Substance Use Flashcards
Abuse
A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 1 (or more) of the following, occurring within a 12-month period:
- failure to fulfill major role obligations at work, school, or home
- recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
- recurrent substance-related legal problems
- continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance
B. The symptoms have never met the criteria for Substance Dependence for this class of substance.
Dependence
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by 3 (or more) of the following, occurring at any time in the same 12-month period:
(1) tolerance
(2) Withdrawal
(3) the substance is often taken in larger amounts or over a longer period than was intended
(4) there is a persistent desire or unsuccessful efforts to cut down or control substance use
(5) a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects
(6) important social, occupational, or recreational activities are given up or reduced because of substance use
(7) use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (i.e. drinking w/ sickle cell disease)
Dependence specifiers
Specify if:
With Physiological Dependence: evidence of tolerance or withdrawal (i.e., either Item 1 or 2 is present)
Without Physiological Dependence: no evidence of tolerance or withdrawal (i.e., neither Item 1 nor 2 is present)
Specify course (1 or none):
Early Full or Partial Remission (months 2 through 12)
Sustained Full or Partial Remission (months 13+)
Specify one, neither or both:
On Agonist Therapy (does not apply to Cannabis, Hallucinogens, Inhalants, PCP)
In a Controlled Environment (does not apply to Nicotine)
precontemplation stage
stage at which no intention to change behavior in the foreseeable future (not within 6 months); see it as a nonissue, usually present for therapy b/c pressure from others
contemplation stage
stage in which people are aware that aproblem exists and are seriously thinking about overcoming it but have not yet made a commitment to take action- want to change within 6 months
preparation stage
intending to take action in next month and have unsuccessfully taken action in past year. Have made some reductions in problem behaviors but not yet reached criterion for effective action
action stage
modify behaviors, experiences, or environment in order to overcome their problems. See most overt behavioral changes here, successfully altered behavior for one day- 6 months
maintenance stage
stage inw hich people work to prevent relapse and consolidate gains attained during action. from 6 months to an indeterminate period past the initial action
stages of change
tell us when change occurs
processes of change
tell us how change occurs
cog behavioral model of relapse process
low self efficacy –> tendency to give in to temptation
decision is mediated by outcome expectancies
(if have positive expectancies, i.e. I’ll feel relaxed –> more likely to use drug vs. negative expectancies, i.e. I’ll be hungover tomorrow –> less likely to use)
individuals who decide to use may be vulnerable to abstinence violation effect
abstinence violation effect
self blame and loss of pereceived control that individuals often experience after the violation of self-imposed rules
relapse
return to previous problematic behavior
prolapse
getting back on track in direction of positive change
lapse-relapse learning curve
higher chance of a lapse immediately after treatment, but incremental changes inc oping skills lead to decreased change of relapse over time
