5 Substance-Related, Addictive, and Impulse-Control Disorders Flashcards
The term _____ refers to chemical compounds that are ingested to alter mood or behavior.
substance
_____ substances alter mood, behavior, or both.
Psychoactive
In one definition, the person is physiologically dependent on the drug or drugs, requires increasingly greater amounts of the drug to experience the same effect (tolerance), and will respond physically in a negative way when the substance is no longer ingested (withdrawal).
addiction, or substance dependence
In early editions of the DSM, alcoholism and drug abuse weren’t treated as separate disorders. Instead, they were categorized as “_____ personality disturbances”—a forerunner of the current antisocial personality disorder, because substance use was seen as a symptom of other problems.
sociopathic
Antisocial personality disorder was considered a sign of _____, and the influence of genetics and biology was hardly acknowledged.
moral weakness
We have grouped the substances into six general categories:
- Depressants
- Stimulants
- Opiates
- Hallucinogens
- Other Drugs of Abuse
- Gambling Disorder
These substances result in behavioral sedation and can induce relaxation. They include alcohol (ethyl alcohol) and the sedative and hypnotic drugs in the families of barbiturates (for example, Seconal) and benzodiazepines (for example, Valium, Xanax).
Depressants
These substances cause us to be more active and alert and can elevate mood. Included in this group are amphetamines, cocaine, nicotine, and caffeine.
Stimulants
The major effect of these substances is to produce analgesia temporarily (reduce pain) and euphoria. Heroin, opium, codeine, and morphine are included in this group.
Opiates
These substances alter sensory perception and can produce delusions, paranoia, and hallucinations. Cannabis and LSD are included in this category.
Hallucinogens
Other substances that are abused but do not fit neatly into one of the categories here include inhalants (for example, airplane glue), anabolic steroids, and other over-the-counter and prescription medications (for example, nitrous oxide). These substances produce a variety of psychoactive effects that are characteristic of the substances described in the previous categories.
Other Drugs of Abuse
As with the ingestion of the substances just described, individuals who display gambling disorder are unable to resist the urge to gamble which, in turn, results in negative personal consequences (e.g., divorce, loss of employment).
Gambling Disorder
These substances are among those most likely to produce symptoms of physical dependence, tolerance, and withdrawal.
Depressants
A. A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
1. Alcohol is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use
3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol,
or recover from its effects.
4. Craving, or a strong desire or urge to use alcohol.
5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use
8. Recurrent alcohol use in situations in which it is physically hazardous
9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
10. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
b. A markedly diminished effect with continued use of the same amount of alcohol.
11. Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for alcohol (refer to Criteria A and B of the criteria set for alcohol withdrawal, pp. 499-500).
b. Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
Specify if:
In early remission: After full criteria for alcohol use disorder were previously met, none of the criteria for alcohol use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use alcohol,” may be met).
or urge to use alcohol,” may be met).
In sustained remission: After full criteria for alcohol use disorder were previously met, none of the criteria for alcohol use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use alcohol,” may be met).
Specify if:
In a controlled environment: This additional specifier is used if the individual is in an environment where access to alcohol is restricted
Alcohol Use Disorder
Apparent _____ is the initial effect of alcohol, although it is a depressant. We generally experience a feeling of well-being, our inhibitions are reduced, and we become more outgoing
stimulation
_____, the loss of memory for what happens during intoxication, may result from the interaction of alcohol with the glutamate system.
Blackouts
The _____ system also appears to be sensitive to alcohol. This neurotransmitter system affects mood, sleep, and eating behavior and is thought to be responsible for alcohol cravings.
serotonin
More seriously, two types of organic brain syndromes may result from long-term heavy alcohol use: _____ and Wernicke- Korsakoff syndrome
dementia
_____, (or neurocognitive disorder), involves the general loss of intellectual abilities and can be a direct result of neurotoxicity or “poisoning of the brain” by excessive amounts of alcohol.
Dementia
_____ syndrome results in confusion, loss of muscle coordination, and unintelligible speech; it is believed to be caused by a deficiency of thiamine, a vitamin metabolized poorly by heavy drinkers
Wernicke-Korsakoff
_____ is now generally recognized as a combination of problems that can occur in a child whose mother drank while she was pregnant.
