Kohlenberg > Treatments for Substance Use Disorders Flashcards
what is the lifetime rate of SUD (%)?
~14.6%
how many people (%) reported a SUD in the past year (over 12yo)?
8.7%
how many people are compulsive gamblers (%)?
~5%
how many people watch porn online more than 11 hours/wk (%)?
fucking 6%!!!!!
how much of the population binge eats?
3-5%
+ me on cheat day
what is SUD assoc w/?
interpersonal violence
HIV risk behavior
suicide
criminal behavior
how many ppl in addiction treatment have PTSD (%)?
~60%
T/F: people in addiction treatment with trauma hx have better outcomes
lol false
what is “seeking safety”?
an evidence-based model for substance abuse & trauma/PTSD
T/F: pts w/ substance abuse & PTSD typically have enormous self-loathing
true
what is compassion?
replacing destructive self-talk with compassionate self-talk
a loving stance toward self produces lasting change
what are 2 questions you can ask yourself when you notice harsh self-talk?
“what would i say to myself if i loved myself?”
“if i were really listening to my deepest needs, what would i say to myself?”
what are 5 things to do to increase compassion?
explore underlying reasons use kinder language imagine you are talking to a small child who has made a mistake experiment w/ compassion practice
T/F: there is a single treatment that will work for everyone w/ a SUD
false
what are some principles of effective SUD tx?
addiction is treatable (even w/ relapse) no 1 tx works for everyone tx must be readily available tx must address multiple needs tx may need to last at least 3 mos (best outcomes w/ more time)
what are the most useful therapies in SUD?
behavioral
focused on motivation, family, relationships
what are 2 examples of meds that can help w/ SUD?
methadone
nicotine replacement
what is the important first step of treating SUD?
medically assisted detox
T/F: treatment is only effective if it is voluntary
NOPE
T/F: most people who get into & remain in treatment stop using drugs
TRUE! yay!
T/F: relapse rates for addiction are much higher than those of other chronic medical conditions
false
they’re about the same as w/ asthma, diabetes (30-50%), & HTN (50-70%)
(drug addiction is 40-60%)
what is the goal of SUD treatment?
management, not cure
what are the 5 stages of change?
precontemplation contemplation preparation action maintenance
what is precontemplation like?
pt not concerned about problem
no intention to change soon
pros of maintaining behavior outweigh the cons of changing
what is contemplation like?
pt acknowledges prob
ambivalent toward change
pros = cons about change
pt considers action in next 6 mos
what is preparation like?
pt plans to take action in next month, makes final adjustments before beginning to change
pros of changing outweigh reasons to stay the same
may still have ambivalence toward change
what should doctors do during the preparation phase?
reinforce preparations to change
what is action like?
pt begins to change
changes are evident to others > recognition
what should doctors do during the action phase?
notice & reinforce change
what is maintenance like?
gains made during action are consolidated & maintained for 6 mos
change still happens & needs work
what should doctors do during the maintenance phase?
reinforce maintenance activities (pts may plateau in visible changes)
is relapse common in the maintenance phase?
YUP
what is abstinence violation syndrome?
after slipping & using after a pd of abstinence, the pt thinks “this is hopeless, i might as well keep using”
what is “lapse”?
minor setback
no real analysis
what is “relapse”?
complete reversion to previous pattern of behavior w/ downward spiral
what is “prolapse”?
work it over, send you forward in your recovery (???)
how can doctors inoculate against relapses?
normalize lapses
teach that lapses don’t have to lead to relapses
develop relapse prevention plans
what is urge surfing?
a relapse prevention skill with a fancy graph
mindfulness to overcome cravings
what has long been implicated in the onset, maintenance, & relapse of SUD?
alcohol, nicotine, &/or illicit drugs to avoid unwanted psychological or physical distress
what mediates the relationship btwn substance USE & substance ABUSE/dependence?
capacity to tolerate stress
what are the goals of mindfulness, ACT, & SUD tx?
emotional acceptance (not avoidance) distress tolerance
what drug can you use w/ behavior therapy for smoking cessation?
bupropion
T/F: doubling the tax on alcohol would lead to an increase in alcohol consumption
false
