difference between abuse and dependence
abuse: using it too much, dependence: using it b/c you need it
three facets of definition of addiction
person, substance or activity regularly used to escape fro negative feelings and uses despite negative consequences
is physiological dependence a part of addiction
not necessarily
four Cs of addiction
crave to use, compulsion, continued use despite adverse consequences, then loss of control
trademark addictive behaviors
denial (first and most basic), manipulation, throwing focus, blaming, minimizing, rationalizing
development of continuum of drugs
recreational use -> gateway drugs -> abuse -> dependence -> the “Slide”
What is SBIRT
screen, brief intervention, and refer to treatment (MI skills - deliver treatment and intervention early)
what percent of population will have a substance abuse problem
50%
what is the Audit-C
alcohol screening test (3 questions): how many standarad drinks do you ahve on a typical day, how often do you drink alcohol, how often do you have 6 or more
what is B-DAST
drug abuse screen tool (cocaine, opiates, etc)
what are the symptoms of alcohol, cocaine, and heroin
CWIA: will tell us how to treat with benzos for withdrawal b/c don’t want them to have a seizure/flee (uses a score)
- alcohol: peaks at 24 hours, can begin as early as several hours after last use
- Cocaine: chest pain, anhedonia, irritability
- heroin: 12-72 hours, major symptom of withdrawal -> piloerection
what two meds are used to treate opiate withdrawal?
methadone -> for people who don’t have insurance
subtrex
- are schedule 2 and mimic effects of opioids, dose downward as recover continues
(remember still working with CBT, coping skills, MI or motivational interviewing)