Fetal alcohol syndrome (FAS)
These problems include fetal growth retardation, cognitive deficits, behavior problems, and learning difficulties. In addition, children with FAS often have characteristic facial features.
Physical characteristics of fetal alcohol syndrome (FAS) include skin folds at the corners of the eyes, low nasal bridge, short nose, groove between nose and upper lip, small head circumference, small eye opening, small midface, and thin upper lip.
Fetal alcohol syndrome (FAS)
According to his model, individuals go through a prealcoholic stage (drinking occasionally with few serious consequences), a prodromal stage (drinking heavily but with few outward signs of a problem), a crucial stage (loss of control, with occasional binges), and a chronic stage (the primary daily activities involve getting and drinking alcohol).
_____ four-stage model for the progression of alcoholism
Jellinek
Alcohol does not cause _____, but it may increase a person’s likelihood of engaging in impulsive acts and it may impair the ability to consider the consequences of acting impulsively.
aggression
A. A problematic pattern of _____ use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
1. Sedatives, hypnotics, or anxiolytics are often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control _____ use.
3. A great deal of time is spent in activities necessary to obtain the _____; use the _____; or recover from its effects.
4. Craving, or a strong desire or urge to use the _____.
5. Recurrent _____ use resulting in a failure to fulfill major
role obligations at work, school, or home (e.g., repeated absences from work or poor work performance related to _____ use; sedative-, hypnotic-, or anxiolytic-related absences, suspensions, or expulsions from school; neglect of children or household).
6. Continued _____ use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of sedatives, hypnotics, or anxiolytics (e.g., arguments with a spouse about consequences of intoxication; physical fights).
7. Important social, occupational, or recreational activities are given up or reduced because of _____ use.
8. Recurrent _____ use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by _____ use).
9. _____ use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the _____.
10. Tolerance, as defined by either of the following;
a. A need for markedly increased amounts of the _____ to achieve intoxication or desired effect.
b. A markedly diminished effect with continued use of the same amount of the _____.
Note: This criterion is not considered to be met for individuals taking sedatives, hypnotics, or anxiolytics under medical supervision.
11. Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for sedatives, hypnotics, or anxiolytics (refer to Criteria A and B of the criteria set for _____ withdrawal, pp. 557-558).
b. Sedatives, hypnotics, or anxiolytics (or a closely related substance, such as alcohol) are taken to relieve or avoid withdrawal symptoms.
Note: This criterion is not considered to be met for individuals taking sedatives, hypnotics, or anxiolytics under medical supervision.
Specify if:
In early remission: After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met for at least 3 months but for less than 12 months
In sustained remission: After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met at any time during a period of 12 months or longer
Specify if:
In a controlled environment: This additional specifier is used if the individual is in an environment where access to sedatives, hypnotics, or anxiolytics is restricted.
Sedative, Hypnotic, or Anxiolytic Use Disorder
The general group of depressants also includes sedative (calming), hypnotic (sleep-inducing), and anxiolytic (anxiety-reducing) drugs.
_____ (which include Amytal, Seconal, and Nembutal) are a family of sedative drugs first synthesized in Germany in 1882. They were prescribed to help people sleep and replaced such drugs as alcohol and opium.
Barbiturates
Barbiturate use has declined and benzodiazepine use has increased since _____.
1960
Included in this group are caffeine (in coffee, chocolate, and many soft drinks), nicotine (in tobacco products such as cigarettes), amphetamines, and cocaine. You probably used caffeine when you got up this morning. In contrast to the depressant drugs, _____—as their name suggests— make you more alert and energetic
Stimulants
A. A pattern of amphetamine-type substance, cocaine, or other _____ use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
1. The _____ is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control _____ use.
3. A great deal of time is spent in activities necessary to obtain the _____, use the _____, or recover from its effects.
4. Craving, or a strong desire or urge to use the _____.
5. Recurrent _____use resulting in a failure to fulfill major role obligations at work, school, or home.
6. Continued _____use despite having persistent or recurrent social or inteφersonal problems caused or exacerbated by the effects of the _____.
