Screening, Assessment & Engagement Flashcards
1
Q
Drug use
A
Using a drug in a socially acceptable or ritualistic manner (having wine with dinner or taking a prescription from your doctor)
2
Q
Drug misuse
A
Inappropriate use of a drug resulting in physical, cognitive, emotional, or social impairment (drinking alcohol while taking medications, saving unfinished prescriptions)
3
Q
Dopamine
A
Body movement, pleasure, reward
4
Q
Serotonin
A
Emotion, mood, sleep, temperature regulation
5
Q
Acetylcholine
A
Muscle movement
6
Q
Norepinephrine
A
Arousal, moods, memory formation
7
Q
GABA (gamma aminobutyric acid)
A
Motor behavior (deficits may result in convulsions)
8
Q
Glycine
A
Spinal reflexes, motor behavior
9
Q
Enkephalins and Endorphins
A
Pain reduction, pleasure
10
Q
_____ depresses the function of the medulla (lowest part of the brain) and can cause death
A
Opiates and barbiturates
11
Q
_____ decreases the normal activity of the ascending reticular activating system (ARAS, controls sleeping and waking).
A
Alcohol and other depressants
12
Q
_____ increases the normal activity of the ascending reticular activating system (ARAS, controls sleeping and waking).
A
Amphetamines
13
Q
_____ can result from both stimulation and depression of the ascending reticular activating system (ARAS, controls sleeping and waking).
A
Hallucinations
14
Q
Hypothalamus
A
Maintains homeostasis (balance), controls heart rate, blood pressure, hunger, and sexual behavior; psychoactive drugs affect this site
15
Q
Cerebellum
A
Coordinates voluntary movements, involved in motor learning, attention, and processing language/movement; Psychoactive drugs acting on the cerebellum causes loss of muscle coordination and balance
16
Q
Physical dependency
A
When a person has physical distress upon discontinuing drug use
17
Q
Users are not concerned with health effects and do not generally have feelings of euphoria with drug use but continue to use drugs to _____
A
Feel normal or to prevent withdrawal symptoms
18
Q
The time span from first drug use to dependency may be 5-10 years depending on _____
A
The individual’s psychological make-up, the amount of drug being used, and the drug’s properties
19
Q
Stages of substance abuse: Experimentation
A
Occasional use, substances may be provided by friends in a social setting or taken in response to stressful situations (loss of job, divorce); The person may continue using, stop using, or progress to the next stage
20
Q
Stages of substance abuse: Regular use
A
A regular pattern of use forms (every weekend, every day, in response to specific stressors)
21
Q
Stages of substance abuse: Problem use
A
The person begins to have problems as a result of substance use (loss of job, social exclusion, physical impairments, depression, motor vehicle accidents, failing grades)
22
Q
Stages of substance abuse: Dependence
A
The person continues chronic use despite problems and risks, builds up a tolerance, requires more substance to reach the same state, has withdrawals if they try to decrease use
23
Q
Stages of substance abuse: Addiction
A
The person feels a physical and psychological need for the substance despite problems its causing, they have cravings, participate in addictive behavior such as lying and stealing
24
Q
Stages of Alcohol Intoxication: Subclinical
A
BAC of 0.01 to 0.05, generally shows no impairment
25
Stages of Alcohol Intoxication: Euphoria
BAC of 0.03 to 0.12, shows signs of drinking such as talkative and decreased inhibitions, may have difficulty walking or short term memory impairment
26
Stages of Alcohol Intoxication: Excitement
BAC of 0.09 to 0.25, shows obvious signs of intoxication with impaired memory and judgement, difficulty maintaining balance, impaired vision, sleepiness
27
Stages of Alcohol Intoxication: Confusion
BAC of 0.18 to 0.30, confused, unstable, blackouts
28
Stages of Alcohol Intoxication: Stupor
BAC of 0.25 to 0.4, needs emergent care, unable to stand or walk, may have vomited or urinated; High risk for aspiration
29
Stages of Alcohol Intoxication: Coma
BAC of 0.35 to 0.45, may be hypothermic with impaired circulation and respirations; at great risk for death
30
Stages of Alcohol Intoxication: Death
