Chap. 11 - Substance-related disorders

Question 1

According to psychodynamic theory, addicts are stuck in the _____ stage of development

Answer 1

Oral

Question 2

Positive reinforcement, such as euphoria and disinhibition, is mediated by which NT pathway?

Answer 2

DA

Question 3

Negative rewards, such as anxiety and dysphoria, are mediated by which NT pathway?

Answer 3

GABA

Question 4

Reinforcement occurs in the reward center of the brain, which is comprised of the _____ _____ _____ and the _____ _____.

Answer 4

Ventral tegmental area

Nucleus accumbens

Question 5

DA release within the reward center is enhanced by the further release of morphine-like NTs called _____.

Answer 5

Neuropeptides

Question 6

Name two neuropeptides

Answer 6

Enkephalins

Beta-endorphins

Question 7

__% of psych patients are also experiencing substance use or dependence

Answer 7

50%

Question 8

Individuals with SZO are __ times more likely than the general population to experience SUD, and those with BIP are __ times more likely.

Answer 8

SZO 4x more likely

BIP 5x more likely

Question 9

The most commonly abused drug is _____

Answer 9

Alcohol

Question 10

Gender with higher rate of substance abuse

Answer 10

Men

Question 11

Ethnicities with highest and lowest rates of SUD

Answer 11

African Americans, Hispanics, and Native Americans are highest
Asian-Americans are lowest

Question 12

__% of all traffic deaths and __% of all crimes occur under the influence of alcohol

Answer 12

55% of traffic deaths and 50% of crimes

Question 13

Lifetime risk for alcohol dependence is __%

Answer 13

15%

Question 14

Family hx of ___ and ___ are predispositions to SUD

Answer 14

MDD

SUD

Question 15

The most common screening tool alcohol abuse is the ____ screen, which stands for…

Answer 15

CAGE
Ever tried to cut down?
Get annoyed when people talk to you about your drinking?
Do you feel guilty about your drinking?
Do you need an eye-opener?

Question 16

Scoring the CAGE

Answer 16

0-2 - mild to moderate risk

3-4 high risk

Question 17

Substance dependence is defined as 3 or more of the following in a 12-month period:

Answer 17

Tolerance
Withdrawal
Using larger amounts than intended
Cravings or an inability to cut down
Large amounts of time spent scoring, using, or recovering
Decreased activities due to use
Using despite consequences

Question 18

Substance abuse is defined by (4)

Answer 18

Maladaptive pattern of use
Repeated failure to fulfill role obligation
Using in a dangerous situation (like driving)
Continued use despite consequences

Question 19

Scoring the CIWA:
0-8?
9-15?
16+?

Answer 19

0-8 - mild withdrawal
9-15 - moderate withdrawal
16 or more - severe withdrawal and possible DTs

Question 20

Tolerance

Answer 20

Need for increased quantities of drug to achieve the desired effects

Question 21

Withdrawal

Answer 21

Behavioral and physiological changes occurring when serum or tissue levels of drug decline

Question 22

Early partial remission

Answer 22

One or more, but less than full, criteria have been met for at least one month but less than 12 months

Question 23

Sustained partial remission

Answer 23

One or more, but less than full, criterial have been met for 12 months or more

Question 24

Early full remission

Answer 24

No criteria have been met for more than one month but less than 12 months

Question 25

Sustained full remission

Answer 25

No criteria have been met for 12 months or more

Question 26

Withdrawal is defined as having at least two of these eight symptoms within hours or days of cessation…

Answer 26

Tremor
Insomnia
Autonomic hyperactivity
N/V
Hallucinations or illusions
Psychomotor agitation
Anxiety
Seizures

Question 27

Four commonly elevated lab values in the alcoholic

Answer 27

GGT
MCV
AST
ALT

Question 28

Drug class used for management of alcohol withdrawal?

Answer 28

BZO

Question 29

Aversion treatment may involve prescribing…

Answer 29

Disulfiram (antabuse)

Question 30

Is addiction an individual or a family disease?

Answer 30

A family disease

Question 31

Who needs help - the addict, the family member, or both?

Answer 31

Both