EXAM REVIEW Flashcards
STIMULANTS
a substance that raises levels of physiological or nervous activity in the body, such as caffeine, nicotine, and cocaine. small doses can increase awareness and concentration, but in large doses, can become unsettling and anxiety-inducing
DEPRESSANTS
depressant substances reduce arousal and stimulation. they do not necessarily make a person feel depressed. they affect the central nervous system, slowing down the messages between the brain and the body. Such as Xanax, alcohol, or cannabis. small doses create relaxation, drowsiness and loss of inhibitions. large doses can cause loss of consciousness, respiratory inhibition and even death
ANTIPSYCHOTICS
any of the powerful tranquilizers (as the phenothiazines or butyrophenones) used especially to treat psychosis and believed to act by blocking the dopamine nervous receptors
HALLUCINOGENS
a diverse group of drugs that alter perception, thoughts, and feelings. they cause hallucinations, or sensations and images that seem real, but they are not. such as LSD, MDMA, and KET. can cause auditory, tactile or visual hallucinations
LSD
lysergic acid diethylamide was created in 1938 in switzerland and later studied by the US military. used in the 1950s for alcoholism, depression, and obsessive disorders. become listed as dangerous in the 1960s
MDMA
created in germany in 1912, tested by the US military in the 1950s, used as clinical treatment for emotional disorders in the 197-s, become illegal in 1985. remains popular amongst youth today
EMERGING PSYCHOACTIVE SUBSTANCES
new substances have been developed to mimic already illegal drugs. but crumvent drug laws. herbal, incense, and not for human consumption labels can get around the laws. because these new substances are highlight available online and always changing it is hard to control for
7 THEMES OF A DRUG WAR
- notion of a public menace
- political interests
- increased criminal justice responses
- influence of media coverage
- portrayal of drug use as infectious
- the need to protect the vulnerable and target groups
- aggressive, militaristic terminology
DRUG RELATED HARM
directly or indirectly affects the health, safety, security, social function, and productivity of all Australian’s
HEALTH HARMS
refers to the increase or risk of: injury, chronic conditions and preventable disease, and mental health in relation to drug use
SOCIAL HARMS
refers to the increase or risk of: violence, crime, trauma, wellbeing, unhealthy childhood development in relation to drug use
ECONOMIC HARMS
refers to the increase or risk of healthcare and law enforcement costs, decreased productivity, marginalisation and disadvantage due to drug use
PHARMACOLOGY
the effect a drug has on someone. this is dependent on the person (e.g., age, gender, individual health), the drug (e.g., how it’s taken, amount used, frequency of use), and social/environmental factors
PHARMACOKINETICS
has to do with absorption, distribution, metabolism, and excretion of a drug or what the body does with the drug
PHARMACODYNAMICS
has to do with the biochemistry, pharmacology, and effects of the drug or what the drug does to the body. Key terms include: dependence, tolerance, withdrawal.
AGONISTIC EFFECT
an increase or stimulation of the action of a neurotransmitter
ANTAGONISTIC EFFECT
decrease or inhibition of the action of a neurotransmitter
HALF-LIFE
time for the drug in the blood system to reduce by 50%. short half-lives are more likely to lead to repeated use, like nicotine
NICOTINE
a stimulant that is dopamine and glutamate agonist, the short time effects and short half life means that it is highly addictive. improves short term memory but has serious long term health effects of smoking
METHAMPHETAMINE
is a pharmaceutical drug that can be used recreationally as a stimulant. significantly alters levels of dopamine and is an extreme agonist. common effects include speeding up body functions, dry mouth, sweating, large pupil, awake, hostility, anxiety, and reduced appetite
ALCOHOL AND BENZODIAZEPINES
these substances are the most commonly used depressants. they act as GABBA agonists to reduce brain activity and glutamine antagonists to reduce the excitatory function. Long term effects of alcohol can be damaging.