7. Important social, occupational, or recreational activities are given up or reduced because of _____ use.
8. Recurrent _____ use in situations in which it is physically hazardous.
9. _____ use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the _____.
10. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of the _____ to achieve intoxication or desired effect.
b. A markedly diminished effect with continued use of the same amount of the _____.
Note: This criterion is not considered to be met for those taking _____medications solely under appropriate medical supervision, such as medications for attention-deficit/hyperactivity disorder or narcolepsy.
11. Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for the _____ (refer to Criteria A and B of the criteria set for _____ withdrawal, p. 569).
b. The _____ (or a closely related substance) is taken to relieve or avoid withdrawal symptoms
Note; This criterion is not considered to be met for those taking _____ medications solely under appropriate medical supervision, such as medications for attention-deficit hyperactivity disorder or narcolepsy.
Specify if:
In early remission: After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the _____,” may be met).
In sustained remission: After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the _____,” may be met).
Specify if:
In a controlled environment: This additional specifier is used if the individual is in an environment where access to _____ is restricted
Stimulant-Related Disorders
At low doses, amphetamines can induce feelings of elation and vigor and can reduce fatigue. You feel “up”. After a period of elevation, however, you come back down and “crash,” feeling depressed or tired.
_____ are manufactured in laboratories; they were first synthesized in 1887 and later used as a treatment for asthma and as a nasal decongestant.
also, reduce appetite, some people take them to lose weight.
Amphetamines
A. A problematic pattern of _____ use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
- _____ is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control _____ use.
- A great deal of time is spent in activities necessary to obtain or use _____.
- Craving, or a strong desire or urge to use _____.
- Recurrent _____ use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., interference with work).
- Continued _____ use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of _____ (e.g., arguments with others about _____ use).
- important social, occupational, or recreational activities are given up or reduced because of _____ use.
- Recurrent _____ use in situations in which it is physically hazardous (e.g., smoking in bed).
- _____ use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by _____.
- Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of _____ to achieve the desired effect.
b. A markedly diminished effect with continued use of the same amount of _____. - Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for _____ (refer to Criteria A and B of the criteria set for _____ withdrawal).
b. _____ (or a closely related substance, such as nicotine) is taken to relieve or avoid withdrawal symptoms.
Specify if:
In early remission: After full criteria for _____ use disorder were previously met,
none of the criteria for _____ use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use _____,” may be met).
In sustained remission: After full criteria for _____ use disorder were previously
met, none of the criteria for _____ use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use _____,” may be met).
Coding based on current severity: Note for ICD-10-CM codes; If a _____ withdrawal or _____-induced sleep disorder is also present, do not use the codes below for _____ use disorder. Instead, the comorbid _____ use disorder is indicated in the 4th character of the _____-induced disorder code (see the coding note for _____ withdrawal or _____ induced sleep disorder). For example, if there is comorbid _____-induced sleep disorder and _____ use disorder, only the _____-induced sleep disorder code is given, with the 4th character indicating whether the comorbid _____ use disorder is moderate or severe: F17.208 for moderate or severe _____ use disorder with _____-induced sleep disorder. It is not permissible to code a comorbid mild _____ use disorder with a _____-induced sleep disorder.
Specify current severity:
- 1 (Z72.0) Mild: Presence of 2-3 symptoms.
- 1 (F I7.200) Moderate: Presence of 4-5 symptoms.
- 1 (F I 7.200) Severe: Presence of 6 or more symptoms
Tobacco Use Disorder
A. Recent consumption of _____ (typically a high dose well in excess of 250 mg)
B. Five (or more) of the following signs or symptoms developing during, or shortly after, _____ use:
- Restlessness.
- Nervousness.
- Excitement.
- Insomnia.
- Flushed face.
- Diuresis—ihi nang ihi
- Gastrointestinal disturbance.
- Muscle twitching.
- Rambling flow of thought and speech.
- Tachycardia or cardiac arrhythmia—heart rate over 100 beats per minute
- Periods of inexhaustibility.
- Psychomotor agitation.
C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance.
