggerated view of self-worth, be unable to finish tasks, lose sleep, act aggressive, act overtly sexual or have a high sex drive, and abuse substances.

Medical Marijuana

FDA has not cleared it. The ill affects of smoking far out weigh the medical affects.

Myth:Attributing drug or alcohol use to stress, just prevents adolescents from taking responsibility for their actions.

Fact:Defining the relationship between a youth's trauma history and his or her substance use can actually enhance his or her ability to take responsibility for their actions.

ANOVA

Factorial analysis of variance - used in the study of 2 or more variables. Most common is the 2x2 where there are 2 independent variables with each having 2 distinct values.

Assessing Nicotine Dependence

Fagerstrom Test and Glover-Nilsson Behavioral Questionnaire

True or False: Drug recognition techniques ARE NOT cost effective?

False. Drug recognition techniques are cost effective

THC

Fat soluable-stored in fat-time released, hard to recognize withdrawal.

Alcohol Abuse symptoms

Flushed cheeks, slurred speech, difficulty with coordination and balance

Clinical supervision: competency based models

Focus primarily on the learning needs of the supervisee and setting goals that are Specific, Measurable, Attainable, Realistic, and Timely (SMART)

Tradition 2

For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.

Dissociative Identity Disorder

Formerly known as multiple personality disorder, is under stress. May feel the presence of one or more other people talking or living inside your head.

Women for Sobriety

Found by Dr. Jean Kirkpatrick. Focused on self-esteem as magic building block for recovery

Cognitive therapy

Founded by Aaron Beck. Uses open-ended questions and Socratic dialogue.

Gestalt Therapy

Fritz Perls was the founder The person strives for wholeness and integration of thinking, feelings, and behaving. The person has the capacity to see how earlier influences are related to present difficulties Assist clients in gaining awareness of moment to moment experiencing Focus on the here and now

Gestalt Therapy

Fritz Perls. Goal of therapy is the integration of experiences into a whole personality. Stays in the here and now and focuses on body language.

neorotransmitters

GABA, norepinephrine, dopamine, serotonin, acetylcholine.

What is considered "the Gold Standard" in urinalysis?

Gas chromatography/mass spectrometry. It is highly accurate and is the only method of US that reliably produces quantitative results

Global Criteria: Assessment

Gather information from the client regarding history of alcohol and other drug abuse. Use appropriate interviewing techniques. Obtain and corroborate information from significant collateral sources in regards to client's alcohol and drug abuse and psychosocial history, through the use of appropriate methods and procedures. Identify appropriate assessment tools. Explain assessment rationale to client. Develop a diagnostic evaluation of the client's substance abuse and co-occurring disorders based on the results of all assessments. The goal is to provide an integrated approach to treatment based on client's strengths, weaknesses, problems and needs.

Assessment

Gather key info from client to enable counselor to understand problems, disabilities, strengths and weakness.

Assessment

Gathers info, engages in a process that enables establishment of disorder, determines client readiness for change, engages client in development of appropriate treatment relationship

MAST-G

Geratric MAST

Gestalt (Fritz Perls)

Gestalt therapy is considered to be a here-and-now therapy focusing on awareness with the belief that when one focuses on what they are and not what they wish to become, they become self-actualized

Standard Deviation

Gives an idea of how close the entire set of data is to the average value.

Reality Therapy

Glasser's therapeutic technique focusing on developing the client's ability to cope with the stresses of reality and assume responsibility for fulfilling his or her own needs, especially the need for identity

GAIN

Global Appraisal of Individual Needs . An integrated biopsychosocial model of treatment assessment.

Corrective recapitulation

Group helps abet family of origin issues and demonstrates healthier ways to behave

Multicultural

Growing up with more than one cultural orientation Accepting, recognizing, and enjoying the differences among groups

Haldol (brand name)

Haloperidol(generic name) antipsycotic, used for treating schizophrenia, acute psychosis, and for tics and vocal utterances of Tourette's syndrome. DO NOT TAKE WITH BZ'S (anit-anxiety) ie. diazepam(valium), loraxepam (Aitvan), clonazepam(Klonopin), aprazolam (Xanax)

Ground for breaching confidentiality

Harm to self or others child abuse elder abuse

Heroin and Cocaine

Have high risks of toxicity per user, but overall public health impact is low compared to tobacco and alcohol.

Step 12

Having had a spirtual awakening as a result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

Caffeine effect on Pregnancy

Having more than 300mg of caffeine each day can have a poor effect on a pregnancy; including spontaneous abortion, slow growth, birth defects etc.

Opiates WD symptoms

Headaches, cramps, tremors, panic, chills, loss of appetite, irritability, yawning

Heavy alcohol drinking is associated with?

Heart Disease. Moderate drinkers have lower heart disease rates than total abstainers.

Community Organizer

Helps the agencies work together to assess the needs of the community and plan how the local human service delivery system will meet those needs.

Thirty years ago, when people spoke of addiction they were most likely thinking of?

Heroin

Opiates-HCFMMO

Heroin, Codeine, Fentanyl, Methadone, Morphine, Opium

Narcotics

Heroin, Morphine, Hydrocodone, Hydro-morphone, Oxycodone, Codeine

Opiates physical/psychological dependency- HCFMMO

Heroine - high, very high Codiene - high, moderate Fentanyl - high, moderate Methadone - high, moderate Morphine- high, moderate Opium - high, high

Schedule II

High potential for abuse, accepted usefulness, i.e, morphine, Demerol, percodan, cocaine, methanphetamines

Schedule I

Highest potential for abuse and no acceptable medical usefulness. i.e Heroin, Marijuana, MDMA (ecstasy)

In reference to psychoactive drug use, it is important to recognize that:

History and expectations influence how one is affected by a drug.

Step 7

Humbly asked him to remove our shortcomings

Semi-synthetic Compounds

Hydromorphone (Dilaudid) or Oxycodone.

Depressants

Hydroxybutyric Acid, gamma, Benzodiazepines etc.

Global Criteria: Referral

Identify needs and problems that the counselor and agency cannot meet. Explain the rationale for the referral to the client. Match client needs and problems to appropriate resources. Protect client's confidentiality by following laws, regulations, and agency policies.

6 Steps for Ethical Decision Making (1)

Identify problem or dilemma

10. Referral

Identifying the needs of a client that cannot be met by the counselor or agency and assisting the client to utilize the support systems and community resources available.

Antagonistic

If one drug, such as a barbiturate, tends to reduce the effectiveness of an oral contraceptive, the drug interaction would be most accurately described as Works against one another

Collaboration for care

Implies consistent, seamless and coordinated care as clients move across different service systems

HIV/AIDS

In 1985, the issue was targeted as a top priority for training and assistance to drug abuse treatment professionals It is a Virus that destroys the immune system that should protect the body from diseases. The disease is passed from person to person through sexual acts, blood transfusions, used hypodermic needles, or from mother to child during birth.

Evaluator

In medical, psychological, financial, social, and vocational areas, they collect information from the client and from other professionals. They go over the effectiveness of the plan in meeting the client's goals, and assess the effectiveness of services and determining if outcomes have been met.

Affective depressive disorders

Include anhedonia and dysphoria. Anhedonia is indicated by apathy, boredom, or meaninglessness Dysphoria is marked by feelings of sorrow, dejection, exhaustion, bitterness, or suicidal tendencies.

Cannabinoids/cannabinols

Includes marijuana, hashish and THC

Clinical supervision: Integrated models

Including the Blended Model, begin with the style of leadership and articulate a model of treatment, incorporate descriptive dimensions of supervision, and address developmental and contextual dimensions in supervision.

Limbic System

Incorporates cerebrum, thalamus, and hypothalamus to regulate emotions including fear, anger, pleasure, and sorrow. Affects behaviors related to survival

Tolerance

Increased ________ describes a heavy barbiturate user who has steadily increased usage over many over many months realizing that it takes a lot of alcohol to get a "buzz"

Stimulant effects

Increased alertness, excitation, euphoria, increased pulse rate, increased blood pressure, insomnia, and loss of appetite, dialated pupils.

Hallucinogen OD

Increased body temp, electorlyte imbalance, cardiac arrest, unable to direct movement, feel pain, or remember.

Hallucinogen signs and symptoms

Increased reflexes, tremors, weakness, flushing and chills, seizures, inappropriate mood, elation, hallucinations, bizarre behafvior, diorientation, confusion, delusions, and impaired judgement.

Physiological Dependence

Increasing tolerance for a drug, withdrawal signs and symptoms when a drug is discontinued, or the continued use of a substance to avoid withdrawal symptoms.

Adlerian Therapy

Individual therapy that takes a positive view of human nature. Looks at social forces and believes people are in control of their own fate.

Glycine

Inhibitory neurotransmitter found in the spinal cord.

GABA

Inhibitory neurotransmitter. When normal function of GABA are disrupted, convulsions can occur

Stimulant (CANC) Withdrawal Syndrome has three distinguishing levels:

Initial Extreme Crash: • An extremely decreased mood and energy with cravings, anxiety, depression and paranoia • This phase ends when hypersomnolence and electroencephalographic changes occur and individuals only awake when experiencing food cravings Euthymia: • The individual is relaxed and experiences very few cravings • No longer feels anhedonia, anxiety, malaise and boredom, or loss of concentration, memory difficulties and suicidal ideation as they may day to day Irregular Conditioned Craving: • Reduces, although sometimes can last for months or years

12 Core Functions (2)

Intake

Level 2.1

Intensive Outpatient

Level 2

Intensive Outpatient/Partial Hospitalization

Substance Induced Disorders

Intoxication, withdrawal, substance induced mental disorders,

Alcoholics Anonymous believes that alcoholism

Is a disease and the only cure is total abstinence. Some critics say it gives alcoholics an "excuse".

Self-Disclosure

Is a sharing by the counselor of his/her own feelings, attitudes, opinions, and experiences with a client for the benefit of the client. This information should be relevant to the client's situation Can build a sense of trust/rapport between counselor and client Can help reduce the client's feelings that he/she is unique in the situation they are experiencing Disclosure should relate directly to the client's situation Counselor should only disclose things that he/she actually experienced Will it benefit the client and will the counselor feel comfortable in revealing this information? Used appropriately, counselor self-disclosure should increase the level of trust, genuineness, and empathy in the counseling relationship and reduce feelings of being unique

Null-hypothesis

Is a statement that there is no relationship between IV and DV.

Enabler

Is assumed to be the person who is emotionally closest to the alcoholic, usually the spouse. Protects the alcoholic by making excuses, taking over responsibilities, rescuing the alcoholic from consequences.

Overall, the dependence risk from alcohol use?

It is neither low nor high but moderate.

Cerebrum

Largest and most complex part of the brain. Contains billions of neurons and nerve centers.

Contolled Substance Act

Law which places drugs in 1 of 5 schedule categories, depending on their abuse potential, potential for dependence/addiction, and currently accepted medical use.

Extinction

Learned behavior patterns tend to weaken and disappear over time if they are not reinforced, so we must remove the reinforcement (implosive therapy and flooding) Implosion asks clients to imagine and relive aversive scenes Flooding is placing the client in a real life situation

Privilege

Legal term that refers to an individuals right not to have confidential information revealed in a court or other legal proceedings

LD50

Lethal Dose 50. The Lethal dose it would take to kill 50% of those who took it.

Levels of Care Placement

Level 0.5 - Early Intervention OTP - Level 1 - Opioid Treatment Program Level 1 - Outpatient Services Level 2.1 - Intensive Outpatient Services Level 2.5 - Partial Hospitalization Services Level 3.1 - Clinically Managed Low-Intensity Residential Services Level 3.3 - Clinically Managed Population Specific High Intensity Services Level 3.5 - Clinically Managed High-Intensity residential services Level 3.7 - Medically Monitored Intensive Inpatient Services Level 4.0 - Medically Managed Intensive Inpatient Services

PCP w/d

Limited reports of w/d effects. Depression, drug craving, increased appetitie and increased need for sleep

Naltrexone(ReVia):How it Works

Long-lasting opioid antagonist(blocker) reduces both the rewarding effects of alcohol and the craving for it. *Help client abstain from drinking. *Reduce heavy drinking in those who drink. Given to heroin-dependent users. can be given three times a week or be administered intravenously only once a month. Particularly effective in helping addicts discontinue the use of drugs when used with methadone and weekly counseling. Allows heroin-dependent people to stop using illegal drugs, to become more emotionally stable and to live more independent lives.

cirrhosis of the liver

Long-term effect of alcohol consumption that is one of the top ten causes of death in America is A chronic disease of the liver characterized by the replacement of normal tissue with fibrous tissue and the loss of functional liver cells

Schedule V

Low abuse potential, may lead to limited psychological/physical dependence. Includes some over the counter drugs. such as, cough meds, mixtures with small amounts of codeine or opium.

Schedule IV

Low potential for abuse; May lead to physical/psychological dependence. librium, valium, darvon, tranxene, alprazolam (xanax) barbital, chloral hydrate, fenfluramine,

Hallucinogens

MDMA and Analogs, LSD, Phencyclidine,

Step 3

Made a decision to turn our will and our lives over to the care of God as we understood him.

Step 8

Made a list of all persons we had harmed and became willng to make amends to them all.

Step 4

Made a searching and fearless moral inventory of ourselves.

Step 9

Made direct amends to such people whereever possible , except when to do so would injure them or others.

Morphine

Main alkaloid ingredient in opium with a purity of 4 to 21 percent.

Counselor

Maintains a primary relationship with the client and his or her family. By knowing the client's mental heath and medical history, they can tell what aspects of his or her current situation support or discourage progress.

Hypothalamus

Maintains homeostasis. Controls heart rate, chemcial balance, hunger, body weight, GI tract, and sexual behavior.

Maintenance

Maintenance is the stage in which people have made specific overt modifications in their lifestyles and are working to prevent relapse; however, they do not apply change processes as frequently as do people in Action. While in the Maintenance stage, people are less tempted to relapse and grow increasingly more confident that they can continue their changes. Based on self-efficacy data, researchers have estimated that Maintenance lasts from six months to about five years. While this estimate may seem somewhat pessimistic, longitudinal data in the 1990 Surgeon General's report support this temporal estimate. After 12 months of continuous abstinence, 43% of individuals returned to regular smoking. It was not until 5 years of continuous abstinence that the risk for relapse dropped to 7% (USDHHS).

Panic Disorder common co-morbid conditions

Major Depression, Social and Specific Phobias and Alcoholism. Occurs twice as often in females than in males. Occurs most often with Agoraphobia.

Diagnostic cluster of mood disorders

Major Depressive Disorder, Dysthymia, Atypical Depression, Bipolar Disorder I & II and Cyclothymic Disorder

AXIS II: DETERMINE THE PRESENCE OF PERSONALITY DISORDER OR MENTAL RETARDATION

Maladaptive patterns must be "embedded in the personality" so the pattern of response is the same whether to family, friends or strangers regardless of setting. The pattern cannot be explained by Substance Abuse or as the consequence of the symptom of another mental disorder.

Holistic Worldview

Many cultures, such as Native American and Asian, view the world in a holistic sense; that is they see all of nature, the animal world, the spiritual world, and the heavens as interconnected.

CANNABIS-RELATED DISORDERS

Marijuana and Hashish difference between cannabis preparations, LSD and other hallucinogens is in the effectiveness of their dose. Cannabis is very mild and must be taken in larger quantities to produce the same effects as other hallucinogens. Another difference is cannabis is typically more sedating and causes impaired coordination and judgment, which frequently results in motor vehicle accidents.

How Acamprosate Works

Mechanism of action not clearly understood, seems to reduce symptoms of protracted withdrawal such as sleep and mood disturbances which trigger relapse.

ED50

Median effective dose; dose effective for 50% of test population. Effective dose for 1/2 of the animals tested.

3 stages of Alcohol and Drug Counseling

Medical (physical intervention) Psychosocial rehabilitation Aftercare

Level 4

Medically Managed Intensive Inpatient Svices

Level 3.7

Medically Monitored Intensive Inpatient Services

Interpersonal Learning

Members receive feedback on how their behavior affects others

hallucinogens

Mescaline, LSD, PCP

Heroin - most well known opioid agonist

Methadone maintenance treatment program is recommended to cure heroin addiction. Methadone-synthetic opiate/obstructs 24 hours LAAM-synthetic opiate/obstructs 72 hours Naloxone-overdose Naltrexone-inhibits morphine, heroin and other opiate effects.

MAST

Michigan Alcohol Screening Test. A self-test that measures obvious signs and subtle attributes of addiction

Schedule III

Moderate physical dependence, high psychological dependence; anabolic steroids, most barbiturates, dronabinol

Convenience Sampling

Most common sampling method. Selecting an easily accessible population that most likely dose not fully represent the population of interest.

Absorption of alcohol occurs where?

Mostly the SI and stomach. Food and water slow the process.

Frontal Lobes

Motor areas which control movements and voluntary skeletal muscles. Deals with higher intellectual processing, planning, and problem solving.

Autonomic Nervous System

Motor nervous system that controls glands, cardiac, and smooth muscle.--also called visceral motor system The subdivisions that act in an antagonistic manner are called sympathetic and parasympathetic divisions

Alcohol Long-Term Effects

Mouth (lesions that can become cancerous) • Bronchi (wind pipes that become cancerous) • Stomach (hemorrhage and ulcerations can be caused by extreme overflow of hydrochloric acid that eventually weakens the lining of the stomach) • Duodenum (small intestines are damaged) • Kidneys (inflammation) • Liver (liver disease) • Circulatory system (high blood pressure) • Nervous system (alcohol kills brain cells causing blackouts, memory loss and poor vision) • Skeletal system (a calcium depletion) • Muscular system (loss of muscle tone) • Reproductive system (in males the testicles shrink and in females the ovaries atrophy

Alcohol is associated with what cancers?

Mouth, tongue, pharynx, larynx, esophagus, stomach, liver, lung, pancreas, colon and rectum.

Biopsychosocial Model

Multicausal model dealing with biology (disease/genetics), psychological, cultural norms/life events.

Hallucinogen withdrawal

Muscle aches, drowsiness, depression, acne, and drug seeking behavior.

Morphine

Narcotic, the primary active chemical in opium and is what heroine is made from.