CANNABIS
is a depressant, THC is the main ingredient for the psychoactive effects, and binds to the cannabinoid receptors. it interferes with the normal functioning brain impacting the cerebellum, hippocampus, cerebral cortex. long term effects of heavy use can cause health problems, impaired brain function
OPIOIDS
opioids is a depressant for pain relief through endorphins. it affects dopamine rewards effects and acts as pain relief. physical and psychological overdose risk is high. common effects can be feelings of well-being or euphoria, pinpoint eyes sedation, slow breathing or vomiting
NALOXONE
is a drug you inject to avoid an overdose or heroin and other opioid drugs. also known as narcan, it can prevent overdose and the effect lasts 20 mins so you still need to get the person to the hospital
INHALANTS
is a depressant, with immediate effects though psychological hangovers and confusion can last for several days. the long term effects can include health risks
GABBA SYSTEM
brain function for the effects of alcohol on the brain and body. young adults have a higher functioning system which limits the sedative effect of alcohol and minimises hangover
DUAL DIAGNOSIS
more than two health diagnoses.
heterotypic - mental health and physical disorder
homotypic - two mental health disorders
concurrent - alcohol dependence and depression at the same time
successive - panic disorder in teen years learning to cannabis use in later life
it is important to recognise that they are all on a continuum, such as symptoms of a disorder but not having a diagnosis
LEVELS OF INTERVENTION
primary - prevention of uptake: preventing non-users from starting or delaying use. this is a supply reduction method, education on harms, and school bases/parent education
secondary - preventing harm: reducing risks to experimental/social users and avoiding transition into addiction
tertiary - reducing harm: reducing potential harms among regular users
RAT PARK EXPERIMENT
Bruce Alexander puts rats into a park with toys, food, and friends with access to drugs. they will not use the drugs. rats alone in a boring cage will chose to use drugs. rats that have been using drugs in the boring cage will slowly stop using drugs when placed in the rat park
THEORIES OF SUBSTANCE USE: MORAL MODEL
during the 19th century, addiction was viewed as a sin. ‘morally weak’ and addiction was viewed as a judge of character. users were characterised as misfits, people were punished physically for using AOD
THEORIES OF SUBSTANCE USE: DISEASE MODEL
assumes that origins of addiction lie within the individual. it suggests that addiction is a disease, and does not exist on a continuum. states that addicted people cannot control their intake and live with addiction for the rest of their life. this is commonly adopted in 12 step models such as AA, NI, AI-Anon. only focuses on abstinence
THEORIES OF SUBSTANCE USE: PSYCHODYNAMIC MODELS
these theories originated with Sigmund Freud and is still used today. basic philosophy links childhood to unconscious motivations. ideologies of nature vs nurture. based off ego, id, and super ego, personality, and attachment style theories.
THEORIES OF SUBSTANCE USE: NEUROSCIENTIFIC AND BIOLOGICAL MODEL
genetic characteristics: people may inherit an increased likelihood of developing dependence on substances. increasing areas of interest, family/twin studies, environment vs genetics. this looks into twin studies, and environmental vs genetic factors. there is no single candidate genes that are directly related to drug abuse.
neuroadaptation: refers to changes in the brain that occur to oppose a drugs acute actions after repeated drug administration. when drugs are repeatedly used you will become tolerant and need more
THEORIES OF SUBSTANCE USE: SOCIAL LEARNING THEORY
Russell 1975 introduced the idea that dependence is not only chemical but also behavioural and social in nature. it is based more on the user’s thought about the substance, and what it is like to be under the influence. there are two central notions: use is learned and it is functional. this model focuses on the interaction between the environment, drug, and individual. focuses on classical, operant conditioning, modeling and tension reduction
THEORIES OF SUBSTANCE USE: COGNITIVE AND BEHAVIOURAL THEORIES
cognitive model focuses on the thoughts/beliefs and impact on behaviour and feelings. the way people interpret specific situations influences feelings, motivations and actions. layers of beliefs, core beliefs and schemas.