Caffeine Intoxication
_____ is the most common of the psychoactive substances, used regularly by almost 90% of all Americans.
Caffeine
A. A problematic pattern of _____ use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
1. _____ are often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control _____ use.
3. A great deal of time is spent in activities necessary to obtain the _____ , use the _____ , or recover from its effects.
4. Craving, or a strong desire or urge to use _____.
5. Recurrent _____ use resulting in a failure to fulfill major role obligations at work, school, or home.
6. Continued _____ use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of _____.
7. Important social, occupational, or recreational activities are given up or reduced because of _____ use.
8. Recurrent _____ use in situations in which it is physically hazardous.
9. Continued _____ use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
10. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of _____ to achieve intoxication or desired effect.
b. A markedly diminished effect with continued use of the same amount of an _____
Note: This criterion is not considered to be met for those taking _____ solely under appropriate medical supervision.
11. Withdrawal, as manifested by either of the following:
a. The characteristic _____ withdrawal syndrome (refer to Criteria A and B of the criteria set for _____ withdrawal, pp. 547-548).
b. _____ (or a closely related substance) are taken to relieve or avoid withdrawal symptoms.
Note: This criterion is not considered to be met for those individuals taking _____
solely under appropriate medical supervision.
Specify if:
In early remission: After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use _____,” may be met).
In sustained remission: After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met at any time during a period
of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use _____,” may be met).
Specify if: On maintenance therapy: This additional specifier is used if the individual is taking a prescribed agonist medication such as methadone or buprenorphine and none of the criteria for \_\_\_\_\_ use disorder have been met for that class of medication (except tolerance to, or withdrawal from, the agonist). This category also applies to those Individuals being maintained on a partial agonist, an agonist/antagonist, or a full antagonist such as oral naltrexone or depot naltrexone. In a controlled environment: This additional specifier is used if the individual is in an environment where access to \_\_\_\_\_ is restricted.
Coding based on current severity: Note for ICD-10-CM codes: If an _____ intoxication, _____ withdrawal, or another _____-induced mental disorder is also present, do not use the codes below for _____ use disorder. Instead, the comorbid _____ use disorder is indicated in the 4th character of the _____-induced disorder code (see the coding note for _____ intoxication, _____ withdrawal, or a specific _____-induced mental disorder). For example, if there is comorbid _____-induced depressive disorder and _____ use disorder,
only the _____-induced depressive disorder code is given, with the 4th character indicating whether the comorbid _____ use disorder is mild, moderate, or severe: F11.14 for mild _____ use disorder with _____-induced depressive disorder or F11.24 for a moderate or severe _____ use disorder with _____-induced depressive disorder.
Specify current severity:
305.50 (F11.10) Mild: Presence of 2 -3 symptoms.
304.00 (F11.20) Moderate: Presence of 4-5 symptoms.
304.00 (F11.20) Severe: Presence of 6 or more symptoms
Opioid Use Disorder
High doses can lead to death if respiration is completely depressed.
Opiates
_____—the most commonly abused opiate.
Heroin
A. A problematic pattern of _____ use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
1. _____ is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control _____ use.
3. A great deal of time is spent in activities necessary to obtain _____, use _____, or recover from its effects.
4. Craving, or a strong desire or urge to use _____.
5. Recurrent _____ use resulting in a failure to fulfill major role obligations at work, school, or home.
6. Continued _____ use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of _____.
7. Important social, occupational, or recreational activities are given up or reduced because of _____ use.
8. Recurrent _____ use in situations in which it is physically hazardous.
9. _____ use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by _____.
10. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of _____ to achieve intoxication or desired effect.
b. Markedly diminished effect with continued use of the same amount of _____.
11. Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for _____ (refer to Criteria A and B of the criteria set for _____ withdrawal, pp. 517-518).
b. _____ (or a closely related substance) is taken to relieve or avoid withdrawal
symptoms.
Specify if:
In early remission: After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use _____,” may be met).
In sustained remission; After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use _____,” may be present).
Specify if:
In a controlled environment: This additional specifier is used if the individual is in an environment where access to _____ is restricted.
