ADDICTION kn601 lecture PP

Question 1

DSM 5 allows clinicians to specify how severe the substance use disorder is depending on how many symptoms are identified [out of 11]. What are symptoms

Answer 1

• Needing more of the substance to get the effect [tolerance]
• Development of [withdrawl] symptoms
• Not managing work, school because of the substance abuse
• Using substances again and again even when it puts you in danger

Question 2

What is addiction?

Answer 2

Addiction is individualised to the person experiencing it. Common behaviours and stages which helps a clinician recognize and use appropriate intervention for each stage.

Question 3

Aetiology of substance abuse

Answer 3

• Genetic factors
• Social factors
• Cultural factors
• Personality factors
• Physiological factors

Question 4

Impact of addiction on the person

Answer 4

4 L’s.
Liver [drinking causes inflammation [hepatitis], worsens if co-morbid to Hep C
Lover – alcohol involved in most domestic disuputes
Livelihood
- leading cause for mistake and poor performance at work
- Alcohol affects serotonin binding in the brain causing depression and anxiety

Law – alcohol leading contributor to crime

Question 5

What are some consequences to long term alcohol use? How would this affect youth? How would this affect adult over 65yrs?

Answer 5

Cirrhosis. Health – memory loss, weight gain/loss, dental neglect
Effects – self, partner, children
Economic, drug debts, fines, gambling
Legal – separation/divorce, law crimes, jail
Spiritual – Paranoia, dishonesty
Employment – missed days of work, job loss

Question 6

Impact of Addiction [Alcohol] on society

Answer 6

75% adult presentations at ED on Thursday-Saturdayt nights are alcohol related [chch ED]
Half of serious violent crimes r/t alcohol
600 children born with FASD in NZ each year

Question 7

BI [brief intervention] is defined by

Answer 7

by any interactions with a client where the clinician is attempting to promote changes to at risk health behaviors. Defined by the delivery style, an empaehtic and non-judgemental approach during assessment and discussion. BI is most effective for clients at the abuse or less severe ‘dependence’ spectrum.

Question 8

BI assessments include

Answer 8

Brief intervention includes FRAMES, MI and advice and management plan (ASEAN)

Question 9

FRAMES -

Answer 9

F – Feedback of personal risk of impairment
R – Responsibility for change
A – Advice to change
M – Menu of alt change options
E – Empathy as a counselling style
S – Self-efficacy or optimism

Question 10

ASEAN

Answer 10

A – Assessment [screening like AUDIT, BI]
S – Summary [feedback to client current risks/harms i.e sexual activity, work performance]
E – Education [ALAC guidelines drinking, risks of drinking for them]
A – Advice [To reduce this risk, it is medically advised to lower your alcohol use]
N – Negotiate a plan [This weekend = movie night]

Question 11

MI [Motivational interviewing] for BI

Answer 11

1. Roll with resistance
   You are right, I am concerned about your ______, but you are the one in control
   Ultimately it is your decision so what would you like to try?
2. Self-efficacy
   How important is this to you?
   How much do you want to ____?
   How confident are you that you can make this change?
3. Reinforcing positive change-talk
   That sounds like a good idea
   That’s a good point
4. Developing discrepancy
   How has _____ stopped you from doing what you want to do?
   What makes you think you need change?