Substance Use and Misuse

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What does moderate alcohol look like?

-2 drinks per day for men -1 drink per day for women

What does binge drinking use look like?

-5 or more drinks in one sitting for men -4 or more drinks in one sitting for women

What are the types of substance misuse assessments?

-Addiction Severity Index (ASI) -Drug Use Screening Inventory -Multidimensional or systems view -Ongoing process

What techniques for treating substance misuse are more effective with adolescents?

-Adolescent Community Reinforcement Approach -Brief Strategic Family Therapy -Family Behavior Therapy -Functional Family Therapy -Multidimensional Family Therapy -Multisystemic Therapy

What are the different types of substances?

-Alcohol -Methamphetamine -Cocaine -Hallucinogens -Marijuana

What indicators show that a child's guardian may be a substance abuser?

-Appear unkempt -Be frequently sleepy -Be late to school -Be frequently absent -Have unexplained bruises -Know too much about drinking -Appear withdrawn/depressed -Display behavioral problems -Complain of stomachaches

What is the Five A's Model for treating tobacco?

-Ask -Advise -Assess -Assist -Arrange

How can a Parent Help their Addicted Child?

-Be respectful -Avoid accusations -Unconditional love. Explain your feelings and fears because you are afraid for their safety, but in a positive and effective manner. -Discuss the issues in a loving, yet firm way. Scolding, yelling, and fighting makes the situation worse. The child tends to recoil from their parents if they feel like there will be conflict. -Educate them about the possible outcomes of substance abuse such as jail, overdosing, or even death. -Seek proper treatment. A child will probably feel more comfortable confiding in a professional therapist than their parent. A professional will be able to strategically approach the child and determine what treatment plan would be the most effective.

Why do people use alcohol and drugs?

-Behavioral -Social -Environmental -Risk vs Protective -Biological Risk and Protective -Unique Combos

What are the types of substance misuse screening instruments?

-CAGE -Michigan Alcoholism Screening Test (MAST) -Alcohol Use Disorders Identification Test (AUDIT) -Drug Abuse Screening Test (DAST) -Problem Oriented Screening Instrument for Teenagers (POSIT) -Substance abuse Subtle Screening Inventory (SASSI) -MacAndrew Alcoholism Scale

What else does medical marijuana treat in older adults?

-Cancer: helps treat symptoms of chemotherapy -Alzheimers Disease: helps treat depression and loss of appetite consistent with this disease -OCD and PTSD: helps with anxiety and depression -Glaucoma: helps relieve pressure in the eyes -Sleep: helps with sleeping struggles

What is nicotine addiction?

-Characterized by tolerance to nicotine -Withdrawal symptoms: Insomnia Anxiety Restlessness Depressed Mood -Use despite harmful effects -Compulsive drug-seeking -Use despite desire or intention to stop -Giving up important activities when smoking is not allowed

What are some normal challenging child behaviors that could further put children at risk of mistreatment with a guardian who abuses substances?

-Colic/Crying -Awakening at night -Separation anxiety -Exploratory behavior -Negativism -Poor appetite -Toilet-training resistance

Why Do Adolescents Experiment?

-Curiosity -They are attempting to self-medicate -Struggling with self-esteem -Fitting in with peers -Craving attention -Boredom

What are the warning signs of relapse?

-Denying vulnerability to relapse, thinking you are cured of the addiction and letting down your guard. (It only takes one more dose to get back into the addiction cycle no matter how far or how long you have progressed in your recovery and abstinence.) -Making excuses for resuming use such as reasoning with yourself or others for your need of the substance and using defense or denial mechanisms when thoughts or behaviors point toward impending relapse. -Becoming complacent or non-compliant in efforts to maintain abstinence such as not going to 12-Step recovery meetings or participating in treatment. -Idealizing substance abuse effects or past experiences and selectively disregarding the consequences. -Neglecting physical, psychological, spiritual, or emotional health problems. -Boredom and isolation, not engaging in healthy or productive relationships or activities. -Entering high-risk situations such as renewing friendships with other substance abusers or staying in environments where reminders of substance abuse are unavoidable. -Replacing abuse of one substance with another -Overreacting to cravings, emotional distress, or relapse when it occurs (by some estimates relapse occurs in up to 90% of recovering individual and should not be viewed as a failure, but rather, as a learning event to prevent future occurrences or to signify a renewed need for treatment.)

What are substance misuse treatment options for adolescents?

-Detox -Inpatient/Residential -Outpatient: is often favorable as it allows adolescent's to continue participating in school and extracurriculars as well as access support from family and friends.

What are the consequences of parental substance abuse on childhood development?

-Disruption of the bonding process -Emotional, academic and developmental problems -Lack of supervision -Parentification -Socia stigma -Adolescent substance use and delinquency

What is nicotine replacement therapy?

-Double success rate -Quit Smoking Now 1: Tobacco Friend or Fo 2: Managing your addiction 3: Let's Quit Now 4: Relapse Prevention 5: Develop a Plan for Life 6: Congratulations

What are ethics of treatment to keep in mind?

-Dual relationships -Impaired professionals -Self-disclosure -Confidentiality -Legal issues -Ethical Obligations

What are risk factors for substance use and misuse?

-Early Aggressive Behavior (Individual) -Lack of Parental Supervision (Family) -Substance Abuse (Peer) -Drug Availability (School) -Poverty (Community)

What are social history topics that should be covered during assessments?

-Education: Especially important to discuss with younger adults (adjustment). When was drug use initiated? -Employment: Is job secure? Stable or erratic employment pattern? Is job at or below educational level? Is job obstacle for recovery? -Military history: Not often asked -Medical history: Has client made connection between medical problems and substance abuse? Is client receiving appropriate care for conditions? What medications is the client taking? -Legal history: Many referrals from legal system. Alcohol or drug related arrests? How much alcohol was consumed before the arrest? -Drinking and drug history: What substances has client used in their life? -Current use? What problems has used caused (withdrawl)? -Psychological or Psychiatric History: Does the client have a mental illness? Suicidal or homicidal ideation? -Family history: Do family members have substance abuse problems? It is common for parents to have issues as well. Also, ask about attitudes of family members toward alcohol and current relationships. -Current relationships: Are others aware client is seeking treatment? How do others perceive the drug use? Are significant others contributing? -Religion and Spirituality: Assess to determine potential source of support -Why the individual is seeking services

How do you help clients deal with resistance?

-Encourage those who resist to participate in an educational program or attend a few meetings before completely rejecting treatment -Note that individuals differ in their willingness or ability to terminate substance use and desire to engage in treatment

What are child welfare approaches to substance abuse?