Code based on current severity: Note for ICD-10-CM codes: If a _____ intoxication, _____ withdrawal, or another _____-induced mental disorder is also present, do not use the codes below for _____ use disorder. Instead, the comorbid _____ use disorder is indicated in the 4th character of the _____-induced disorder code (see the coding note for _____ intoxication, _____ withdrawal, or a specific _____-induced mental disorder). For example, if there is comorbid _____-induced anxiety disorder and _____ use disorder, only the _____-induced anxiety disorder code is given, with the 4th character indicating whether the comorbid _____ use disorder is mild, moderate, or severe:
F12.180 for mild _____ use disorder with _____-induced anxiety disorder or F12.280 for a moderate or severe _____ use disorder with _____-induced anxiety disorder.
Specify current severity:
- 20 (F12.10) Mild: Presence of 2-3 symptoms.
- 30 (F12.20) Moderate: Presence of 4-5 symptoms.
- 30 (F12.20) Severe: Presence of 6 or more symptoms.
Cannabis Use Disorder
A. A problematic pattern of _____ (other than phencyclidine) use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
1. The _____ is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control _____ use.
3. A great deal of time is spent in activities necessary to obtain the _____, use the _____, or recover from its effects.
4. Craving, or a strong desire or urge to use the _____.
5. Recurrent _____ use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences from work or poor work performance related to _____ use; _____-related absences, suspensions, or expulsions from school; neglect of children or household).
6. Continued _____ use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the _____ (e.g., arguments with a spouse about consequences of intoxication; physical fights).
7. Important social, occupational, or recreational activities are given up or reduced because of _____ use.
8. Recurrent _____ use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by the _____).
9. _____ use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the _____.
10. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of the _____ to achieve intoxication or desired effect.
b. A markedly diminished effect with continued use of the same amount of the _____.
Note: Withdrawal symptoms and signs are not established for _____, and so this criterion does not apply
Specify the particular _____.
Specify if:
In early remission: After full criteria for other _____ use disorder were previously met, none of the criteria for other _____ use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the _____,” may be met).
In sustained remission: After full criteria for other _____ use disorder were previously met, none of the criteria for other _____ use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the _____,” may be met).
Specify if:
In a controlled environment: This additional specifier is used if the individual is in an environment where access to _____ is restricted.
Coding based on current severity: Note for ICD-10-CM codes: If a _____ intoxication or another _____-induced mental disorder is also present, do not use the codes below
for _____ use disorder. Instead, the comorbid _____ use disorder is indicated in the 4th character of the _____-induced disorder code (see the coding note for _____ intoxication or specific _____-induced mental disorder). For example, if there is
comorbid _____-induced psychotic disorder and _____ use disorder, only the _____-induced psychotic disorder code is given, with the 4th character indicating whether the comorbid _____ use disorder is mild, moderate, or severe: F16.159 for mild _____ use disorder with _____-induced psychotic disorder or F16.259 for a moderate or severe _____ use disorder with _____-induced psychotic disorder.
Specify current severity:
- 30 (FI 6.10) IWild: Presence of 2-3 symptoms.
- 50 (F16.20) Moderate: Presence of 4-5 symptoms.
- 50 (F16.20) Severe: Presence of 6 or more symptoms.
Other Hallucinogen Use Disorder
Albert _____ experienced the first recorded “trip” on LSD.
Hoffmann
LSD (d-lysergic acid diethylamide), sometimes referred to as “acid”, is the most common _____ drug.
hallucinogenic
A. A problematic pattern of use of a hydrocarbon-based _____ substance leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
- The _____ substance is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control use of the _____ substance.
- A great deal of time is spent in activities necessary to obtain the _____ substance, use it, or recover from its effects.
- Craving, or a strong desire or urge to use the _____ substance.
- Recurrent use of the _____ substance resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued use of the _____ substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.
- Important social, occupational, or recreational activities are given up or reduced because of use of the _____ substance.
- Recurrent use of the _____ substance in situations in which it is physically hazardous.
- Use of the _____ substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
- Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of the _____ substance to achieve intoxication or desired effect.
b. A markedly diminished effect with continued use of the same amount of the _____ substance.
Specify the particular _____: When possible, the particular substance involved should be named (e.g., “solvent use disorder’’).
