substance abuse disorders

Question 1

substances are…

Answer 1

psychoactive materials such as alcohol, caffeine, nicotine and other drugs that are used by people to get certain effects

Question 2

substance misuse or dependence occurs….

Answer 2

when people continue to use a drug/ drugs despite negative consequences occurring as a result of these drugs, which often lead to the development of various substance use disorders (SUD)

Question 3

common pattern of substance use

Answer 3

• experimental use (intrigue of the drug),
• recreational use, situational use (smoking at a party when it is offered),
• bingeing,
• dependent use (prioritising the drug over other things),
• intoxication (short term effects of the drug such as violence, risky sexual behaviour),
• regular excessive use (problems arise over using the drug excessively- may be physical or medical consequences such as liver cirrhosis)

Question 4

using injectable substances leads to a risk of

Answer 4

• psychosis
• depression
• injury
• overdose
• blood borne viruses
• physical illness
• nutrient deficiencies

Question 5

4 Ls of substance use effects

Answer 5

Liver
Lover
Livelihood
Law

Question 6

Liver

Answer 6

involves physical impacts of abusing substances

chance of cirrhosis, overdose, cancer, psychiatric/psychological or emotional issues

Question 7

Lover

Answer 7

Relationship problems with family, friends, partner, children

Question 8

Livelihood

Answer 8

problems relating to worklife and non work related activities such as hobbies

Question 9

Law

Answer 9

legal issues that may occur as a result of substance use

DUIs, possession, trafficking

Question 10

Stigma and SU

Answer 10

• people with SUD are negatively portrayed in society- seen as less worthy of respect
• comorbid SUDs are further stigmatised
• Leads to low self worth and avoidance of contact with mainstream society, and seeing HPs
• Drug and alcohol probram can inc. stigma as seeking treatment means an ‘ addict’ or ‘junkie’ identity

Question 11

impact of HPs attitudes on treatment

Answer 11

if the HP has conflicting views about the persons SU, it can negatively affect the ability for the individual to get the help they deserve.
HPs may lack the confidence to treat the person
gatekeeping may occur- rejecting referrals of service because the person has other MH issues as well as a SUD
HPs are encouraged to seek out further training about SUDs

Question 12

Language that HPs should avoid when working with SUDs

Answer 12

avoid terms that stigmatise the individual- eg. “addict” “junkie” “drug seeker”
do not even use these words when the individual with a SUD is absent

Question 13

comorbidities/dual diagnoses and SUDs

Answer 13

the rates of substance use issues are much higher in people with mental health problems and, likewise, that the incidence of mental health problems is significantly higher in people seeking treatment for substance use issues

Question 14

approach taken to the care & treatment of people with SUDs

Answer 14

Harm minimisation

Question 15

what is harm minimisation?

Answer 15

it acknowledges that substance use will continue in the community and the work of health services and health professionals is to assist to reduce the harm associated with substance use for individuals and also for the community as a whole.

Question 16

major categories of substances

Answer 16

stimulants
depressants
hallucinogens

Question 17

stimulants_________neurochemical activity in the brain

a. increase
b. decrease
c. have no affect on

Answer 17

a

Question 18

stimulants include…

Answer 18

caffeine, nicotine, amphetamines, cocaine

Question 19

stimulants lead to….

Answer 19

• euphoria/sense of wellbeing
• increased energy
• wakefulness & confidence
• improved cognitive and physical performance
• decreased appetite

Question 20

depressants____ activity in the brain

a. change perceptual
b. increase
c. decrease

Answer 20

c

Question 21

depressants impact…

Answer 21

cognition
impairs coordination
induces sedation

Question 22

in larger doses, depressants can..

a. lead to seizures
b. induce chronic diarrhoea
c. lead to respiratory depression
d. induce heart attacks

Answer 22

c

Question 23

examples of depressants

Answer 23

benzodiazepines, alcohol, GHB/fantasy, inhalants, opiates cannabis

Question 24

4 levels of criteria for a SUD

Answer 24

• impaired control
• social impairment
• risky use
• pharmacological criteria

Question 25

impaired control

Answer 25

consumption of the substance in larger amounts/ over a longer period than intended - desire to cut down SU and multiple attempts to do so - intense cravings

Question 26

social impairment

Answer 26

– Recurrent use may result in a failure to fulfil major role obligations at work, school, or home. – Continued use despite having persistent or recurrent social or interpersonal problems. – Withdrawal from, or reduction of, important social, recreational, or occupational activities.

Question 27

Risky use

Answer 27

– Recurrent use of the substance in situations considered hazardous. – – Continued use of the substance despite knowledge of having a persistent or recurrent physical or psychological problem.

Question 28

pharmacological criteria

Answer 28

– Tolerance as seen by a markedly increased level of use to achieve the desired effect or a reduced effect of the substance when usual dose levels are used. – – Withdrawal symptoms (when there is a cessation or reduction in regular use of a substance).

Question 29

hallucinogens

Answer 29

- Alter the perceptions of the user- auditory, vidual, kinaesthetic, olfactory, gustatory, time perception

Question 30

hallucinogens include

Answer 30

ketamine, LSD, magic mushrooms, angel dust/ PCP (cannabis & LSD may also have hallucinogenic properties)

Question 31

Biopsychosocial factors that influence the risk of addiction

Answer 31

- genes - maturational stages (adolescence as a time of increased risk taking) - personality (sensation seeking, impulsivity, anxiousness) - poor coping styles

Question 32

What the community offers to people with alcohol/drug problems

Answer 32

- Prevention- at risk people- decrease risks - Early intervention/counselling - Treatment - Harm reduction

Question 33

a client's success in treatment may depend on....

