Midterm

Question 1

Etiologies of Addiction

Answer 1

Personal responsibility/moral– person is of blame,root of stigma

Agent–blame substance

Genetic/biological

Social learning

Sociocultural

Disease**

Question 2

What is addiction?

Answer 2

a chronic disease of brain reward, reflected in pathologically seeking out substance
* Organ= brain, defect in reward system (midbrain, prefrontal cortex–>fight vs. flight system, logic system)–> bx: inability to stop using substances, despite harmful consequences–> impact: continued SU, cravings (response when drug cut off), impulsive decisions

Frequency, compulsion, persistence despite adverse consequences

Question 3

neuron

Answer 3

signal processor

Question 4

synaptic cleft

Answer 4

space b/w neurons

Question 5

axon

Answer 5

sender

Question 6

dendrite

Answer 6

receiver

Question 7

reuptake

Answer 7

recycle/reuse

Question 8

neurotransmitter

Answer 8

signal

Question 9

dopamine

Answer 9

pleasure/feel good

Question 10

prefrontal cortex

Answer 10

logic/thinking

Question 11

midbrain

Answer 11

fight vs flight

Question 12

neuroflooding

Answer 12

“being high”–lots of neurotransmitters in the synaptic cleft

Question 13

dependence

Answer 13

brain is functioning only when the substance is present; you become dependent on the presence of a drug–body adapts, requiring more to maintain a certain effect (tolerance), eliciting drug/mental symptoms if use stops

Question 14

tolerance

Answer 14

requiring more for same effect

why? our bodies seek BALANCE, to level off neurotransmitter levels, we kill off endogenous neurotransmitters, receptor down regulation, or deactivate receptors b/c we come to expect external source of substance in high doses

Question 15

withdrawals

Answer 15

lack of needed neurotransmitters

why? body became dependent on substance, when you no longer provide body w/ external source, your body adapted by down regulating receptors or killing endogenous ones, balance is OFF–> withdrawal symptoms (explains anhedonia)

Question 16

anhedonia

Answer 16

inability to feel pleasure

Why? you have fewer receptors than you originally did, you may have lower endogenous levels of dopamine being released–>not producing same effects as your brain pre-substance use

Question 17

hypofrontality

Answer 17

inability to use prefrontal cortex

stress–> activation of fight vs. flight–> deactivation of prefrontal cortex–> seeking out dopamine to help deal with stress–> cravings–> SU

Question 18

cravings

Answer 18

natural response d/t cutting off a substance

Question 19

9 areas of treatment planning (HELMMSSDF)

Answer 19

housing, ed/vocational, legal, medical, mental health, social/leisure, SU, D/C, family

Question 20

problem statement

Answer 20

should reflect 9 problem domains; written in bx terms

Question 21

goal

Answer 21

pt’s words, strengths-based, presence vs. absence, compliments problem definition

Question 22

objective

Answer 22

what will the pt do to accomplish their goal, SMART, action terms

Question 23

Intervention

Answer 23

compliment objective, therapists portion, must include frequency

Question 24

ASAM

Answer 24

numbers represent benchmarks a continuum, meaning pts move up or down in terms of intensity

Question 25

6 dimensions of ASAM

Answer 25

-acute intoxication/withdrawal/SU hx -health (physical) -psych/mental health -readiness to change -relapse, continued use -recovery/living situation

Question 26

Order of treatment

Answer 26

referral--> screening--> assessment--> diagnosis--> decide

Question 27

screening

Answer 27

detect possible presence of problem and need for further evaluation

Question 28

OARS= motivational interviewing

Answer 28

O: open ended questions A: affirm R: reflective listening S: summarize

Question 29

RULE= motivational interviewing principles

Answer 29

R: resist telling clients what to do U: understand motivations L: listen with empathy E: empower

Question 30

SMART= treatment plan goal setting

Answer 30

S= specific M= measurable A= attainable R= realistic T= time-frame

Question 31

FRAMES= SF

Answer 31

F= feedback R= responsibility for change A= advice M= menu of options E= empathic counseling style S= self-efficacy

Question 32

ATL

Answer 32

Ask, Tell, Listen

Question 33

precontemplation

Answer 33

(pros> cons): no intention to change bx, not even on mind

Question 34

contemplation

Answer 34

(pros= cons): I’m thinking about change

Question 35

preparation

Answer 35

(pros of use< cons): I am intending to change

Question 36

action

Answer 36

(pros of abstinence> cons): I am successfully changing bx

Question 37

maintenance

Answer 37

(pros of abstinence> cons): I am remaining free from bx, >6 mos

Question 38

termination

Answer 38

end of cycle, no temptations, 100% confident in all previous situations; years of maintenance

Question 39

Narcan mechanism of action

Answer 39

reverses overdose by... OPIOID RECEPTOR ANTAGONIST-->binds to opioid receptor and reverses/blocks effects of other opioids (higher affinity compared to opioids)

Question 40

Suboxone mechanism of action

Answer 40

* Buprenorphine= partial agonist-->producing fraction of rxn as other opioids, weaker rxn-->no high, but no withdrawals, block other opioids from attaching * Naloxone= antagonist-->block reaction-->used in suboxone to deter intravenous use-->if person tries to inject suboxone intravenously, naloxone will block opioid receptors--> immediate withdrawal symptoms w/o high

Question 41

semi-synthetic opiod

Answer 41

modification of an opiate (natural); ex: morphine heroin

Question 42

synthetic opioid

Answer 42

chemically derived in lab; not derived from poppy

Question 43

opioid

Answer 43

(all-encompassing natural+ synthetic+ semi-synthetic)

Question 44

opiate

Answer 44

(derived from poppy)

Question 45

opioid mechanism of action

Answer 45

o Opioid receptor agonists o Bind to opioid receptors--impact on Ca channels-- release of dopamine-- euphoria+ other effects o Half life= .6-150 hours

Question 46

opiate exames

Answer 46

opium, codeine, morphine

Question 47

semi-synthetic opioid examples

Answer 47

heroin hydrocodone oxycodone oxymorphone buprenorphrine

Question 48

synthetic opioid examples

Answer 48

methadone fentanyl tramadol

Question 49

meds can address (opioid)

Answer 49

withdrawals, cravings, aversion therapy (intravenous), psych disorders, "maintenance", overdoses (narcan)

Question 50

DSM mild, moderate, severe

Answer 50

2-3= mild 4-5= moderate 6+= severe

Question 51

screening tool examples

Answer 51

CAGE, CRAFFT, S2BI, TAPS, UA