TX for Substance Use Disorders Flashcards
Lifetime rates of SUD are around (blank) percent
14.6%
(blank) percent of people over the age of 12 reported a SUD in the past year
8.7%
Compulsive gamblers approach (blank) percent of the pop
5%
(blank) percent of the pop views porn online more than 11 hours per week
6%
Binge eating is (blank) percent of the population
3-5%
People with Serious Mental Illness have a lifetime prevalence rate of SUD of (blank)%
50%.
Addiction is comorbid with what kind of behaviors?
interpersonal violence, HIV risk behavior, and suicide, criminal behavior.
(blank) percent of people in addiction tx have PTSD. If you have both you have worse tx outcomes :(
60%
How do you treat addiction?
Withdraw the substance, invite the feeling, teach skills, e.g., compassion.
Pnts with PTSD and substance abuse typically have enormous (blank). How do you help them with this?
self loathing
-teach pnts to replace destructive self-talk with compassionate self-talk. They are taught that only a loving stance toward the self produces lasting change.
What are the principles of effective tx?
- addiction is treatable (even with relapse)
- no single tx is appropriate for everyone
- tx must be readily available
- tx must address multiple needs (medical, social, job, legal)
- tx may need to last at least 3 months, and best outcomes occur with long term tx
(balnK) therapies focused on motivation, family and relationship are useful for addiction tx
behaviora
Medications along with counseling can be useful such as (blank or blank)
methadone, nicotine replacement
What is the first step in addition tx?
medically assisted detox
Does tx need to be voluntary to be effective?
no
How effective is tx for addiction?
most people who get into and remain in tx stop using drugs and improve their lives
T or F
Relapse rates for addiction resemble those of other chronic conditions such as asthma, diabetes, and hypertension.
T
Type I diabetes (30-50% relapse)
Drug addiction (40-60% relaspe)
Hypertension (50-70%)
Why is addiction tx evaluated differetly?
because it requires ongoing care
What is motivational interviewing?
a profoundly respectful tx, rooted in compassion
What are the 5 stages of Motivational Interviewing?
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
What stage of MI is this:
Patients are not concerned about their problem
No intention to change anytime soon
Pros of maintaining behavior > cons of changing
(and you are curious, respectful)
Precontemplation
What stage of MI is this: Patients acknowledge problem Ambivalence about changing Pros and cons about change are equal Patients consider taking action in the next 6 months (And you remain curious, respectful…)
Contemplation
What stage of MI is this:
Patients plan to take action in the next month or so
Patients make the final adjustments before they begin to change
Pros of changing outweigh the reasons to stay the same
Patients may appear ready to change, but may not have resolved their ambivalence toward change
Important for MD’s to reinforce preparations to change
Preparation
What stage of MI is this:
Patients begin to change
Changes are evident to others and may receive recognition
Important for MD’s to notice and reinforce change
Action
What stage of MI is this:
Gains made in the action stage are consolidated and maintained for > 6 months
Change work does not end in the action phase
Maintenance requires a lot of work and commitment
Important for MD’s to reinforce maintenance activities, as patients may plateau in visible changes
Relapse is common
Maintenance
What are some relapse prevention strategies?
Identify triggers
Get rid of irrational thoughts (one lapse means total failure)
What is Abstinence Violation Syndrome?
When a pnt slips and uses drugs after a period of abstinence and thinks “this is hopeless, i will never get sober and I might as well keep using”
What is this:
a minor setback, no real analysis
Lapse
What is this:
a complete reversion to a previous pattern of behavior, spiral downwar
Relapse
What is this:
work it over, send you forward in your recovery
prolapse
How can MDs inoculated against relapse?
normalize lapses, teaching that lapses dont have to lead to relapses, and developing relapse prevention plans
WHat is urge surfing?
What should you tell your patients about this?
it is being at the high point in craving?
Craving are like waves, if you wait it out, it will decrease
What are seemingly irrelevant decisions and why are they so important?
remember that every decision that can “seem irrelevant,” can lead you to a environmental trigger.
Though psychological (blank) is a robust predictor of SUDs, it has been suggested that the capacity to tolerate (blank) mediates the relationship between substance use and substance abuse or dependence
distress
distress
Wht is the focus of ACT (acceptatnce and commitment therapy) and SUD treatment?
A focus on emotional acceptance vs avoidance
-cued to help with distress tolerance
What is distress tolerance?
the ability to tolerate distress without the use of substances
What is the most effective tx for addiction?
CBT with medication
Alcohol is the (blank) leading cause of preventable death in the United States.
3rd
Increased taxes on alcohol would reduce problems
T or F
T