Answer 33

how ready they are to change

Question 34

transtheoretical model of change stages

Answer 34

``` pre-contemplation contemplation preparation action maintenance relapse ```

Question 35

Motivational Interviewing

Answer 35

* Weighing up pros and cons against life goals * Identifies the helps and hinders of change and enhances resolution to change * Best suited to those who are ambivalent about change * Importance, willingness and confidence (about change) are assessed and enhanced * Useful assessment and ongoing therapeutic tool

Question 36

CBT Counselling

Answer 36

* Focuses directly on reducing or stopping the addict's illicit drug use * Addresses related areas of impaired functioning such as employment status, illegal activity, family/social relations as well as the content and structure of the patient's recovery program * Emphasis on short-term behavioural goals * Individuals are encouraged to attend sessions one or two times per week

Question 37

Contingency Management

Answer 37

• Voucher-Based Reinforcement (VBR) augments other community-based treatments for adults who primarily abuse opioids (e.g. heroin) or stimulants (especially cocaine) or both.

Question 38

Relapse Prevention

Answer 38

* Begins at contemplation stage * A cognitive-behavioural therapy -- collection of strategies intended to enhance self-control: * Identifying, avoiding or managing high risk situations * Dealing with ‘slip-ups’ * Specific techniques include: * Exploring the positive and negative consequences of continued use

Question 39

Harm reduction

Answer 39

* Strategies directed towards minimisation of risk: * Detailed Information and Psychoeducation on drugs, drug use and drug effects * On-site assessment of drug risks * Needle exchange programs • Heroin substitution programs

Question 40

3 pillars of harm minimisation

Answer 40

demand reduction supply reduction harm reduction

Question 41

A health professional has identified that a client requires referral to a specialised service for drug rehabilitation. The health professional shows continued support of the client by: Select one: a. leaving the ongoing care to the specialists with a discharge summary. b. giving the client written information about the service and how to contact them. c. assisting with the transfer process and ensuring client knows where and how to access the service. d. all of the above.

Answer 41

c

Question 42

``` Which of the following substances are stimulants? Select one: a. Alcohol. b. Angel dust c. Fantasy. d. Cocaine. ```

Answer 42

d

Question 43

The mother of a teenager who has developed an ecstasy problem is asking the health professional for some advice on how to deal with her son. She is concerned that by showing love and support that she will be encouraging the behaviour. The health professional would advise the mother: Select one: a. that loving your son does not condone the addiction but shows trust for your son. b. to enforce tough love and make him see what the drug is doing to him. c. to make her son develop some will power to overcome the addiction. d. to accept that she may be responsible for the problem.

Answer 43

a

Question 44

A client is admitted as a result of a party where large amounts of inhalant were used. The health professional would expect to observe: Select one: a. impaired coordination and respiratory depression. b. out of body experiences. c. sensory impairment and gating. d. hypertension and tachypnoea.

Answer 44

a

Question 45

The three main complication of withdrawal that health professionals must observe for include? Select one: a. Disorientation, sweats and flushed appearance. b. Tachycardia, irritability and confusion. c. Seizures, delirium and hallucinations. d. Nausea, tremor and insomnia.

Answer 45

c

Question 46

A client who has inadvertently been intoxicated with gold top mushrooms is concerned that he will become dependent and suffer withdrawal symptoms. The health professional will advise him: Select one: a. dependence is common and withdrawal includes hallucinations. b. dependence is uncommon and withdrawal includes hallucinations. c. dependence is uncommon and no withdrawal symptoms have been reported. d. dependence is common but there have been no withdrawal symptoms reported.

Answer 46

c

Question 47

``` What is the most common drug prescribed by doctors to relieve stress and anxiety, relax muscles and help a person to sleep? Select one: a. Methadone. b. Benzodiazepine. c. Subutex. d. Naltrexone. ```

Answer 47

b

Question 48

Millar and Rollnick (2013) suggest four micro skills that can be used throughout motivational interviewing. Known as the 'four OARS': Select one: a. Open questions, Affirming, Restating and Summarising b. Orientation, Affirming, Restating and Summarising. c. Open questions, Affirming, Reflective listening and Summarising. d. Orientation, Affirming, Reflective listening and Summarising

Answer 48

c

Question 49

A health professional is providing information to a client who is suffering substance withdrawal of benzodiazepines. The health professional will advise the client that he/she will: Select one: a. not experience any unpleasant effects and recover in the long term. b. experience unpleasant effects and recover over a short period of time. c. not experience any unpleasant effects and recover over a short time. d. need to be hospitalised as withdrawal is potentially life threatening.

Answer 49

d

Question 50

``` A health professional is working with a client who wants to quit smoking. The health professional says to the client, "you must be very happy that you have succeeded with this. You obviously are very strong and motivated." Which micro skill is the health professional using? Select one: a. Affirming. b. Open questioning. c. Reflective listening. d. Summarising. ```

Answer 50

a