Physical Withdrawal

Narcotics and synthetic narcotics, barbiturates, minor tranquilizers are associated with

3 Classifications of Narcotics

Naturally occurring (opium, morphine, codeine) Semi-synthetics (Heroin, Hydromorphone) Synthetics (Methadone, Darvon)

Hallucination MDMA acute effects

Nausea, jaw and teeth clenching, muscle tension, blurred vision, panice attacks, confusion, depression, anxiety, paranoid psychosis, hyperthermia, and cardiac arrest.

Double blind study

Neither researcher or participant knows who belongs to control group or experimental group

Dopamine

Neuotransmitter linked to pleasure, reward, and motivation.

Serotonin

Neurotransmitter associated with regulation of sensory perception, sleep, and body temperature.

Norepinephrine

Neurotransmitter in the brain associated with arousal moods. It is excitatory

Dopamine

Neurotransmitter that influences voluntary movement, attention, alertness;Found in basal ganglia

liver

Nicotine is deactivated by the ______

Chi Square

Nonparametric test used when the population is not necessarily normal.

Amphetamines chemical structure resembles?

Nonrepinephrine and stimulates functions, activates the sympathetic branch are referred to as sympathomimetic drugs.

Antihistamines

OTC sleep aids are based on __________

6 Steps for Ethical Decision Making (3)

Obtain consultation from supervisor or peer

The Median

Obtained by dividing the sum of observed values by the number of observations

Objective

Obtained only through the Physician 1.PEx 2.MDM 3. DDx

Type I error

Occurs when a decision is made to reject a null hypothesis

Type II error

Occurs when a decision is made to retain the null hypothesis that should have been rejected because the null hypothesis was indeed false.

Nigrostriatal dopamine pathway

One of the two major dopamine pathways. The one damaged in Parkinson's disease.

CNS Stimulants

One of three types of prescription drugs most commonly abused (along with opioids and CNS depressants). Dopamine is the most highly effected of these neurotransmitters. Used for treatment of the sleep disorder Narcolepsy and some depression cases where the individual may not have responded well to other types of treatment.

Mesolimbic dopamine pathway

One of two major dopamine pathways; may be involved in psychotic reactions and in drug dependence.

12 Core Functions (3)

Orientation

Tradition 1

Our common welfare should come first; personal recovery depends upon A.A. unity.

Tradition 11

Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films.

Level 1

Outpatient Services

Caffeine effect on brain

Overall lower brain performance. It has been shown to be beneficial short term, but have long term bad effects if regularly used in large quantities.

Cocaine

Paranoia, insomnia and irritability, compulsive use and loss control problems with headaches, coughing and nosebleeds indicates chronic _______ abuse

Cocaine Abuse Symptoms

Paranoia, rapid talking, nose bleeds

Medulla Oblongata

Part of the brain that connects to the spinal column. Controls vital centers including breathing, heart rate, and sleep/wake cycle.

Level 2.5

Partial Hospitalization

Blind Study

Participants are not aware to the assigned position/group

Pure Food and Drug Act

Passed in 1906, the act attempted to control addictions by requiring companies to label the drugs contained in their products (morphine, heroin, cociane)

12 Core Functions (9)

Patient Education

Plan

Patient's disposition: home, transferred, admitted

Pre-contemplation

People in the Precontemplation stage do not intend to take action in the foreseeable future, usually measured as the next six months. Being uninformed or under informed about the consequences of one's behavior may cause a person to be in the Precontemplation stage. Multiple unsuccessful attempts at change can lead to demoralization about the ability to change. Both the uninformed and under informed tend to avoid reading, talking, or thinking about their high-risk behaviors. They are often characterized in other theories as resistant, unmotivated, or unready for help. The fact is, traditional programs were not ready for such individuals and were not designed to meet their needs.

What is the fastest growing at-risk group, for problems of substance abuse?

People over the age of sixty. The drugs of choice for this age group are generally alcohol and prescription drugs. about 17% are never diagnosed or identified as substance abusers

Secondary prevention programs are those aimed mainly at?

People who have tried the drug in question or a variety of other substances

Development of socializing techniques

Person learns how to interact with people

Installation of hope

Person must feel there is hope to solve problems

Toxicity

Physiological poisoning or dangerous disruption of behavior. Acute, results of too much of a drug. Chronic, which results from long-term exposure of a drug.

T test

Popular test for comparing two means

Anabolic Steroids withdrawal

Possible depression

Sedative Hypnotics interaction with alcohol

Potentiation of effects, especially respiratory depression, Some degree of cross tolorance.

The stages of a crisis are:

Pre-Crisis State - all events leading up to the crisis Impact - the distressing situation or event occurs Crisis - acute emotional reaction to the situation with two elements: - Period of confusion and disorganization - Period when the individual tries many alternatives ("trial and error"), some of which work and some of which do not. Resolution - end of the event and the individual works toward adjustment to the circumstances remaining in the aftermath of the event. Post-Crisis - individual lives with whatever alterations in circumstances that occurred during the crisis

Stages of Change

Pre-contemplation Contemplation Preparation Action Maintenance (Relapse)

Preparation

Preparation is the stage in which people intend to take action in the immediate future, usually measured as the next month. Typically, they have already taken some significant action in the past year. These individuals have a plan of action, such as joining a health education class, consulting a counselor, talking to their physician, buying a self-help book, or relying on a self-change approach. These are the people who should be recruited for action-oriented programs.

Global Criteria: Report and record keeping

Prepare reports and relevant records. Integrate available information. Chart ongoing information in regards to the client. Use relevant information from records to monitor client's care.

Global Criteria: Patient Education

Present relevant information about alcohol and other drug use and abuse to the client, through formal and informal processes. Present information about available support services and resources for the treatment of alcohol and other drug abuse.

Interpreting

Presenting the client with alternative ways of looking at his/her situation

Interpreting

Presenting the client with alternative ways of looking at his/her situation (feedback)

Opium

Prevalence of narcotic use in America can be shown by the fact that during the nineteenth century: children were given ______ for colic and diarrhea

Morphine addiction

Prevalence of narcotic use in America can be shown by the fact that during the nineteenth century: heroin was used to treatment ____________

over the counter

Prevalence of narcotic use in America can be shown by the fact that during the nineteenth century: medications with opium and morphine could be purchased ___________

Soldier's Disease

Prevalence of narcotic use in America can be shown by the fact that during the nineteenth century: morphine addiction was known as _________ during the Civil War Epidemic in 1800-1905 of morphine addiction (that's how we figured out it was addictive)

POSIT

Problem Oriented Screening Instrument for Teenagers. 139 question self-administered questionnaire for treatment needs. Target population 12-19 y.o.

Clt, family and community education

Process of providing clts, families, significant others, and community agencies w/information on risks related to psychoactive substance use as well as available prevention, treatment and recovery resources

Volatile Solvents

Produce feelings of intoxication, hallucinations at high doses. Examples: paint, paint thinners, nail polish remover, correction fluid and thinner, glues and cements, dry-cleaning agents, spot removers.

Global Criteria: Orientation

Provide an overview to the program, describing the program goals and objectives for client care. Provide the client with a description of the program rules, and client's obligations and rights. Provide information about the program hours of operation.

9. Client Education

Provision of information to individuals and groups concerning alcohol and other drug abuse and the available services and resources.

Core function of client education

Provision of information to individuals and groups concerning alcohol and other drug abuse and the available services and resources. Psychoeducation, harm reduction.

Psychotherapeutics

Prozac, Haldol are both _______. Medications to treat psychological disorders.

Depression is called what in the elderly?

Pseudodementia because it often "looks like" Dementia (e.g., psychomotor retardation, confusion, memory impairment).

PCP common problems

Psychotic reactions, bizarre behavior, ooutbursts of hostililty and violence, feelings of anxiety, doom or impending death, gross impairment of coordination, nystagmus, hypersalivation, vomiting, fever. With longterm use: Persistent cognitive and memory problems speech difficulties, mood d/o, loss of puposive activities and weight loss.

Opiate physical/mental exam

Pupil constricted, relexes absent or diminished, pulmonary edema, convulsions. Euphoria, sedation, possible normal mood, possible stupor.

Paraphrasing

Putting into words the ideas or feelings you have perceived from the message

Group cohesiveness

Qualities of a group that bind members together and promote liking between members

Primary reasons for clinical supervision

Quality of client care Clinical staff continue development in a systematic and planned manner

Opiate (HCFMMO) Detoxification Withdrawal Symptoms

Raised: • Blood pressure, Pulse rate, Temperature Piloerection (also known as gooseflesh) Enlarged pupils Rhinorrhea (where the nose drains excessively) Lacrimation (the secretion of tears especially when abnormal or excessive) Tremor, Insomnia, Vomiting, Nausea, Muscle aches, Stomach cramps, Touchiness, Anorexia, Fatigue, Restlessness, Headaches, Dizziness, Light-headedness

Random Assignment

Randomly assigning participants to different groups, such as treatment or control group.

Opiate problems

Rapid acquired tolerance, dependence, respiratory dpression, cellulitis, sepsis, endocarditis, @ risk for HIV, and legal problems.

Cannabis withdrawal

Rare. Appear limited to some heavy users. Possible irritability, restlessness, craving, loss of appetite, nausea, diarrhea, muscle twitching, overt aggression and depression.

Dimension 4

Readiness to Change

Whether we see drug use as a problem depends on all of the following:

Reason one takes a drug Quantity consumed and the manner by which one takes the drug When and where the drug is used The age of the individual taking the drug

Euphoric Recall

Recalling how good it used to be and forgetting the negative consequences

Global Criteria: Consultation

Recognize issues that are beyond the counselor's knowledge and skills. Consult with appropriate resources in order to secure the provision of effective treatment services. Abide by applicable laws, regulations, and agency policies in regards to client's confidentiality. Explain the rationale for the consultation to the client, if appropriate.

Global Criteria: Crisis Intervention

Recognize the elements of the client's crisis. Implement an immediate course of action appropriate to the crisis. Enhance overall treatment by using crisis events.

Dimension 6

Recovery/Living Environment

Cannabis signs and symptoms

Red eyes, mild dilation of pupils, mild tremor, decreased coordination, decreased strength, less ability to perform complex motor tasks and dry mouth, feelings of depersonalization, anxiety, panic, memory problems, alterationin mood disorganization, hallucinations, paranoid thoughts.

PCP signs and symptoms

Red eyes, muscle rigidity, increased reflexes, repetitive movements, flushing, salivation, sweating, nausea, vomiting, possible coma, seizures, stroke. Abnormal appearance and behavior, diorientation, inappropriateeffect, memory problems, depression, elation, suicidal or homicidal behavior, and impaired judgement.

12 Core Functions (10)

Referral

chronic

Referring to drugs, the long-term effects from repeated use.

Freebasing

Refers to smoking cocaine that has been processed

Cerebellum

Reflex center responsible for coordinating muscle movements.

Dimension 5

Relapse, Continued Use, or Continued Problem Potential

Core function of consultation

Relating with counselors and other professionals in regard to client treatment to ensure comprehensive quality of care for client

12. Consulatation With Other Professionals In Regard To Client Treatment/Services

Relating with in-house staff or outside professionals to assure comprehensive, quality care for the client.

Adlerian Therapy

Relationship based on mutual respect and identifying, exploring, and disclosing mistaken goals and faulty assumptions. This is followed by a reeducation of the client toward a useful side of life. The main aim of therapy is to develop the client's sense of belonging and to assist in the adoption of behaviors and processes characterized by community feeling and social interest.

12 Core Functions (11)

Report and Record Keeping

Defense Mechanisms

Repression - forcing unacceptable thoughts and feelings from the conscious mind into the unconcscious mind Projection - accusing others of motives and traits that the person senses are true about him/herself but he/she finds unacceptable Displacement - discomfort is created by one person but there is too much anxiety to talk directly with the person, so the individual takes out his/her feelings on someone or something less threatening Regression - returning to more immature behavior that used to be satisfying, occurs more frequently when under extreme pressure Rationalization - finding a satisfactory reason for doing something unacceptable Intellectualization - understanding a difficult situation with the mind but not allowing any feelings about it

Level 3

Residential/Inpatient Services

Major depressive and anxiety disorders are best classified as substance-induced disorder if they what?

Resolve within days to weeks with abstinence. Co-occurrence of anxiety and substance abuse disorders in general population is 5-20%

When 2 or more psychoactive drugs are consumed together, the most serious risk from their "interaction" is?

Respiration-Breathing, which can slow down to the point of starving the brain of oxygen. Blood pressure or circulation may also be at risk.

With continued use of a drug, a user damages their ___________ ____________, making it difficult to enjoy things they used to enjoy (like roller coasters, getting good grade).

Reward System or Reward Pathway

CNS stimulant used for ADHD

Ritalin (methylphenidate) and Dexedrine (dextroamphetamine)

Counseling Skills of Stage 3 (Feedback)

Role-playing, values clarification, goal-setting, problem solving. Feedback should be directed toward the person's behavior, which the person can do something about, they have control over behaviors.

Pons

Rounded bulge on the underside of the brain stem that connects medulla to mid-brain

SASSI-A2

SASSI for adolescents ages 12-18

substance classifications

SHOP N MD - stimulants, hallucinogens, opioids, psychotherapeutics, nicotine, marijuana, depressants

Instrument for Opioids Dependence and Withdrawal

SOWS-Subjective Opiate WD Scale-higher score more severe WD OOWS-Objective Opiate WD Scale-0-13 higher score more severe WD

Many screening instruments are available to detect the need for a full evaluation of a substance use disorder, including?

SSI-SA - Simple Screening Instrument for Substance Abuse AUDIT - Alcohol Use Disorders Identification Test

Panic Disorder medication

SSRIs, tricyclics and benzodiazepines are quite effective. Medication should be used in conjunction with cognitive-behavioral treatment. Medication is used for six months with cognitive-behavioral treatments then the patient is slowly weaned off the medication. However, relapse is high and may require "half dose" maintenance.

Probability Sampling

Sampling a known population

DAST

Screen drugs other than alcohol

12 Core Functions (1)

Screening

Screening VS Assessment

Screening is process for EVALUATING the possible presence of a problem VS Assessment process for DEFINING the nature of the problem.

SOS

Secular Organization for Sobriety. Alternative recovery method for those alcoholics uncomfortable with spiritual content of 12 step programs.

Sedative Hypnotics acute effects

Sedation, impaired judgement, impaired operation of vehicles, respiratory and cardiac depression with overdose (much less likely with benzoidiazepines alone).

Global Criteria: Counseling

Select the counseling theory (ies) that is/are more appropriate. Apply techniques to help the client, family, or group explore problems and their effects. Apply techniques to help the client, family, or group examine behaviors, attitudes, and feelings. Individualize counseling based on cultural, gender, age, and lifestyle differences. Elicit solutions and decisions from the client. Implement the treatment plan.

Purposeful Sampling

Selecting a sample from a population on who will be the most informative about a topic of interest.

Random Selection

Selecting participants from a population so that every member as an equal chance of being chosen

Advantages of Group Counseling

Sense of safety in numbers intense learning Expectation to be concerned about others Cost efficient

Temporal Lobes

Sensory areas responsible for hearing, visual memories, and language comprehension

Parietal Lobes

Sensory areas responsible for temperature, touch, pressure, and skin pain

burn-out

Several experts believe that it occurs in stages. The first stage is enthusiasm It is a state of physical, emotional, intellectual, and spiritual exhaustion

SMAST

Short MAST, 13 items

Psychoanalytic therapy

Sigmund FREUD'S therapeutic technique. freud believed the patient's free associations, resistances, dreams and transference and the therapist's interpretations of them released previously repressed feelings, allowing the patient to gain self-insight.

Sedative Hypnotics withdrawal

Similar to alcoho, but may have slower onset. Severity and time of onset vary wtih half life of drug. Mild: anxiety, restlessness, nausea, vomiting, insomnia, hpertention, tachycardia, agitation, tremors, sensory, hypersensitivity, dizziness, confusion, fatigue. Severe: Autonomic hyperactivity, vital sign instability, elevated temp, delusions, hallucinations, mania, delirium, catatonia, seizures, tremulousness, altered perceptions, w/d seizures possibly leading to death.

Sedative Hypnotics desired effects

Similar to alcohol. Reduction of anxity; possible elation, secondary to decrease alertness and judgment.

What are the advantages of screening instruments?

Simple in use and scoring. Limited training needed for administration. Known level of reliability and availability of cut-off scores.

Sedative Hypnotics Medical uses

Sleep, anxiety, muscle relaxation, alcohol, and sedative/hypnotic w/d, control of seizures includes Benzodiazepines, barbiturates, and others.

Opiate OD

Slow and shallow breathing, clammy skin, convulsions, coma, possible death due to suppression of breathing

Narcotics effects of OD

Slow/shallow breathing, clammy skin, convulsions, coma, and possible death

Sedative Hypnotics physica/mental exam

Slurred speech, ataxia, stupor, coma, and for nonbenzo's respiratory depression. confulsion, impaired judgement, delirium.

decaffeinated coffee

Soaking unroasted beans in an organic solvent (methylene chloride)

Community Orientation

Some cultures are oriented towards the collective good of the group rather than the individual's welfare. Clients of these cultures may care more about how the substance use is affecting family over how it affects them individually.

Heroin

Some effects of _______ use include euphoria followed by "nodding' and possible nausea

When US deaths are classified and ranked according to the contributions of alcohol and other drugs, TOBACCO causes the most deaths, followed by alcohol, and then all other drugs.

Some of the "all other drugs" are cocaine, heroin, and tranquilizers.

When knowledge of BAC is combined with clinical info, the healthcare provider can make what?

Some predictions regarding the acuteness of withdrawal.

What are disadvantages of screening instruments?

Sometimes becomes the ONLY component of the screening process. Provides little opportunity to establish a connection with the client.

Step 11

Sought through prayer and meditation to improve our conscious contact with God as we understood him, praying only for knowledge of his will for us and the power to carry that out.

Crisis Intervention Goals

Stabilize the situation and protect the individual from additional stressors. Mobilize whatever resources are required to assist the individual (i.e. assist the person in managing and recovering from the unusual circumstances). Restore the person to adaptive or pre-crisis level functioning.

Transtheoretical Model of Change (TTM)

Stages of change process of change self-efficacy decisional balance

SMART Recovery

Started in 1992. Recovery program that looks as addiction as behavioral. 4 Point program: Enhance motivation to abstain Coping with Cravings Solving problems through management of thoughts, feeling and behaviors Developing and maintaining lifestyle balance

Drug Dependence

State in which the individual uses the drug so frequently and consistently that it appears that it would be difficult for the person to get along without using the drug.

