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Psyc4121 > Alcohol And Drug Treatments > Flashcards

Alcohol And Drug Treatments Flashcards

1
Q

Who has the highest rates of drugs, alcohol and mental disorders?

A

Young people 15-25 year olds

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2
Q

What is the leading cause of death in young people?

A

Suicide

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3
Q

What is the prevalence of smoking?

A

Down 24% in 1991 to 15% in 2010

20% 20-24 year old

12-17 year girls more likely to smoke than boys

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4
Q

What is the prevalence of alcohol abuse?

A

Drinking to get drunk rates falling but still very high in young people 60-50%

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5
Q

What is the prevalence of cannabis use in Australia?

A

Au biggest consumers in the world until us leagalised

Rates going down

Young people biggest consumers

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6
Q

What are 4 comorbidities that commonly occur with cannabis use?

A
  1. AOD disorders - Psychiatric symptoms caused by alcohol and drugs
  2. Depression
  3. Psychotic experiences
  4. Psychotic disorders
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7
Q

What has changed in the DSM-4 to the DSM-5 edition regarding substance use disorders?

A

**legal problems has been removed

Added- craving the drug

Substance abuse and disuse have been separated

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8
Q

What is the number 1 cause of disability and death in 15-29 year olds?

A

AOD disorders

Alcohol and other drug disorders

24%-32% total disability
19-36% deaths

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9
Q

What are the help seeking behaviours found in young people experiencing AOD related problems? Give 3 reasons why

A

Very few seek help
7% of males
18% females

Because:

  1. Social norms
  2. Don’t view use as problematic
  3. Stigma associated with AOD treatment
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10
Q

What is the most common drug young people seek assistance for?

A

Cannabis

Treatment episodes increasing

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11
Q

How many people globally seek help for AOD?

A

1 in 6

50% first time for cannabis

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12
Q

What are the 4 options for youth treatment for AOD?

A
  1. Regulatory- reduce risk
  2. Prevention- delay age of use
  3. Early intervention- reduce progression from regular to problematic
  4. Treatment of AOD dependence
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13
Q

What are the regulatory actions taken to reduce AOD?

A
  1. Use law policies and enforcement to reduce supply and demand
  2. Australian AOD policy is harm minimisation
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14
Q

What are the 4 regulatory approaches for tobacco?

A
  1. Cigarette tax- 12.5% increase

$1 per cigarette

1 billion less sold a year

  1. Media campaigns: attitudes/policies
  2. Package changes
  3. Not smoking in venues
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15
Q

What are the regulatory actions for alcohol?

A

Alcopops tax

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16
Q

What are the health policies around alcohol consumption?

A
  1. Amount of drinks reduced to less than 2 per day

2. For people under age of 18 no alcohol is safest

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17
Q

NHMRC guidelines state to reduce the risk of lifetime alcohol related disease or injuries, how many drinks per day?

A

Less than 2

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18
Q

NHMRC guidelines state to reduce the risk of injury due to alcohol, how many drinks on a single occasion?

A

Less than 4

Drinking more than 4 drinks doubles the risk of injury in the next 6 hours

Evidence based research

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19
Q

What evidence for regulation of alcohol policy has been found to be effective (Burton et al, 2017)

A
  1. Tax and price regulation
  2. Regulation and marketing
  3. Regulating availability
  4. Provision of information
  5. Managing the drinking environment
  6. Preventing drug/drink driving
  7. AOD school education (does not work)
  8. Brief intervention
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20
Q

What is the purpose of universal school based drug education?

A

Prevent/delay age of onset

But may not work as increased curiosity

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21
Q

What is Climate Schools Combined?

A

Online universal school based drug prevention program

  • substance use - alcohol and cannabis
  • mental health

Social melodrama about social relationships (cartoon)

22
Q

What are the 4 methods used for Climate schools combined?

A
  1. Combined- substance use (y9) and mental health (y10)
  2. Mental health only (y10)
  3. Substance use only
  4. Control-hpe as normal

Which one prevents anxiety/depression and substance use best?

What do you target to delay onset?

23
Q

What was it about the Climate schools combined that put kids off drinking?

A

Cool girl vomiting on cool guy

24
Q

What were the initial results from the Climate schools course for alcohol?

A

After 6 Months Climate group significantly less average weekly alcohol. This difference even more significant at 12 Months

25
Q

What were the initial results from the Climate schools course for cannabis?

A

Not significant at pre to post treatment but significantly less likely to use cannabis at 6 and 12 Months after treatment than in control group

26
Q

What were the initial results from the Climate schools course for psychological distress?

A

Intervention group less likely to have symptoms of distress than control group

27
Q

What is an evidence based approach to prevention of AOD use?

A

Climate schools course found to be effective

28
Q

Who are early intervention courses targeted at?

