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PAI > Week 11: Substance Abuse > Flashcards

Week 11: Substance Abuse Flashcards

1
Q

List the substance use disorders

A
  • abuse
  • dependence
  • intoxication
  • withdrawal
  • substance induced psychiatric disorders
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2
Q

Addiction

A

A primary, chronic, neurobiology disease with genetic, psychosocial, and environmental factors influencing its development and manifestations

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3
Q

Addiction is characterised by

A
  • impaired control over drug use
  • compulsive use
  • continued use
  • craving
  • relapse
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4
Q

Craving

A

A compelling urge affecting mood, thought and behaviour

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5
Q

What can affect cravings?

A
  • environmental cues or triggers
  • physiological/psychological moderators
  • release of dopamine
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6
Q

% of australians using an illicit drug in the previous 12 months

A

15%

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7
Q

% of australians aged 14 and over who had used illicit drugs in their lifetime

A

41.8%

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8
Q

Most common drug used by people aged 14 and over

A

Cannabis

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9
Q

Methamphetamine use

A
  • doubled from 21.7% in 2010 to 50.4% in 2013
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10
Q

Early stage symptoms of alcoholism RBDRLHG

A
  • relief drinking
  • blackouts
  • drunk driving
  • repeated trauma
  • loss of control or predictability
  • hypertension
  • gastritis
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11
Q

Middle stages of alcoholism FJLPDP

A
  • family problems
  • job problems
  • legal problems
  • personality changes
  • decline in moral behaviour
  • physical deterioration
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12
Q

Late stages of alcoholism CDHD

A
  • continued physical deterioration
  • decrease in tolerance
  • hitting impaired functioning
  • most substances have a desensitisation process
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13
Q

List the substance abuse continuum

A
  • abstinence
  • non problem use
  • problem use
  • abuse
  • dependence
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14
Q

Abstinence

A

No use

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15
Q

Non-problem use

A

Social use

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16
Q

Problem use

A

Public health issue; grey area

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17
Q

Abuse

A

50% may progress to dependence

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18
Q

Dependence

A

Ongoing physical addiction and or psychological need for the substance

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19
Q

Moderate drinking

A
  • men: on or above 2 drinks a day, on or above 10 a week

- women/those over 65: on or above one drink a day, on or above 7 a week

20
Q

At risk or hazardous drinking

A
  • men: more than 4 drinks per occasion, more than 10 a week

- women: more than 3 drinks per occasion, more than 7 a week

21
Q

Problem drinking

A

Maladaptive pattern of alcohol or substance use leading to problems with major roles, physical hazards, legal issues, social difficulties, and health consequences

22
Q

What are the goals with each patient?

A
  • prevention
  • screening and assessment
  • brief intervention
  • full intervention
23
Q

When would you use a brief intervention

A
  • heavy or problem use

- function impairment might not be existent

24
Q

When would you use a full intervention

A
  • if use or dependence is identified

- likely to involve hospitalisation, enforcing the client’s coming off the substance and helping them manage withdrawal

25
Q

Assessment and screening process

A
  • ask
  • assess
  • advise
  • assist
  • arrange
26
Q

Ask

A

Direct and or indirect screening

27
Q

Assess

A

Point on continuum, readiness for change

28
Q

Advise

A

Provide psychoeducation

29
Q

Assist

A

To get to preparation and action steps

30
Q

Arrange

A

Follow up, re-screen, referral

31
Q

CAGE model: In the past have you

A
  • felt you need to cut down
  • been annoyed by others complaining
  • felt guilty about the consequences
  • had a drink or taken drugs (eye opener) to decrease hangover or withdrawal?
32
Q

Score 1 on CAGE

A

Concern

33
Q

Score 2 or more on CAGE

A

Increasing likelihood of a serious drug or alcohol problem

34
Q

Personal factors that can contribute to substance abuse

A
  • family of origin, genetics, modelling
  • abuse
  • trauma
35
Q

Environmental factors that can contribute to substance abuse

A
  • early exposure
  • violence, poverty, deprivation
  • modelling
  • peer reinforcement
  • immersion in drug subculture
36
Q

Drug factors that could contribute to abuse

A
  • exposure to the drug
  • pattern of abuse
  • reinforcement
37
Q

How can substance abuse be treated beyond brief intervention?

A
  • initiation of recovery, e.g. detox
  • formal intensive treatment programs
  • long term remission
38
Q

List motivational interviewing principles

A
  • use empathy
  • acknowledge the clients reality
  • roll with resistance
  • avoid arguments
  • be persuasive but not personally invested
39
Q

Describe the readiness for change model

A
  • precontemplation
  • contemplation
  • preparation
  • action
  • maintenance
  • relapse
40
Q

Describe naltrexone

A
  • most common aversive treatment

- causes unpleasant nausea after one drink

41
Q

What is methadone?

A

A replacement for withdrawal

42
Q

Describe the alcoholics anonymous model

A

Worldwide, largely religiously informed 12 step program for conquering alcohol abuse

43
Q

What are the disadvantages of AA?

A
  • explicitly religious framework can be a barrier
  • abstinence can set up extreme, all or nothing negative relapse
  • ambivalent
44
Q

Why is drug alcohol counselling and motivational interviewing effective?

A

More forgiving of relapse, and views recovery as a process

45
Q

Describe recovery

A
  • return of lost function or attainment of optimal, achievable health
  • establishing a life worth living without drugs, alcohol or gambling
46
Q

What comes after brief intervention?

A
  • initiation of recovery
  • formal intensive treatment programs
  • long term remission
47
Q

Examples of formal intensive treatment programs

A
  • day treatment

- inpatient

PAI (11 decks)

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