Exam 2 Flashcards
Caused physiological changes to occur when blood and tissue concentrations of a drug decrease in individuals who have maintained heavy and prolonged use of a substance
Withdrawal
Occurs when a persons physiological reaction to a drug decreases with repeated administrations of same dose
Tolerance
What is the most common drug of abuse in the US and poses the treated withdrawal danger?
Alcohol
Transitory recurrences of perceptual disturbance caused by a persons earlier hallucinogenic drug use when he or she is in a drug-free. Experiences such as visual distortions, time expansion, loss of ego boundaries, and intense emotions are reported.
Flashbacks
When drugs are taken together, the effect of either or both of the drugs is intensified or prolonged. Ex. is combinations of alcohol plus a benzodiazepine, alcohol plus opiate, and alcohol plus a barbiturate.
Synergistic effects
Combination of drugs to weaken or inhibit the effect of one if the drugs
Antagonistic effect
Opiate antagonist that is often given to people who have overdosed on an opiate to reverse respiratory and CNS depression
Naloxone (Narcan)
Cluster of behaviors originally identified through research involving the families of alcoholic families. These people find excuses for the persons substance abuse and often define their self worth in terms if caring for others to the exclusion of their own needs
Codependence
________ ________ is more common in men, young people, whites, and those who are unmarried.
Alcohol abuse
_______ ____________ is highest in men, young people, whites, native Americans, people with low incomes, and those who are unmarried.
Alcohol dependence
Approximately ___ out of every 10 people affected by a substance abuse disorder are also affected by a mental health disorder
6
Common examples include the combination of major depression with cocaine addiction, alcoholism with generalized anxiety disorder, alcoholism and poly drug addiction with schizophrenia, and borderline personality disorder with episodic polydrug abuse
Co-curring disorders
______ drug users have a higher incidence of infections and sclerosing of veins.
IV
______ users may have sinusitis and a perforated nasal septum.
Intranasal
________ a substance increases the likelihood of respiratory problems.
Smoking
Characterized by loss if control of substance consumption, substance use despite associated problems, and tendency to relapse.
Addiction
Main systems involved in substance abuse are the
Opioid, catecholamine (especially dopamine) and gamma-aminobutyric acid (GABA) systems.
What does alcohol and other CNS depressants act on?
GABA receptors and increase bioavailability of glutamate, norepinephrine, and dopamine.
Cocaine and amphetamines increase levels of
norepinephrine, serotonin, and dopamine
_______ theories view substance use as a defense against anxious impulses, a form of oral regression, or self-medication for depression.
Psychodynamic
_______ theories attempt to explain differences in the incidence of substance use in various groups.
Sociocultural
Current alcohol and other drug problems can be detected by asking 2 questions:
- In the last year, have you ever drunk or used drugs more than you meant to?
- Have you felt you wanted or needed to cut down on your drinking or drug use in the last year?
Responses that serve as red flags indicating the need for further assessment are:
Rationalizations (You’d smoke dope too if…), automatic responses as if the question were predicted (“I figured you’d ask me that”), and slow, prolonged responses as if the person were being careful about what to say
Elements of this style include various defense mechanisms (e.g. denial, projection, rationalization) as well as characteristic thought processes (e.g. all-or-none thinking, selective attention) and behaviors (e.g. conflict minimization and avoidance, passivity, and manipulation)
Predictable defensive style
Can result when an individual has consumed large amounts of alcohol quickly or over time. Signs include an inability to arouse the individual, cool or clammy skin, respirations less than 10 per minute, cyanosis under the fingernails or gums, and emesis while semiconscious or unconscious.
Alcohol poisoning
Early signs peak after 24 to 48 hours after cessation or reduction of intake. Person may appear hyperalert, manifest jerky movements and irritability, startle easily, and experience subjective distress often described as “shaking inside.” Grand mal seizures may appear 7 to 48 hours after cessation.
Alcohol withdrawal
Misinterpretations, usually of a threatening nature, of objects in the environment
Illusions
Considered a medical emergency and can result in death even if treated. Death is usually due to sepsis, myocardial infarction, fat embolism, peripheral vascular collapse, electrolyte imbalance, aspiration pneumonia, or suicide.
Alcohol withdrawal delirium
Common signs of stimulant abuse:
dilation of pupils, dryness of the oronasal cavity, and excessive motor activity
________ blocks the reuptake of norepinephrine, dopamine, and serotonin and this imbalance of neurotransmitters may be responsible for many of the physical withdrawal symptoms reported by heavy, chronic cocaine users.
