Substance Misuse Psych Flashcards
What is TRAP for alcohol/substance use?
TRAP = Type, route, amount, pattern
[alcohol = units, drugs e.g. heroin, cocaine and amphetamine = grams, cannabis = fractions of oz]
Don’t stop until you’ve covered everything including tobacco, prescription and OTC medications
What is the overall structure for an alcohol/substance use history?
Current use - TRAP
Current use - dependency and effect on life
Past use
Future use
How can you ask about alcohol tolerance?
Do you need to drink more than you used to, to get the same effects?
How can you ask about withdrawal?
How do you feel before your first drink of the day?
How do you feel if you haven’t had a drink in a while?
What happens when you stop drinking?
How do you make yourself feel better? / use to stop withdrawal symptoms
How can you ask about strong desire/compulsion to use?
Do you ever really crave or desperately want a drink?
How can you ask about difficulties controlling use?
is it hard to stop drinking once you have started?
Do you ever feel like your drinking is out of control?
how do you ask about narrowing of repertoire / stereotypes pattern of use?
Do all your days seem to have the same pattern?
how do you ask about effect on life?
[ask +ves before negatives to show non-judgement, people usually have good reasons for substance misuse (at least, initially)
What are the good things about alcohol for you?
What do you like best about having a drink?
what are you looking for when asking about the negatives of substance use?
salience / neglect of normal activities
- It sounds like alcohol has become one of the most important things in your life…
- anything you feel like you miss out on because of it?
- how would life have been different if you hadn’t used it?
Continued use despite harm
- Has alcohol caused you any problems or difficulties?
- Does it affect your health / have you had to see a doctor because of it?
- Has it affected your mood/memory?
- How does it affect your work/studies/relationships
- Has it got you into any trouble? or debt?
What should be covered in a past use and other history?
Current substance - First tried? - Use changed since then (tolerance) - Times you've used more ? - Tried to stop and/or get help? What happened? What was the longest time you were able to stop? What helped the most? When you started again how quickly did you return to your usual levels? Other substances: - What else have you tried in the past? - How old were you? (each substance) - Do you still use this now? if not, what happened?
How can you ask about future use?
Do you think your drinking is a problem?
What are you most worried about if you keep drinking?
It’s helped you through the hard times but it sounds like its making things worse for you now. What do you think about that?
What are 8 features of dependency?
1) Tolerance
2) Compulsion
3) Withdrawal
4) Problems controlling use
5) Continued use despite harm
6) Salience (primacy / neglecting other interests for the drug/using it)
7) reinstatement after abstinence (returning to the previous pattern and level of use after a period of abstinence)
8) narrowing of the repertoire - loss of variation in use of the substance