Omnibus Drug Act

Stiffened penalties for drug trafficking, specifically on airplanes and boats, allowed government to confiscate.

Amphetamines Examples

Stimulants that have a substituted phenylethylamine structure such as: Dextroamphetamine Methamphetamine (Speed) Chemicals structurally different with the same action: • Methylphenidate • Other types Diet Pills, appetite suppressants

CANC

Stimulants: Cocaine Amphetamine Nicotine Caffeine

crank

Street name for illicitly manufactured methamphetamine

Phenomenology

Subjective fashion through which people perceive their world.

Sedative-Hypnotic

Substances that induce depression on the CNS 3 Categories: 1) Barbiturates - used to treat anxiety, induce sleep, and control seizures (reduce tension and anxiety, relax) - barbiturates have slowly been replaced with safer benzodiazepines 2) Minor Tranquilizers - depressant drugs used to treat anxiety and insomnia (basically benzodiazepines) 3) Other Sedatives-hypnotic: "catch-all" category for sedatives/hypnotics

Buprenorphine is sold under what brand name?

Subutex and in combination with naloxone, as Suboxone. Subutex is intended for use at the beginning of treatment while Suboxone is intended for the maintenance treatment of opiate addiction. (Naloxone was added to guard against intravenous abuse of buprenorphine by individuals physically dependent on opiates.)

Highlights of clinical supervision

Supervisory relationship must be supportive and culturally competent, provide direct oversight, and prioritize skill development and counselor wellness Supervision is a formal process that is provided frequently and employs direct observation techniques Supervision is expected to result in improved staff retention, counselor skills, and client outcomes.

AXIS II: PERSONALITY DISORDERS AND MENTAL RETARDATION - difference from AXIS I

Symptoms last longer do not generally change much over time are integral to the individual's interaction with the world

Anabolic steroids

Synthetic illicit drugs that are used to increase muscle mass and improve athletic performance. Include Depo-testosterone, Durabolin, Danocrine, and Halotestin. Some are approved for veterinary medicine and sold illicitly for human use.

Methadone

Synthetic opiate used for heroin detoxification and maintenance programs. Extremely addictive, legal and generally considered safer than heroin because it does not produce a "high" state, therefore allowing methadone maintenance users to have a performance superior to heroin users. Gives a longer lasting high when taken orally, which is a preferred, cleaner and safer way to take drugs than by intravenous administration. More extreme withdrawal symptoms than heroin that can last with great intensity for up to ten days.

T-ACE (Alcohol screening instrument for pregnant women)

T Tolerance: How many drinks does it take to make you feel high? A Have people Annoyed you by criticizing your drinking? C Have you ever felt you ought to Cut down on your drinking? E Eye opener: Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?

Disulfiram: Trade name Antabuse

Tablet by mouth once daily - may be crushed. 250mg or 500 mg. Typically begins about 10 to 30 min after alcohol is ingested. May occur for up to 14 days after last dose. Inhibits the enzyme aldehyde dehydrogenase

Catharsis

Talking about difficulties is beneficial. Group members release intense emotions and open up opportunities to group.

Harrison Act

Taxation act of 1914 that taxed opium and coca products

The four roles of a Clinical Supervisor

Teacher Coach mentor Consultant

Termination

Termination is the stage in which individuals are not tempted; they have 100% self-efficacy. Whether depressed, anxious, bored, lonely, angry, or stressed, individuals in this stage are sure they will not return to unhealthy habits as a way of coping. It is as if their new behavior has become an automatic habit. Examples include adults who have developed automatic seatbelt use or who automatically take their antihypertensive medication at the same time and place each day. In a study of former smokers and alcoholics, researchers found that less than 20% of each group had reached the criteria of zero temptation and total self-efficacy (Snow, Prochaska & Rossi, (1992). The criterion of 100% self-efficacy may be too strict or it may be that this stage is an ideal goal for population health efforts. In other areas, like exercise, consistent condom use, and weight control, the realistic goal may be a lifetime of maintenance.

"The way to tell whether a man is having drinking problems is to ask..."

The BEST answer is "whether he has tried several times without success to reduce his drinking."

Stimulants (Cocaine, amphetamine, Adderall, Ritalin)

The Buzz - Alertness, energy, talkativeness, increased heart rate and blood pressure, euphoria Bad Effects (three dangers) - death at high doses, psychiatric state of hostility, paranoia, schizophrenia, addiction rate is high Withdrawal Effects - Miserable but not life threatening, cravings, exhaustion, excessive sleep, depressive symptoms, strong appetite, inability to feel pleasure

Hallucinogens (LSD, PCP, Ketamine)

The Buzz - Detachment from surroundings, hallucinations, illusions, jitteriness, racing or slowed heart beat, nausea, chills, numbness Bad Effects- Bad trips

Alcohol

The Buzz - First half hour one will experience pleasure and relaxation, talkative, which is then replaced by sedation, quietness, and being withdrawn Bad effects - Low overdose potential, slurred speech, vomiting, hyperthermia, hypothermia, comatose

Caffeine

The Buzz - Increased alertness and ability to concentrate, sometimes euphoria. Higher doses can result in nervousness/agitation Bad effects - Overdose is rare, anxiety, stimulation of urination, increased blood pressure, headaches

Nicotine

The Buzz - Increases attention and concentration, calming Bad Effects - Dizziness, weakness, and nausea Withdrawal - Craving and irritability

Ecstasy

The Buzz - Increases heart rate and blood pressure and body temperature and produces a sense of energy and alertness, suppression of appetite, feelings of empathy, and good feelings Bad Effects - Jitteriness, teeth clenching, hyperthermia, high blood pressure, heart attacks, strokes, seizuers

Sedatives (Barbiturates, benzodiazepines, sleeping medications)

The Buzz - Relaxation, mellow feelings, lightheadedness, vertigo, drowsiness, slurred speech Bad Effects - Benzos: Low fatal overdose potential unless combined with other sedatives Any other sedative can cause death by suppression of breathing and heart failure Progression as follows: drowsiness, muscle discoordination, slurring speech, deep sleep, loss of reflexes such as gagging, suppressed breathing, death Withdrawal Effects - Sudden withdrawal because the CNS adapts to the drug by turning down the inhibitory systems that these drugs enhance

Inhalants

The Buzz - Relaxes muscles, drop in blood pressure, increased heart rate, sense of warmth, mild euphoria Bad Effects - Loss of consciousness, heart palpitations, headaches, solvent lethal overdose high

Marijuana

The Buzz - Relaxes, elevates mood, drowsiness, sedation, hilarity, tranquility, illogical thinking, impaired memory, lack of focus, analgesic, increased appetite Bad Effects - Lethal overdose is impossible, anxiousness, fearful, impaired judgment and coordination, increases heart rate Withdrawal - Mild withdrawal effects: Agitation, anxiety, tremors, seizures

Opiates (Heroin, morphine, fentanyl, oxycodone, hydrocodone)

The Buzz - Rush of pleasure, dreamy state, little sensitivity to pain, breathing slows, skin flush, pin point pupils Bad Effects - Overdose can happen, nausea, vomiting, constipation Withdrawal - Miserable but not life threatening, cravings, watery eyes, runny nose, yawning, sweating, restless, irritable, loss of appetite, difficulty sleeping, dysphoria, flu like symptoms (diarrhea, shivering, sweating, muscle aches)

LOCUS

The Level of Care Utilization System is a tool used to assess the immediate services needs for a client.

Psychoactive

The ability of certain medications, drugs, and other substances to cause acute psychomotor effects and a relatively rapid change in mood or thought. Changes in mood include stimulation, sedation, and euphoria. Thought changes include a disordering of thought such as delusions, hallucinations, and illusions. Behavioral changes include an acceleration or retardation of motor activity. All drugs of abuse are by definition psychoactive.

External Validity

The ability to generalize the the results to a larger group.

2. Intake

The administrative and initial assessment procedures for admission to a program.

Core Function of Intake

The administrative and initial assessment procedures for admission to a program; an extension of screening

Service coordination

The administrative, clinical and evaluative activities that bring the clt, treatment services, community agencies, and other resources together to focus on issues and needs identified in the treatment plan

The Nervous System

The brain, the spinal cord, the peripheral nerves Central - brain and the spinal cord, psychoactive drugs primarily affect the CNS Peripheral - all the nerves that branch out

Internal Validity

The changes in the DV are due to the effects of the IV

Independent Variable

The construct that is manipulated or controlled in some way i.e. sex, race, treatment group, etc.

Concreteness

The counselor characteristic or ability used to guide the client in relating and communicating in specific terms rather than in general or abstract terms.

Intervention

The creation or use of a crisis involving the alcoholic that is so emotionally painful that he/she will stop denying that alcohol/drugs is a problem before he/she has lost everything

Reliability

The degree to which a measure in consistent

Tolerance refers to?

The diminishing effect of a drug as a result of repeated exposure to the same dose of the drug.

Motivational Interviewing

The direct, client centered counseling form implemented to elicit behavior change by helping clients resolve ambivalence to change.

Independent effect

The effect of individual drug is not changed when combined with another drug. Neither drug affects the other.

Antagonistic effect

The effect of one drug blocks or reduces the effect of another drug or both drugs in the system

Reflection of Feeling

The essence of the client's feelings, either stated or implied, as expressed by the counselor

Reflection of Feeling

The essence of the client's feelings, either stated or implied, as expressed by the counselor (feedback). Focuses primarily on the emotional element of the client's communication Identification and formulation. The counselor must first identify basic feelings

Neurons

The functional and structural unit of the nervous system are Cells in nervous system that communicate to perform info-processing tasks

Core function of referral

The identification of client's needs that cannot be met by the counselor or agency and assisting the client to use the support systems and community resources available

treatment plan

The initial ______________ should be based on assessment of the needs as revealed during the intake Consist of goals and objectives based upon the assessment needs of the ct

Imitative behavior

The leaders and senior group members act as role models of healthy behavior for newer members

Duty to Warn

The legal obligation of a counselor to notify the appropriate authorities or victim when there is a serious danger

Dissociative Fugue

The main sign is creating physical distance from your real identity. For example, you may abruptly leave home or work and travel away, forgetting who you are and possibly adopting a new identity in a new location.

Dissociative Amnesia

The main symptom is memory loss that's more severe than normal forgetfulness and that can't be explained by a medical condition.

The Median

The median is the middle value of a set of data containing an odd number of values, or the average of the two middle values of a set of data with an even number of values

Detoxification

The metabolic process that changes alcohol to the compound acetaldehyde is known as

Oxidation

The metabolic process that leads to the formation of water and carbon dioxide by the process of chemically heating acetic acid is

Disulfiram (Anatabuse)

The method of which __________acts to deter the consumption of alcohol is by decreasing the body's ability to break down poisonous metabolites of alcohol A drug that inhibits acetylaldehyde dehydrogenase

Effect

The most common classification of drugs is by their ______

Oral

The most common manner of drug administration is

Stimulant Withdrawal Syndrome (CANC)

The most difficult symptom is craving, of which there are two types: Anhedonic: A craving because of boredom and the wish for a high Conditioned: Due to environmental reminders of pleasure derived from stimulant use. Because stimulants are powerfully effective, Conditioned craving typically accompanies stimulants more than other drugs.

Norepinephrine

The neurotransmitter associated with arousal and mood is A neurotransmitter associated with eating and alertness. Too little has been associated with depression and too much has been associated with schizophrenia.

Benzodiazepines (Anti-Anxiety Agents) - Depressant

The newest class of widely prescribed psychoactive chemicals that relieve anxiety.

Tradition 3

The only requirement for A.A. membership is a desire to stop drinking.

Dependent Variable

The outcome variable that is influenced.

parasympathetic

The part of the autonomic nervous system relating to relaxing activities (in coordination with the sympathetic division)

Hypothalamus

The part of the brain that controls heart rate, hunger, body weight, and arterial blood pressure is A small area of the brain that regulates emotional behaviors and motives.

Prohibition

The period from 1920 to 1933 when the sale of alcoholic beverages was prohibited in the United States by the 18th Amendment Decreased the number of deaths associated with alcoholism

Universality

The person must feel he or she has a problem common to others

Dimension II: Biomedical Conditions and Complications

The placing authority must use the criteria in Dimension II to determine a client's biomedical conditions and complications.

Dimension III: Emotional/Behavioral/Cognitive

The placing authority must use the criteria in Dimension III to determine a client's emotional, behavioral, and cognitive conditions and complications.

Dimension IV: Readiness for Change

The placing authority must use the criteria in Dimension IV to determine a client's readiness for change.

Dimension V: Relapse/Continued Use/Continued problem potential

The placing authority must use the criteria in Dimension V to determine a client's relapse, continued use, and continued problem potential.

Dimension VI: Recovery Environment

The placing authority must use the criteria in Dimension VI to determine a client's recovery environment.

Dimension I: Acute Intoxication/withdrawal potential

The placing authority must use the criteria in dimension 1 to determine a client's acute intoxication and withdrawal potential.

Core function of assessment

The procedures by which a counselor/program evaluates an individual's strengths, weaknesses, problems, and needs for the development of a treatment plan.

4. Assessment

The procedures by which a counselor/program identifies and evaluates an individual's strengths, weaknesses, problems, and needs for the development of a treatment plan.

1. Screening

The process by which the client is determined appropriate and eligible for admission to a particular program.

Core function of treatment planning

The process by which the counselor and client ID and rank the problems needing resolution. They establish agreed upon immediate and long-term goals and decide upon a treatment process and the resources to be used.

5. Treatment Planning

The process by which the counselor and the client identify and rank problems needing resolution; establish agreed upon immediate and long-term goals; and decide upon a treatment process and the resources to be utilized.

Detoxification

The process of making a substance nonpoisonous in the human body is Also known as metabolism or biotransformation

42 CFR

The regulations directing the implementation of confidentiality of alcohol and drug abuse patients

The driving force behind narcotic addiction?

The reinforcing effect of a drug on the brain rather than fear of withdrawal.

Cluster Sampling

The researcher identifies existing subgroups and not individual participants

Claudia Black's family roles

The responsible one The adjuster The placater The acting-out child

Threshold Dose

The smallest amount of a given drug which is capable of producing some detectable response

Pharmacodynamics

The special study of where and how drugs act in the human body is called _________ Effects of a drug within the body ( the absorption, metabolism, excretion)

Nicotiana Tobacum

The species of tobacco widely cultivated for smoking and chewing products

Overt racism and hostility

The style of counseling in which a counselor acts out the deep-seated prejudices that he/she has toward a minority group

Hypothesis

The testable, concise statement involving the expected relationship between two or more variables.

Transference

The unconscious redirection of emotions from one person to another

Drug use

The use of a drug in some socially prescribed fashion is referred to as

Medication Assisted Treatment (biologically based)

The use of approved medications with medical supervision. Intended to be an adjunct to formal therapies. Agonists - These drugs can be substituted for the drug of abuse to provide a more controllable form of addiction. The properties and actions of these drugs are similar to the drug of abuse. Using them alleviates withdrawal symptoms Methadone and Clonidine) Methadone blocks the cravings for opiate drugs and does not create a sense of euphoria like heroin Antagonists - These drugs occupy the same receptor sites in the brain as specific drugs of abuse, they do not produce the same effects as the drug and are not addicting. When they are present, the effects of the abused drug are blocked because they cannot act on the brain in the same way (Naltrexone, Buprenorphine/Suboxone Antidipsotropics - create adverse physical reactions when the person consumes the substance of abuse. These drugs are used to develop an aversion to the abused drug (antabuse) Psychotropic Medications - These control various symptoms associated with drug use and withdrawal

6. Counseling

The utilization of special skills to assist individuals, families, significant others, or groups in achieving objectives through exploration of a problem and its ramifications; examination of attitudes and feelings; consideration of alternative solutions; and decision-making.

The Mode

The value which occurs most frequently

Joan Jackson

Therapist who first began to focus efforts of treatment toward the family of the chemically dependent individual in 1954 Wrote "Alcoholism and the Family"

energy drinks

These became a slightly lower caffeine content drink with about 80mg of caffeine each. i.e. red bull, rockstar, monster

Depressants/Sedative-hypnotics

These drugs are central nervous system depressants. Include but are not limited to: alcohol, benzodiazepines and barbituates. In general these drugs bind to GABA receptors resulting in sedation.

Hallucinogens/Dissociatives

These drugs change sensory perception and have the ability to alter reality and produce hallucination-like effects. Includes naturally occuring and synthetic drugs such as: LSD, mescaline, psylocybin, psilocin, MDMA, PCP and ketamine.

French

These people consume more alcohol per capita than any other nation and have the highest rates of alcohol dependence, suicide and deaths from cirrhosis of the liver.

Fat-soluble drugs

These store in the fatty areas of the body and can have longer lasting traces in the body that water-soluble drugs do not.

Cocaine and Amphetamines

These two drugs interact with several neurotransmitters: dopamine, norepinephrine, and serotonin.

What is the misconception of dependence potential for all psychoactive drugs?

They are all not rated as "high". i.e. alcohol, marijuana, or hallucinogens they are moderate.

Expediter

They help the client get through problems of duplicated services, ineligibility, seemingly closed doors, poor service quality, and irrelevant services. Services are delivered efficiently and effectively.

Collaborator

They help the professionals establish and maintain good working relationships. The case manager knows the human service community and has established a network of other professionals.

Consultant

They help with cost analysis, quality control, and organizational structure. They identify the problem, study it, and make recommendations. They also help with special information or expertise.

Record Keeper

They maintain detailed information relating to all contracts and services. They provide long-term care, communicating with other professionals and agencies, and monitoring and billing for services.

System Modifier

They possess authority to change agency policy or redirect priorities in addition to having the respect of the community and colleges.

Tolerance is the reduced effectiveness of a drug after repeated use. An example would be...

Think of the person who "can drink me under the table." As drinkers gain more "tolerance" to alcohol over time, the negative effects of drinking on their driving can decline.

40,000

This many fatalities related to alcohol each year.

autonomic

This nervous system provides involuntary control over smooth muscle, cardiac muscle, and glands.