-Focus on early identification of at-risk families in substance abuse programs -Improve communication between the child welfare system and the substance abuse treatment system -Close the gap between treatment need and available treatment slots

After the results of the screening instrument are determined what happens?

-Following a positive screening, clinicians must determine if the diagnosis of a substance use disorder is necessary. -Biopsychosocial assessment is also completed at this stage. -DSM-V -Co-occurring diagnoses

How do you help clients with denial?

-Help clients reduce their denial gradually, as many are not aware that their problems are the result of substance abuse -Note that family members and other loved ones are also likely to engage in denial

How does having a mental disorder effect substance use?

-It more than doubles a person's chances of having an alcohol diagnosis -It increases chances of a drug abuse diagnosis by more than 4 times -Is your diagnosis an affective or anxiety disorder? •The rates of SUDs exceed 50%

What are targeted goals for building relapse prevention skills in addiction treatment?

-Making informed, healthy choices and lifestyle changes that support physical, psychological, and emotional wellbeing while decreasing the need or desires for drugs -Developing pleasurable and rewarding alternatives to drug use -Learning to identify and avoid people, places, and things that might trigger drug use -Understanding social pressures to use and developing new coping skills for high-risk situations -Developing methods to cope with negative emotional states or cognitive distortions -Combating memories of drug abuse and associated euphoria while reinforcing recollections of negative aspects of drug use -Increasing participation in meaningful daily activities, such as a working or going to school, volunteering, or family care-taking -Improving relationships with significant others and developing a supportive relapse prevention network -Improving social functioning such as gaining independence, income, and resources to participate in normal societal roles -Developing a plan to interrupt a slip or relapse and measures to take in case it occurs

What are the effects or prenatal exposure?

-Neurological and behavioral differences -Cognitive and communication/ language difficulties

What are dissociative analgesics?

-PCP -Ketamine

What are things to keep in mind when administering screening instruments?

-Practitioners may need to modify cutoff scores or change how items are weighed. -Clinicians must select instruments with good psychometric properties. -Research has demonstrated agreement with client's self-reports and other sources; however, it's important to attend to external factors. -Face valid vs. nonface-valid instruments.

What are the stages of behavior?

-Pre-contemplation: not thinking about quitting -Contemplation: thinking about quitting in the next 6 months -Preparation: planning to stop in the next month -Action: has stopped -Maintenance: smoke-free for 6 months or more -Relapse: smoking regularly again

What are different defense mechanisms?

-Rationalization -Projection -Avoidance or Evasion -Minimization -Repression

What are the topics of seeking safety therapy?

-Safety (combination) -PTSD: taking back your power (cognitive) -Detaching From Emotional Pain: Grounding (behavioral) -When Substance Control You (cognitive) -Asking for Help (interpersonal) -Taking Good Care of Yourself (behavioral) -Compassion (cognitive) -Red and Green Flags (behavioral) -Honesty (interpersonal) -Recovery Thinking (cognitive) -Integrating the Split Self (cognitive) -Commitment (behavioral) -Creating Meaning (cognitive) -Community Resources (interpersonal) -Setting Boundaries in Relationships (interpersonal) -Discovery (cognitive) -Getting Others to Support Your Recovery (interpersonal) -Coping with Triggers (behavioral) - Respecting Your Time (behavioral) -Healthy Relationships (interpersonal) -Self-Nurturing (behavioral) -Healing from Anger (interpersonal) -The Life Choices Game (combination) -Termination

How do you use referrals to help clients?

-Substance Use Disorder professionals often make referrals to other agencies -Identify potential barriers -Mutual-help groups

How does substance abuse effect adolescents?

-Substance abuse effects metabolism, internal organs, the central nervous system, emotional and cognitive functioning. Effects can last beyond adolescence into adult years. -When cognitive functioning is negatively affected-leads to lower IQ, difficulty learning, memory issues, etc. -Mental Health- Substance use can cause mental illness such depression, anxiety, amnesia, and psychosis. -Future Addiction: brain reward system becomes altered

What is the opioid epidemic?

-The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999. -The second wave began in 2010, with rapid increases in overdose deaths involving heroin. -The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl.5,6,7 The market for illicitly manufactured fentanyl continues to change, and it can be found in combination with heroin, counterfeit pills, and cocaine.

What is screening?

-Use of rapid assessment instruments and other tools to determine the likelihood that an individual has a substance use disorder. -Often an informal process in practice.

What is face validity?

-Whether examiners and examinees perceive the instrument as a reasonable measure of what it is meant to measure (affects motivation) -does this test actually measure what it claims to?

What are examples of substance abuse and prevention models?

-Zero-tolerance model of prevention - the policy that the US and the United Nations supports ("War on Drugs") -Harm-reduction model of prevention - objectives are two-fold Reduce the mortality (death) and morbidity (sick) associated with drug and alcohol related problems Reduce the rates of abuse for drugs and alcohol

What is seeking safety?

-designed to treat PTSD and substance abuse at the same time

What are examples of solvents?

-gasoline -benzene -trichlorethylene

What does the Central Nervous System do?

-integrates the information that it receives from, and coordinates the activity of, all parts of the body -It contains the majority of the nervous system and consists of the brain and the spinal cord. -Some classifications also include the retina and the cranial nerves in the CNS. -Together with the peripheral nervous system, it has a fundamental role in the control of behavior.

What are the substance of choice for adolescents?

1.Alcohol 2.Marijuana 3.Nicotine nNow most commonly utilized in the form of e-cigarettes 4.Adderall 5.Oxycontin -Closely followed by other prescription Opioids

What is the philosophy behind motivational interviewing?

1.Client resistance typically is a behavior evoked by environmental conditions. 2.The client/counselor relationship should be collaborative and friendly. 3.Motivational Interviewing gives priority to resolving ambivalence. 4.The counselor does not prescribe specific methods or techniques. 5.Clients are responsible for their progress. 6.MI focuses on clients' sense of self-efficacy

How does motivational interviewing work?

1.Motivation to change is elicited from the client, and not imposed from without. 2.It is the client's task, not the counselor's, to articulate and resolve his or her ambivalence. 3.Direct persuasion is not an effective method for resolving ambivalence. 4.The counseling style is generally a quiet and eliciting one. 5.The counselor is directive in helping the client to examine and resolve ambivalence. 6.Readiness to change is not a client trait, but a fluctuating product of interpersonal interaction. 7.The therapeutic relationship is more like a partnership or companionship than expert/recipient roles.