Cocaine
First phase of withdrawal in which users report depression, anergia, and an acute onset of agitated depression. Craving for the drug peaks during this phase along with anxiety and paranoia.
Crash phase
Phase of withdrawal that is described as a prolonged sense of dysphoria, anhedonia, and lack of motivation, along with intense cravings that can last up to 10 weeks. Relapse is most likely during this phase.
Second phase
Phase of withdrawal that is characterized by intermittent craving that can last indefinitely
Third phase
Successful treatments for many individuals during smoking cessation
Wellbutrin (Zyban) and nicotine-replacement therapy
Phase of heroin intoxication that is described as a euphoria or rush that occurs almost immediately after injection of the drug. Users frequently characterize this euphoria in sexual terms and is characterized physiologically by facial flushing and a deepening of the voice.
First phase
Phase of heroin intoxication that is classified as “the high” and has been described as a sense of well being and can extend for several hours
Second phase
Phase of heroin intoxication that is often termed “the nod” is an escape from reality that can range from lethargy to virtual unconsciousness.
Third phase
Phase of heroin intoxication that is the period before withdrawal occurs. Users often seek more of the drug in order to avoid withdrawal.
Fourth phase
___________ is the most widely used illicit drug in the United States
Marijuana
LSD, mescaline (peyote) and psilocybin (mushrooms) are
Hallucinogens
_______ causes a significant reliease of the neurochemicals serotonin, dopamine, and norepinephrine.
MDMA
After the effects of MDMA wear off, the user commonly goes through a period of depression that is caused by a depletion of _____
Serotonin
Odorless, tasteless, and colorless drugs that mix easily with drinks and can render a person unconscious in a matter of minutes.
Date rape drugs such as Rohypnol and GHB
`The aim of treatment is ____________, not compliance.
self responsibility
_________ programs work best for people with substance abuse disorders who are employed and have an involved social support system.
outpatient
People who have no support and structure in their day may do better in ___________ programs when these programs are available
Inpatient
Primary prevention in children is to get involved in activities because they help to build
Self-confidence and self-esteem
What does the the acronym for key interventions, called FRAMES, mean?
Feedback of personal risk Responsibility of the patient (personal control) Advice to change Menu of ways to reduce substance use Empathetic counseling Self-efficacy or optimism of the patient
Al-anon is a self-help group that offers support and guidance for _______ family members of an addicted person.
Adult
Alateen is a self-help group that offers support and guidance for ________ family members of an addicted person
Teenage
Agent used for narcotic addiction that is sometimes used in the treatment of alcoholism, especially for those with high levels of craving and somatic symptoms. Works by blocking opiate receptors, thereby interfering with the mechanism of reinforcement and reducing or eliminating the alcohol craving.
Naltrexone (Trexan, Revia)
Used by people who have quit drinking and wish to remain abstinent; it probably works to reduce intake of alcohol by suppressing excitatory neurotransmission and enhancing inhibitory transmission
Acamprosate (Campral)
Works to decrease alcohol cravings by inhibiting the release of mesocorticolimbic dopamine, which has been associated with alcohol craving
Topiramate (Topamax)
Used with motivated pts who have shown the ability to stay sober
Disulfiram (Antabuse)
Used in treatment of opioid addiction. Synthetic opiate that blocks the craving for and effects of heroin. Has to be taken every day, is highly addictive, and when stopped produces withdrawal.
Methadone (Dolophine)
Used as an alternative to methadone and is effective for up to three days
LAAM
Nonopioid suppressor of opioid withdrawal symptoms
Clonidine (Catapres)
A state of crisis is produced by three interconnected conditions:
A hazardous event that poses a threat, an emotional need that represents earlier threats and increased vulnerability, and an inability to respond adaptively.
The outcome of crisis depends on
the realistic perception of the event, the adequate situational supports, and adequate coping mechanisms
________ ___________ is a short term, therapeutic process that focuses on the rapid resolution of an immediate crisis or emergency using available personnel, family, and/or environmental resources
Crisis intervention
Type of crisis that is brought on by an unanticipated external life event such as a loss or change (divorce, loss of job)
Situational
Type of crisis that occurs because the person is transitioning to a new developmental stage
Maturational
Type of crisis that occurs because of natural disaster, crimes, national disaster (Floods, mass shooting, war)
Adventitious
What is Erickson’s first stage?
Trust vs. Mistrust
What is Erickson’s second stage?
Autonomy vs. Shame and Doubt