Control Group

Those in the study who share similar attributes with the experimental group, but do not receive treatment

Core function crisis intervention

Those services which respond to an alcohol and/or drug abuser's needs during acute emotional and/or physical distress; safety plan

8. Crisis Intervention

Those services which respond to an alcohol and/or other drug abuser's needs during acute emotional and/or physical distress.

Three basic processes

Tolerance physical dependence psychological depnedence

Sedative Hypnotics common problems

Tolerance, dependence, addiction, elderly falls, respiratory dpression

Alcohol common problems

Tolorance, Dependence, Depression, neurologic deficits, hypertension, liver and heart disease.

monoamine theory of mood

Too little activity of MA neurotransmitters can cause depression, too much can cause mania - supported by the fact that monoamine-enhancing drugs, like amphetamines & cocaine, elevate mood

Acamprosate

Trade name: Campral How taken: Two delayed-release tablets by mouth three times per day, with or without food (a lower dose may be effective with some clients and must be prescribed for those with impaired renal function). How supplied: Enteric-coated 333 mg tablets

Clinical supervision: treatment based models

Train to particular theoretical approach to counseling, incorporating evidence-based practices.

Remission

Treated differently than dependence: Early- symptoms have not been present for a period of two days to one year Sustained - one year has passed. In addition to the length, the intensity must be determined. Full - no symptoms are present after a period of 30 days. Partial -some symptoms return

No Wrong Door

Treatment is available at every point of someone trying to get help in any stage of substance abuse.

12 Core Functions (5)

Treatment planning

Alcohol Withdrawal

Trembling, autonomic hyperactivity, Anxiety, insomnia, vitamin deficiency, confusion, hallucination, and convulsions.

True or False: Initial screenings procedures should be brief

True

True or False. Reports from persons in treatment often are more credible than those from individuals in criminal justice system

True. Assurance of confidentiality is an important factor that enhances self reporting, while potential of prosecution and other sanctions is likely to diminish disclosure

Potentiating

Two drugs have different actions, but when taken together, one enhances the effects of the other If an antiulcer medicine tends to increase blood alcohol levels and thus makes drinkers more intoxicated, this type of drug interaction would be best describes as

DSM V: Substance Use Disorder (specifiers)

Two or three symptoms indicate Mild. Four or five symptoms indicate a moderate substance use disorder, and six or more symptoms indicate a severe substance use disorder.

Two by Four Programs

Two phase approach to treatment. Detox for two weeks followed by outpatient for two weeks

Mania Disorder Cognitive symptoms

Unable to concentrate, have lax ideas and associations in conversations, develop an exaggerated view of self accomplishments, and add few, if any, insights during conversation.

Clinical supervision: developmental models

Understands that each counselor goes through stages of development and recognizes that these stages are not always linear.

Barbiturate examples

Used for Insomnia and Seizures. Thiopental (Pentothal, used as a general anesthetic) Amobarbital (Amytal, used for control of agitated patients) Secobarbital (Seconal)

Clonidine (Catapres)

Used for opioid detoxification.

Chi-squared

Used to determine if there are significant differences in the distribution of two data sets. Used to determine if two populations are homogeneous when compared to each other.

Naloxone

Used to treat cases of Heroine (opiate) overdose

MANOVA

Used when investigating more than one dependent variable

Factorial Analysis

Used when investigating more than one independent variable

Two Hallmarks of Axis II

Usually it should be early onset (in adolescence into adulthood) • They younger the client is, the more difficult it is to diagnose as personality disorder The personality pattern has to occur under all situations: at home, at work, on vacation, etc. • The client will react to everything using the same personality modality

The Hero

Usually the oldest child. Provides self-worth to the family. Knows something is wrong and feels obligated to fix the problem through achievement.

The Scapegoat

Usually the second child. Since the hero has the positive attention, the second child seeks what is left: negative attention. the child's role is to take attention away from the alcoholic by accepting blame for the family's troubles.

Mascot

Usually the third or middle child. Senses that something is wrong in the family but gets reassurance from other members that nothing is wrong. This causes anxiety and continual conflict for the child.

Lost Child

Usually the youngest child. The child's role is to cause no trouble for the family. They receive little positive or negative attention from the family.

Benzodiazepines (BZs) examples

Valium(diazepam) Halcion(triazolam) Xanax (alproazolam) Ativan (lorazepam) Klonopin (clonazepam)

Safety of Acamprosate

Very safe!! Do not use with patients with kidney problems. Diarrhea and Drowsiness are side effects. No potential for abuse. No drug interactions.

Amphetamine Effects

Very similar to cocaine intoxication Maladaptive behavior Psychological alterations Intoxication characterized by euphoria Interpersonal sensitivity Talkativeness Hypervigilance Impaired judgment

Delirium Tremens (DTs)

Vibrant hallucinations, delusions, autonomic hyperactivity and agitation

Systems Theory

View of behavior as an interactive part of a larger social structure.

Anabolic Steroids effects

Virilization, edema, testicular atrophy, gyneco-mastia, acne aggressive behavior

Occipital Lobe

Vision

Inhalants

Volatile solvents inhaled for intoxicating purposes. WD usually lasts 2-5 days.

Alcohol OD

Vomiting, respiratory depression, loss of consciousness, possible death.

Stimulants can produce at moderate doses?

Wakefulness and a sense of well-being. Cocaine and amphetamines (methamphetamine) are the most frequently abused CNS stimulants.

Narcotics withdrawal syndrome

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

Step 1

We admitted we were powerless over alcohol and that our lives had become unmanageable.

Step 6

Were entirely ready to have God remove all these defects of character

AXIS I: IDENTIFY THE DISORDER

What are the symptoms? What is their duration? What is the intensity? Identification of the disorder is determined by symptom clusters of certain intensity and duration.

AXIS III: ASSESS THE MEDICAL CONDITION

What is the client's current medical condition? How does the medical condition affect psychiatric symptoms? How does the current medical condition affect treatment planning?

AXIS IV: CONSIDER THE PRESENCE OF STRESSORS

What stressors have been confronted in the past year? Are stressors controllable or uncontrollable?

Negative correlation

When X goes up and Y goes down

Positive Correlation

When X goes up and Y goes up

Synergistic Effects

When alcohol and barbiturates are taken together Drug interactions in which the effect of a combination of two or more drugs with similar actions is greater than the sum of the individual effects of the same drugs given alone. For example 1 + 1 is greater than 2

Intoxication

When alcohol is consumed faster than it is being oxidized, the result is Means disturbance of mental or physical capacity resulting from introduction of any substance into the body.

Group Cohesiveness

When members feel a sense of togetherness, they are moer willing to attend, participate, help other members, and defend group rules

How are clients with COD best served?

When screening, assessment, and treatment planning are integrated, addressing both substance abuse and mental health disorders, each in the context of the other.

Additive Effect

When two or more drugs are present in the body that have similar effects, the impact of adding one drug to the others doubles the efforts of the drugs.

Reality Therapy

William Glasser's therapy that feels a person can develop a successful identity or a failure identity. Value judgments and personal responsibility are stressed. Acceptance of responsibility.

Substance Dependence specifiers

With/Without Psychological Dependence • Remission, specify if: - Early Full - Early Partial - Sustained Full - Sustained Partial • In a Controlled Environment • On Agonist Therapy

Five Recovery Stages for Individuals Addicted to Cocaine

Withdrawal Honeymoon The wall Adjustment Resolution stage

Women and Alcohol

Women show "telescoping" response to alcohol and have often more severe consequences. Faster progression into dependency.

85

__% of all lung cancers come from smoking

90

___% of nicotine is absorbed by the body through inhalation

Hallucinogens

_________ is not associated with physical withdrawal, A diverse group of drugs that have powerful effects on mental and emotional functioning, marked most prominently by distortions in sensory and perceptual experience.

Drug recognition techniques

__________ provide immediate information about current or recent drug use, and they are minimally intrusive. They rely on observations of body parts and functions that are visible to anyone at anytime, rather than the collection of body fluids and the observation of bodily functions that are considered private

electroconvulsive therapy

a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient

caffeine

a bitter alkaloid found in coffee and tea that is responsible for their stimulating effects

cocaethylene

a chemical formed when ethanol and cocaine are co-administered

emphysema

a chronic lung disease characterized by difficulty breathing and shortness of breath

Selective Reuptake Inhibitors

a class of antidepressant drugs that work specifically on increasing availability of the neurotransmitter serotonin by interfering with its reuptake

chlorpheniramine maleate

a common antihistamine in cold products

Alcohol Myopia

a condition that results when alcohol hampers attention, leading people to respond in simple ways to complex situations

dependence

a condition where, after using drugs, an individual finds it difficult or impossible to control use. Dependence usually involves a physical and or psychological need for the drug in order to function normally and it usually involves tolerance and withdrawal.

Countertransference -

a counselor's unresolved feelings for significant others that may be transferred to the client.

sympathomimetic

a drug that stimulates the sympathetic branch of the autonomic nervous system

Lithium

a drug used to treat mania and bipolar disorder. A mood stabilizer.

Alcohol is eliminated from the body within ____________ of ingestion

a few hours

neuroleptic

a general term for antipsychotic drugs

dose-response curve

a graph comparing the size of response to the amount of drug.

phenothiazines

a group of drugs used to treat psychosis

antipsychotics

a group of drugs used to treat psychosis; same as neuroleptic

Client- Centered Therapy

a humanistic therapy, developed by Carl Rogers, in which there therapist uses techniques such as active listening within a genuine, accepting, empathetic environment to facilitate clients' growth. (Also called person- centered therapy.) - Patients responsibility to find ways to deal w/reality

depression

a major type of mood disorder including long periods of sadness.

alcohol abuse

a maladaptive pattern of use indicated by continued use despite knowledge of having persistent problems caused by alcohol

proof

a measure of a beverage's alcohol content; twice the alcohol percentage. ie 90 proof whiskey contains 45% alcohol

Cognitive- Behavioral Therapy

a popular integrative therapy that combines cognitive therapy with behavior therapy

relapse prevention program

a process whereby indentification of individualized triggers and a plan to confront those triggers is developed

Beriberi heart disease

a reduction of vitamin B-1 that over time cause a normal heart to fail to keep up with an abnormally high metabolic need of the body.

Opiates can produce at low doses?

a relaxed dreamlike state

Screening should be conducted on persons to be ....

a risk, in a variety of settings, by a range of professionals

alcoholic heart muscle disease or AHMD

a serious condition in which the heart does not pump the amount of blood needed to meet the demands of the body.

Physical dependence

a state of functional adaptation to a drug in which the presence of a foreign chemical becomes normal and necessary, and the absence of the drug would present an abnormal state.

.57 correlation coefficient adequate?

a statistic representing how closely two variables co-vary The quantity r, called the linear correlation coefficient, measures the strength and the direction of a linear relationship between two variables. -1 to +1 0 is no correlation or no relationship between the two variables r>.8 is strong r<.5 is week

Cocaine

a stimulant; the primary active chemical in cocoa

Form 90

a structured assessment interview for drinking and related behaviors; uses calendar and standard drink units; self-reported drinking behavior *a comprehensive measure of drinking

longitudinal study

a study done over a period of time (months or years)

ephedrine

a sympathomimetic drug used in treating asthma

amphetamine

a synthetic CNS stimulant and sympathomimetic

General paresis refers to?

a syphilitic infection of the nervous system

nitrosamines

a type of chemical that is carcinogenic; several are found in tobacco

schizophrenia

a type of chronic psychosis, "shattered mind" including world salad.

bipolar disorder

a type of mood disorder, also known as manic-depressive disorder.

correlate

a variable that is statistically related to some other variale such as drug use

leukoplakia

a whitening and thickening of the mucous tissue in the mouth considered to be a precancerous tissue change.

theobromine

a xanthine found in chocolate

theophylline

a xanthine found in tea

Summary of controlled Substances - Schedule III

a. Potential for abuse less than I and II b. Currently accepted medical use c. abuse may lead to moderate physcial dependence or high psycholgoical dependence (anabolic steroids, most barbituates, dronabinol)

Summary of controlled Substances - Schedule II

a. high potential for abuse b. Currently accepted medical use c. Abuse may lead to severe psychological or physical dependence (Morphine, cocaine, methamphetamine)

Summary of controlled Substances - Schedule I

a. high potential for abuse b. No currently acceptable medical use in treatment in the US (heroin, marijuana, MDMA (ecstasy)

Summary of controlled Substances - Schedule IV

a. low potential for abuse relative to III b. currently accepted medical use c. abuse may lead to limited physical or psychological dependence relative to III (alprazolam (xanax) barbital, chloral hydrate, fenfluramine)

Summary of controlled Substances - Schedule V

a. low potential for abuse relative to IV b. currently accepted medical use c. Abuse may lead to limited physicla or psychological dependence to IV (mixtures having small amounts of codeine or opeium

Key symptoms words for Impulsive Actions

abusive behavior, destructive behaviors, throws things, disturbs others, excessive talking, interrupts often, unpredictable behavior, unresponsiveness to discipline

Key symptom words for Neuromuscular Involvement

accident-prone, eye muscle disorder, tics

The neurotransmitter at the neuromuscular junctions in the somatic system is?

acetylcholine - patients who die from Alzheimer has less than normal amount

Common signs and symptoms of Crisis:

active elements:agitation, screaming/yelling, crying, rapid speech, nausea, vomiting, pacing, hyperactivity, flushed face, and intense emotional reactions. passive elements: fainting, going into shock, inactivity, weak pulse, profuse sweating, pale face, emotionally subdued and dull eyes.

acute versus chronic

acute - means sharp or intense - in medicine acute means a condition that comes on suddenly as opposed to a chronic or long-lasting condition. Chronic is long lasting condition. Emphysema

Drug Abuse Screening Test (DAST)

adapted from MAST, in the past 12 months; self-report instrument is used to detect abuse of or dependence on drugs other than alcohol

drug interaction classifications

addititive, synergistic, antagonistic

time course

administration of a drug & its effect over time

Mood Disorders: Depressive disorder

affective, behavioral or vegetative, cognitive, and social or interpersonal

ANXIETY DISORDERS

affective, behavioral, cognitive, or somatic

Cocaine action

affects dopamine, norepinephrine, and serotonin levels. Blocks re-uptake of dopamine, prolonging dopamine effects. Depleats it with prolonged use. Toxic effects on cardiac, respiratory, and cns.

Catharsis

after a person has a release of intense emotions, they may be freer to use information and new experience to grow

The most widely-used sedative-hypnotic drug is?

alcohol

Which drug is most clearly linked to violent crime?

alcohol

Opiates - HCFMMO

all are narcoticanalgesics Natural- opium, morphine and codeine pure or semisynthetic derivatives - heroin, Percodan, Demerol and methadone

Type I error

alpha error - null hypothesis is rejected as false or unproven when it is actually true.

panic attack

alprzolam (xanax)

potency

amount of a drug that must be given to obtain a particular response

In the 1960s, cocaine became popular again because?

amphetamines became harder to obtain

dextromethorphan

an OTC antitussive (cough control) ingredient

delirium tremens

an alcohol withdrawal syndrome that includes hallucinations and tremors.

Tolerance

an altered physiological state that develops after repeated drug use when the body becomes accustomed and adapts to the presence of the drug and functions normally. Evidence of this is when the drug has less of an effect when using the same dose, or when a larger dose must be used to get the desired effect.

detoxification

an early treatment stage, in which the body eliminates the alcohol or other substance

Acetylcholine

an excitatory neurotransmitter released by axons

double blind procedure

an experiment in which neither the doctor nor the patient knows which drug is being used

Cirrhosis

an irreversible, frequently deadly liver disorder associated with heavy alcohol use.

Alcoholic dementia

an overall decline of intellect

Major tranquilizers are now referred to as?

antipsychotics

The DSM-IV now refers to neurosis as?

anxiety disorder

Korsakoff's psychosis

apparently irreversible condition characterized by the individual's inability to learn new information and remember recent events.

Substance Dependence Severity Scale (SDSS)

assesses DSM-IV dependence and abuse and ICD-10 harmful use for alcohol & other drugs in the past 30 days; frequency & severity of symptoms

Cognitive Lifetime Drinking History (CLDH)

assesses when respondents started drinking regularly, when their drinking patterns changed, and why; drinking patterns assessed for each time interval; quantity-frequency questions, consumed with meals or not, frequency of intoxication; *a comprehensive measure of drinking

diabetes mellitus

associated w/ atypical neuroleptics excessive thirst, headaches, frequent urination, fatigue cuts/blemishes heal slowly

Wernicke's disease

associated with Vitamin B1 deficiency and may be corrected nutritionally

Norepinephrine

associated with arousal reactions and moods.

Acetylcholine

associated with arousal reactions or inhibitory factors.

Dopamine

associated with feeling of pleasure.

Serotonin

associated with feelings of anxiety, depression and aggressiveness.

A less safe class of drug and the one typically used for suicide attempts.

barbiturates

Sedatives, hypnotics and anxiolytics all contain?

barbiturates and anti-anxiety medications such as benzodiazepines (commonly used prescription anti-anxiety drugs). These medications all work by increasing neurotransmitter (GABA) activity to inhibit the user's central nervous system.

Barbiturates have been replaced by safer?

benzodiazepines

anxiety

benzodiazepines (valium, librium, xanax) buspirone (buspar)

Most common agents used in anxiety disorders are?

benzodiazepines - alprazolam and lorazepam not recommended for long-term use

Type II errors

beta error- null hypothesis is not rejected when it is actually false. Often result of too small of sample size.

Maslow's hierarchy of human needs

biological esteem cognitive love/belongingness aesthetic safety selfactualization

Naltrexone-synthetic opioid antagonist

blocks opioids from binding to receptors reduces craving for alcohol was approved by the FDA in 1994 for the treatment of alcoholism

neuroleptic malignant syndrome

blood pressure up and down dazed and confused difficulty breathing, muscle stiffness, rapid heart rate sweating and shakiness, temp above normal

Other side effects

blurred vision, changes in sexual functioning, constipation, diminished enthusiasm, dizziness, drowsiness, dry mouth, lowered blood pressure, muscle rigidity, nasal congestion, restlessness, sensitivity to bright light, slowed heart rate, slurred speech, upset stomach, weight gain

endorphins (role of)

brain chemical similar to morphine that plays a role in pain, but there is not a strong link between it and drug dependence

Suboxone

brand name for buprenorphine in combination with naloxone(maintenance)

aldehyde dehydrogenase

breaks down acetaldehyde, a by-product of alcohol .