What are the categories of preventative strategies?

1.Public information and education 2.Service measures 3.Technologic measures 4.Regulatory, legislative, and economic measures 5.Family and community approaches

What does heavy drinking look like?

5 or more binges in one month

What is addiction?

A disease -Progressive -Potentially fatal -Incurable

What is lake adolescents?

About 18 to 20, but some researchers disagree on exact age. Some say 18-22. Some call 18-23 age emerging adults rather than late adolescents.

What is adolescence?

Adolescence is the period between childhood and adulthood. There are three stages of adolescence: early, middle, and late. Early adolescence (ages 11 to 14). Biological maturity proceeds psychosocial maturity

What is middle adolescence?

Adolescents (ages 15 to 17) tend to be more impulsive, explorative, and risk takers than adults. Thus, they are more likely to try drugs.

How does the war on drugs contribute to the over-representation of racial minorities in American prisons?

African Americans are incarcerated in state prisons across the country at more than five times the rate of whites, and at least ten times the rate in five states.

How does the drug use screening inventory (DUSI) work?

Also assesses the severity of adults and adolescents problems. 3 phases.

What is naloxone?

An antagonist of endorphins and also decreases the effects of opiates

How can we help the LGBT community with addiction?

By providing specialty groups can offer people the safety of a treatment community that addresses their specific lifestyles and needs. The LBGT client can benefit from groups. When compared with their heterosexuals peers, LGBT individuals have been found to suffer significantly higher incidences of stressful childhood experiences, school victimization, neighborhood-level hate crimes and family conflict - stressors that correlate with increased substance abuse.

What does high risk drinking look like?

Consumption to >.08 BAC

How does SASSI work?

Contains both direct and subtle items about alcohol and drug use. Increased interest in such measures because denial/defensiveness is very common.

What does NIDA want to emphasize?

De-emphasis on morality, new emphasis on health model

How does AUDIT work?

Developed for use by primary health care providers. Ten items; clinical screening procedures also recommended.

What are drug schedules?

Drugs, substances, and certain chemicals used to make drugs are classified into five (5) distinct categories or schedules depending upon the drug's acceptable medical use and the drug's abuse or dependency potential. The abuse rate is a determinate factor in the scheduling of the drug; for example, Schedule I drugs have a high potential for abuse and the potential to create severe psychological and/or physical dependence. As the drug schedule changes-- Schedule II, Schedule III, etc., so does the abuse potential-- Schedule V drugs represents the least potential for abuse.

What is the systematic review of IDDT?

Effective with seriously mentally ill populations with AOD disorder, limited effectiveness otherwise.

How is the nature of addiction different for LGBT?

Gay and bisexual men have a higher propensity to abuse methamphetamines than heterosexual men, while lesbians and bisexual women are more likely to engage in hazardous drinking than heterosexual women. Members of the LGBT community are also more likely to suffer from mental illness.

What are the biological changes of middle adolescence?

Girls: mid to late puberty, end of growth spurt, physical appearance changes, period usually begins but can begin in early adolescence. Development of female body with fat disposition. BOYS: mid puberty-spermarche, nocturnal submissions, voice breaks, start of growth spurt.

What are examples of central nervous system depressants/sedatives?

Hypnotics -Alcohol (methyl and ethyl) -Barbiturates -Benzodiazepines -Cannabis

What do central nervous system stimulants do?

In small doses, CNS stimulants produce an increased sense of alertness and energy, elevated mood, and decreased appetite. It is also a stimulant and an appetite suppressant. It stimulates the central nervous system (nerves and brain) by increasing the amount of certain chemicals in the body. This increases heart rate and blood pressure and decreases appetite, among other effects.

What is the systematic review of management?

Increases treatment use, increases use of range of bio/psycho/social services

What do hallucinogens do?

Induce altered perceptions, thoughts, feelings

How does MacAndrew work?

It is a subscale of the MMPI.

What is the systematic review of supportive housing?

Little research, increases housing stability

Why do older adults prefer medical marijuana?

Many elderly also prefer medical marijuana because it is seen as a healthier alternative with less risk to misuse compared to other pain treatments (National Council for Aging Care, 2018).

How is the LGBT community effected by addiction?

Members of the LGBT community face a two-edged sword when it comes to addiction. The emotional stress that lesbian, gay, bisexual and transgender individuals often feel - including rejection, isolation and low self-esteem - as well as the threats of physical violence, prejudice and discrimination, make them vulnerable to addiction. At the same time, these factors decrease the likelihood that they will receive effective treatment. Too often, members of the LGBT community face internalized stigma and homophobia. These internal struggles with themselves can make it more difficult to seek out or achieve long-term recovery.

What are opioids?

Narcotic analgesics - pain killers

Which two populations of seniors are most commonly using medical marijuana?

One is the baby boomer population who are now elderly. Many of these people used it in the 60's and 70's but gave it up. The other are those who have never tried it and are drawn to its potential health benefits (Davidson, 2018).

What are the psychological changes of late adolescence?

Operational thought/complex thinking. Moral reasoning (development or rejection of religion and political views).

Why do people continue to use substances even when the negative effects outweigh any positive effects?

Physical dependence on the substance, and the changes in their brain chemistry

What are the prevention strategies of substance abuse of the public health model?

Primary - convincing elementary school kids not to some Secondary - identifying and treating those with AOD problems Tertiary - avoid relapse and maintain the health of those treated

What is the systematic review of TREM?

Promising, little systematic evidence

What does the ecological approach to prevention of substance abuse protective factors look like?

Protective Factors - those aspects across ecological systems that increase the chance that a person will avoid problems with substances Microsystem - Creative problem solving, social value Exosystem - Family school, positive adult role models, supportive relationships Macrosystem - Community - safe neighborhood environment, availability of wholesome activities

What are the biological changes of adolescence?

Puberty: gonads, sex hormones, menarche in females, spermarche in males. Hormone changes, beginning of puberty, physical appearance, may experiment with sex, substances, etc.

What does sensitivity mean in regard to screening instruments?

Refers to the instrument's ability to identify someone with an alcohol or drug problem (true positive).

What is the resilience model?

Resilience focuses on protective factors found in youth from high-risk situations. It is a phenomenon that empowers a person to return to a functional status despite high-risk events. It is observed through adaptive functioning and enabled by protective factors that work to offset negative influences.

What does the ecological approach to prevention of substance abuse risk factors look like?

