Psych of Addic 2nd Exam

Question 1

Who are the founders of AA?

Answer 1

Bill W. and Dr. Bob

Question 2

What is AA?

Answer 2

Alcoholics Anonymous are sessions run by and for alcoholics where they share their stories.

Question 3

What is the Big Book?

Answer 3

It’s a non secular text published by Bill W. and Dr. Bob.

Serves as basic text of AA.

Goal of this book is to make it possible for the reader to find a power greater than himself to solve his problem.

Question 4

What is “The First Step”?

Answer 4

It’s the first of the 12.

“We admitted we were powerless over alcohol—that our lives had become
unmanageable”

Question 5

What is a sponsor?

Answer 5

In A.A. sponsor and sponsored meet as equals, just as Bill and Dr. Bob did. Essentially, the process of sponsorship is this: An alcoholic who has made some progress in the recovery program shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety through A.A.

Usually same sex.

Question 6

What is the Helper Therapy Principle?

Answer 6

Helping someone with the same problem as yourself helps you with your own.

Question 7

What are open and closed meetings?

Answer 7

AA meetings are “quasi-ritualized therapeutic sessions run by and for, alcoholics.”

Those listed as “closed” are only for those with “a desire to stop drinking.”

“Open” meetings are available to anyone.

Question 8

What is “Hitting Botoom”?

Answer 8

Bottom is different for each person.

True Hitting Bottom: a point where you have lost everything and have nothing left to lose

Question 9

What is the term “90 meetings in 90 days” mean?

Answer 9

A recommendation that a new comer should attend at least 90 meetings in 90 days in order to be adequately acquainted with AA.

Question 10

What is meant by the AA slogan “One day at a Time”?

Answer 10

The members take one day at time or focus on “today” and not yesterday or tomorrow.

Worrying about yesterday’s mistakes, and the fear of discovery which comes with doing the wrong thing (acting out in our character defects) comes with a huge emotional load.”

Question 11

What is the Serenity Prayer?

Answer 11

Prayer adopted by AA and other 12 step program.

“God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.”

Question 12

What is Synanon?

Answer 12

This was the first therapeutic community for drug addiction.
•Created by Charles “Chuck” Dederich, Sr.
•A serious AA member – he got in trouble for cross-talk at a meeting
•He began working with “hard core” heroin addicts
•Recovery was a complete healing process
•Had to attack the addict/criminal values from the outside in

Question 13

What is the TC perspective?

Answer 13

Drug abuse is a disorder of the whole person.

Question 14

The community is __________ and use ____ _______ as example.

Answer 14

healer/ teacher

role models

Question 15

What is a role model?

Answer 15

those who demonstrate the expected behaviors and reflect the values and teaching of the community.

In a TC (therapeutic community) peer and staff are the role models.

Question 16

What is Right Living?

Answer 16

A clear moral message.

In TC’s, clear “moral” positions are held regarding social and sexual conduct.

• Explicit right and wrong behaviors are identified
• These are rewarded or met with sanctions
• The working-through of guilt is seen as important
• Truth and honesty (in word and deed)

Question 17

What is “Act as if”?

Answer 17

Behaving as the person that you should be, not the person you have been.

Question 18

What’s an “Encounter Room”?

Answer 18

–The cornerstone
–Confrontational
–Peer-led
–12-20 residents, 3x week, 2 hours

Question 19

What is “Haircut”?

Answer 19

A group session in which a relatively new member is “taken apart” by community elders and given prescriptions for improving attitude and behavior.

Question 20

Research Finding

Answer 20

The longer the individual stays in TC (Therapuetic Community), the better the outcome.

Question 21

Contemporary TCs seek to be flexible while maintaining their core values

Answer 21

•Individual client needs dictate the services provided
•The model is adapted to the client
•This is a fundamental change in the TC model
•The traditional model was fixed
*The clients need to adapt to it

Question 22

Oxford Houses:
People in recovery living together

Answer 22

1. Must be voted in by peers
2. Immediately expelled if there is any drug or alcohol use
3. Financially self-sustaining

Question 23

Minnesota Model: 28-Day inpatient, 12-Step-oriented treatment program

Answer 23

Core philosophy:
• the house must be democratically self-run
• the house must be financially self-supporting

Question 24

What are the 7 key elements of the Minnesota Model?

Answer 24

Some of the key elements are:
1.The integration of professional staff with trained recovering alcoholics;
2.The focus on the disease concept and our link to the 12-step fellowships;
3.The dedication to family involvement;
4.The insistence on abstinence from the use of all addicting drugs….
The emphasis on patient and family education;
6. An individualized treatment plan; and
7. A continuum of care integrating sustained aftercare into all treatment plans.”

Question 25

What is the Harrison Act?

Answer 25

Harrison Act- was a United States federal law that regulated and taxed the production, importation, and distribution of opiates.
•required prescriptions for narcotics

Question 26

What is the Immochemical Theory of Addiction?

