Principles of Screening, Assessment, & Treatment

Question 1

What are the 5 categories of substance abuse?

Answer 1

1. Abstinence
2. Low risk, non problematic use
3. At high risk, non problematic use
4. Substance abuse
5. Substance dependence

Question 2

Describe the ‘abstinence’ category of substance abuse.

Answer 2

No use, consequences, or repetition.

Question 3

Describe the ‘low risk, non problematic use’ category of substance abuse.

Answer 3

Use, no consequences, or repetition.

Question 4

Describe the ‘high risk, non problematic use’ category of substance abuse.

Answer 4

Use, may or may not have consequences, no repetition.

Question 5

Describe the ‘substance abuse’ category of substance abuse.

Answer 5

Use, consequences and repetition.

Question 6

Describe the ‘substance abuse’ category of substance abuse.

Answer 6

Use, many consequences, repetition and loss of control, preoccupation, compulsivity, and physical dependence.

Question 7

What are the methods of screening/identification for high risk, abuse or dependence?

Answer 7

1. Observe signs and symptoms
2. Corroboration from collaterals
3. Informal review
4. Screening tools (CAGE-AID)

Question 8

What are the signs/symptoms of opioid use?

Answer 8

Track marks, pinpoint pupils, drowsiness, slurred speech, double doctoring, requesting OTC codeine.

Question 9

What are the signs/symptoms of amphetamine and cocaine use?

Answer 9

Rapid rate of speech, short attention span, irritability, mood swings, dilated pupils, paranoia, formication.

Question 10

What are the signs/symptoms of marijuana use?

Answer 10

Munchies, red eyes, short attention span, paranoia.

Question 11

What are the signs/symptoms of LSD use?

Answer 11

Dilated pupils, visual changes, psychosis, flashbacks.

Question 12

What are the signs/symptoms of PCP?

Answer 12

Blank stares, agitation, violent outbursts.

Question 13

What are the 4 questions of the CAGE-AID screening tool?

Answer 13

1. Have you ever felt like you should cut down on your drinking or drug use?
2. Have people ever annoyed you by criticizing you drinking or drug use?
3. Have you ever felt guilty about your drinking or dug use?
4. Have you ever had a drink of or used drugs first thing in the morning to steady your nerves or get rid of a hangover or residual drug effect?
   - screens for abuse and dependence, but not at risk use
   - yes to one or more warrants investigation

Question 14

What are the advantages of urine testing?

Answer 14

• broad range of drugs and metabolites can be screened and detected
• easier to collect than blood

Question 15

What are the disadvantages of urine testing?

Answer 15

• difficult to witness sample collection
• can dilute with fluid overload
• can cheat
• poppy seeds give a false positive opioid result
• provides of use preceding 1-3 days

Question 16

What are the advantages of blood sample testing?

Answer 16

• can give record of drug use preceding 12-24 hours
• easy to witness sample collection
• used to measure toxicity of a variety of drugs and alcohol

Question 17

What are the disadvantages of blood sample testing?

Answer 17

• more invasive

- panel of drugs is more limited than urine

Question 18

What are the advantages of hair sample testing?

Answer 18

• record of drug use over the preceding 90 days
• even a few uses of most drugs are detectable
• metabolites of alcohol are detected
• can readily witness sample collection
• won’t get a false positive poppy seed test
• 90 day snapshot of intensity of use based on quantitative comparison to other samples

Question 19

What are the disadvantages of hair sample testing?

Answer 19

• doesn’t provide info on drug use for the preceding 7 days prior to sample collection
• cannabis detection is low
• less commonly used, small panel of drugs able to be measured to date

Question 20

What are the advantages of saliva testing?

Answer 20

• results align with blood testing picks up on drug use within the preceding 12-24 hours of sample collection
• easy to witness sample collection
• sensitivity similar to urine testing; except for cannabis use

Question 21

What are the disadvantages of saliva testing?

Answer 21

• insensitive to cannabis use
• limited range drugs that can be tested
• gives data over 12-24 hour period only

Question 22

What are some causes of relapse?

Answer 22

Negative emotional states, positive emotional states, physical discomfort, testing personal control, strong temptations/urges, conflict with others, social facilitation/pressure to use, good times with others, easy access, boredom.

Question 23

How can you prevent relapse?

Answer 23

Educate about relapse, limit access, identify likely triggers/rituals and avoid them, identify pay offs, develop new coping strategies, use leisure time, build a balanced lifestyle, establish support, carry an emergency sobriety card.

Question 24

How do you manage relapse?

Answer 24

• don’t view it as a failure
• look for changes in behaviour like using less of a drug, using it less often, positive lifestyle changes, reducing or eliminating high risk behaviours
• identify triggers and ways to deal with them
• encourage to continue in or resume treatment