Risk Factors - those aspects across ecological systems that increase the chance that a person will have problems with substances Microsystem - Mental illness and genetic tendencies toward addictions Exosystem - Family school, history of physical or sexual abuse and affiliations with those who use drugs Macrosystem - Community issues such as poverty and accessibility of substances; and cultural issues, including cultural acceptance and media images of substance use.

What is a schedule I drug?

Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples of Schedule I drugs are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote

What is a schedule II dug?

Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs are: Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin

What is a schedule III drug?

Schedule III drugs, substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples of Schedule III drugs are: Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone

What is a schedule IV drugs?

Schedule IV drugs, substances, or chemicals are defined as drugs with a low potential for abuse and low risk of dependence. Some examples of Schedule IV drugs are: Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol

What is a schedule V drug?

Schedule V drugs, substances, or chemicals are defined as drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. Schedule V drugs are generally used for antidiarrheal, antitussive, and analgesic purposes. Some examples of Schedule V drugs are: cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin

What do opiates do?

Small doses produce effects similar to CNS depressants but with somewhat less impairment of the motor and intellectual processes

What is the systematic review of AA/NA?

Some evidence that it decreases adolescent substance use.

Why are some people at high risk of relapse?

Some people can detox from a substance and have little difficulty in remaining abstinent as they resume a healthy and positive lifestyle, while others are at a high risk of relapse due to age, genetics, underlying health conditions, and lack of environmental or social support.

What are the social changes of adolescence?

Start of independence from parents and culture. More peer centered relationships. Early exploring of behaviors (smoking, substances, sex, violence)

What does the continuum of substance misuse look like?

Starts with substance use, and moves to abuse, and then dependence

Is stress a tigger for relapse?

Stress can be a major instigator to relapse causing the person to be more sensitive to other "triggers" and immediately shifting their perspectives and focus from the positive to the negative. Developing coping skills such as controlling powerful emotions or having a strategy in place when cravings and other vulnerable risks are high is a crucial part of the recovery process.

How does an addiction severity index (ASI) work?

Structured interview designed to indicate the severity of the client's problems in 7 life areas (alcohol, drugs, vocational, family and social supports, medical, psychological or psychiatric, or legal).

Why is medication assisted treatment for substance misuse not an option for youth?

The FDA has not approved Medication Assisted Treatment for people younger than 18.

How can a parent avoid being the enabler with their addicted child?

The child is no longer acting like their true self by displaying compulsive behavior, irrationality, and aggression. It is common that the parent begins to feel overwhelmed with guilt, anxiety, and frustration. It is important to realize the difference between helping and enabling such as: -Being manipulated -Being used to financially support the addiction -Being used to financially support the child since they spend all their money on drugs -Allowing them to use substances within the home -Exposing other siblings to substances can increase the likelihood of them using as well

What is the Jellinek Curve?

The curve of addiction and recovery

What is methadone maintenance treatment?

The opioid dependent patient takes a daily dose of methadone as a liquid or pill. This reduces their withdrawal symptoms and cravings for opioids. -MMT significantly reduces drug injecting; because it reduces drug injecting, MMT reduces HIV transmission; -MMT significantly reduces the death rate associated with opioid dependence; -MMT reduces criminal activity by opioid users; and -Methadone doses of greater than 60mg are most effective.15

What is the definition of substance use?

The use of alcohol and other drugs to socialize and feel their effects

What happens when children are overloaded with stress hormones?

They are in flight, fright, or freeze mode.They often have difficulty trusting adults or developing healthy relationships with peers (i.e., they become loners).

True or False "While substance abuse in older adults often goes unrecognized and therefore untreated, research indicates that currently available addiction treatment programs can be as effective for them as for younger adults (NIDA, 2018)."

True

True or False A relapse is a highly risky situation that could lead to overdose or death, in the least worsening conditions, but, in your efforts to recover, it should not be viewed as a failure, simply that more work needs to be done.

True

True or False Addiction changes the brain in fundamental ways, disturbing a person's normal hierarchy of needs and desires and substituting new priorities connected with procuring and using the drug. The resulting compulsive behaviors that weaken the ability to control impulses, despite the negative consequences, are similar to hallmarks of other mental illnesses.

True

True or False Alcohol use is a common and risky behavior among adolescents in the United States. More than 3 in 5 high school students reporting having had at least one drink. Fortunately, alcohol use has decreased over the past decade.

True

True or False Although people 65 years of age and older comprise only 13% of the population, they account for almost 30% of all medications prescribed in the United States (NCADD, n.d.).

True

True or False As sensitivity increases, specificity often decreases and vice versa

True

True or False Counseling and behavioral therapies according to the SAMHSA, "share a number of basic elements, including teaching clients to recognize high‐risk situations that may lead to relapse, preparing them to meet those high‐risk situations, and helping them develop balance and alternative ways of coping with stressful situations."

True

True or False Coupled with counseling and behavioral therapies, many services of an addiction treatment program come together to help addicts avoid relapse and prepare for the future in case they occur.

True

True or False Education, awareness, and practicing coping skills increase the capability of resisting relapse. In these group sessions, members can practice with each other and see how different approaches are effectively used by others to live a stabilized lifestyle through behavioral changes and mitigated risks.

True

True or False Like many other chronic illnesses, addiction is a chronic, relapsing, brain disease that, while treatable, is almost never cured

True

True or False Marijuana use is more common among older adolescents than younger youth.

True

True or False Medication is processed differently later in life due to the body changes that occur as we age. -Less lean muscle -More body fat This leads to the substances staying in the body longer.Benzodiazepines are the best example of this as they are fat soluble drugs and highly prescribed to the elderly

True

True or False Million of adolescents and adults are affected by co-occurring mental health disorders that were either caused by the substance abuse or were underlying causes of it leading to long-term relapse vulnerabilities.

True

True or False Mixing substances increase the potency of the overall effects for older adults?

True

True or False Public information and education have been the key components of most AOD prevention programs.

True

True or False Real life experiences and feedbacks from others in addiction recovery cannot be outdone when it comes to reducing isolation and serving as support for addicts who have diminished communication channels elsewhere.

True

True or False Relatively low amount of seniors use medical marijuana overall. The number of seniors using medical marijuana is increasing quickly (Ehrenfeld, 2017).

True

True or False Studies have demonstrated that members of the LGBT community suffer a significantly higher incidence of drug addiction. According to the Center for American Progress, an independent, nonpartisan policy institute, an estimated 20 to 30 percent of gay and transgender people abuse substances, compared to about nine percent of the general population.

True

True or False The LGBT community seek treatment at a significantly higher rate than their heterosexual counterparts.