Answer 26

•Taking morphine stimulated the creation of antibodies
•Maintenance doses of opiate would bring the body into balance with the level of antibodies
•If too little opiate was administered,
–The body would go into withdrawal because the antibodies were active
•If too much opiate was administered,
–The antibodies would be overwhelmed and the patient would experience intoxication
•Because this theory implied maintenance
•There were steps taken by government, public health, and medical organizations
•To restrict or ban any discussions of “physiological balance”
•Unfortunately, for addiction medicine
•Researchers were unable to find the antibodies for morphine and heroin
–The theory was discredited
•The first time that the Government had stepped in to dictate what physicians could do in the treatment of their patients

Question 27

Narcotic Farms: Lexington, Kentucky, and Fort Worth, Texas

Answer 27

• The next step in treatment, was the “narcotic farms” that were built in Lexington, Kentucky and Fort Worth, Texas (1929 – 60’s)
• **A kind of a combination prison and hospital
• Patients were usually prisoners but some were volunteers
• Patients were detoxified off of drugs**
• Attempts were made to rehabilitate them through work and psychosocial methods
• Roughly 90% of these patients relapsed back to use after leaving the farm
• Research was done with patients in Kentucky
• A great deal was learned about opiates from this work
• Including research treating patients addicted to heroin with other opiates

Question 28

Relapse rates

Answer 28

75-90% of opiate-addicted persons who are detoxified off of opiates or who undergo a dose reduction off of methadone will relapse back to opiate use within two years

Question 29

Mu Opiate Receptor

Answer 29

Three chemicals act on the neurons in the brain and throughout the nervous system and are known as the endogeneous opoid system:
1. endorphins
2. enkephalins
3. dynorphins
These bind to specific receptors in the brain and nervous system:
1. mu
2. kappa
3. delta

• Heroin and other abused opiates are usually MU agonists

Question 30

Metabolic Theory (a non psychiatric theory of addiction)

Answer 30

Long-term addicts continue to use heroin
•Repeatedly relapsed to heroin use after detoxification, drug-free treatment, or imprisonment
•In an attempt to correct a fundamental metabolic imbalance.
•They experience this as “drug hunger”
•Whether the imbalance was caused by
–The drugs
–The person’s genetic endowment
–Traumatic developmental and environmental experiences,
–Or some combination of these factors
•Was unknown.

Question 31

What is Cross Tolerance?

Answer 31

Blocks affects of other opiates.

Question 32

Marijuana

1. What is the main ingredient?
2. Activates the _______ receptors
3. Leads to release of ________

Answer 32

1. THC (delta-9- tetrahydrocannabinol) – Major active chemical
2. Activates the cannabinoid receptors
3. Leads to the release of Anandamide

Question 33

Amotivational Syndrome

Answer 33

• *A state marked by:
  1. Passivity
  2. Aimlessness
  3. Apathy
  4. Uncommunicativeness
  5. Lack of ambition**

Def: is a psychological condition associated with diminished inspiration to participate in social situations and activities, with lapses in apathy caused by an external event, situation, substance (or lack of), relationship, or other cause.
While some have claimed that chronic use of cannabis causes amotivational syndrome in some users, empirical studies suggest that there is no such thing as “amotivational syndrome”, per se, but that chronic cannabis intoxication can lead to apathy and amotivation

Unclear if caused by marijuana use, a precursor to marijuana use,

synergistically affected by marijuana use

Question 34

Medical Marijuana:
Name three disorders that it can allegedly be useful for
1.

2.

3.

Answer 34

Current proposed uses include:

• *1. Nausea and vomiting due to cancer chemotherapy
  2. AIDS-related weight loss
  3. Alcoholism treatment**
• Neuropathic pain states
  •Epilepsy that is nonresponsive to anticonvulsants
  •Muscle spasms and tremors for those suffering from spastic disorders, i.e., multiple sclerosis, cerebral palsy
  •(Paradoxically) Asthma – might do well with the vaporizer
  •Glaucoma

Question 35

Buprenorphine

Answer 35

*Partial mu-opioid agonsist and kappa antagonist
*Initially used for the treatment of pain- approved in 2002 by FDA for treatment of opiod dependence.
*The first and only opiod that physicians can prescribe for the treatment of addiction.
*Combined with naloxone to prevent diversion
* will bind to the mu receptor and activate it

Question 36

Naltrexone

Answer 36

* Opiate antagonist

* It works by decreasing the craving for alcohol and blocking the effects of opioid medications and opioid street drugs.

* Blocks activation of receptors by heroin and other opiates. Heroin is no longer rewarding. Tends to be successful with physicians and other professionals who will lose their jobs/ license if they relapse.

Question 37

Antabuse (Disulfiram)

Answer 37

Creates an “allergic” reaction to alcohol
•vomit, flushing, anxiety, nausea, thirst, headache

Disulfiram is used to treat chronic alcoholism. It causes unpleasant effects when even small amounts of alcohol are consumed. These effects include flushing of the face, headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety.

Question 38

What is Acamprosate?

Answer 38

*treats alcohol dependence and to avoid drinking again

*reduces cravings to drink

Question 39

What is Baclofen?

Answer 39

•A muscle relaxant – used for muscle spasms

* used in alcohol treatment

•This effects three neurotransmitters
–Dopamine
–GABA
–Glutamate

Question 40

What is Topiramate/Topamax?

Answer 40

• Anticonvulsant medication- used for migraines and seizures
• Decreases drinking in those who are motivated to stop
• Also undoes some of the damage that has been caused to the liver and the heart
• Also works on the GABA and glutamate systems

Question 41

Nicotine Replacement Therapy: 5 Methods- Provides smokers with doses of nicotine to stop cravings

Answer 41

1. Patch
2. gum
3. lozenge
4. nasal spray
5. inhaler

Question 42

What is Step Meeting?

Answer 42

A different step is discussed at each meeting.