substance use disorders Flashcards
What are the ten classes of substances included in substance-use and substance-induced disorders?
Alcohol, caffeine, cannabis, phencyclidine and other hallucinogens, inhalants, opioids, sedatives, hypnotics, or anxiolytics, stimulants, tobacco, and other/unknown.
How does the DSM-5-TR define substance use disorders?
A cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems.
What is required for the diagnosis of substance use disorder?
Two or more characteristic symptoms within a 12-month period.
What are the specifiers used for substance use disorders?
Severity of the disorder and if the person is in early or sustained remission, on maintenance therapy, or in a controlled environment.
What are substance-induced disorders?
Disorders that include substance intoxication, substance withdrawal, and substance/medication-induced mental disorders.
What symptoms characterize alcohol intoxication?
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.
What are the symptoms required for alcohol withdrawal diagnosis?
At least two of eight symptoms: autonomic hyperactivity, hand tremor, insomnia, nausea or vomiting, transient hallucinations or illusions, anxiety, psychomotor agitation, generalized tonic-clonic seizures.
What is required for a diagnosis of alcohol-induced major neurocognitive disorder?
Evidence of a significant decline in one or more cognitive domains that interferes with independence in everyday activities.
What is Korsakoff syndrome linked to, and what are its characteristics?
Linked to a thiamine deficiency; involves anterograde and retrograde amnesia and confabulation.
What are the symptoms of opioid intoxication?
Significant behavioral or psychological changes, pupillary constriction, and at least one of three symptoms: drowsiness or coma, slurred speech, impaired attention or memory.
What is required for opioid withdrawal diagnosis?
At least three of nine symptoms following cessation of heavy opioid use: dysphoric mood, nausea or vomiting, muscle aches, diarrhea, yawning, fever, insomnia.
What characterizes stimulant intoxication?
Maladaptive behavioral and psychological changes, and at least two of nine symptoms during or shortly after use.
List some symptoms of stimulant withdrawal.
Dysphoric mood and at least two of five physiological changes: fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor agitation or retardation.
What symptoms characterize tobacco withdrawal?
At least four of seven symptoms: irritability, anger or anxiety, impaired concentration, increased appetite, restlessness, depressed mood, insomnia.
What is the typical duration for withdrawal symptoms following nicotine cessation?
Ordinarily peak 48 to 72 hours after cessation and gradually wane over several weeks.
What is hallucinogen persisting perception disorder?
Reexperiencing at least one of the perceptual symptoms experienced while intoxicated, causing significant distress or impairment.
What are the common visual disturbances in hallucinogen persisting perception disorder?
Flashes of color and halos around objects.
True or False: Reality testing during episodes of hallucinogen persisting perception disorder is intact.
True.
What factors influence the treatment of substance use disorders?
The type of substance(s), the severity of the disorder, the presence of comorbidities, and the person’s preferences
Treatment ordinarily includes individual, family, and/or group interventions and medication.
What are some evidence-based interventions for substance use disorders?
Cognitive behavioral therapy, motivational interviewing, contingency management, family behavior therapy, community reinforcement approach, personalized normative feedback, text messages, relapse prevention therapy, 12-step facilitation
Research has generally found that combined interventions are most effective.
What is the Community Reinforcement Approach (CRA)?
A method based on operant conditioning that helps people arrange their lifestyles for healthy, drug-free living
It competes with alcohol and drug use.
What is the primary focus of Community Reinforcement and Family Training (CRAFT)?
Working with a concerned significant other (CSO) instead of the identified patient
Goals include influencing the identified patient to enter treatment and improving the CSO’s quality of life.
What does Voucher-Based Reinforcement Therapy (VBRT) involve?
Giving patients vouchers that can be exchanged for goods and services when they achieve treatment goals
Effective for promoting abstinence for substances like cocaine and tobacco.
What is the effect of combining VBRT with other interventions?
Combining VBRT with another intervention may be the optimal approach
VBRT is useful for promoting initial abstinence but its effects fade when vouchers are discontinued.
What is Personalized Normative Feedback (PNF)?
An intervention aimed at correcting misperceptions about the prevalence of behaviors to reduce those behaviors
Initially developed for heavy-drinking college students.
What are the four major functions of text messages in mental health interventions?
Appointment reminders, health care information, support, self-monitoring
Effective for several mental health conditions, including substance use disorders.
What is Relapse Prevention Therapy (RPT) based on?
Describing substance addiction as a learned habit pattern and identifying high-risk situations for lapses
It utilizes cognitive and behavioral strategies to manage these situations.
What was the objective of Project MATCH?
To compare the effectiveness of different therapies for alcohol dependence or abuse and evaluate the client-treatment matching hypothesis
Included cognitive behavioral coping skills therapy, motivational enhancement therapy, and twelve-step facilitation.
What were the results of Project MATCH at the follow-ups?
All treatments produced significant reductions in drinking, with twelve-step facilitation having a slight advantage
Support for the matching hypothesis was also observed.
True or False: Combined interventions are generally found to be less effective than single interventions for substance use disorders.
False
Research shows that combined interventions are most effective.
Fill in the blank: __________ is a cognitive-behavioral approach that helps clients recognize and deal effectively with high-risk situations.
Relapse Prevention Therapy (RPT)
RPT includes training in coping skills and enhancing self-efficacy.
What is a common outcome for clients whose social networks are supportive of drinking in Project MATCH?
They benefited most from twelve-step facilitation
This was observed at the three-year follow-up.