BAC of 0.45 or greater, the person has respiratory failure
31
Stages of Alcohol Withdrawal: Beginning
Usually within 8 hours of no longer drinking; tremors, stomach cramping, anorexia, weakness, nausea, vomiting, sweating, irritability, mood swings, depression (similar to a severe hangover)
32
Stages of Alcohol Withdrawal: Withdrawal
Usually within 24 hours of no longer drinking; In addition to stage 1 symptoms, increased anxiety and mood swings, increased blood pressure and heart rate, incontinence, muscle rigidity, clenching of teeth, bite the tongue
33
Stages of Alcohol Withdrawal: Severe withdrawal
Up to 1/3 of people in withdrawal will have this stage; Usually between 3-14 days of no longer drinking but may also occur within 12 hours; extremely confused, hallucinations, severe agitation, seizures, delirium tremens, circulatory collapse, death
34
Misuse/abuse of prescribed medications: Altering dose/administration
The person takes a higher dose of medication or taking it in an unintended way (smoke a fentanyl patch or dissolve and inject medications intended for oral use)
35
Misuse/abuse of prescribed medications: Utilizing drugs for different purposes
Drugs intended for one purpose may be used to get high because of opioid properties (dextromethorphan and loperamide)
36
Misuse/abuse of prescribed medications: Combining drugs to create a new product
OTC medications may be mixed with other drugs such as cocaine in order to increase the effect
37
One drink of alcohol is _____
12 ounces of beer, 5 ounces of wine, 1.5 ounces of liquor
38
In most states, the legal BAC is ____
0.08
39
Two factors separate alcohol use from abuse
Tolerance, loss of control (inability to predict when intake will stop at any time)
40
The most widely abused drug and the most accepted
Alcohol
41
What affects the rate of absorption of alcohol?
Concentration of alcohol in drink, rate of consumption, amount of food in the stomach, emotional state of drinker
42
_____ occurs when the blood alcohol concentration increases faster than the body can remove the alcohol from the system
Intoxication
43
A condition known as sludge
Is when alcohol kills red blood cells and can block circulation to the heart which may cause damage
44
Ingestion of _____ causes an increase in insulin release which depletes the blood sugar and may cause hypoglycemia. As a result of low blood sugar, the body increases production of _____, which can lead to high blood sugar or hyperglycemia.
Alcohol; glycogen
45
After _____, motor function impairment occurs and reaction time is slowed. After _____, vision and hearing are affected. After _____, mental confusion occurs, mobility is affected. The ability to tolerate alcohol at this stage is an indicator of alcoholism as this stage is not usually passed unless alcohol is consumed very quickly. After _____ ingested quickly, loss of consciousness occurs and death by respiratory failure is possible.
3 drinks; 5 drinks; 8 drinks; 15 drinks
46
Hangovers result from
Accumulation of acetaldehyde in the body, dehydration, poisoning, and depletion of important enzymes
47
_____ are drugs that can induce drowsiness and a state similar to normal sleep.
Sedative-hypnotic drugs
48
The three types of barbiturates: _____ are used as surgical anesthetics with rapid onset and short duration, rarely abused; _____ used as anxiolytics and are used to aid in sleep, with an onset effect of 15-40 minutes and effects lasting up to 6 hours, very frequently abused; and _____ used as sedatives, hypnotics, and anticonvulsants with an onset of up to one hour and effects lasting up to 16 hours. These are less likely to be abused because of their slow onset.
Ultra short-acting barbiturates; Short-intermediate acting barbiturates; Long-acting barbiturates
49
Barbiturates are _____ and the physical effects include _____
Anxiolytic; relaxation, increase in reaction time, loss of coordination.
50
Withdrawal symptoms from barbiturates
Includes anxiety, tremors, insomnia, nausea, convulsions, nightmares; can be life threatening. Barbiturates should not be stopped suddenly and should gradually decrease usage under doctor supervision. Those who abuse barbiturates have a high chance of overdose.