Currently _________ __________ __________are the most practical accurate and cost effective methods for detecting substance abuse

breath analysis, saliva tests and urinalysis

Substance Abuse Subtle Screening Inventory (SASSI-3)

brief self-reports; identifies probability of substance use disorders and provides clinical insight into level of defensiveness, willingness to acknowledge problems, and the desire for change

Drug recognition process techniques originally were developed by ......

by the Los Angeles Police Department

With drug recognition techniques, categories of drugs ...

can be detected, but specific drugs can't be determined.

identification

can be through self, court order, a condition of probation or parole, or intervention. screening process helps determine the likelihood of a problem with drugs or alcohol

effects of MDMA

can cause nausea, clenching of jaw and teeth, muscle tension, blurred vision, panic attacks, confusion, depression, anxiety, paranoid psychosis, increased body temperature, cardiac arrest

other effects of LSD

can cause panic attacks, increased blood pressure, heart palpitations, tremors, nausea, muscle weakness, increased body temperature, ataxia (loss of control of body movements)

biploar disorder for treating mania

carbamazepine, valporic acid, olanzapine, risperidone, haloperidol (haldol, epitol, tegretol, dpaken, valproate, valrelease, zyprexa, risperdal)

responsibility-based case management

case management function may be performed by family members, a supportive care network, volunteers, or the client. short and long term involvement. strengths: helps client who does not have easy access to services because responsibilities can be assumed by family members, volunteers, neighbors, or the client. Cost effective, community is involved, and independence encouraged. weaknesses: case managers may not have training or may be inefficient if they are a volunteer.

Broker

case manager links the client with needed services. They help the client choose the most appropriate service and negotiates the terms of service delivery. Their concern is the quality of service and client difficulties

Coordinator

case manager works with other professionals and agency staff to ensure that services are integrated. They must know the state of the client, service delivered, and the progress being made.

Alcohol flush syndrome

causes an individual to feel sick after consuming alcohol because of a lack of the enzyme aldehyde dehydrogenase.

Role-based case management

centers on the roles the case manager is expected to perform. they may serve as the link to a variety of needed services, be a provider of therapeutic care, of monitoring the efficiency or services.

Bipolar depression is a mood disorder?

characterized by manic-depressive

As addiction is a chronic relapsing condition _____________ testing is a therapeutic tool to help prevent relapse

chemical

Drug recognition techniques are a good screening device before ___________ testing

chemical testing

precursors

chemicals that are acted on by enzymes to form neurotransmitters

When BAC is 200mg % already showing tremulousness(shakiness of hands), brisk reflexes, tachycardia, diaphoresis (excessive sweating), a CIWA-Ar score in mod or high(15 or higher)?

clinician can predict withdrawal will be relatively severe

Tricycilcs are useful in treating what people?

co-occurring anxiety disorders and depression. Clomipramine

In South America, a popular way to use cocaine is?

coca paste

Crack?

cocaine mixed with baking soda

Wernicke-Korsakoff syndrome

combined condition of Wernicke's encephalopathy and Korsakoff's syndrome - symptoms include nystagmus (abnormal eye movement), problems with gait, memory, confabulation, low Bi, low blood pressure, tremor. Often called wet brain.

Stacking

combining oral and injectable steroids.

Key symptom words for Marked Hyperactivity

constant motion, running instead of walking, inability to sit still

withdrawal from cannabinoids

cravings, anxiety, irritability, nausea, anorexia, agitation, restlessness, tremors, and depression

Before beginning treatment a counselor must: a. Establish rapport b. Reassure the client and reduce anxiety c. Make a formal diagnosis d. Identify the problem

d. Identify the problem

Symptoms of Depressant intoxication

decreased inhibition, slowed reaction times, memory impairment, possible decrease in respirations, slurred speech, ataxia,

THC

delta-9-tetrahydrocannabinol, the most important psychoactive chemcial in marijuana

Drug absorption is most rapid when the intramuscular injection is given into the?

deltoid muscle

Stages of family response to drug and alcohol abuse

denial, attempts to eliminate the problem, disorganization and chaos, reorganization in spite of the problem, efforts to escape, family reorganization.

rehabilitation/treatment programs

depends upon assessment and diagnosis and can range from providing education, an intensive outpatient program to an inpatient residential program.

Importance of drug interaction and respiration rate in psychoactive drugs?

depressants action on brain stem slows breathing

steroid withdrawal

depression, fatigue, restlessness, insomnia, loss of appetite, and decreased interest in sex

Short Alcohol Dependence Data (SADD)

derived from Alcohol Dependence Data (ADD); measure of dependence

African Americans are at greater risk than other populations for the co-occurrence of?

diabetes and hypertension(high blood pressure) predisposing them to risks of stoke.

safety margin

difference between effective dose & toxic dose - estimating this is an important part of animal testing

The safety margin of a drug is measured by the:

difference between the effective dose level and the lowest toxic dose

Indicators for drug recognition techniques are ....

dilated or constricted pupils, abnormal eye movements, elevated on lowered vital signs, muscle rigidity, and observation of behavioral indicators such as speech, affect, and appearance.

The process by which alcohol concentration is increased to more than 15%?

distillation

Key symptom words for Learning Problems

distraction, failure to complete projects, inability to listen or follow directions, short attention span

nonpsychoactive pharmacotherapy

don't cause psychomotor effects or euphoria, may at high doses. azapirones (buspirone), amino acids, beta blockers, antidepressants, monoamine oxidase inhibitors, antipsychotics, lithium, antihistamines, anticonvulsants, and anticholinergic

Cocaine's behavior effects are believed to depend on blocking the reuptake of?

dopamine and serotonin

coca

dried leaves of the coca plant (and related plants that also contain cocaine) Stimulant.

Which of the following is an example of behavioral toxicity?

driving inattentively after smoking marijuana

physical dependence

drug dependence defined by the presence of a withdrawal syndrome, implying that the body has become adapted to the drug's presence

The reduced effect of a drug that may result from more rapid metabolism or excretion of the drug is referred to as?

drug disposition tolerance

snorting

drugs can be inhaled into the nose and absorbed through the mucous membranes.

SSRNI Examples

duloxetine (Cymbalta) and venlafaxine (Effexor). Although buproprion (Wellbutrin) is primarily known to primarily treat depression, preliminary research suggests that it may also be helpful in the treatment of anxiety

cumulative effects

effects of giving multiple doses of the same drug

alcohol dehydrogenose

enzyme converts alcohol to acetaldehyde(common by-product of breakdown of alcohol)

Indivdiuals who use antipsychotic drugs may?

exhibit photosensitivity and jaundice

Dysfunctional family roles

family hero, mascot, scapegoat, lost child

Cognitive Depressive Disorder

feeling of hopelessness or cynicism, lack of ambition, brooding behavior, and a general susceptibility of the cognition process.

antipyretic

fever reducing

SSRI Examples

fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro). Examples of SNRI medications are

Inhalants effects

flushing, hypotension, headache, cardiac depressants leading to "sudden sniffing death.

Organizational-based case management

focuses on providing a comprehensive set of services and meeting the needs of clients with multiple problems through single point of access, with one location for service delivery

Dysthymic Disorder

form of Depression that is not as debilitating as Major Depressive Disorder. Sometimes called, Neurotic Depression (or Minor Depression). The result of psychological or social factors that create a depressive reaction as opposed to Major Depression that is endogenous and neurochemically based. Diagnostic criteria include a course that lasts for 2 years or more. Only about 6% of the population will suffer.

Effective treatment of youth includes acknowledging the importance of what?

gender differences girls internalize experiences - mood and anxiety disorders boys externalize them-disruptive disorders such as conduct and ODD(oppositional defiant disorders)

Abuse potential

generally related to the drug's speed of action and how long the effects last.

Piloerection

gooseflesh- opiate withdraw symptom

inhalant overdose

hallucinations, muscle spasms, headaches, dizziness, loss of balance, irregular heartbeat, coma from lack of oxygen

Nonbarbiturate paraldehyde is not used because?

has a noxious taste and odor

Speedball is generally the combination of?

heroin and cocaine

cocaine, administration & effects

high from snorting lasts 20-30 min, high from smoking lasts 5-10 min, high from oral administration lasts 8-24 hours, can also be injected; cocaine remains in brain for 2-3 days; affects dopamine (blocks reuptake), norepinephrine, and serotonin; decreased amount of dopamine in brain with prolonged use

Routes of administration

how a person takes substances into the body

Drugs used to induce sleep are called

hypnotics

A smokeable form of methamphetamine is referred to as?

ice

The treatment and recovery continuum of care

identification, assessment, stabilization, rehabilitation, relapse prevention and substance substitution (if necessary)

Goal

identify and change risk factors for unsafe and unhealthy drug use

Elements of a Treatment Plan

identify problems List goals and objectives Resources to be applied person responsible for actions Time frame Expected benefits

Antidepressants treatment for comorbid depression examples

imipramine and nortriptyline and SSRIs(Prozac) - have low addiction potential

Acute induced toxicity

immediate 1) behavioral - intoxication from alcohol, marijuana, or other drugs that impair behavior and increase danger to the individual 2) physiological - overdose of heroin or alcohol causing the user to stop breathing

Ataxia

impaired gait

Cannabis problems

impairment of ability to learn. Medical effects wth prolonged use include respiratory problems, possible impaired immune function and possible reproductive problems includinglow birth weight infants.

stabilization

includes the need for detoxification at an appropriate medical facility if needed.

alcohol dependence

includes the physiological factors of tolerance and withdrawal when usage stops.

Symptoms of Stimulant intoxication

increased heart rate, elevated blood pressure and temperature, decreased respiration. dilated pupils, dry mouth, cardiac arrhythmias, twitching tremors, impaired judgment, confusion, disinhibited behavior, paranoid thoughts, hypervigilance, hallucinations, elation.

reinforcement potential

increased likelihood of repeated use, removal of negative sx or conditions or the amplification of positive sx or states.

Solution Focused Model

increases self-worth, client becomes more invested in accomplishing Tx goals

The fastest method by which the drug is delivered to the brain is?

inhalation

adenosine

inhibitory neurotransmitter through which caffeine acts

intravenously

injected directly into a vein

intramuscularly

injected into the large muscles

Cannabis OD

insomnia, hyperactivity, decreased activity

1933 to help schizophrenic patients, Sakel used what?

insulin

Heroin WD

intestines moving slowly - diarrhea is one of the most reliable and dramatic symptom

caffeine intoxication and withdrawal

intoxication: restlessness, incrrease diuresis, muscle twitching, arrhythmias withdrawal: Headache, lethargy, depression, weight gain

Tardive dyskinesia

involuntary movements of the tongue or mouth jerky, purposeless movements of legs, arms, or entire body usually seen w/ long-term tx using traditional antipsychotic medications more often seen in women risk increases w/ age and length of time on the med

LD50

lethal dose for half of the animals tested

bipolar disorder for treating depression

lithium, carbamazepine, lamotrigine, fluoxetine, ilmipramine, tranylcypromine (eskalith, carbolith, cibalith-S, lithonate, lithotabs, epitol, tegreto, lamictal, prozac, janimine, tofranil, parnate)

GABA transmitters

located in the mesolimbic system stimulated by certain drugs

Chronic induced toxicity

long-term 1) behavioral - personality changes reported to occur in alcoholics and suspected by some to occur in marijuana users (a motivational syndrome) 2) physiological - heart disease, lung cancer, and other effects related to smoking; liver damage resulting from chronic alcohol exposure

tolerance or withdrawal potential

long-term or chronic use of certain meds can cause tolerance to the subjective and therapeutic effects and prompt dosage increases to recreate the desired effects. drugs that produce tolerance and withdrawal generally have higher risks for abuse and addiction

Behavioral or vegetative depressive disorder

loss of sleep or appetite, increase or decrease in psycho motor functioning, lack of sex drive, loss of energy, and self-destructive behavior.

Alcohol acute effects

low doses: eupohoria, mild stimulation, relaxation, and lowered inhibitions. high doses: drowsiness, slurred speech, nausea, emotional volatility, loss of coordination, visual dostortions, impaired memory, sexual dysfunctions, loss of consciousness/increased risk or injuries, violence, fetal damage.

Pleasure/reward center of the brain

made up of the ventral tegmental area (VTA), nucleus accumbens and other structures of the brain.

the basal ganglia is important for

maintaining proper muscle tone

Time Line Follow Back (TLFB)

makes connections between significant events in the client's life and alcohol/drug use patterns and intensity, for the past year; includes calendar and standard drink chart to aid memory; clients fill in number of drinks for each calendar day; useful with elderly; *a comprehensive measure of drinking

problem solver

makes the client self-sufficient by helping them determine their strengths, find alternatives to their current situations, and learn to solve their own problems. They clarify the roles of the client, family, caregiver, and case manager.

Alcohol idiosyncratic intoxication

maladaptive behavior changes will result from an amount of alcohol use that in the majority of people will not intoxicate

Lithium was demonstrated to be effective on

manic patients

Phenobarbital

may be used for detoxifying patients who have been abusing both alcohol and benzodiaxepines.

potency

measured by the amount of drug required to produce an effect.

CNS Depressant dependence

med to high risk of Physical med to high risk of psychological low to medium risk of tolerance

LD50

median lethal dose; dose required to kill 50% of test population. Used to determine acute toxicity, and usually well above the effective dose for 50% of subjects

Anxiety disorder

mental disorders characterized by excessive worry, fears or avoidance

pleasure pathway in the brain

mesolimbic dopamine system

Cure for heroin (opiate) addiction?

methadone maintenance treatment program Methadone: A synthetic opiate used to obstruct the effects of heroin for twenty- four hours LAAM: (Levomethadyl acetate) A synthetic opiate used to obstruct the effects of opiates for as many as seventy-two hours Naloxone: Used to treat cases of overdose Naltrexone: Used to inhibit morphine, heroin, and other opiate effects

Quaalude and Sopor were brand names for

methaqualone- Schedule 1 drug

The current drug of choice for treating attention-deficit hyperactivity disorder (ADHD) is?

methylphenidate(Ritalin) and dextroamphetamine (Dexedrine) - CNS stimulant most commonly abused along with opioids and CNS depressants.

About 1/2 of the emergency room episodes and 3/4 of the drug related deaths are associated with?

multiple drug episodes

Signed Consent should include

name, name of agency, nature of info, purpose for release of info, specific date, event or condition

Opiates

naturally derived from poppies

Affective Anxiety

nervousness, uneasiness, panic, and irritability

serotonin

neurotransmitter found in raphe nuclei; may be important for impulsivity, depression (linked with suicide)

acetylcholine

neurotransmitter found in the parasympathetic branch in the CNS. Nicotine mimics by stimulating then blocking the receptor sites.

norepinephrine

neurotransmitter that may be important for regulating walking and appetite

Chemicals released from neurons (nerve cells) are called?

neurotransmitters

More than half of the prescribed antidepressants are prescribed by?

non-psychiatrists

NSAID

nonsteroidal anti-inflammatory drugs, such as ibuprofen

DSM Axises

o Axis I-Clinical syndromes • Alcohol abuse, cannabis dependency o Axis II-Personality disorders/mental retardation • Not used very often in alcohol or chemical use o Axis III-Medical Conditions • Psuerosis of the liver o Axis IV-Psychosocial/environmental stressors • Losing kids because of substance abuse, lacks good social support system o Axis V-Global assessment of functioning • 0-100 how the person is functioning overall

Cognitive anxiety

obsessive worrying and thinking, confusion, lack of concentration, a feeling of impending doom, being overwhelmed and preoccupied by objects, situations, dying, or going crazy by loss of self-constraint

antagonistic interactions

occur when two or more drugs are used at the same time, and the results are less than the sum of the actions of the drugs or the drugs cancel out the effects of each other.

acoholic hepatitis

occurs after a heavy or extended bout of alcohol use and can occur in non-alcohol dependent persons. An inflammation of the liver where metabolism is disrupted, jaundice, yellowing of the skin and whites of the eyes.

gateway

one of the first drugs (alcohol or tobacco) used by a typical drug user. Then moves onto marijuana, amphetamines, cocaine, heroin.

endorphin

opiate-like chemical that occurs naturally in human & animal brain (endogenous)

nalaxone

opioid antagonist used to treat heroin addiction (generic name)

Naltrexone: trade name ReVia

opioid antagonist- medication given to heroine dependent users. May be used to treat alcoholism co morbid with schizophrenia. May cause liver-toxicity

psychosexual stages of development

oral - birth to 1 - mouth anal - 2-3 years - anus phallic - 4-5 years - genitals latency - 6-12 years - latent or dormant genital - puberty on - again active

PCP, administration & effects

oral, smoked, snorted; causes psychotic reactions, bizarre behavior, outbursts of hostility and violence, and feelings of severe anxiety, doom, or impending death

Hallucination LSD acute effects

panic attacks, increased b/p, heart palpitiations, tremors, nausea, muscle weakness, increased body temp, ataxia, accidental dealth (believing one can fly).

Common SSRIs

panic disorder, OCD, PTSD and social phobia use Fluoxetine, sertraline, fluvoxamine, paroxetine and citalopram

sympathetic

part of the autonomic nervous system that controls the "flight or fight" response

Therapeutic doses of medications should be continued through any withdrawal if what?

patient has been taking the medication asprescribed

time course of caffeine

peak blood pressure at 30 minutes, peak CNS effects at 2 hours, half life is 3 hrs

Tertiary prevention programs are those aimed mainly at?

people who have been treated for substance abuse or has stopped the substance abuse without assistance

cirrhosis

permanent, widespread destruction of liver cells, which are replaced with nonfunctioning scar tissue. irreversible and fatal if alcohol continues to be used.

Somatic anxiety

physical problems such as dry mouth, dizziness, sweaty hands, stomach problems, and pain or tightness in the chest as well as social or interpersonal anxiety symptoms, which are also termed social discomfort

Transactional Analysis (TA)

popular in 1970's many suggest it is a repackaging of Freudian ideas

Inhalants signs and symptoms

possible asphyxiation and frostbite of nose, lips, or larynx if inhaled from a tank, loss of motor control, nausea, ataxia, muscle weakness, dysarthia, nystagmus, diminished reflexes.

cocoa

powder of ground roasted cocao beans with most of the fat removed

Planner

preparing for the service or treatment that the client is to receive. Setting goals, determining outcomes, and implementing the plan with input from the client, family members, other professionals and agencies.