Specify if:
in early remission: After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the _____ substance,” may be met).
In sustained remission: After full criteria for _____ use disorder were previously met, none of the criteria for _____ use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the _____ substance,” may be met).
Specify if:
In a controlled environment: This additional specifier is used if the individual is in an environment where access to _____ substances is restricted.
Coding based on current severity: Note for ICD-10-CM codes: If an _____ intoxication or another _____-induced mental disorder is also present, do not use the codes below for _____ use disorder. Instead, the comorbid _____ use disorder is indicated in the 4th character of the _____-induced disorder code (see the coding note for _____ intoxication or a specific _____-induced mental disorder). For example, if there is comorbid _____-induced depressive disorder and _____ use disorder, only the _____-induced depressive disorder code is given, with the 4th character indicating whether the comorbid _____ use disorder is mild, moderate, or severe: F18.14 for mild _____ use disorder
with _____-induced depressive disorder or FI 8.24 for a moderate or severe _____ use disorder with _____-induced depressive disorder.
Specify current severity:
- 90 (F18.10) Mild: Presence of 2-3 symptoms.
- 60 (F18.20) Moderate: Presence of 4-5 symptoms.
- 60 (FI 8.20) Severe: Presence of 6 or more symptoms
Inhalant Use Disorder
Drug abuse and dependence, once thought to be the result of _____ weakness, are now understood to be influenced by a combination of biological and psychosocial factors.
moral
_____, involves providing the person with a safe drug that has a chemical makeup similar to the addictive drug (therefore the name agonist).
Agonist substitution
In addition to looking for ways to block the euphoric effects of psychoactive drugs, clinicians in this area may prescribe drugs that make ingesting the abused substances extremely unpleasant.
Aversive Treatment
Obstacles to successful treatment for substance use and dependence include a lack of personal awareness that one has a problem and an unwillingness to change. An increasingly common intervention approach that directly addresses these needs is referred to as _____.
Motivational Enhancement Therapy (MET)
A. Persistent and recurrent problematic _____ behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:
- Needs to gamble with increasing amounts of money in order to achieve the desired excitement.
- Is restless or irritable when attempting to cut down or stop _____.
- Has made repeated unsuccessful efforts to control, cut back, or stop _____.
- Is often preoccupied with _____ (e.g., having persistent thoughts of reliving past _____ experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).
- Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
- After losing money _____, often returns another day to get even (“chasing” one’s losses).
- Lies to conceal the extent of involvement with _____.
- Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of _____.
- Relies on others to provide money to relieve desperate financial situations caused by _____.
B. The _____ behavior is not better explained by a manic episode
Specify if:
Episodic: Meeting diagnostic criteria at more than one time point, witli symptoms subsiding between periods of _____ disorder for at least several months.
Persistent: Experiencing continuous symptoms, to meet diagnostic criteria for multiple years.
Specify if:
in eariy remission: After full criteria for _____ disorder were previously met, none of the criteria for _____ disorder have been met for at least 3 months but for less than 12 months.
in sustained remission: After full criteria for _____ disorder were previously met, none of the criteria for _____ disorder have been met during a period of 12 months or longer.
Specify current severity:
Mild: 4-5 criteria met.
Moderate: 6-7 criteria met.
Severe: 8-9 criteria met.
Gambling Disorder
People with _____ have episodes in which they act on aggressive impulses that result in serious assaults or destruction of property
Intermittent Explosive Disorder
—a recurrent failure to resist urges to steal things that are not needed for personal use or their monetary value? This disorder appears to be rare, but it is not well studied, partly because of the stigma associated with identifying oneself as acting out this illegal behavior.
the person begins to feel a sense of tension just before stealing, which is followed by feelings of pleasure or relief while the theft is committed.
no memory (amnesia) about the act of shoplifting
Kleptomania
Some refer to kleptomania as an “_____” behavior, or a reaction on the part of some to relieve unpleasant feelings
antidepressant
—an impulse-control disorder that involves having an irresistible urge to set fires.
Again, the pattern parallels that of kleptomania, where the person feels a tension or arousal before setting a fire and a sense of gratification or relief while the fire burns.
Pyromania