CBT: thoughts and behaviours are learnt and therefore can be unlearnt
THEORIES OF SUBSTANCE USE: MOTIVATION AND CHANGE THEORIES
transtheoretical model, meaning it can be applied across all other theories. focuses on clients own potential, problems, and consequences. it is a cyclical model for change with stages:
precontemplation, contemplation, preparation, action, maintenance, and relapse
THEORIES OF SUBSTANCE USE: FAMILY SYSTEMS
determinants of behaviour are based on an individuals role within a system. unlike other models, it focuses on a society as a whole, not just the individual. there are many different theories under this umbrella. shared assumptions include: boundaries, group interventions, and homeostasis
THEORIES OF SUBSTANCE USE: BIOPSYCHOSOCIAL MODEL
an approach describing and explaining how biological, psychological and social factors combine and interact to influence physical and mental health
DUAL DIAGNOSIS: DEPRESSION AND AOD MISUSE
alcohol interferes with medications, cannabis heightens symptoms of depression, stimulants can cause heightened depression symptoms on the come down period, opioids can bring a lifestyle that does not allow for depression recovery
DUAL DIAGNOSIS: ANXIETY DISORDERS
depressants can cause anxiety and symptoms of anxiety. hangxiety can cause anxiety or psychosis when the effects of the substance wear off. stimulants and opioids can cause and accentuate the symptoms of anxiety
DUAL DIAGNOSIS: PSYCHOSIS
reinforcing the effect of the drug is called the dopamine effect. cannabis and stimulants can cause psychosis, alcohol can heighten the effects of psychosis and decrease the efficacy of medication. amphetamines can cause short term psychosis that can become recurring
TREATMENT MODELS FOR DUAL DIAGNOSIS
sequential or parallel services, specialist DD programs, collaboration programs, or integrated models. evidence shows that integrated programs are most effective, focusing on maintaining motivation and engagement
TREATMENT MODELS FOR ADDICTION
biopsychosocial model of addiction looks at three areas (all of which overlap for a holistic approach):
- systems: national/regional policies, drug laws, socioeconomic context
- social: interpersonal relationships, treatment and drug use settings, social norms around use
- psychological: identity as a user, ability to cope, counselling and support services
- biological: dopaminergic reward, hypothalamic, pituitary, adrenal axis response, cortical response
COMPONENTS OF COMPREHENSIVE DRUG ABUSE TREATMENT
centred around intake processing assessment, treatment plan, pharmacology, continuing care, substance use monitoring, behavioural therapy and counselling, clinical case management, self help and peer support groups. also looks at peripheral support, child care services, vocational services, mental health services, medical services, educational services etc
EFFICACY OF TREATMENT: RESEARCH CASE 1
a comparison of treatment approaches and matching was analysed over an 8 year period across 130 clinical professionals. they analysed the 12 step program, CBT, and motivational interviewing. they found that there was no outstanding program and were criticised for excluding poly drug use in their eligibility criteria. abstinence being the only measure of success, no control, and too much focus on follow up and assessment for the evidence instead of improvement
EFFICACY OF TREATMENT: RESEARCH CASE 2
another study conducted in australia on heroin users looking into replacement, withdrawal, residential rehabilitation, and non-treatment control with 3 and 12 month follow ups. they found that there was general function improvements across all groups including the control
EFFICACY OF TREATMENT: RESEARCH CASE 3
australian patient pathway study conducted in melbourne found that different drugs have different success rates from treatment. meth and amphetamines being the most effective
MILLER AND HESTERS THEORY OF INFORMED ECLECTICISM OF TREATMENT
assumptions include: there is no single approach to treatment for all individuals, programs/systems should be constructed with a variety of approaches that have been shown to be effective, different individuals respond best to different approaches. it is possible to match clients to option treatments therefore increasing effectiveness
ETHICAL CODE: ADCA
only a discussion paper and not available anymore because of lost funding. outlines: equity and access, the client relationship. privacy, training, and professional development. responsive services, effective and efficient services, reducing stress and workload issues, community consultation and involvement, ethics and committee approval for research, advocacy in public policy and public health outcomes
ETHICAL CODE: APS
2009, unique to psychology. built on three general ethical principles: respect, propriety, and integrity
BREACHES IN ETHICAL THERAPEUTIC PROCESS ARE MOST LIKELY TO OCCUR WHEN:
- workload is too high
- staff are stressed
- client and clinicians values are in conflict
- lack of defined policies, procedures, and guidelines
- lack of supervision/support
- lack of professional development opportunities
THERAPEUTIC RELATIONSHIP CORNER STONES:
- autonomy
- justice
- beneficence
- non-maleficence
- fidelity