True

True or False The United States Military does not condone the illegal or improper use of drugs or alcohol. If military personnel use or abuse illegal drugs or alcohol, they risk national security, due to their lower level of mission readiness.

True

True or False The alterations in the physical structure and physiological functioning of the brain from exposure to psychoactive substances increases the person's susceptibility to anxiety, depression, stress, negativity, mood swings, sleep disorders, behavioral disorders, cognitive disorders, and suicidal or violent tendencies.

True

True or False Tobacco use by adolescents and young adults has declined substantially over the past 40 years. As of 2014, more teenagers used electronic cigarettes (e-cigarettes) than smoke tobacco cigarettes.

True

True or False Unlike drinking alcohol or smoking tobacco currently marijuana use among adolescents has increased in the last ten years for students in 12th grade.

True

True or False One of the most problematic situations of drug abusers in recovery is that the brain "remembers" the good feelings that were experienced from the drug effects and the rewards associated with use despite persistent efforts to try and forget.

True

How does DAST work?

Used to screen for problems other than alcohol.

What is substance-exposed newborn according to the child maltreatment index?

When a child is exposed to a controlled substance or alcohol prenatally is established by: a test, administered at birth, a diagnosis of Neonatal Abstinence Syndrome or Fetal Alcohol Syndrome Disorder, or knowledge or suspicion by medical personnel or hospital staff that an infant was exposed to a substance

What is DJJ Involvement: Juvenile Justice Process?

When adolescents break the law they are "taken into custody" rather than arrested. They will then face one of several different outcomes. They may be sentenced to a diversion program, they may be referred to adult court if charged with a crime as an adult, or they may be referred to JDAI. JDAI is an initiative that aims to move low risk youth from secure detention into community based alternative programs. If one of these three options is not used, youth may be referred for a DRAI assessment to determine if the youth meets detention criteria and whether they will be placed in secure, non-secure, or home detention. Youth will then either be placed in secure detention until their next court date or be released and await their next court date at home. The case will end in one of three ways. The case could be dismissed and the youth will be released. The state attorney could decide to withhold adjudication and place the youth on community supervision. If the youth is adjudicated guilty they may be committed or be placed on community supervision. If adjudication is withheld or the youth is adjudicated guilty they will either be ordered into residential treatment, or work with Juvenile Probation Officers (JPO) and case managers to create a plan of goals and actions. Ultimately the youth will be released at some point.

Is relapse apart of recovery?

Yes

Is the ecological approach effective in substance abuse prevention?

Yes

Are grandparents likely to be guardians of their grandchildren?

Yes, the 2000 U.S. Census reported that 2.4 million grandparents are the primary caregivers to their grandchildren

Does older adults social stage of life lead to the need to use substances or use more substances?

Yes, those stages include •Generativity vs. Stagnation •Ego integrity vs. Despair

Is tobacco still a problem in the U.S.?

Yes... -Leading cause of death in the U.S. -The greatest cause of preventable disease and premature death -Smoking kills more ppl then alcohol, AIDS, car accidents, drugs, murders, and suicides combined -Cost American economy over $100 billion a year in healthcare cost

What is motivational interviewing?

a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence."

What is neonatal abstinence syndrome (NAS)?

a group of conditions caused when a baby withdraws from certain drugs he's exposed to in the womb before birth. NAS is most often caused when a woman takes drugs called opioids during pregnancy.

How is recovery from substance misuse achieved?

abstinence is essential to relapse prevention and recovery can be achieved only when patients change their attitudes and behaviors that led to and or were associated with drug use

What are the psychological changes of middle adolescence?

abstract thought, bulletproof thinking, identity development: questioning morals, religion, society structure. Prepping for college/career. Reactions to physical changes including late maturation.

What does the adjuster/lost child do?

behaves apathetically to distance self from pain; passively withdraws from upsetting situations; hurting but attempts to avoid feeling the pain by refusing to confront the addiction or its consequences.

What is a false positive in screening instruments?

characterize individuals as having a substance abuse problem when that is not the case

How can prenatal exposure of other substances effect the developing fetus?

cocaine or marijuana use during pregnancy may result in premature birth, low birth weight, decreased head circumference, or miscarriage. Prenatal exposure to marijuana has been associated with difficulties in functioning of the brain. Even if there are no noticeable effects in the children at birth, the impact of prenatal substance use often can become evident later in their lives. As they get older, children who were exposed to cocaine prenatally can have difficulty focusing their attention, be more irritable, and have more behavioral problems. Difficulties surface in sorting out relevant versus irrelevant stimuli, making school participation and achievement more challenging.

What are the psychological changes of adolescence?

concrete thinking, reactions to physical changes including early maturation, increased body awareness/modesty, moodiness, sexual identity development.

What are the social changes of late adolescence?

development of intimate relationships. Renewed interest in culture/tradition. vocational capability and possible beginning of financial independence. This is usually the traditional age for college.

What does the scapegoat/rebel do?

draws attention away from the family's primary problem of dependency through delinquency or other misbehavior; reacts to feeling trapped by the situation at home by poor school performance, hostility and other behavior problems.

What are the biological changes of late adolescence?

end of puberty

What is the purpose of relapse prevention groups according to SAMHSA?

help clients maintain their sobriety by providing them with the skills and knowledge to "anticipate, identify, and manage high‐risk situations" that lead to relapse into substance use "while also making security preparations for their future by striving for broader life balance.

What are the social changes of middle adolescence?

more focus on peer groups, beginning of romantic relationships, increased health risk from (smoking, alcohol, drugs, etc)

How many drinks per day must occur to be considered heavy drinking?

more than 2 standard drinks/day (male) or more than 1 standard drink/day (female)

What does the rescuer/enabler do?

often steps in to save the addict, bails the addict out, makes excuses or fills in for the addict. Shielding the addict from consequences of substance abuse makes it easier for the addict to continue using.

What is the most prescribed reason for medical marijuana in older adults?

pain and seniors experience the most pain. Thus, many seniors prefer to try it over opioids (Ehrenfeld, 2017).

What are benzodiazepines used for?

prescribed to treat anxiety, acute stress reactions, and panic attacks.

What are the primary triggers for relapse?

re-exposure to the drug, environments, people, and things associated with substance use, cravings, stress, and lasting physiological changes to brain systems that mediate the effects of these triggers.

What is tobacco dependence?

the chronic condition with periods of remission and relapse

What is the War on Drugs?

the effort in the United States since the 1970s to combat illegal drug use by greatly increasing penalties, enforcement, and incarceration for drug offenders.