A

At risk youth

  • early onset (<14 years)
  • disengaged youth
  • AOD related injury/illness
  • family history of AOD dependence
29
Q

In early interventions for AOD, what happens in a brief intervention?

A

1-2 sessions (10-15 minutes to 2x1 hour sessions)

Brief assessment and feedback

Motivational interviewing

30
Q

What makes it hard to commit to behaviour change?

A

Ambivalence is the key dilemma we all face when making a change to our behaviour

31
Q

What are the 3 key dimensions needed for behaviour change?

A
  1. Readiness
  2. Confidence
  3. Importance
32
Q

What is motivational interviewing?

A

A collaborative conversation style for strengthening a persons own motivation and commitment to change

Counselling approach

33
Q

What are the 3 components of motivational interviewing?

A
  1. Strategies (commitment/motivation)
  2. Principles
  3. Spirit
34
Q

What is the Spirit of motivational interviewing under a fundamental approach of MI?

A

Fundamental approach to MI:

  1. Collaboration
  2. Evocation
  3. Autonomy
  4. Compassion
35
Q

What is motivational interviewing NOT?

A

Confrontation

Education

Authority

36
Q

*****what are the 4 principles of motivational interviewing?

A
  1. Express empathy
  2. Develop discrepancy (between how things are and how the person wants to be)
  3. Respond to sustain (“I like smoking”) talk and discord (formerly roll with resistance)
  4. Support self-efficacy (support them to find their own way and make the change that they want to, however long that takes.

***roll with resistance is OUT

37
Q

What evidence is there for Brief Motivational Interventions?

A

Well established efficacy for alcohol in meta analysis reviews

Small to moderate affects compared to Control or other interventions

38
Q

What are the advantages to web based alcohol interventions?

A

99%young people online daily

Own smart phones

Check phone regularly

These interventions simple and effective

Rapidly increase treatment access

39
Q

What is Ray’s night out?

A

An app developed to promote harm minimisation and controlled drinking strategies

Aims to increase safe drinking behaviours and awareness of alcohol use limits

40
Q

What was found in a randomised Control trial for Rays night out?

A

Gave Young people who used alcohol in the last month the Rays night out app

Some had immediate access, some 1 month delay

Wanted to determine the apps impact on alcohol knowledge, use and related behaviours

Results:

Immediate access group had greater alcohol knowledge

Every ones drinking went down

Feedback:

Think about drinking goals
Helps identify stupid lines
Hints on safer drinking

41
Q

What evidence is there for how do we increase the impact of motivational interventions?

A

A randomised Control trial of enhanced brief motivational interviewing

Methods:

Target alcohol, cannabis and psychological stress

1-3 face to face sessions

MI + brief coping skills VS assessment feedback/information

Results:

Greater reductions in alcohol, cannabis and distress

42
Q

What are the 4 Personality Risk Profiles for substance use?

A
  1. Anxiety sensitivity
  2. Depression proneness
  3. Sensation seeking
  4. Impulsively
43
Q

What evidence is there for matching personality risk targeted and coping skills for alcohol illness and injury?

A

CBT type interventions

Good results

Those who got the personality type targeted intervention had over 50% reductions in days they were drinking

Amount of drinks reduced

Not much reduction in alcohol related harm

44
Q

What are the 4 points of evidence that has been found for all brief AOD interventions?

A
  1. All brief interventions work
  2. All groups improve over time
  3. Personality targeted coping skills training enhances motivational interviewing effects
  4. Is an effective early intervention model for risky alcohol use in non help seeking young people
45
Q

What are 7 AOD treatment types?

A
  1. Telephone
  2. Outpatient care
  3. Outreach
  4. Day programs
  5. AOD withdrawal
  6. Residential rehabilitation
  7. Pharmacotherapy
46
Q

What is the biggest problem with treatment for AOD abuse/dependence?

A

There is a huge gap between the current evidence base and routine practice

47
Q

What model does residential rehabilitation use?

A

A therapeutic community model

Abstinence based

Run by residents

Self help

Mutual aid groups

Hierarchy structure

Mixed evidence

48
Q

What is the goal of CBT?

A

Assist individuals in changing maladaptive behaviours by acquiring coping skills

49
Q

What are 3 methods to prevent AOD relapse?

A
  1. Reinforce self efficacy
  2. Coping skills
  3. Planning for set backs
50
Q

What is the evidence for CBT for AOD dependence in adolescents?

A
  1. CBT better substance use outcomes than insight orientated therapy and psycho education
  2. CBT VS CBT+FFT - both groups min lvls at post treatment but CBT+FFT only maintained
51
Q

What is the evidence for CBT for depression and alcohol dependence in adolescents?

A

Methods:

10 sessions CBT

Results:

84% full or partial remission

Decreased anxiety and depression
More days abstinence
Decreased cannabis and other drugs

Psyc4121 (11 decks)

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