Interpreting

presenting the clt with alternative ways of looking at their situation

All of the following are types of prevention:

primary prevention secondary prevention tertiary prevention

GHB/GABA

produced in the CNS and acts as an inhibitory neurotransmitter. Sedative-hypnotic may look like alcohol of s-h intoxication.

Symptoms of PCP adverse reactions

psychotic reactions, bizarre behavior, outbursts of hostility and violence, severe anxiety, doom or impending death.

Stimulant physical and mental status

pupils dialated, dry mouth, cardiac arrhythmias, twitching, tremors, convulsions, stroke, coma, confusion, disinhibited behaivor, parnaoid thoughts, hallucinations, hyper vigilance, elevation and or depression, suciadal behavior, impaired judgement.

Alcohol Dependence Scale (ADS)

quantitative measure of severity of alcohol dependence (withdrawal, impaired control over drinking, awareness of compulsion to drink, tolerance, drink-seeking behavior); last 12 months

Screening is the first step in establishing

rapport with a potential client •May be clients' first attempt to seek help •An opportunity to provide needed emotional support and guidance

Opiate users

rate of relapse goes down by 60% 6 months to 1 year after stopping methodone/suboxonel maintenance.

therapeutic index

ratio of LD50 to ED50 TI

receptors

recognition mechanisms that respond to specific chemical signals

Drinking Self-Monitoring Log (DSML)

recording drinking on a daily or drink-by-drink basis; subject to fewer memory errors; shows number of drinks consumed each day during monitoring interval; *a comprehensive measure of drinking

Tolerance

reduced effect of a drug after repeated use

effects of inhalants

reduces inhibition, produces euphoria, dizziness, slurred speech, unsteady gait, drowsiness, nystagmus (constant involuntary movement of the eyes), giddiness, headaches, feeling like user is going to pass out, causes damage to the liver, kidneys, brain, and lungs

Symptoms of Inhalant intoxication

reduction of inhibition and euphoria, dizziness, slurred speech, unsteady gait and drowsiness. Nystagmus may be noted, altered consciousness and enhanced sexual pleasure.

acute

referring to a drug, the short-term effects of a single dose

Drug use is positively correlated with?

rejection of traditional cultural systems

GABA

relates to inhibitory factors and slows communication.

amphetamines, effects

releases dopamine & norepinephrine and blocks reuptake, creating a euphoric effect

African Americans may display mistrust and a reluctance to show any weakness, to overcome this a counselor should?

respect the client as an equal partner in treatment. FYI- propranolol(alleviates anxiety, can cause memory loss) is less effective (beta blockers), less enzyme activity needed to eliminate diazepam, lower dosages on SSRIs.

Ugo Cerletti introduced electroconvulsive therapy (ECT) to treat?

schizophrenia

Opiate acute effects

sedation, decreased judgement, decreased ability to operate vehicles, posssible respiratory depression if oding.

Methaqualone

sedative-hypnotic drug (trade name Quaalude) that is a drug of abuse

SSRI

selective serotonin reuptake inhibitors, a type of antidepressant drugs.

Depressant overdose

shallow respiration, clammy skin, dilated pupils, weak and rapid pulse, coma, and possible death.

Psychosis (schizophrenia)

short-acting: phenothiazines, butyrophenones, clozapine, trifluoperazine, pimozide, flupenthixol, cholorpromazine (thorazie, haldol, cloziril, stelazine, orap, fluanxol, largactil) long-acting: flupenthixol, fluphenazine decanoate, pipotiazine, haloperidol decanoate (fluanxol, modecate, piportil L4, haldol LA)

Caffeine most effective

short-term in small doses and on a not-to-frequent basis. It also helps with performing physical activities that require a lot of energy (worse with mental activities)

Amphetamines uses

short-term weight reduction, narcolepsy and ADHD

psychoactive pharmacotherapy

significant and acute alterations in psychomotor, emotional, and mental actitivity at therapeutic doses. at high doses euphoria. opioids, stimulants, benzodiazepines, barbiturates, and sedative-hypnotics

subcutaneously

skin-popping, injecting in the fatty layer just under the external skin.

'skin popping'

slang for subcutaneous injection

Symptoms of cannabinoid intoxication

slowed reaction time, altered perceptions, panic, anxiety, nausea, dizziness, depersonalization, paranoid thoughts, trouble expressing thoughts. May cause increases in respiration and heart rate and a slight increase in body temperature. Red eyes, mild dilation, mild tremors, decreased coordination, decreased strength, less ability to perform complex motor tasks and dry mouth.

Depressant effects

slurred speech, disorientation, drunken behavior without odor of alc., imparired membory of events, interacts with alc.

ketamine, administration & effects

snorted or injected; frightening experience of complete sensory detachment, explained as a near-death experience, boredom, paranoia, and possibly coma

Individual Psychology (Alfred Adler)

spanning both the past, present, and the future. motivated toward this feeling of belonging. .teleology, which simply put means that a person is as influenced by future goals as by past experiences. birth order.examination of faulty logic and empowering the client to take responsibility to change through a re-educational process. confronting logic versus behavior. gain insight. take responsibility

Advocate

speaks on behalf of the clients when they are unable to do so, or when they speak but no one listens. Represents interest for the client

effects of caffeine

stimulation, headaches and hyperactivity

speed

street name for amphetamine

crystal meth or ice

street names for crystals of methamphetamine hydrochloride

regression

subconscious retreat to a previous stage

basal ganglia

subcortical brain structures controlling muscle tone; contains striatum, a part of the nigrostriatal dopamine pathway

SOAP

subjective, objective, assessment, plan

inhalation

substances can be inhaled into the lungs by smoking or huffing

behavioral view of etiology

suggests the influence of both positive and negative reinforcement as causal factors for continued drug use.

nicotine poisoning

symptoms often experienced by beginning smokers, including dizziness, diarrhea, light-headedness, rapid and erratic pulse, clammy skin, nausea, and vomiting

Drug recognition techniques are ....

systematic and standardized evaluations process to detect observable signs and symptoms of drug use

oral administration

taken by mouth and swallowed into the stomach.

Confrontation

the act of honestly telling another person your perception of what is going on w/o putting them down

effective dose

the amount of a drug necessary to get the desired effect in about 50 percent of those who use the drug

potency

the amount of a drug necessary to produce the desired effect.

Epidemiology

the branch of medical science dealing with the transmission and control of disease. The study (or the science of the study) of the patterns, causes, and effects of health and disease conditions in defined populations. It is the cornerstone of public health, and informs policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive medicine.

Etiology

the cause of a disease

acetylsalicylic acid

the chemical known as aspirin

Xanthines

the class of chemicals to which caffeine belongs

assessment

the collection of data from the individual and corroborative sources to determine the extent of the individual's problem and their strengths, weaknesses, and needs.

Nystagmus

the constant involuntary movement of the eyes.

Group process

the continuing development of the individual member and the group as a whole which involves many changes

Counselor self-disclosure

the counselor's sharing of their personal feelings, attitudes, opinions, and experiences for the benefit of the clt

Validity

the degree to which an instrument or process measures what it is designed to measure.

therapeutic index

the dose determined to be safe for use and get the desired effect; determined by dividing the lethal dose by the effective dose

buccal administration

the drug is absorbed through the mucous membranes in the mouth.

transdermal

the drug is absorbed through the skin from a patch.

Reflection of feeling

the essence of the clt's feeling, either stated or implied, as expressed by the counselor

glutamate

the excitatory neurotransmitter found in most regions of the brain

The eligibility criteria are generally determined by

the focus, target population and funding requirements of the counselor's program or agency

half-life

the length of time a drug remains in the body and continues to affect the user.

Nicotiana rustica

the less desirable species of tobacco, which is not widely grown in the United States

Existential factors

the person own responsibility for their own thoughts, feelings and behaviors

Role induction

the process of educating clts about treatment and preparing them to participate fully in order to obtain what they need

psychopharmacology

the study of the behavioral effects of drugs

TI

therapeutic index: LD50/ED50

Korsakoff's Syndrome

thiamine deficiency damaging to the thalamus that causes deficits in recent memories, disorientation, lack of insight, retrograde amnesia and confabulation - satisfying memory gaps with false information

Cross-dependence

this is evident when a person who is physically dependent on one drug can lessen or prevent withdrawal symptoms by using other drugs from the same or similar classification.

acute fatty liver

this occurs when fat deposits build up in the normal liver cells and can develop in anyone who has been drinking heavily even for a short period of time.

pancreatitis

this occurs when swelling of the pancreatic duct causes a backup of digestive juices causing irritation and swelling of the pancreas.

no doz

this stimulant drug contains 100mg of caffeine

vivarin

this stimulant drug contains 200mg of caffeine

Screening within the criminal justice system and juvenile justice system; screening should occur ......

throughout the individual's contact. It should begin upon entry into the system and continue until release

time course

timing of the onset, duration and termination of a drug's effect

What would you use the BDI-II for?

to measure the severity of the patient's Depression.

Alcohol ranks SECOND after WHAT?

tobacco and before drugs in annual deaths - after tobacco and other drugs

pharmacodynamic tolerance

tolerance caused by altered nervous system sensitivty

behavioral tolerance

tolerance caused by learned adaptation to the drug

drug disposition tolerance

tolerance caused by more rapid elimination of the drug

The three basic processes related to the concept of addiction are?

tolerance, physical dependence, reinforcement

behavioral toxicity

toxicity resulting from behavioral effects of a drug

All of the following are key elements of the social influence model:

training refusal skills countering advertising use of teen leaders

Barbiturates are now used for?

treat migraine headaches together with analgesics, such as aspirin or codeine. Thiopental (Pentothal, used as a general anesthetic) Amobarbital (Amytal, used for control of agitated patients) Secobarbital (Seconal)

Alcohol WD symptoms 6-24 hours after last drink.

tremors, nausea, anxiety, irritablility insomnia, feelings of unreality convulsions hallucinations

monopolar disorder (depression)

tricyclic antidepressants, MAO inhibitors, serotonin reuptake inhibitors, trazodone, bupropion (tofranil, elavil, nardil, parnate, prozac, luvox, paxil, celexa, lexapro, desyrel, wellbutrin)

cacao

tropical tree whose seeds are used to make chocolate and cocoa

additive effects

two or more drugs are used at the same time and the results are equal to the sum of the actions of the drugs used.

Behavioral anxiety

typically includes motor tension, compulsive or nervous actions, voice and speech cues (including shakiness or strain in the voice), and constant watchfulness and scanning.

Acamprosate directions

typically started 5 days after drinking stops reaches full effectiveness in 5 to 8 days Does not interact with BZs or other medications should be taken even if a client relapses Remind patients to take 3 TIMES per day.

Ataxia

uncoordinated walking

side effects

unintended effects of a drug that are not relevant to the treatment

Dependence

use of a substance more often or in greater amounts than user intended and having trouble stopping or reducing its use

abuse

use of a substance that causes problems - social, legal, occupational, psychological, or physical

injected

using a needle and syringe

The first of the pharmacological revolution was associated with the development of?

vaccines

Dependence potential of psychoactive drugs

very high: heroin (IV) crack cocaine(AA) high: morphine (injected) Opium (smoked) Moderate/high - cocaine powder (snorted) - tobacco cigarettes and PCP (smoked) Moderate: diazepam (valium) alcohol, amphetamines (oral) Moderate/Low: caffeine, MDMA (ecstasy) Low: kestamine very low: LSD, mescaline, psilocybin

PCP acute effects

visual illusions, hallucinations, and distroted perceptions, feelings of stregth, power, and invulnerability, depresonalization, distorted body image.

An experiment in which rats were allowed to self-inject drugs showed that the rats?

were more likely to die form cocaine than heroin

behavioral tolerance

when after a period of time and repeated drug use, the users are able to modify their behavior in hopes that others will not notice they are intoxicated

reverse tolerance

when the individual can become more sensitive to the drug's effects rather than less sensitive. Also known as the kindling effect.

Psychological dependence

when the individual has a strong desire to continue to use the drug for emotional reasons and is related to the rewarding effects of the drug. There are no physical withdrawal symptoms with the discontinuation of use.

metabolic tolerance

when the liver adapts to the presence of a drug over time and may produce more of the enzyme needed to break down the drug.

Pharmacodynamic tolerance

when the nerve cells become less sensitive to the effects of the drug over time and repeated use

synergistic interactions

when two or more drugs are used at the same time, and the results are greater that the sum of the actions of the drugs used.

CAGE Questionnaire

widely used screening test for problem drinking and alcoholism; 2 "yes" responses indicated the possibility of alcoholism; Have you ever felt you need to CUT down on your drinking?; Have people ANNOYED you by criticizing your drinking?; Have you ever felt GUILTY about drinking?; Have you ever felt you needed a drink first things in the morning (EYE-OPENER) to steady your nerves or to get rid of a hangover?

Social and Interpersonal Depressive Disorder

withdrawal, selfishness, passiveness, bad temper, resentment, as well as a lack of healthy relationships and tolerance.

Michigan Alcohol Screening Test (MAST)

yes/no answers to 25 questions; 0-3=absence of alcohol dependence; 4=possible substance dependence; 5+ = likely alcohol dependence

What are the Scientific Methods of Chemical Testing?

• Breath analysis • Saliva tests • Urinalysis • Blood analysis • Hair analysis

SASSI

• Doesn't directly question about alcohol/drug use (not like the previous ones) • Around 50 questions • Asks questions about alcohol/drug use on one side and don't on the other • Looking for defensiveness, looking at others, personal affect • Disadvantages-could be hard to profile

AUDIT

• Ten items 1-3 frequency and quantity 4-6 alcohol dependence 7-10 how harmful alcohol use. • Advantages-you can use it in an interview, it's not that long, it's more specific • Disadvantage-not specific enough, doesn't add in the times when drinking is more acceptable like vacation etc., not valid • Can be self report questionnaire or an interview

CAGE

• The briefest and most widely used. • Only four questions asked directly to the person. • If someone answers yes to one of the questions then there is an indicator that their might be a problem that needs to be further investigated. • If they answer yes to two or more they are sent for further testing. • Advantages-yes or no questions • Disadvantages-not asking about time frame, self report, not in depth about environment, not in depth

MAST

• Widely used • Good reliability and validity • Original had 25 self administered questions the one now has only 22. • Advantages-it could be a reality check to someone taking it, not very time consuming, simple yes and no • Disadvantage-it doesn't ask you to explain, doesn't ask time frame

BAC and metabolism in a standard drink has ½ ounce of ethanol, and the body eliminates ¼ ounce of ethanol per hour or 10-30 mg(.01-.03)

"If you drink faster than one drink every two hours, your BAC will climb."

Rapid Alcohol Problems Screen (RAPS4)

"yes" to one or more questions indicates possibility of alcohol dependence; during the last year have you had a feeling of guilt or REMORSE after drinking?; has a friend or family member ever told you about things you said or did while you were drinking that you could not remember (AMNESIA)?; have you failed to do what was normally expected of you because of drinking (PERFORM)?; do you sometimes take a drink when you first get up in the morning (STARTER)?

psychadelic

'that which manifests the soul' Substances that increase the creativity and perceptions of aspects of one's own mind previously unknown.

deactivation - 2 methods

(1) drug is excreted from the body unchanged (2) drug is chemically changed such that it no longer has same effect on body

four questions about dosage that must be answered in rational use of drugs

(1) what is the effective dose? (2) what dose will be toxic? (3) what is the safety margin? (difference between effective dose & toxic dose) (4) adverse reactions?

Lithium (generic name)

(brand names Eskalith, Lithobid) most widely used and studied medication for treating manic episodes due to bipolar disorder. Combined with antidepressants to treat depression. Helps reduce the severity and frequency of mania. May also help relieve bipolar depression. Significantly reduce suicide risk. Helps prevent future manic and depressive episodes. May be prescribed for long periods of time (even between episodes) as maintenance therapy. Natural salt, effective in reducing or preventing the recurrence of manic and depressive episodes.

What treatment is best for Anxiety clients who present with phobia?

*exposure-based treatments (including desensitization) relaxation and social skills training are effective treatment choices. *Antidepressants or benzodiazepines may be needed.

Disulfiram: who should NOT take

*hypersensitivity to rubber derivatives, sulfur, or nickel *coronary artery disease *liver disease *women who are nursing

Cultural blindness

- Believes that color or culture makes no difference & that all people are the same - Ignores cultural strengths

Behaviorism

- Pavlov - All people are subject to "conditioning" - Classical and Operant conditioning

Substance-Induced Disorders specifiers

- With Onset During Intoxication - With Onset During Withdrawal

Behavior therapy

-B.F. Skinner - Humans are shaped and determined by socio- cultural conditioning

Behavioral Modification Theory

-Based on the idea that all behavior is learned, and what is learned can be unlearned. - Modeling means learning a behavior by observing another performing the behavior.

How many oz of alcohol can be metabolized an hour?

.25

What is the BAC LD50?

.40 or 400 mg/dL

Levels of Care

.5 early intervention II Intensive outpatient, III Residential/Inpatient, IV medically managed

DSM V: 11 Criteria for Substance Use Disorder

1 Taking the substance in larger amounts or for longer than the you meant to 2 Wanting to cut down or stop using the substance but not managing to 3 Spending a lot of time getting, using, or recovering from use of the substance 4 Cravings and urges to use the substance 5 Not managing to do what you should at work, home or school, because of substance use 6 Continuing to use, even when it causes problems in relationships 7 Giving up important social, occupational or recreational activities because of substance use 8 Using substances again and again, even when it puts the you in danger 9 Continuing to use, even when the you know you have a physical or psychological problem that could have been caused or made worse by the substance 10 Needing more of the substance to get the effect you want (tolerance) 11 Development of withdrawal symptoms, which can be relieved by taking more of the substance.

