7: Substance Use Disorder Flashcards
what is the key indicator for substance use disorder?
substance use has to impair functioning in everyday life
what are examples of direct physical harm as a result of substance abuse
Liver, heart & lung damage, increased cancer risk
what are examples of indirect physical harm of substance use?
illness, injury, self-neglect, harm from risky behaviours (hepatitis, HIV, overdose)
what are 4 examples of indirect social/interpersonal harm of substance use?
Conflict with others (e.g. disapproving family members)
Exclusion / stigma
Poor educational attainment
Homelessness
what are examples of indirect mental health harm of substance use?
Transient psychosis (e.g. cannabis induced psychosis)
Depression & Anxiety (e.g. depressant effects of alcohol)
For people with established illness (e.g. psychosis)
More / worse symptoms
Poorer functioning
More relapses and hospitalisations
Increased suicidality; Aggression
what % of adults ages 16-59 have taken drugs at some point?
35%
what % of adults aged 16-59 have taken an illicit drug in the last year?
9%
what % of young adults aged 16 to 24 had taken an illicit drug in the last year & how many would be classed as frequent drug uses?
21%, 4.3%
what % of men and women have drunk alcohol in the past week?
65% of men and 50% of women
what % of men and women drink above the safe amount of alcohol in the past week?
38% of men and 19% of women
does NICE suggest getting people with mental health issues to stop using drugs completely
no, only reduce
what is the timeframe for early remission?
at least 3 but less than 12 months without substance use disorder criteria (except craving)
what is the timeframe for sustained remission?
Sustained remission is defined as at least 12 months without criteria (except craving).
what is the role of naltrexone and which drugs is it effective for?
reduces craving for alcohol
blocks effects of opioids in the brain (reducing pleasure)
what is the role of methadone?
reduces withdrawal symptoms
which family of drugs is there no pharmacological aid for?
amphetamines (& cannabis)
what does reducing substance use lead to in someone’s substance use journey
greater treatment adherence; fewer relapses & hospitalisations etc
what are the 5 predominant psychological interventions for substance use?
Motivational interventions (MI) – motivational interviewing
Cognitive Behavioural Therapy (CBT)
Contingency management (CM)
Family (systemic) therapy (FT)
Psychoeducation (PE)
what are the 5 goals of psychological assessment for substance use?
Patterns of use (what substances; when used; where; how much?)
History of use; previous treatment
Motives for use
Consequences (negative AND positive) – impact of use
Motivation to address problems
OVERALL: Seeks: To understand role played by substances in client’s life; identify factors maintaining substance use and obstacles to change / relapse risks
what does motivational interviewing seek to resolve?
ambivalence in patients towards their substance use - helping clients to understand how their substance use keeps them from achieving their goals and help them prepare to change
what is the theoretical underpinning of behaviour modification?
learning theory (positive and negative reinforcement)
what is contingency management?
abstinence maintenance technique:
incentivises and reinforces abstinence with the aid of vouchers, privileges, prizes or financial incentives (clear urine screen = reward) can also be used in interventions to reduce substance use
