Week 8 Dr. Drew's Dealing with addicted patient

Question 1

What is the DSM diagnostic criteria for alcohol use disorder?

Answer 1

A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
-Alcohol is often taken in larger amounts or over a longer period than was intended.
-There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
-A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects
-Craving, or a strong desire or urge to use alcohol.
-Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
-Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
-Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
-Recurrent alcohol use in situations in which it is physically hazardous.
-Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
(2-3 is mild, 4-5 moderate, 6+severe)

Question 2

What questions would you want to ask an addicted patient?

Answer 2

• Do not expect information to be forthcoming
• Assess motivation – “why are you here”
• Ask specifically each drug category
• Age at onset
• Last use
• Use patterns – most recent, heaviest

Question 3

What is the mechanism of dissociation in trauma as explained by jacksonian dissolution?

Answer 3

“when the higher are suddenly rendered functionless, the lower rise in activity”

• 3 neural circuits via evolution, there’s a hierarchy of response-newest used first, and if that fails, older circuits used
• vagal defensive system: death feigning behavior, shutting down, dissociating
• a primitive unmyelinated system that responds to novelty or threat by shutting down
• importance: quality of therapeutic alliance is most robust predictor of treatment success