Three major categories of abused substances that require detox

1) Alcohol and other CNS depressants (benzos/barbiturates) 2) Opiate drugs 3) Cocaine

Five Critical Components of Effective Treatment

1) Assessment 2) Patient-Treatment Matching 3) Comprehensive Services 4) Relapse Prevention 5) Accountability

The Purpose of Assessment

1) Identify those who are experiencing problems with substance abuse or have progressed to the stage of addiction 2) Assess the full spectrum of problems for which treatment may be needed 3) Plan appropriate interventions 4) Involve appropriate family members or significant others 5) Evaluate the effectiveness of the interventions that are implemented The first stage of the treatment process Gather information from a variety of sources Without a CA, there is a risk of treating the wrong set of problems or failing to provide any intervention for some problems Include physical and medical problems, drug use history., psychosocial problems, psychiatric disorders, current SES and eligibility for various problems

Six Stages of Counseling

1) Information Gathering - Counselor gathers as much info as possible to make a valid assessment and treatment plan 2) Evaluation - Nature and severity of the presenting problem, cause of the symptoms, relief of the symptoms, client's readiness for counseling, and client/counselor match 3) Feedback 4) Counseling Agreement - Practical issues which set limits (length of session, number of sessions, payment), expectations, goals 5) Changing Behavior 6) Termination - Is a stage in the counseling process, not the last session

Three Stages of Drug/Alcohol Counseling

1) Medical/Physical Intervention 2) Psychosocial Rehabilitation 3) Aftercare

What are the three models of case management?

1) role-based case management 2) organization-based case management 3) responsibility-based case management

The number of people in the US arrested for drug-law violations each year is?

1,000,000

9 categories of symptoms

1. Emotional Concern 2. Compulsive Actions 3. Impulsive Actions 4. Marked Hyperactivity 5. Learning Problems 6. Neuromuscular Involvement 7. Cognitive and Perceptual Disturbances 8. Physical complaints 9. Sleep Problems

Screening - Global Criteria

1. Evaluate psychological, social, and physiological signs and symptoms of alcohol and other drug use and abuse. 2. Determine the client's appropriateness for admission or referral. 3. Determine the client's eligibility for admission or referral. 4. Identify any coexisting conditions (medical, psychiatric, physical, etc.) that indicate need for additional professional assessment and/or services 5. Adhere to applicable laws, regulations and agency policies governing alcohol and other abuse services.

Case Study steps

1. ID treatment issues (symptom clusters) 2. Find and ID symptoms (9 categories)

HPI Elements

1. Location 5. Timing 2.Quality 6. Context 3.Severity 7. Modifying Factors 4. Duration 8. Associated Signs and Symptoms

Steps of an intervention

1. Someone must reach out for help 2. During the first meeting, the counselor discusses with the individual what important issues are facing the client 3. A list is made of the important people in the clients life who have seen the behavior and consequences 4 a training is set up to teach the family how to intervene 5. The intervention happens

What are the 3 key elements in drug recognition process?

1. Verifying that the person's physical responses deviate from normal 2.Ruling out a non-drug related cause of the deviation 3.Using diagnostic procedures to determine the category or combination of drugs that is likely to cause the impairment.

Drug related emergency room visits

1. cocaine 2. alcohol in combination 3. opiods (not heroin) 4. marijuana 5. benzodiazepines 6. heroin 7. stimulants includes methamphetamine 8. PCP 9. MDMA (ecstasy 10. inhalants

Discharge

1. instructions 2. prescriptions 3. plan/follow up/referral 4. warnings 5. documentation on ER discussion

drug related deaths

1. opiods (not heroin) 2. cocaine 3. alcohol in combination 4. benzodiazepenines 5. antidepresssants 6. methadone 7. sedative-hypnotics (non benzodiazepeine 8. heroin 9. stimulants (includes methamphetamine 10. marijuana

Withdrawal Process

1. tremors, heartbeat rapidity, sweating, loss of appetite, 2. hallucinations in many senses 3. delusions, disorientation, amnesia, delirium 4. seizures

How many of the adult population label themselves as abstainers?

1/3

Alcohol related crime

1/3 of suicides, 36-70% of homicides

Brief MAST

10 items

Alcohol Use Disorders identification Test (AUDIT)

10 items on instrument, developed by WHO; asks about frequency of drinking, alcohol dependence & problems caused by alcohol in the past 12 months; scores range from 0-40; a score of 8+ indicates likelihood of harmful alcohol consumption

Serving sizes for alcohol

12 oz. of beer = 5 oz. of wine = 1.5 oz. of liquor

The age group that is least likely to have used alcohol in the previous 30 days is?

12 to 17

Assessment - Global Criteria

12. Gather relevant history from the client including but not limited to alcohol and other drug abuse using appropriate interview techniques. 13. Identify methods and procedures for obtaining corroborative information from significant secondary sources regarding clients' alcohol and other drug abuse and psycho-social history. 14. Identify appropriate assessment tools. 15. Explain to the client the rationale for the use of assessment techniques in order to facilitate understanding. 16. Develop a diagnostic evaluation of the client's substance abuse and any coexisting conditions based on the results of all assessments in order to provide an integrated approach to treatment planning based on the client's strengths, weaknesses, and identified problems and needs.

POSIT

139 items on it Used for substance use problems and social, behavioral, and learning problems Disadvantages-too long, repetitious, lack of consistency Advantages-more detailed

Obsessive Compulsive Drinking Scale (OCDS)

14 questions regarding drinking and attempts to control drinking; ideas, thoughts, impulses, images related to drinking

What is the epidemiology of substance related disorders?

14% of all Americans will have an alcohol related substance use disorder in their lifetime. 7% (15 million) 12 or older current users of illicit drugs

Treatment Planning - Global Criteria

17. Explain assessment results to the client in an understandable manner. 18. Identify and rank problems based on individual client needs in the written treatment plan. 19. Formulate agreed upon immediate and long-term goals using behavioral terms in the written treatment plan. 20. Identify the treatment methods and resources to be utilized as appropriate for the individual client.

The highest rates of illicit drug use are in what age group?

18 to 25

Controlled Substance Act

1970's Act that classified drugs according to medical use, potential for abuse, and possibility of dependence

Mild

2-3 symptoms

Alcohol Intoxication Signs and Symptoms

20mg-80mg=.02-.08% loss of muscular coordination, changes in mood, personality alteration. 80mg-200mg=.08-.2% ataxia, slurring 200mg-300mg=.2-.3% nausea, vomiting, sedation 300mg = hypothermia, unconsciousness 400mg = coma 600mg= death

Counseling - Global Criteria

21. Select the counseling theories that apply. 22. Apply techniques to assist the client, group, and/or family in exploring problems and ramifications. 23. Apply techniques to assist the client, group, and/or family in examining the client's behavior, attitudes, and/or feelings if appropriate in the treatment setting. 24. Individualize counseling in accordance with cultural, gender, and lifestyle differences. 25. Interact with he client in an appropriate therapeutic manner. 26. Elicit solutions and decisions from the client. 27. Implement the treatment plan.

How many general hospital admissions are related to chronic alcohol use?

25%

Hazelden

28 day version of the Minnesota Model that started in teh '60s. Has strong AA orientation. Uses primary therapists,psych testing, therapeutic milieu, systems therapy, and family involvement

Case Management - Global Criteria

28. Coordinate services for client care. 29. Explain the rationale of case management activities to the client.

Impaired Control Scale (ICS)

3 part instrument measuring attempts to control drinking in last month, degree of success in controlling drinking in last 6 months, and perception of ability to control it now

Alcohol use is associated with?

3/5 of all murders 40% of all assaults 1/3 of forcible rape and child molestation 50% committing violent crime

Rate for co-occurrence of bipolar and addictive disorders range from?

30-60%

Crisis Intervention - Global Criteria

30. Recognize the elements of the client crisis. 31. Implement an immediate course of action appropriate to the crisis. 32. Enhance overall treatment by utilizing crisis events.

About how many homeless people in the US have some form of mental illness?

33%

Client Education - Global Criteria

33. Present relevant alcohol and other drug/abuse information to the client through formal and/or informal processes. 34. Present information about available alcohol and other drug services and resources.

Referral - Global Criteria

35. Identify needs and/or problems that the agency and/or counselor cannot meet. 36. Explain the rationale for the referral to the client. 37. Match client needs and/or problems to appropriate resources. 38. Adhere to applicable laws, regulations and agency policies governing procedures related to the protection of the client's confidentiality. 39. Assist the client in utilizing the support systems and community resources available.

In most commercial beers today, alcohol content is a little over?

4%

Moderate

4-5 symptoms

Rate for co-occurrence of schizophrenic and addictive disorders range from?

40-80%

Report and Record Keeping - Global Criteria

40. Prepare reports and relevant records integrating available information to facilitate the continuum of care. 41. Chart pertinent ongoing information pertaining to the client. 42. Utilize relevant information from written documents for client care.

Consulatation With Other Professionals In Regard To Client Treatment/Services - Global Criteria

43. Recognize issues that are beyond the couselor's base of knowledge and/or skill. 44. Consult with appropriate resources to ensure the provision of effective treatment services. 45. Adhere to applicable laws, regulations and agency policies governing the disclosure of client-identifying data. 46. Explain the rationale for the consultation to the client, if appropriate.

TWEAK

5-item scale developed to screen for risk drinking during pregnancy; TOLERANCE - how many drinks can you hold?; WORRIED - have close friends and relatives worried or complained about your drinking in the past year?; EYE-OPENER - do you sometimes take a drink in the morning when you first get up?; AMNESIA - has a friend or family member every told you about things you said or did...; K (CUT DOWN) - do you sometimes feel the need to cut down on your drinking?

Severe

6 or more symptoms

Barbiturate WD effects

6-8 hours after use nausea, vomiting, rapid heart rate, extreme sweating, stomach cramps, tremors

Intake - Global Criteria

6. Complete required documents for admission to the program. 7. Complete required documents for program eligibility and appropriateness. 8. Obtain appropriately signed consents when soliciting from or providing information to outside sources to protect client confidentiality and rights.

% male drinkers % female drinkers % college students drinking past month

60 45 62

Orientation - Global Criteria

9. Provide an overview to the client by describing program goals and objectives for client care. 10. Provide an overview to the client by describing program rules, and client obligations and rights. 11. Provide an overview to the client of program operations.

glia

90% of brain cells are these - they produce myelin, the loss of which causes multiple sclerosis

Rational- Emotive Therapy

A Cognitive Therapy based on Albert Ellis' theory that cognitions control our emotions and behaviors; therefore, changing the way we think about things will affect the way we feel and the way we behave. - Belief system is the cause of emotional problems

Psychodynamic Theory

A Freud-influenced perspective that sees behavior, thinking, and emotions as reflecting unconscious motives.

Summarizing

A brief review of the main points discussed in the session to insure continuity in a focused direction

Summarizing

A brief review of the main points discussed in the session to insure continuity in a focused direction (feedback) Can focus on both feelings and content, should be brief and to the point, without new or added meanings This can take place after an entire session or after long statements from a client Selection and tying together - Select the key components discussed, bring about themes

Alcoholism

A chronic, progressive, potentially fatal illness characterized by tolerance and loss of control over beverage alcohol is

Variable

A construct that has two levels or categories a therefore can vary.

Paraphrasing

A counselor statement that mirrors the client's statement in exact or similar wording

Paraphrasing

A counselor statement that mirrors the client's statement in exact or similar wording (feedback). The counselor must identify the client's message and give that back to the client in one's own words Communicates to the client that the counselor understands or is trying to understand Can clarify confusing content Determining the basic message and rephrasing it The counselor should get in the habit of "checking out" if he/she was right Determine the client's basic message and rephrase the content

Probing

A counselor's response that directs the client's attention inward to help both parties examine the client's situation in greater depth (feedback)

Probing

A counselor's response that directs the clients attention inward to help both parties examine the client's situation in greater depth

Probing

A counselor's response that directs the clt's attention inward to help both parties examine the clt's situation in greater depth

Confrontation

A counselor's statement or question intended to point out contradictions in the client's behavior and statements, or to induce the client to face an issue the counselor feels the client is avoiding

Confrontation

A counselor's statement or question intended to point out contradictions in the client's behavior and statements, or to induce the client to face an issue the counselor feels the client is avoiding (feedback)

Alcohol Short-Term Effects

A distorted sense of perception Reduced inhibitions Drowsiness Raised heartbeat Impaired motor coordination

In relation to physical dependence, psychological dependence is?

A greater problem, since many addicts have gone through withdrawal will later relapse.

Predisposition factors for Dysthymic Disorder

A major loss in childhood (often an important caretaking person), a recent loss, chronic stress, the presence of a personality disorder with compulsive or dependent features and alcohol or drug abuse.

Acculturated Interpersonal Style

A member of a minority group has made a conscious or subconscious decision to reject the general attitudes, behaviors, customs, rituals, and stereotypic behaviors associated with his/her own minority group to assimilate into the mainstream white culture

Bicultural Interpersonal Style

A member of a minority group has pride in his/her racial identity, its history and cultural traditions and yet is comfortable in operating in the white world

Culturally Immersed Interpersonal Style

A member of a minority group has rejected white values and culture

Traditional Interpersonal Style

A member of a minority group is neither accepting nor rejecting of his/her cultural identify

Statements about certain types of stressors are used as hints about the type of disorder. For example:

A normal stressor suggests an adjustment disorder Trauma suggests an anxiety disorder Certain types of stressors without clinical symptoms suggest V codes

LSD

A powerful hallucinogenic drug; also known as acid (lysergic acid diethylamide).

Buprenorphine

A prescription medication for people addicted to heroin or other opiates that acts by relieving the symptoms of opiate withdrawal such as agitation, nausea and insomnia. More weakly addictive and has a lower risk of overdose than methadone. The effects last for about three days.

Alcoholism

A primary, chronic disease with genetic, psychosocial, and environmental factors influencing it's development and manifestations. the disease is often progressive and fatal. It is characterized by impaired control, preoccupation, use despite consequences, and distortions in thinking.

Research question

A question that identifies what the study hope to examine.

Core Function of Screening

A quick snapshot of who the client is and to determine if the client is eligible/appropriate for the type of treatment

Extrinsic Motivator

A rationale for changing substance use that comes from outside the client

Withdrawal syndrome refers to?

A set of consistent symptoms that appear when drug usage stops.

Minnesota Model

A state hospital in Minnesota that used the 12 steps in the treatment setting. Typical length of stay was 60 days. Level of care happened all within the same system.

Culturally Liberated Counselor

A style of counseling in which a counselor does not fear racial or cultural differences and is aware of his/her attitudes, making efforts to be actively involved professionally and personally in the solutions to racial problems

Cultural Ignorance

A style of counseling in which a counselor has little or no prior exposure to a minority culture and whose fear causes him/her to be ineffective in working with a minority client

Covert (Hidden) Prejudice

A style of counseling in which a counselor is aware of his/her fears and dislikes for a minority culture but hides those fears beneath the surface of the counseling posture

Methadone

A synthetic narcotic drug that is used for heroin treatment, is long lasting and eliminates the need for a patient to take medication at home is

ANOVA (Analysis of variance)

A test that is used when there are two or more means to compare.

Biopsychosocial

A theory or perspective that relies on the interaction of biological, individual psychological and social variables.

Existential therapy

A therapy that encourages clients to accept responsiblity for their lives & to live with greater meaning & values; most therapists place great emphasis on the relationship btwn therapist & client & try to create an atmosphere of candor, hard work, & shared learning and growth.

Tradition 9

A.A., as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.

Stimulant Legitimate uses

ADHD, Narcolepsy, Weight Loss Adderall, Dexedrine, Ritalin

Evidenced-Based Strategies for youth

ARC- Attachment, Self-Regulation, Competency. BSFT-Brief Strategic Family Therapy Girls Circle and Boys Council MI-Motivational Interviewing SPARCS-Structured Psychotherapy for Adolescents Responding to Chronic Stress

Neuroplasticity

Ability for the brain to repair, replace, and retrain it's neural circuitry.

Rational Recovery

Abstinence based Addictive Voice Recognition technique Recovery is simple No groups

Non-probability Sampling

Accessing samples of convenience

AIDS

Acquired Immune Deficiency Syndrome

Psychotic disorder symptoms

Act out of touch with reality and experience delusions, hallucinations, or randomly associated ideas. Act flatly, oddly, or inappropriately and are frequently confused with fantasies, irrational ideas and strange thoughts. They have a low quality of insight, demonstrate weak judgment, incorrectly interpret stimuli (such as illusions), withdraw from social situations or do not speak at all or speak disjointedly in conversations with others.

Action

Action is the stage in which people have made specific overt modifications in their lifestyles within the past six months. Because action is observable, the overall process of behavior change often has been equated with action. But in the TTM, Action is only one of six stages. Typically, not all modifications of behavior count as Action in this Model. In most applications, people have to attain a criterion that scientists and professionals agree is sufficient to reduce risk of disease. For example, reduction in the number of cigarettes or switching to low-tar and low-nicotine cigarettes were formerly considered acceptable actions. Now the consensus is clear—only total abstinence counts.

Core function of case management

Activities intended to bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals.

7. Case Management

Activities which bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals. It may involve liaison activities and collateral contacts.

Dimension 1

Acute Intoxication and/or Withdrawal Potential

Alcohol Assessment Tools

Addiction Severity Index (ASI) and Alcohol Use Disorders Identification test (AUDIT)

psychological dependence

Addiction. psychological and behavioral dependence; indicated by loss of CONTROL, obsessive-COMPULSIVE high rate of drug use, craving for the drug, CONTINUED in spite of adverse consequences. Tendency to relapse after stopping use. ie Heroine-VH, codine/fentynl/methadone/morphine-mod, opium-high

Nicotine

Addictive drug found in tobacco that speeds the heartbeat, raises blood pressure, and causes dizziness and upset stomach. Cotinine, a metabolite, is slower in African Americans, causing different smoking patterns.

Immediacy

Addressing what is going on between the client and therapist right now. Presence The ability to be with someone fully in the present moment; being engaged and absorbed in the relationship with the client - Ability to focus on the "here and now" relationship w/another person

Four focuses of Clinical Supervision

Administrative Evaluative Clinical Supportive

Step 5

Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

Counseling Skills of Stage 2 (Evaluation)

Advanced accurate empathy, self-disclosure, confrontation (pointing out discrepancies), immediacy

Metabolized

After absorption and distribution of a drug, it is _______ by the liver This is when drugs enter the body and transform a chemical to another chemical to facilitate elimination from the body.

