Substance-Related and Addictive Disorders Flashcards
Q: What major structural change occurred in the DSM-5 for Substance-Related Disorders?
A: The DSM-5 combines substance abuse and substance dependence into a single category: Substance Use Disorder. This reflects the understanding that the two conditions represent different degrees of severity within a single disorder.
Q: How does the DSM-5 indicate the severity of Substance Use Disorder?
**A: The DSM-5 introduces severity specifiers based on the number of criteria met:
Mild: 2-3 criteria
Moderate: 4-5 criteria
Severe: 6 or more criteria.**
Q: What changes were made to the diagnostic criteria for Substance Use Disorder in DSM-5?
A: The DSM-5 removes the criterion related to legal problems and adds a new criterion for craving or a strong desire or urge to use a substance.
Q: What new disorders were added in the DSM-5 under Substance-Related and Addictive Disorders?
A: The DSM-5 adds Gambling Disorder as a behavioral addiction and includes Cannabis Withdrawal as a diagnosable condition.
Q: How does the DSM-5 recognize behavioral addictions?
A: The DSM-5 includes Gambling Disorder in the category of Substance-Related and Addictive Disorders, acknowledging that behaviors can lead to addiction-like conditions.
Q: How are substance-specific diagnoses handled in the DSM-5?
A: The DSM-5 provides specific criteria for various substance-related disorders, such as Alcohol Use Disorder, Opioid Use Disorder, Stimulant Use Disorder, and others, with tailored criteria for each substance.
Q: What disorder was removed in the DSM-5?
A: The DSM-5 removes the diagnosis of Polysubstance Dependence, recognizing that individuals often have multiple substance use disorders rather than a single diagnosis for polysubstance use.
Q: What new course specifiers are included in the DSM-5 for Substance Use Disorders?
A: The DSM-5 adds specifiers such as “in early remission” and “in sustained remission” to provide more detailed information about the individual’s recovery status.
Q: How does the DSM-5 define remission for Substance Use Disorders?
**A: The DSM-5 defines remission as follows:
Early Remission: 3 to 12 months without meeting substance use disorder criteria (except craving)
Sustained Remission: Over 12 months without meeting criteria (except craving).**
Q: Why was craving added as a criterion in the DSM-5?
A: The addition of craving as a criterion highlights the importance of the intense desire to use a substance as a key aspect of addiction.
Q: What does the category of Substance-Related and Addictive Disorders in DSM-5 include?
A: This category includes substance-use and substance-induced disorders for 10 classes of substances: alcohol; caffeine; cannabis; phencyclidine and other hallucinogens; inhalants; opioids; sedatives, hypnotics, or anxiolytics; stimulants; tobacco; and other/unknow
Q: What are Substance-Use Disorders characterized by according to DSM-5?
A: Substance-Use Disorders are characterized by “a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems.”
Q: What categories of symptoms are included in Substance-Use Disorders?
A: Symptoms fall into four categories: impaired control, social impairment, risky use, and pharmacological criteria (tolerance and withdrawal).
Q: How many symptoms and for what duration are required for a diagnosis of Substance-Use Disorder?
A: The person must have two or more symptoms within a 12-month period.
Q: Can Substance-Use Disorder be diagnosed for all classes of substances?
A: No, Substance-Use Disorder can be diagnosed for all classes of substances except caffeine.
Q: How is the severity of Substance-Use Disorder determined?
A: The severity is determined by the number of symptoms present.
Q: What are some of the evidence-based interventions for treating Substance-Use Disorders?
A: Evidence-based interventions include cognitive behavioral therapy, motivational enhancement therapy, contingency management, family behavior therapy, the community reinforcement approach, and 12-step facilitation.
Q: What medications are used to treat Alcohol Use Disorder?
A: Disulfiram, naltrexone, acamprosate, and topiramate are used to treat Alcohol Use Disorder.
Q: What is the Community Reinforcement and Family Training (CRAFT) approach?
A: CRAFT is designed for individuals who refuse to seek treatment for substance abuse. It works with a concerned significant other (CSO) to help influence the identified patient to enter treatment, reduce substance use, and improve the CSO’s quality of life.
Q: What combination of interventions is often most effective for Substance-Use Disorders?
A: Combined interventions, such as therapy and medication, are often most effective. For example, combining therapy with nicotine nasal spray or varenicline is most effective for tobacco use disorder.
Q: What is Marlatt and Gordon’s relapse prevention therapy (RPT)?