51
_____ are well known drugs to treat anxiety.
Minor tranquilizers/benzodiazepines
52
Minor tranquilizers/benzodiazepines can produce fatal results when used with _____
Alcohol
53
Drugs classed as narcotics are sometimes referred to as _____
Opiates, which are manufactures from the opium poppy or designed to mimic effects of morphine
54
Three classifications of narcotics: _____ (opium, morphine, codeine); _____ (heroin, hydromorphone); _____ completely in the lab (meperidine, methadone, propoxyphene)
Natural; semi synthetic; synthesized
55
Narcotics are clinically used to treat _____. Narcotics depress the CNS and cause _____. They do not cause loss of motor coordination, as other drugs do.
pain, affect sleep, diarrhea, relieve coughs; euphoria and drowsiness
56
With continued use, _____ is taken solely to ward off withdrawal symptoms which appear within 8-12 hours of the last dose
Heroin
57
A person on narcotics generally exhibits _____
A decrease in activity level and drowsiness
58
_____ has little difference between a euphoric dose and a dose that causes death. They can also cause neurological damage.
AMF/fentanyl
59
3 categories of inhalants: _____ found in cleaning products, nail polish remover, plastic cement, gasoline, and are easily obtained; _____ found in hair spray, deodorant spray, refrigerators, and air conditioners; _____ of abuse are chloroform, ether, halothane, and nitrous oxide which can only be obtained at medical supply stores.
Solvents; aerosol sprays; anesthetics
60
Recovery from the effects of _____ usually lasts 15 minutes to 1 hour but there is a risk of death from cardiac or respiratory arrest. Long term users may have weight loss, bone marrow damage, visual deficits, memory deficits, paralysis, and cognitive difficulties
Inhalants
61
_____ is classified as both a psychedelic and a depressant and is the second most abused drug in the US behind alcohol
Marijuana
62
Smoking marijuana damages the _____ and is a _____. Marijuana has 50% more cancer causing agents than tar and regular cigarettes
Respiratory tract; cancer risk
63
When taken _____, the effects of marijuana develop over a period of 2-3 hours. When _____, the effects appear almost immediately and have a shorter duration
Orally/ smoked
64
Marijuana can be detected in lab tests for up to _____ after use
Six weeks
65
The _____ is the most common type of mushroom used in Northern America. The two main psychoactive chemicals in this mushroom are _____ and _____
Psilocybe mushroom; psilocybin; psilocin
66
LSD is short for _____ and can be manufactured using the _____ (a fungus that grows on rye) and _____ (found in morning glory seeds). LDS is also known as acid.
Lysergic acid diethylamide; ergot compounds; lysergic acid amide
67
3 related synthetic compounds of amphetamines
Amphetamine/Levoamphetamine, dextroamphetamine, methamphetamine
68
Physical withdrawal symptoms from amphetamines
Rapid pulse, stomach cramping, anxiety, nausea, tremors, convulsions; may las up to 21 days after last use
69
Individuals taking amphetamines may be _____
More talkative and restless, suppressed appetite; injection provides a rush similar to orgasm
70
Individuals taking amphetamines in high doses may be _____
Suspiciousness, anxiety, paranoia, delusions, psychosis, auditory hallucinations
71
Physical affects of amphetamines include _____
Pupil dilation, increased blood pressure, hand tremors
72
Individuals taking amphetamines in small doses may cause _____
Panic attacks, circulatory and cardiac problems, hallucinations, and coma
73
Overdose from amphetamines may lead to _____
Death from cerebral vascular accidents or cardiac arrest
74
_____ and _____ contained in nonprescription decongestants are used to make Ice which is a highly addictive, colorless, odorless form of methamphetamine.
