Substance Use Disorders

Question 1

DSM criteria for abuse

Answer 1

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:

B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

Question 2

mnemonic for abuse sx’s

Answer 2

Jen LuSHR

Legal (problems)
Social (recurrent, use despite)
Hazardous (situations, physically)
Role (failure to fulfill)

Question 3

DSM criteria for dependence

Answer 3

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:

Specify if:
With/without Physiological Dependence: evidence vs. no evidence of tolerance or withdrawal (i.e., either vs. neither Item 1 or 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)

Question 4

mnemonic for dependence symptoms

Answer 4

TWAT CAK

Tolerance
Withdrawal
Activities (given up/reduced)
Time (getting it/using/recovering)
Amounts (large)
Cut down (unsuccessful)
Knowledge (but still use)

Question 5

stages of change

Answer 5

prochaska

Precont – and not in the near future (not in the next 6 months) – sometimes it has to do with the absence of knowing about the consequences (e.g. smoking) – really changes what we would do for these people (e.g. psycheducation – the person isn’t ready for that –what would my ife be life? If I change? – Mike: I don’t want to change my habits – may be thinking a lot about

Contemplation – may be thinking more about long term consequences – but there’s still this ambivalence (behavioral procrastination); and the ambivalence can keep you stuck there – implicates the need for using MI???

Preparation – this si the best palce to atch someone for an action oriented treatment – just about ready to change and if you can capture that (give themt he tools, skills, support) — based on the research that been done with this model –

Action – using the skills to matintint eh bx change – for example, with smoking – in research we have criterion for when youre in each stage but clincially speaking we ont have tse clear cut cut off – the main pint their effectivel, and consistnel susing things like sitmulus control (or other change processes)

Maintenance – shifting toward continued relaspe prevention

Relapse – this wasn’t an original step in the model – nicley follows the discussion of Marlatt’s work – its highlighting the assumption that a person will lapse – i.e. the stages of change are no linear – dynamic system

PCP will MAR your brain