What is relapse?

the recurrence of a prior condition, usually representing a negative connotation such as the return of an illness after a period of improvement, or also, in the context of substance abuse, the re-initiation of drug-seeking behaviors and the resumption of use after a period of abstinence.

What is prescription drug use?

the use of a prescription medication in a way not intended by the prescribing doctor. It includes everything from taking a friends prescription painkiller for your backache to snorting ground-up pills to get high

What are barbiturates used for?

to treat anxiety, tension, and sleep disorders.

What are Amphetamines used for?

to treat narcolepsy and attention deficit disorder with hyperactivity (ADHD).

How does MAST work?

widely used; 25 self-administered items.

What are examples of outpatient substance misuse programs?

•Assessments using evidence based instruments- ASI-GAIN •Urine Screens* •MI* •Seeking Safety and/or other trauma EBPs •Relapse Prevention Techniques* •Psycho-educational support groups* •CBT counseling (depending on state/traditions etc). •Medications •Case management* •Technology •Connections to AA/NA

What are examples of central nervous system stimulants?

•Caffeine •Cocaine •Amphetamines •Methamphetamines •Amphetamine-like substances (e.g., Ritalin, Preludin, like ADHD meds) •Nicotine

What are the cons of the disease concept of addiction?

•Define addiction as an inevitable course of illness (and an inevitable course of treatment) •"Disease Concept" has expanded well beyond substance use/misuse into other compulsive behaviors

What situations and populations work with motivational interviewing?

•Eating disorders •Substance abuse •Risky behaviors •Use of safe water system •Dual diagnoses •Clinical psychiatry •Corrections •Couples •Groups •Adolescents •Treatment adherence

What are the key principles of motivational interviewing?

•Express Empathy •Support Self-Efficacy •Roll with Resistance •Develop Discrepancy

What should social workers consider for grandparents raising their grandchildren?

•Grandparents have increased stress and a decrease in overall health and are at risk of social isolation and depression. •Often puts a financial stain on families, many are already below the poverty line. •Often dealing with feelings of anger and guilt. •Have to learn how to parent children with higher rates of mental and behavioral health concerns than children who have not experienced trauma. •Have to become tech savvy to navigate the children's school, to apply for benefits, and to learn how to keep their children safe from social media. •Need to be made aware of secondary trauma.

In Florida what are the grandparents role in caregiving and child welfare?

•If the children are removed from the care of their parents by DCF and the case is transferred to case management voluntary kinship is not an option. •Grandparents become caregivers in a moment of crisis and after they pass background checks and a preliminary home study. •They are expected to participate in court hearings and meetings. •There are relative caregiver funds available through ACCESS. •There may is assistance for daycare. •Children under the states care are enrolled in a child welfare Medicaid plan. •Grandparents still have to get permission from the courts to travel with the child out of state, medical procedures involving anesthesia, when there are changes in psychotropic medications. •There are new state programs rolling out in January to provide additional assistance to relative and non-relative caregivers. •Many areas throughout Florida are beginning to hold support groups for grandparents raising their grandchildren.

What are substance use disorder trends in older adults?

•Life changes and stressors in late life can easily impel older adults to develop substance abuse disorders, or worsen symptoms of ongoing SUDs. •SUDs in older adults can manifest differently than in younger populations, and can be more difficult to identify. •SUDs in elderly populations can be far more dangerous considering the risk of alcohol and drug-related injuries, harmful medication interactions, and physical effects of long-term substance use(NCADD, n.d.).

What are treatment and continuity of care services important for social workers to be aware of?

•MI •Relapse Prevention Techniques •Integrated Dual-Diagnosis Treatment, Assertive Community Treatment •Harm Reduction •Multidimensional Family Therapeutic approaches •treatment and continuity of Care Services important for social workers to Be Aware of •Contingency Management •Trauma interventions (e.g., Seeking Safety, TREM), Intensive case-management and other case management models, supportive housing.

How are veterans affected by mental health problems?

•Many veterans enter the military with unaddressed mental health disorders. • While deployed, millions of veterans encounter traumatic experiences which can result in or worsen physical or mental injuries. •The most common mental health disorders amongst veterans are post-traumatic stress disorder, depression, and substance abuse disorder. •There were approximately 18.5 percent Iraq or Afghanistan veterans that battle PTSD or depression (Lynsen, 2014). •There is more than 11 percent of veterans that meet the criteria for substance use disorder (Teeters, Lancaster, Brown, & Back, 2017).

What are concerns for older adults and medical marijuana?

•Medical marijuana can slow the reaction time and balance of someone who takes it. Some doctors report falls being a major concern with the elderly due to them already being vulnerable to this concern (Ehrenfeld, 2017). •Medical marijuana is not very well studied in the elderly population. Thus, there are still unknown risks. •Federal law still states that medical marijuana is illegal. While state law permits in many state, doctors are in a difficult spot with being able to prescribe medical marijuana. There are still many legal issues to work out with medical marijuana (National Council for Aging Care, 2018).

What are factors that make older adults at risk for substance abuse?

•Mixing medications by using a prescribed medication borrowed from a friend •Taking more than intended or prescribed •Often use multiple medications •Liver and kidneys may not work as well •Increased sensitivity to many medications •Impaired memory and hearing and vision loss leading to confusing pills •Seeing different healthcare professionals (Medication management for older adults, 2017)

What is the systematic review of relapse prevention?

•Multiple countries, large range of populations increases length of days of abstinence, reduces days of relapse. Increases treatment seeking •Caveat: so often used with other EBPs that it may be difficult to assess intervention effects. Tested in numerous adaptations

What is the systematic review of harm reduction approaches?

•Needle-exchange: Reduces HIV transmission, increases treatment entry. •Methadone/Buprenorphine: Reduces criminal activity-likelihood of entering prison. •Narcan/Naloxone: Reduces overdose deaths. •Some evidence that teaching adolescents harm-reduction approaches to AOD use reduces DUIs, mortality due to AOD use and chronic AOD disorder.

What are key therapist behaviors during motivational interviewing?

•Seeking to understand the person's frame of reference, particularly via reflective listening •Expressing acceptance and affirmation •Eliciting and selectively reinforcing the client's own self motivational statements expressions of problem recognition, concern, desire and intention to change, and ability to change •Monitoring the client's degree of readiness to change, and ensuring that resistance is not generated by jumping ahead of the client •Affirming the client's freedom of choice and self-direction

Why are older adults misdiagnosed?