Ephedrine; pseudoephedrine
75
The acute psychological effects of Ice (methamphetamine) include _____ and negative effects include _____
Euphoria, increased alertness, energy, confidence, a sense of well being; panic attacks, aggression, paranoia, and psychosis
76
The acute physical effects of Ice (methamphetamine) include _____
Tremors, dizziness, stomach cramps, nausea, difficulty sleeping, heart palpitations
77
Long term effects of Ice (methamphetamine) include _____ include _____
Depression, paranoia, anxiety, malnutrition, weight loss, heart problems
78
Ice (methamphetamine) increases the amount of _____ in the brain and damages neurons containing _____ and _____
Dopamine; serotonin; dopamine
79
_____ is called the mellow drug of America. It is primarily a _____ and effects (euphoria) start about 60 seconds after using and last about 8 hours. This drug is popular as it enhances sexual pleasure. Continued use results in _____
MDA; depressant; tolerance but not dependence
80
MDMA is a combination of _____ and _____. It has depressant and stimulant qualities
Amphetamine; mescaline
81
Moderate to high doses of MDA can be toxic because it damages neurons containing ____ and increases brain level of _____. It hinders the body's temperate control mechanism and can lead to overheating and death
Serotonin; norepinephrine
82
DOM is a combination of _____ and _____. It has similar effects to LSD and remains in the body for 12-72 hours depending on the size of the dose
Amphetamine; mescaline
83
Caffeinism
Chronic caffeine poisoning; symptoms include anxiety, headache, sleep disturbances, irritability, lack of energy, depression, irregular heartbeat, ulcers, pain
84
Cocaine is absorbed through the blood stream by the mucous membrane in ____ and a typical dose lasts ____
1 to 3 minutes; 20 to 30 minutes
85
Cocaine taken _____ results in a milder high
Orally
86
When injected, cocaine produces a rush lasting _____, which is not experienced when the drug is taken any other way
10 minutes
87
Emergency procedure for alcohol
Manage airway, perform CPR, maintain body temperature with blankets, reduce noise/light (decrease stimuli), position on side if person has nausea and/or vomiting to prevent aspiration
88
Emergency procedure for cocaine
Manage airway, administer oxygen if available, avoid overheating body as temperature may increase, remove any visible cocaine from nose, speak soothingly and calmly, avoid physical restraint if possible
89
Emergency procedure for opioids
Manage airway, perform CPR if necessary, provide oxygen if available, inject with naloxone
90
Emergency procedures for acute withdrawal for alcohol
Provide a quiet space and emotional support, keep lighting soft and provide adequate fluids and food, observe for any sudden changes or seizures
91
Emergency procedures for acute withdrawal for cocaine
Observe client for signs of suicidal ideation, paranoia, or aggression; take safety measures to protect client and others; provide a quiet, calm space; monitor the heart rate
92
Emergency procedures for acute withdrawal for opioids
Adequate fluids and electrolytes, OTC drugs (acetaminophen or NSAIDs), antidiarrheal, Clients who are vomiting should be positioned on their side and not be left unattended due to aspiration risk
93
At the abuse stage, drugs are taken not only to get high but also to feel _____ or to _____
Normal; be rid of the unwanted feelings of discomfort from withdrawals
94
Delusions are _____
Beliefs that are not founded in reality (someone believing they are a fictional figure or God)
95
A hallucination is _____
A trick of the senses; A person may see, feel, hear, or smell something that is not really there
96
A brief psychotic disorder is _____
Includes at least one of these symptoms that lasts more than one day but less than one month and is not attributed to any other disorder: delusions, hallucinations, disorganized speech, disorganized behavior
97
Five traits involved in personality disorders _____
Neuroticism, extraversion/introversion, openness to experience, agreeableness/antagonism, and conscientiousness
98
Cluster A personality disorders
Eccentric type; paranoid, schizoid, and schizotypal
99
Cluster B personality disorders
Dramatic type; antisocial, borderline, histrionic, and narcissistic
100
Cluster C personality disorders
Fearful type; avoidant, dependent, and obsessive compulsive
101
Panic disorder
Recurrent brief but intense fear in the form of panic attacks with physiological or psychological symptoms
102
Specific phobia
Fear of specific situations or objects
103
Generalized anxiety disorder
Chronic physiological and cognitive symptoms of distress, excessive worrying lasting at least 6 months
104
Separation anxiety disorder
Excessive anxiety related to being separated from someone the client is attached to
105
Selective mutism
Inability to speak in social settings though normally able to speak
106
Social anxiety disorder
Anxitey about social situations
107
Agoraphobia
Anxiety of being outside of the home or in open places
108
