Treatment and Prevention Pt 2 Flashcards
Abstinence
- goal of many self help groups
- typically not questioned
- illicit drugs due to legality
Moderation
- controversial despite numerous reports on self-change
- depends on individuals’ beliefs
What doesn’t harm reduction do?
condone or criticize substance misuse
What does harm reduction emphasize
- reducing negative consequences of substance use
Exmples of harm reductino
- DD
- training bartenders to stop serving
- narcan
- educational class
Why is there widespread resistance to the concept of harm reduction?
contrasts w goals of war on drugs
What’s the biggest problem with abstincence?
- relapse rates very high in addiction
- addiction is a disease- relpase rates for common disease like diabetes is als very high
Stages leading to relapse
- social drinking
- problem/abusive drinking
- dependence/altered brain function
- excessive and uncontrollable drinking
- abstinence
- acute/protracted withdrawal symptoms
- relapse
Can neuroadaptations be reversed?
meth abuser after 14 months abstinence had dopamine transporters practically back to normal
How can relapse initially be prevented?
- preventing withdrawal symptoms (self medication)
- goal is to detoxify the individual and get them through the initial withdrawal symptoms
What does detox depend on?
- depends on drug of misuse
- if wihtdrawal symptoms are severe then better to be monitered during detox
How can withdrawal symptoms be prevented/lessened during and after detox?
pharmacotherapies
typically well accepted in our society
What pharmacotherapy prescribed for hyper-excitability of the CNS and PNS during alc detox?
benzodiazepines
What pharmacotherapy prescribed for seizure and tremors during alc detox?
benzodiazepines, anti-epileptics
What pharmacotherapy prescribed for anxiety/irritability during alc detox?
benzodiazepines
Goal of pharmacotherapies post-alc detox?
lessen the impact of protracted withdrawal symptoms by restoring neurochemical balance
Pharmacotherapies post-alc detox: anxiety
benzos and SSRIs
Pharmacotherapies post-alc detox: negative effect/depression
SSRIs
Pharmacotherapies post-alc detox: sleep disturbances/insomnia
benzs
Pharmacotherapies post-alc detox: craving
naltrexone (opioid antagonist)
Are pharmacotherapies post-alc detox well accepted in society?
no bc why use drugs to treat a drug problem
Pharmacotherapies post-alc detox: Disulifrim (Antabuse)/temposil (outside US)
- used during protracte abstinence because if they drink on it they will not geel good, can even lead to feeling adverse to alcohol
- aversion therapy
disulfiram (antabuse) effect on alc breakdown
- block aldehyde dehydrogenase to increase aldehyde in body
Disulfiram/ antabuse effects
- flush,rapid heart rate/respiration
- nausea, vomiting, headache at higher alc amounts
Do ppl w SUD misuse only one drug?
- Study found in 1981 that out of 1340 people:
- 50% used at least 1 drug other than alcohol in the past 30 days
- 20% used drug combo
many differences in combinations/drug interactions
What is better than trying to treat each addiction separate?
treating an individual as having an addictive behavior
What do you do if addiction is the result of another condition?
- dual-diagnosis patients have both psychiatric problem and addiction problem
- drug use initiated to alleviate symptoms of psychiatric problem (self-medication)
Treatment settings: hospital
- medical and psychological treatment
- detoxification
Treatment settings: intermediate
- half-way houses
- focus on counseling, psychotherapy, self-help groups
Treatment settings: outpatient
- individual: work w professional one-to-one
- group: sessions led by a professional, organized around specific themes (ex. preventing relapse)