•Social isolation •Ageism, prejudice of how an older adult should be using substances •Other health issues with similar symptoms (American Addiction Centers, n.d.)

What are the signs and symptoms of SUDs in Older Adult Populations?

•Solitary or secretive drinking. •A ritual of drinking before, with, or after dinner. •A loss of interest in hobbies or pleasurable activities. •Drinking in spite of warning labels on prescription drugs. •Immediate and frequent use of tranquilizers. •Slurred speech, empty liquor and beer bottles, smell of alcohol on breath, change in personal appearance. •Chronic and unsupported health complaints. •Hostility or depression. •Memory loss and confusion (NCADD, n.d.).

What are the differences in treatment for younger and older adults?

•Stigma of the addiction due to it being more taboo in their younger years •Often feel like "mom" or "dad" in younger group therapies •Life stage may lead to depression, pain, and suffering that substance abuse fixes for them •Social isolation also attributes to depression (Kuehn, 2015)

What is the systematic review of motivational interviewing (MI)?

•Tested in multiple countries, multiple populations, reduces treatment drop-out, extends treatment stay. •Caveat: so often used with other EBPs that it may be difficult to assess intervention effects. Tested in numerous adaptations.

What is the systematic review of seeking safety?

•Tested in multiple countries, with a range of populations: increases safe (mental health, sexual, and AOD behaviors). •Caveat: new research studies is testing this EBP using numerous adaptions

Is medical marijuana cost effective for older adults?

•The average senior will spend $3,000 on prescriptions per year. However, medical marijuana is only about $650 a year. Thus, many seniors want to try it for the cost benefit (National Council for Aging Care, 2018)

What are trends in substance use disorders for older adults?

•There are 2.5 million older adults with an alcohol or drug problem. •Adults aged 50-59 now largest age group in opioid treatment programs (Han et al., 2015). •6-11% percent of elderly hospital admissions are a result of alcohol or drug problems — 14 percent of elderly emergency room admissions, and 20 percent of elderly psychiatric hospital admissions. •Widowers over the age of 75 have the highest rate of alcoholism in the U.S. •Nearly 50% of nursing home residents have alcohol related problems. •Older adults are hospitalized as often for alcoholic related problems as for heart attacks. •Nearly 17 million prescriptions for tranquilizers are prescribed for older adults each year. Benzodiazepines, a type of tranquilizing drug, are the most commonly misused and abused prescription medications (NCADD, n.d.).

How do veterans cope?

•There is approximately 50 percent of veterans that voluntarily seek professional treatment (Lynsen, 2014). •Many veterans self-medicate, including substance abuse. •Substance abuse among veterans has significantly increased over time. •Alcoholism is more prevalent among veterans. •Veterans engage in PTSD support groups •Connect back with civilians

What are the National Institution on Drug Abuse (NIDA) treatment principles?

•Treatment needs to be readily available. •Remaining in treatment for an adequate period of time is critical. •Counseling—individual and/or group—and other behavioral therapies are the most commonly used forms of drug abuse treatment. •Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. •An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.

What are examples of residential substance misuse programs?

•Urine screening •Minnesota- or standard 12 step (work) •Assessment - ASI-GAIN, AUDIT, etc •Groups: acknowledging your addiction, trauma support (seeking safety, ...) •Relapse prevention techniques •Case management •Contingency management

What does medical marijuana treat in older adults?

•treats arthritis pain and nerve damage pain. These are very common and chronic issues for the elderly (National Council for Aging Care, 2018)

How does substance abuse affect the family?

-Basic needs of children often overlooked -Impairment while high/intoxicated -Use of limited family resources on alcohol or drugs -Time spent seeking out alcohol or drugs -Time spent using alcohol or drugs -Co-occurring other problems: mental health, health, or poverty

What factors in the last 12 months of using substances indicates substance abuse?

-Effects seriously interfered with health, work or social functioning -Person has engaged in hazardous activity on a recurring basis, such as driving or operating machinery under the influence -Person has experience use related legal problems -Person has continued use despite ongoing or recurring problems caused or exacerbated by use, this includes a maladaptive pattern of use, such as binge drinking

How is substance misuse established according to the child maltreatment index?

-Evidence of extensive, abusive, and chronic use of a controlled substance or alcohol by a parent when the child is demonstrably adversely affected by such usage -Knowledge or suspicion that a parents ongoing use of a controlled substance or alcohol has resulted in harm or a threat of harm to a child

What are examples of inhalants?

-Glues -Freon -Spray paint -Whip-its -Keyboard cleaners

What are some other family conditions that often occur with substance abuse?

-Lack of knowledge about child development -Poor problem-solving and social skills -Low maternal affection -Poor attachment relationships -Poor attention to the needs of an infant -Disinterest in spending time with ones children -Social isolation -Mental health problems, especially depression -Anger toward or a lack of attention to one's children -Engagement in criminal behavior

What are the family roles in substance abusing families?

-Rescuer/Enabler -Hero/Caretaker -Adjuster/Lost Child -Scapegoat/Rebel -Mascots/Pleasers

What are protective factors for substance use and misuse?

-Self Control (Individual) -Parental Monitoring (Family) -Academic Competence (Peer) -Anti drug Use Policies (School) -Strong Neighborhood Attachment (Community)

How does substance abuse effect child maltreatment?

-Substance abuse may serve as a disinhibitor for the parent -Substance abuse can lead to illegal activity to support parental addiction -Substance Abuse can drain family resources -Substance abuse may impair child caring behaviors

What is the criteria for substance dependence?

-Tolerence -Withdrawal -Large amounts, longer period -Desire to cut back -Other activities given up or reduced -Continued use despite knowledge of problem

What do providers asses during screenings?

-Validity -Reliability -Suicidal ideation or other mental health issues.

What are the personal-professional dimensions of substance use?

-Views and experiences -Your viewpoint affects others -Unique -Discuss your issues

What do stimulants do to the body?

-create fake messages in the brain, telling the body that its under stress -blood to skin decreases; the body is less able to cool itself. Overheating is a risk -heart rate speeds up. Blood vessels to the heart constrict. -the liver releases sugar into the blood, reducing the body's energy stores -if real stress occurs, the body won't be able to respond

What do depressants do to your brain and body?

-slow messages between the body and brain -signals from the eyes and other senses reach the brain slowly -heart rate drops, leaving the body with less energizing oxygen -breathing rate decreases; risk of lung infection rises -messages to muscles are slower; arms and legs can't move well -the body can't sense or respond to danger quickly

How does POSIT work?