Inhalants withdrawal

Agitation -pyschological but no known physical symptoms

Stimulant OD

Agitation, increased body temperature, hallucinations, convulsions, and possible death

Systematic Desensitization

Aimed at teaching an individual to relax or behave in some other way that is inconsistent with anxiety while in the presence (real or imagined) of the anxiety producing stimulus. Systematic refers to the carefully graduated manner in which someone is exposed. A client is first taught to induce a state of relaxation, then an "anxiety hierarchy" is constructed, then one must repeatedly imagine the scenes in the hierarchy under conditions of deep relaxation

Supportive Groups for Families

Al-anon Alateen ACOA Nar-Anon

Rational Emotive Therapy

Albert Ellis is the founder Humans are born with potentials for rational thinking but also with tendencies toward crooked thinking. They tend to fall victim to irrational beliefs and to reindoctrinate themselves with these beliefs. A persons belief system is the cause of emotional problems. Clients are challenged to examine the validity of certain beliefs Thinking and feeling are two processes but are closely linked together The event does not cause the action, the person's thoughts and feelings about the event cause the action Teach a client to analyze his/her belief system and correct the irrational distortions The counselor identifies the client's irrational beliefs

Depressants - ABB physical/physchological dependence

Alcohol - high, moderate Barbiturates - high, moderate Benzodiazepines (BZ) - low, mod to high

Diagnostic Interview Schedule (DIS-IV) Alcohol Module

Alcohol Module: 28 questions permits diagnosis of alcohol abuse or dependence; based on DSM-IV

American Indians have the greatest rates of?

Alcohol and illicit drug use. Fetal Alcohol Syndrome is 33X higher! Women have a six-fold increase in cirrhosis of the liver. Frame 12-step programs in terms of a circle rather than ladder.

Prioritizing Substances of Abuse

Alcohol and sedative-hypnotics have the most serious w/d syndromes(address it first). Oral methadone, LAAM, or buprenorphine should be used to stabilize WD from opioids while tapering the dose of s-h or anxiolytic(anti-anxiety Rx).

Depressants

Alcohol, Barbiturates, other sedatives, sleeping pills, inhalants. Slow CNS activity

Tradition 10

Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy.

Tradition 8

Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers.

Codeine

Alkaloid found in opium, though most is morphine. Used as antitussive.

CNS Depressants examples:

Ambien, Chloral Hydrate, Doriden, Meprobamate, Noludar, Paraldehyde, Placidyl and Quaaludes. These substances are administered orally or with water in an injection.

Tradition 6

An A.A. group ought never endorse, finance, or lend the A.A. name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.

Inpatient Medical Unit

An _______________ is appropriate for treating an alcoholic who has experienced seizures

methylphenidate

An amphetamine used to treat ADHD

Managed Care

An approach to delivery of health and mental health services that seeks to reduce the cost of care by monitoring the access to and use of medical services and supplies,as well as outcomes of that care.

Drug misuse

An example of _________ would be combining alcohol with other depressant drugs

Acetylcholine

An excitatory neurotransmitter released by axons.

Imparting information

An informed person is better able to cope and think through new problems

Tradition 12

Anonymity is the spiritual foundation of all our Traditions, ever reminding us to place principles before personalities.

Meprobramate

Anti-anxiety drug became very popular in the 1950's. Miltown, Equanil, Meprin - sedative and tranquilizer used to treat muscle tension and anxiety.

Anxiolytics

Anti-anxiety medications. Prescribed to relieve anxiety symptoms (e.g. generalized anxiety or panic, insomnia, petitmal epilepsy or extreme alcohol withdrawal.

monoamine oxidase

Antidepressant drug. First used in the 1950s to treat tuberculosis, showed an elevation in mood.

Phenothiazines are now referred to as?

Antipsychotics

Benzodiazepines medical use:

Anxiety and panic disorders and acute stress. Depressant chemical group of sedative-hypnotics. WD-tremors, cramps, sweating, vomiting.

Examples of Nicotine WD symptoms that can be confused with other Psychiatric conditions:

Anxiety, Depression, Increased REM sleep, Insomnia, Irritability, Restlessness, Weight Gain

Depressant withdrawal

Anxiety, insomnia, tremors, delirium, convulsions, possible death.

Schedule I

Any drug included here has a high level of abuse/dependence. Also, there is no accepted medical use. Include are heroin, LSD and marijuana.

Stimulant withdrawal

Apathy, long periods of sleep, irritability, depression (possible with suicidal potential), and disorientation, increased appetite, anhedonia (absence of pleasure) and craving.

Minor Tranquilizers

Are depressant drugs used to treat anxiety and insomnia. Low doses make the user feel calm, relaxed, and drowsy. High doses can cause loss of coordination and stupor. Can cause both physical and psychological dependence. examples: Valium, Xanax, and Ativan.

Four types of Client Resistance

Arguing, interrupting, denying, ignoring

Alcohol Effect Asians

Asians usually do not have enzyme acetaldehyde to break down etoh and will flush, sweat, and feel ill. Alcoholism rate is low for Asians.

5 A's for Tobacco Brief Intervention

Ask about use. Advise to quit. Assess willingness to quit. Assist in quitting. Arrange follow-up.

12 Core Functions (4)

Assessment

Norepinephrine

Associated with arousal reactions

Dopamine

Associated with body movement and pleasure

Serotonin

Associated with regulation of sensory perception, sleep and body temperature

How often are treatment plans reviewed

At least 90 days at outpatient level of care

Who May benefit from Acamprosate

At treatment onset are motivated to achieve complete abstinence rather than decrease in drinking. Receiving opioid maintenance therapy at risk of relapsing to opioid use taking opioid for chronic or acute pain

Counseling Skills of Stage 1 (Information Gathering)

Attending to self and client, concreteness (identifying specific feelings, clarifying general statements), distinguishing content from feelings, probing (open-ended questions), accurate empathy, genuineness, respect

Styles of Group Leadership

Authoritarian Democratic Laissez-faire

V Codes

Axis I factors worthy of attention in treatment, but not part of the disorder.

blood alcohol concentration

BAC- measured in milligrams (mg) of alcohol per deciliter (dL) of blood. 100 mg/dL = .1 percent

Beck Depression Inventory II

BDI-II is 21 items to assess the intensity of depression.

3 Types of Sedative/Hypnotics

Barbiturates Minor Tranquilizers Other Sed/Hypnotics

Anxiety disorder most effective therapy?

Behavioral in approach with a secondary cognitive emphasis. Depending on the nature of the disorder, group therapy may prove equally effective. Ancillary family therapy may be needed as well. Unless the condition is disabling, medication is not generally needed; however, it may provide supplementary treatment, particularly with Panic Disorder and OCD

MAO Inhibitors

Behavioral stimulants that reduce depression by inhibiting the action of an enzyme called MAO, which normally breaks down and deactivates norepinephrine and serotonin.

Benefits of behavioral therapy

Behavioral techniques that are often used to decrease anxiety include relaxation techniques and gradually increasing exposure to situations that may have previously precipitated anxiety in the individual. Helping the anxiety sufferer to understand and how to handle the emotional forces that may have contributed to developing symptoms (anxiety-focused psychodynamic psychotherapy) has also been found to be effective in teaching an individual with panic disorder how to prevent an anxiety attack or to decrease or stop a panic attack once it starts.

Phencyclidine (PCP) Action

Behvior effects believed to be meediated through the N-Methyl-D-Aspartate (ND) excitatory amino acid receptor-channel complex in the brain.

Multiculturalism

Being comfortable with many standards and customs; being able to adapt behaviors and judgments to a variety of interpersonal settings.

Anti-anxiety Medications

Benzodiazepines - TCAs, SSRIs, Buspirone

CNS Depressants

Benzodiazepines, in the form of Valium, Librium, Ativan, Serax, Xanax, Tranxene, and Klonopin. Alcohol, in the form of ethyl alcohol Ethanol (beer, liquor and wine) Barbiturates, in the form of Amytal, Nembutal, Phenobarbital, Seconal and Tuinal

Withdrawal and isolation

Best characterizes the changes that occur in an alcohol or drug abuser's relationship with family , friends, and society as a result of the substance abuse.

Residential or Inpatient (behaviorally/psychologically based)

Best type of care for individuals who have not been successful in outpatient, have very serious substance abuse problems, need concomitant medical or psychiatric care, and those without a stable support system in the community Therapeutic Communities - Self-contained residential programs that emphasize self-help and rely heavily on ex-addicts as peer counselors, administrators, and role-models

Opiates Action

Bind to opiate receptors in the cns where they block normally occuring opiate-like substances.

Dimension 2

Biomedical Conditions and Complications

How Opiates (HCFMMO) work?

Block communication between neural impulses by tying up encephalin-receptors in the central nervous system. An overdose will cause a decrease in pulse, convulsions, coma or even death.

While waiting to be filtered by liver,alcohol travels throughout the body in a person's _________.

Blood

Marijuana Abuse Symptoms

Bloodshot eyes: Most likely (especially if the patient's heart is racing), but could suggest Alcohol Abuse

Neurons

Brain cells. Contain dendrites, nucleus, axon terminals.

Buprenorphine forms?

Buprenex-injectable form Subutex-oral form (starting treatment) Suboxone-buprenorphine and nalxone(intedend for persons dependent on opioids who have already started and are continuing medication therapy.)

Buspirone (generic name)

Buspar (brand name) - treats GAD or MODERATE anxiety WITHOUT sedation.

Instrument for Alcohol Dependence and Withdrawal

CIWA-Ar 10 items; scores 0-67, 10 or greater is significant

Withdrawal scales include?

CIWA-Ar - Clinical Institute Withdrawal Assessment for alcohol withdrawal CINA - Clinical Institute Narcotic Assessment for opioid withdrawal.

Inhalants

CNS Depressants Creates an effect similar to alcohol intoxication, excitability. and delirium Physical and psychological dependence Cleaners, cosmetics, paint solvents, glues, motor fuels

Instrument for Cocaine Dependence and Withdrawal

CSSA - Coacaine Selective Severity Assessment 18 items;high scores correlate with poor outcome

CNS Stimulants include:

Caffeine (yes, as simple as your Latte and soda) Nicotine (those cigarettes you've promised to give up) Amphetamines Cocaine Methylphenidate (e.g., Ritalin) Dextroamphetamine (e.g., Dexedrine) MDMA (e.g., Ecstasy

Step 2

Came to believe that a power greater than ourselves could restore us to sanity.

Psychoactive drugs

Can alter the normal course of body functions including thoughts, mood and emotions

SOAP - Subjective

Can be given by: patient, family, EMS Consists of CC, HPI, ROS, PMHx

Altruism

Caring about others decreases unhealthy self-absorption

Client-Centered Therapy

Carl Rogers was the founder View of the person is essentially good, that he/she is capable of living a meaningful life The client has the potential for becoming aware of problems and the means to resolve them The therapist creates a safe healing environment by expressing: genuineness (counselor is him/herself), empathy (the ability to feel with the client and sense what his/her world is like), unconditional positive regard

12 Core Functions (7)

Case Management

Disulfiram: How it works

Causes a toxic physical reaction when mixed with alcohol. Pproduces acetaldehyde, co-morbid treatment of alcohol and cocaine addiction, may induce psychiatric symptoms(don't use with psychotic clients)

Barbiturates

Central nervous system depressants, used to treat anxiety, induce sleep, and control seizures. Can cause intoxication similar to that caused by alcohol. Can cause death by respiratory failure or by seizure. Can create both physical and psychological dependence - withdrawal can be dangerous and even fatal. Combining them with depressants can cause a synergistic effect that can produce death.

Independent Variable

Changed by the researcher. Dependent variable is what being measured.

Injection

Characteristics that are common of drugs taken by ______ include: a rapid response; a greater drug effect than it taken orally; the necessity for sterile conditions; a smaller dose than if taken orally

Depersonalization Disorder

Characterized by a sudden sense of being outside yourself, observing your actions from a distance as though watching a movie. Size and shape of things, such as your own body or other people and things around you may seem distorted. Time may seem to slow down, and the world may seem unreal. Symptoms may last only a few moments or may come and go over many years.

11. Report and Record Keeping

Charting the results of the assessment and treatment plan, writing reports, progress notes, discharge summaries and other client-related data.

Neurotransmitters

Chemical messengers that traverse the synaptic gaps between neurons. EXAMPLE: sedative-hypnotics(Bz's and Barb's) affect GABA

psychoactive drugs

Chemicals that affect the nervous system and result in altered consciousness

Inhalants

Chemicals that can be legally purchased and that are normally used for non-recreational purposes. Includes industrial solvents and aerosol sprays and include, but are not limited to: gasoline, kerosene, airplane glue, acetone, lighter fluid, metallic paints, correction flids, amyl, butyl and isobutyl nitrite and nitrous oxide.

A popular sedative that was introduced in 1960?

Chlordiazepoxide(Librium)- benzodiazepine

Wernicke-Korsakoff syndrome

Chronic mental impairments produced by heavy alcohol use over a long period of time.

Hippocrates

Classified all mental disorders into the categories: mania, melancholia, phrentis "Father of Medicine" all disorders are caused by natural factors; four humors; body has ability to heal self; treat the whole patient

What type of client would not benefit from psychoanalysis?

Clients suffering from severe depression or such psychotic disorders as schizophrenia, although some analysts have successfully treated patients with psychoses. It is also not appropriate for people with addictions or substance dependency, disorders of aggression or impulse control, or acute crises; some of these people may benefit from psychoanalysis after the crisis has been resolved.

Mania Disorder Affective symptoms

Clients will experience both extremes—high spirits and elevated moods or low spirits with anger and irritability.

The 10 Domains

Clinical Evaluation Treatment Planning Referral Service Coordination Counseling Client family and community education Documentation Professional Ethical responsibilities Research Design analysis and utilization Clinical Supervision

Level 3.5

Clinically Managed High-Intensity Residential Services

Level 3.1

Clinically Managed Low-Intensity Residential Services

Level 3.3

Clinically Managed Population-Specific High-Intensity Residential Services

Rohypnol

Club Drug - benzodiazepine; the "date-rape" drug

GHB

Club Drug - gamma hydroxybutyrate; chemically related to GABA; used recreational as a depressant

Stimulants

Cocaine half life=one hour, Amphetamine=6-12 hours, Methylphenidate=2 hours

Stimulants

Cocaine, Amphetamine, Caffeine-these drugs can reverse the effects of fatigue, maintain wakefulness, decrease appetite, and temporarily elevate the mood of the user

Narcotics drug classification

Codeine, morphine and opium fall under________

Anxiety disorders respond well to?

Cognitive-behavioral interventions and behavior therapy, particularly in-vivo desensitization. Tx objectives include reduction of anxiety and improved management of stress. Development of socialization skills and giving a sense of mastery are additional goals

Mood Disorder treatment

Cognitive-behavioral, interpersonal and related interventions. Larger objective of overall adjustment, mood stabilization, alleviation of depression and mania, enhancement of coping skills, improvement in relationships and the prevention of relapse are vital treatment objectives.

Synergistic effect

Combination of two or more drugs that produce an exaggerated effect. Goes above and beyond what might be expected of adding one drug to another.

Benzodiazepines

Combined sales of the make them easily the most widely prescribed drug class. Flumazenil (Romazicon) acts at the receptor and reverses the sedative and overdose effects, but not alcohol or other sedative-hypnotics.

Mood disorders

Common psychiatric disorders accompanied by dependency: Affecting all areas of clients, long-lasting emotional state characterized by pathological or depressed mood disturbances

Mood Episodes

Common psychiatric disorders accompanied by dependency: Clients have symptoms that last for a long period

Delusional disorder

Common psychiatric disorders accompanied by dependency: dominating and well-ordered delusions or may not yet have had hallucinations as in the case of disorganized thoughts or behaviors

Major depressive disorder

Common psychiatric disorders accompanied by dependency: have one or more depressive episodes characterized by depressed moods, loss of pleasure, weight loss, insomnia, fatigue, misplaced guilt, and a limited ability to think clearly or focus

t-test

Compares the mean of 2 independent data sets to determine if there is a significant statistical difference between them.

Narcotics

Complaints of extreme constipation and poor appetite Drugs derived from opium that are capable of relieving pain (also called opiates) Kill pain; depress the central nervous system; induce sleep

Global Criteria: Intake

Complete require documents for admissions into the program. Obtain signed consents in order to protect client's confidentiality and rights.

Adverse Ketamine reacation

Completed sensory detachment, explained as a near-death experience, paranoia, boredom and possible coma.

3 Characteristics of Addiction

Compulsive use, Loss of Control, Continued use despite adverse consequences

Cognitive Disorder symptoms

Confused, cannot remember things, primarily accompanies dementia. Poor judgment, act out oddly or dramatically, impulsive, delusions or hallucinations, experience changes in sleep and mood patterns, and have marked personality changes (such as no longer performing basic hygiene or acting rudely).

Gestalt

Consciousness can never be broken down into parts because it can be understood only as a whole. - Personal responsibility, unfinished business, avoiding, experiencing & awareness of the now. - Lives in the present, responsible for their own thoughts, feelings & actions

6 Steps for Ethical Decision Making (4)

Consider courses of action

Reliability

Consistency of results over time, no intervening events, use correlation or decision consistency to judge. r=same people, same test, different times

12 Core Functions (12)

Consultation

Contemplation

Contemplation is the stage in which people intend to change in the next six months. They are more aware of the pros of changing, but are also acutely aware of the cons. In a meta-analysis across 48 health risk behaviors, the pros and cons of changing were equal (Hall & Rossi, 2008). This weighting between the costs and benefits of changing can produce profound ambivalence that can cause people to remain in this stage for long periods of time. This phenomenon is often characterized as chronic contemplation or behavioral procrastination. Individuals in the Contemplation stage are not ready for traditional action-oriented programs that expect participants to act immediately.

Step 10

Continued to take personal inventory and when we were wrong promptly admitted it.

Global Criteria: Case Management

Coordinate services for client care. Explain the rationale of case management to the client.

12 Core Functions (6)

Counseling

Probing

Counselor's use of a question or statement to direct the client's attention inward to explore his/her situation more in depth (open-ended question)

12 Core Functions (8)

Crisis Intervention

CAGE

Cut back Annoyed Guilty Eye Opener

Tricyclic/Tetracyclic

Cyclic antidepressants - among the earliest antidepressants developed. Effective, but they've generally been replaced by antidepressants that cause fewer side effects. Other antidepressants are prescribed more often, but cyclic antidepressants are still a good option for some people. In certain cases, they relieve depression when other treatments have failed.