A: RPT is a cognitive-behavioral approach that views substance addiction as a “learned habit pattern” and focuses on helping clients recognize and deal more effectively with high-risk situations to prevent lapses from becoming full-blown relapses.
Q: What disorders are included in Substance-Induced Disorders?
A: Substance-Induced Disorders include substance intoxication, substance withdrawal, substance withdrawal delirium, and substance/medication-induced mental disorders.
Q: What are the criteria for Alcohol Intoxication?
A: Alcohol Intoxication involves problematic behavioral and psychological changes with at least one of six symptoms: slurred speech, incoordination, unsteady gait, nystagmus, impaired attention or memory, stupor or coma.
Q: What are the criteria for Alcohol Withdrawal?
A: Alcohol Withdrawal requires at least two of eight symptoms within several hours to a few days following cessation or reduction of heavy and prolonged alcohol use: autonomic hyperactivity, hand tremor, insomnia, nausea or vomiting, transient hallucinations or illusions, anxiety, psychomotor agitation, generalized tonic-clonic seizures.
Q: What is Alcohol-Induced Major Neurocognitive Disorder?
A: This diagnosis requires evidence of a significant decline in one or more cognitive domains that interferes with independence in everyday activities, with a specifier indicating if the disorder is the nonamnestic-confabulatory type or amnestic-confabulatory type (Korsakoff syndrome).
Q: What are the criteria for Opioid Intoxication?
A: Opioid Intoxication involves significant problematic behavioral or psychological changes plus pupillary constriction and the development of at least one of three symptoms during or shortly after opioid use: drowsiness or coma, slurred speech, impaired attention or memory.
Q: What are the criteria for Opioid Withdrawal?
A: Opioid Withdrawal requires the development of at least three of nine symptoms following cessation of heavy and prolonged opioid use or administration of an opioid antagonist after opioid use: dysphoric mood, nausea or vomiting, muscle aches, diarrhea, yawning, fever, insomnia.
Q: What are some examples of opioids?
A: Opioids include opium, heroin, morphine, codeine, methadone, oxycodone, hydrocodone, and fentanyl.
Q: What are the criteria for Sedative, Hypnotic, or Anxiolytic Intoxication?
A: This disorder involves maladaptive behavioral and psychological changes with at least one of six symptoms that develop during or shortly after use: slurred speech, incoordination, unsteady gait, nystagmus, impaired cognition, stupor or coma.
Q: What are the criteria for Sedative, Hypnotic, or Anxiolytic Withdrawal?
A: Sedative, Hypnotic, or Anxiolytic Withdrawal requires the development of at least two of eight symptoms within several hours to a few days after cessation or reduction of use: autonomic hyperactivity, hand tremor, insomnia, nausea or vomiting, transient hallucinations or illusions, psychomotor agitation, anxiety, grand mal seizures.
Q: What is Korsakoff syndrome and what causes it?
A: Korsakoff syndrome, linked to a thiamine deficiency, involves anterograde and retrograde amnesia and confabulation, and is a specifier for Alcohol-Induced Major Neurocognitive Disorder.
Q: What characterizes Stimulant Intoxication?
A: Stimulant Intoxication is characterized by maladaptive behavioral and psychological changes (e.g., euphoria, hypervigilance, anxiety, impaired judgment) and at least two of nine symptoms during or shortly after stimulant use: tachycardia or bradycardia, pupillary dilation, elevated or lowered blood pressure, perspiration or chills, nausea or vomiting, weight loss, psychomotor agitation or retardation, respiratory depression or cardiac arrhythmia, seizures or coma.
Q: What are some examples of stimulant drugs?
A: Stimulant drugs include amphetamines, methamphetamines, and cocaine.
Q: What is required for a diagnosis of Stimulant Withdrawal?
A: Stimulant Withdrawal requires a dysphoric mood and at least two of five physiological changes within a few hours to several days after cessation of prolonged stimulant use: fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor agitation or retardation.
Q: What are the criteria for Tobacco Withdrawal?
A: Tobacco Withdrawal involves at least four of seven symptoms within 24 hours of abrupt cessation or reduction of tobacco use: irritability, anger or anxiety, impaired concentration, increased appetite, restlessness, depressed mood, insomnia.
Q: How long do tobacco withdrawal symptoms typically last?
A: Withdrawal symptoms typically peak 48 to 72 hours following cessation of nicotine use and then gradually wane over several weeks.
Q: What can cause early and late relapses in tobacco cessation?
A: Cravings for nicotine, which last longer than withdrawal symptoms, can cause early and late relapses.