In Bipolar I disorder, the client must have a manic episode that is followed by an episode of _____
Major depression or hypomania
109
In Bipolar II disorder, the client has had one or _____ and one or more _____. The client has never had a manic episode
Major depressive episodes; hypomanic episodes
110
Hypomania is defined as _____
An episode of elevated, demonstrative, or irritable mood
111
Screening _____; Assessment _____
Determines if there is a problem; determines the exact nature and severity of the problem and to develop a treatment plan to deal with the problem
112
Principles of motivational interviewing
Show empathy for client by reflective listening; expose inconsistencies between the client's goal and their actions; should not use a confrontational approach; should be flexible in approach and avoid challenging directly; any show of effectiveness or hopefulness by the client should be rewarded by counselor
113
Five strategies of motivational interviewing
Asking open ended questions, listening reflectively, summarizing, affirming, eliciting self-motivational statements
114
Four types of self-motivational statements
A conscious acknowledgement of the issue, an emotional expression of concern about the problem, a statement of intention to change behavior, an expression of optimism about the possibility of change
115
Methods for handling resistance: simple reflection
Repeating the client's statement in a nonjudgmental way
116
Methods for handling resistance: amplified reflection
Repeating the client's statement in an exaggerated form
117
Methods for handling resistance: double-sided reflection
Acknowledging the client's statement and referring to a statement the client made in the past that contracts themselves now
118
Methods for handling resistance: shifting focus
Counselor turns the client's attention away from a problem area
119
Methods for handling resistance: agreeing with a twist
Counselor makes a statement that agrees with the client while also changes the direction of the conversation
120
Methods for handling resistance: reframing
Counselor restates the client's negative comment in a positive way
121
Methods for handling resistance: siding with the negative
Counselor agrees with a negative statement made by the client, inducing a change of direction on the part of the client
122
Standardized interview
Predetermined questions asked during an interview, no deviation is allowed. No probing is allowed but it does eliminate bias by the counselor leading the client
123
Structured interviews
Allows the counselor to explore areas of concern that are brought up during the interview
124
Self-administered tests
Filled out by the client without the intervention of the counselor, which is less threatening to the client
125
C.A.G.E.
Cutting down, annoyed at criticism, guilty feeling, eye opener; Yes on one question suggests a drinking problem; Yes for two or more questions indicates a drinking problem
126
S.B.I.R.T.
Screening, Brief Intervention, and Referral to Treatment; brief intervention may take 5-15 minutes to discuss negative affects of use or for moderate risk planning 4-6 sessions to help client develop motivation to change, coping skills, and problem solving skills; For high risk clients, they should be referred to an drug/alcohol rehabilitation program
127
T.A.P.S.
Tobacco, Alcohol, Prescription Medication, and Other Substance Use; TAPS-1 asks four questions about substance use frequency and responses include never, daily/almost daily, weekly, less than monthly, and monthly; TAPS-2 includes questions about frequency and situation of substance use in the past 3 months
128
C.R.A.F.F.T.
Recommended for use with clients under the age of 21; Have you ever drove or rode in a CAR while under the influence of substances? Do you use substances to RELAX? Do you ever use substances when ALONE? Do you ever FORGET things you did while using? Do your FAMILY or FRIENDS ever tell you that you should stop using? Have you ever gotten into TROUBLE while using?
129
_____ assesses whether or not the screening and assessment process led to a suitable treatment plan for the patient. _____ examines whether or not the client was accurately assessed and if they benefited from the treatment plan
Process evaluation; outcome evaluation
130
_____ are the behavioral, psychological, and physiological symptoms due to use or restriction of a substance
Substance intoxication or withdrawal
131
The DSM-5 states that two or more of these symptoms must be met anytime during the past 12 months for a diagnosis of substance use disorder
Tolerance, withdrawal, an increase in the amount or using longer than intended, an inability to control usage, a large amount of time and effort devoted to using, giving up important activities to use, the continued use of the drug, cravings, inability to fulfill major roles, physically harmful situations, continued social problems
132
Characteristics of an addictive personality
Thrill seeking, impulsive, history of addiction, history of family addiction, lying, stress