RESEARCH INTO ETHICS AND PSYCHOLOGY
Duncan, Williams and Knowles (2013) explored the views of 264 australian psychologists in the case of a 15 year old client using substances. asked if they would breach confidentiality in a number of scenarios involving frequency, time, and substance the boy is using
APS GUIDELINES ON CONFIDENTIALITY
- understanding the legal context and the organisations requirements
- informed consent
- only breach confidentiality when: consent exists to do so, there is a legal obligation to do so, there is an immediate and specified risk to a person that can be averted by disclosure
- when disclosing information, only disclose what is needed
- where safety permits, psychologists inform clients if their information is being disclosed
CENTRALITY OF AMBIVILENCE
ambivalence is central to addictive behaviours, awareness of risks, costs and harms, as well as an attraction to behaviour. confrontation about negatives will also turn the conversations to positives
MOTIVATIONAL INTERVIEWING
there are five important assumptions of motivational interviewing: motivation is a state not a trait, resistance is not a force we must overcome, ambivalence is normal, person seeking help should be an ally rather than adversary, recovery and change is innate and constant within the human experience. often confused with the transtheoretical model. motivational interviewing is a directive and client centres for initiating behavioural change by helping clients to explore and resolve ambivalence
SPIRIT OF MOTIVATIONAL INTERVIEWING - PACE ACRONYM
partnership - collaboration between clinicians expertise and clients expertise
acceptance - empathy and respect for autonomy
comparison - clients welfare and growth comes first
evocation - eliciting the clients wisdom, plans and values
FOUR PROCESSES OF MOTIVATIONAL INTERVIEWING
engaging: use the client centred counselling skills remembered by the acronyms OARS
O = open ended questions allow exploration
A = affirming, affirm clients strengths
R = reflecting your understanding back to the client
S = summarise, show that you have been listening and value their words
TRANSTHEORETICAL MODEL FOR CHANGE
change is a process rather than an event. process of changing addictive behaviours happens via a series of stages from pre-contemplation to maintenance. replace is a common occurrence and a rule rather than an exception. 90% of clients will experience a lapse within 12 months of completing treatment
MATCHING INTERVENTION TO THE STAGES OF CHANGE
precontemplation and contemplation: experiential, cognitive, and psychoanalytic approaches. educational feedback and motivational interviewing
action: existential, and behavioural approaches, encouraging will power and self-esteem
maintenance: behavioural approaches such as relapse prevention
ASSESSING CHANGE
- importance
- confidence
- readiness
DECISIONAL BALANCE
perceived advantages and disadvantages of staying the same or making a change. it is a powerful tool for realisation and can be conceptualised through a pros and cons list for making a change or staying the same
DELIRIUM TREMMENS
tremors from alcohol withdrawal
INTERVENTIONS THAT TARGET THE ENVIRONMENT
- community development
- employment, educational, and recreational opportunities
- family therapy
- case management
- rehabilitation centres
INTERVENTIONS THAT TARGET THE INDIVIDUAL
- controlled drinking/drug use
- self-help groups
- brief interventions
- social skills training
- endorsed psychotherapeutic interventions
- trauma informed care
INTERVENTIONS TARGETING THE DRUG
- psychoeducation and drug education
- withdrawal management and detox
- naltrexone and rapid detox
- methadone
- buprenorphine
- anti-craving medications e.g., campral
- antabuse maintenance therapy
- nicotine replacements
- urine drug screening
NALTREXONE
an opioid antagonist, blocking the effects of the drug and causing a rapid withdrawal from opiates. main risk is overdose and pain relief stops working if needed medically. expensive and has a daily dosing
METHADONE
is a full opioid agonist, blocking the effect of the drug. usually used in maintenance for people who are unable to abstain. often preferred for higher levels of dependence
BUPRENORPHINE
partial agonist and antagonist for maintenance treatment. can be a detoxification aid for less symptoms
CAMPRAL (ACAMPROSATE)
anti-craving medication to be taken three times a day, can be taken with naltrexone
NICOTINE REPLACEMENTS
patches, gum, lozenges, or inhalers. most effective with counselling and online support when abstinence is the goal
BRIEF INTERVENTION
1-5 sessions with follow up and self-help materials. Upton and Tirlaway (2014) suggest the four key components of brief interventions are:
- focused on reduced substance use
- address motiatoin
- remain individualised
- have features of FRAMES (feedback, responsibility, advice, empathy, self-efficacy)
TRAUMA INFORMED CARE (TIC)
based on the understanding that a significant number of people living with AOD addiction and mental health conditions have faced trauma
THE QUALITY OF THE COLLABORATIVE RELATIONSHIP CAN BE IDENTIFIED BY:
- 15% therapists with techniques and skills
- 30% clients with experiences with the therapeutic relationship
- 40% extra-therapeutic factors