Assesses substance use as well as social, behavioral, and learning problems. 139 items; takes 20-30 minutes to complete.

How does gender effect alcohol use and differences in quantities consumed?

Differences in the quantities consumed between men and women relate to the different physiological responses to alcohol by gender. Women have a larger percentage of water in their bodies compared to men, and a woman will achieve a higher blood alcohol concentration (BAC) after drinking the same amount of alcohol as a man of similar weight.

What is fetal alcohol spectrum disorder?

Drinking alcohol during pregnancy can have serious effects on fetal development. Collectively, these defects are called Fetal Alcohol Syndrome (FAS) which is one of the most commonly known birth defects related to prenatal drug exposure. Children with FAS may exhibit: growth deficiencies, both prenatally and after birth; problems with central nervous system functioning; IQs in the mild to severe intellectual disabilities range ; small eye openings and poor development of the optic nerve; a small head and brain; and joint, limb, ear, and heart malformations.

The Child Maltreatment Index divides substance misuse which three areas?

First, the caregiver(s) inappropriately using drugs or alcohol. Second, a child inappropriately consuming or being given drugs or alcohol. Third, poisoning due to caregiver(s) actions or neglect.

How might a parent simply using a substance put a child at risk?

For example, a parent driving with children in the car while under the influence places a child at risk. Another example that we will focus on more in-depth later is a mother who uses drugs or alcohol during pregnancy. This can harm the fetus.

What is specificity in regard to screening instruments?

Increases the likelihood that people who do not have problems with alcohol or drugs will be classified correctly (true negatives), and minimizes the likelihood that people who have substance abuse problems will be misclassified as not having such a problem (false negatives)

Why is substance abuse is called a family disease?

It is... -A constant strain -Unemployment -Increasing stress levels -Arguing and hostility -Overall chaos -Anxiety, confusion, and conflict among the children

What age do people often first use drugs?

Middle to late adolescence

What do solvents do?

Produce effects similar to CNS depressants and hallucinogens when vapor is inhaled

What is the definition of reliability?

Refers to whether a test produces the same results with the same person at a different time and under different circumstances.

What is the definition of validity?

Refers to whether an instrument measures what one wants it to measure.

How does CAGE work?

Shortest and most widely used screening instrument. Two or more positive responses generally indicate issue. Effective for screening adults with alcohol problems, CAGE-AID adapted to include drug use.

Why is the concept of addiction being a disease a heated debate?

Some feel that people have a choice to use or not use drugs. Everyone has a viewpoint with regard to addiction that is often based on personal experiences.

How many of the criteria must a person fit to be considered to have a substance dependence?

Three or more

Can children overloaded with stress hormones become substance misusers?

To relieve their anxiety, depression, guilt, shame, and/or inability to focus, they turn to easily available biochemical solutions — nicotine, alcohol, marijuana, methamphetamine — or activities in which they can escape their problems — high-risk sports, proliferation of sex partners, and work/over- achievement.

True or False 23.9 million Americans report being current users of illicit drugs.

True

True or False A person's battle with addiction is usually closely tied to the personal relationships he or she has with family members

True

True or False Heavy drinkers only make up 6.5% of the drinking population

True

True or False Legal drugs are more widely used (alcohol and tobacco) and

True

True or False Marijuana is the most popular illicit drug

True

True or False More than 6 million children (9% of children in the US) lived with at least one parent or family member who abused or was dependent on alcohol or illicit drugs last year

True

True or False Slightly more than half (52.1) of all Americans aged 12 and older reported being current users of alcohol as of 2012

True

True or False The person's loss of control in limiting the use of the addictive substance is a major hallmark of addiction.

True

True or False When a person is addicted, he/she engages in compulsive behavior, even when faced with negative consequences.

True

True or False Addiction is a disease with its own psychopathology characterized by compulsion, loss of control, and continued use in spite of adverse consequences.

True

True or False One in four children under 18 will live with a family member who is a alcoholic or dependent on alcohol

True

True or False Over 22 million adults over 18 are dependent on alcohol or other drugs

True

True or False Prescription drug abuse is the most rapidly escalating form of substance abuse.

True

What is the definition of addiction or substance dependence?

a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three or more of the criteria for substance dependence

What does the mascot/pleaser do?

also draws attention away from the family by trying to please, by acting in a humorous way like being "the clown."

What is the definition of tolerance?

either a need for markedly increased amounts of the substance to achieve intoxication or the desired effect, or markedly diminished effect with continued use of the same amount of the substance.

What is the definition of withdrawal?

the characteristic withdrawal syndrome for the substance, or the same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.The substance is often taken in larger amounts or over a longer period than intended. There is a persistent desire or unsuccessful efforts to cut down or control substance use. A great deal of time is spent in activities necessary to obtain the substance (such as visiting multiple doctors or driving long distances), use the substance (for example, chain-smoking), or recover from its effects. Important social, occupational or recreational activities are given up or reduced because of substance use. The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance.

What does the hero/caretaker do?

tries to divert attention away from the problem by being too good to be true, secretly hoping that exemplary behavior will somehow make it easier for the addict to stop using. High achievers who do everything to assure that the addict has as little responsibility as possible, minimizing the possibilities for trouble to occur.

What is substance misuse according to the child maltreatment index?

when a parent purposely gives a child substances that substantially affect the child's behavior, motor coordination or judgment, or that result in sickness or internal injury. Substance misuse also occurs when the caregiver exceeds the proper dosage for drugs and the drug substantially affects the child's behavior, motor coordination or judgment, or when the child sustains an internal injury from the drug.

What does the data taken from the 2012 National Survey on Drug Use & Health (SAMHSA) say about kids current alcohol use?

•12-13 y/o - 2.2% •14-15 y/o - 11.1% •16-17 y/o - 24.8% •12 - 17 y/o - 12.9%

What are examples of opiates?

•Heroin •Morphine •Codeine •Opioids •Synthetic morphine-like substances (e.g., pethidine, methadone, dipipanone)

What are examples of hallucinogens?

•Lysergic acid diethylamide (LSD) •Mescaline •Magic mushrooms (psilocybin) • Peyote • MDMA • Psilocybin

What does current illicit drug use among 12-17 year olds look like?

•Marijuana = 7.2% •Psychotherapeutics = 2.8% •Inhalants = 0.8% •Hallucinogens = 0.6% •Any Illicit Drugs = 9.5%

What are the pros of the disease concept of addiction?

•Moved addiction away from a moral issue made it more of a health issue •As a health issue, it is eligible for insurance reimbursement


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