Kohlenberg > Treatments for Substance Use Disorders

Question 1

what is the lifetime rate of SUD (%)?

Answer 1

~14.6%

Question 2

how many people (%) reported a SUD in the past year (over 12yo)?

Answer 2

8.7%

Question 3

how many people are compulsive gamblers (%)?

Answer 3

~5%

Question 4

how many people watch porn online more than 11 hours/wk (%)?

Answer 4

fucking 6%!!!!!

Question 5

how much of the population binge eats?

Answer 5

3-5%

+ me on cheat day

Question 6

what is SUD assoc w/?

Answer 6

interpersonal violence
HIV risk behavior
suicide
criminal behavior

Question 7

how many ppl in addiction treatment have PTSD (%)?

Answer 7

~60%

Question 8

T/F: people in addiction treatment with trauma hx have better outcomes

Answer 8

lol false

Question 9

what is “seeking safety”?

Answer 9

an evidence-based model for substance abuse & trauma/PTSD

Question 10

T/F: pts w/ substance abuse & PTSD typically have enormous self-loathing

Answer 10

true

Question 11

what is compassion?

Answer 11

replacing destructive self-talk with compassionate self-talk

a loving stance toward self produces lasting change

Question 12

what are 2 questions you can ask yourself when you notice harsh self-talk?

Answer 12

“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?”

Question 13

what are 5 things to do to increase compassion?

Answer 13

explore underlying reasons
use kinder language
imagine you are talking to a small child who has made a mistake
experiment w/ compassion
practice

Question 14

T/F: there is a single treatment that will work for everyone w/ a SUD

Answer 14

false

Question 15

what are some principles of effective SUD tx?

Answer 15

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)

Question 16

what are the most useful therapies in SUD?

Answer 16

behavioral

focused on motivation, family, relationships

Question 17

what are 2 examples of meds that can help w/ SUD?

Answer 17

methadone

nicotine replacement

Question 18

what is the important first step of treating SUD?

Answer 18

medically assisted detox

Question 19

T/F: treatment is only effective if it is voluntary

Answer 19

NOPE

Question 20

T/F: most people who get into & remain in treatment stop using drugs

Answer 20

TRUE! yay!

Question 21

T/F: relapse rates for addiction are much higher than those of other chronic medical conditions

Answer 21

false
they’re about the same as w/ asthma, diabetes (30-50%), & HTN (50-70%)
(drug addiction is 40-60%)

Question 22

what is the goal of SUD treatment?

Answer 22

management, not cure

Question 23

what are the 5 stages of change?

Answer 23

precontemplation
contemplation
preparation
action
maintenance

Question 24

what is precontemplation like?

Answer 24

pt not concerned about problem
no intention to change soon
pros of maintaining behavior outweigh the cons of changing

Question 25

what is contemplation like?

Answer 25

pt acknowledges prob
ambivalent toward change
pros = cons about change
pt considers action in next 6 mos

Question 26

what is preparation like?

Answer 26

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

Question 27

what should doctors do during the preparation phase?

Answer 27

reinforce preparations to change

Question 28

what is action like?

Answer 28

pt begins to change

changes are evident to others > recognition

Question 29

what should doctors do during the action phase?

Answer 29

notice & reinforce change

Question 30

what is maintenance like?

Answer 30

gains made during action are consolidated & maintained for 6 mos
change still happens & needs work

Question 31

what should doctors do during the maintenance phase?

Answer 31

reinforce maintenance activities (pts may plateau in visible changes)

Question 32

is relapse common in the maintenance phase?

Answer 32

YUP

Question 33

what is abstinence violation syndrome?

Answer 33

after slipping & using after a pd of abstinence, the pt thinks “this is hopeless, i might as well keep using”

Question 34

what is “lapse”?

Answer 34

minor setback

no real analysis

Question 35

what is “relapse”?

Answer 35

complete reversion to previous pattern of behavior w/ downward spiral

Question 36

what is “prolapse”?

Answer 36

work it over, send you forward in your recovery (???)

Question 37

how can doctors inoculate against relapses?

Answer 37

normalize lapses
teach that lapses don’t have to lead to relapses
develop relapse prevention plans

Question 38

what is urge surfing?

Answer 38

a relapse prevention skill with a fancy graph

mindfulness to overcome cravings

Question 39

what has long been implicated in the onset, maintenance, & relapse of SUD?

Answer 39

alcohol, nicotine, &/or illicit drugs to avoid unwanted psychological or physical distress

Question 40

what mediates the relationship btwn substance USE & substance ABUSE/dependence?

Answer 40

capacity to tolerate stress

Question 41

what are the goals of mindfulness, ACT, & SUD tx?

Answer 41

emotional acceptance (not avoidance)
distress tolerance

Question 42

what drug can you use w/ behavior therapy for smoking cessation?

Answer 42

bupropion

Question 43

T/F: doubling the tax on alcohol would lead to an increase in alcohol consumption

Answer 43

false