Assessment & Screening

Brief and easy
Empircal; 94% accuracy with substance misuse disorders
Spanish and teenage versions
Free consultation service

Used and effective, especially with those who are in denial or are trying to cover it up

Handful of questions about substance use
Section of subtle questions related to substance abuse/etc

2011 new definition of addiction
-Addiction is a primary, chronic disease involving brain reward, motivation, memory, and related circuitry
-Neurobiology of addiction encompasses more than neurochemistry

Addiction is chracterized by
-Inability to abstain
-Impairs behavioral control
-Craving or increased hunger for drugs or rewarding experiences
-Diminished recognition of significant problems with your behaviors and interpersonal relationships
-Dysfunctional emotional response
(IICDD)

DSM-5 now includes gambling
-Food, sex, and video games, etc are being looked into

If these are evident - physiological dependence is likely

Delerium Tremens (some symptoms)
-Shaking Tremors
-Change in mental functioning
-Confusion/shortened attention span
-Deep sleep
-Hallucinations
-Restlessness
-Mood changes

Can be fatal if not addressed

Increased anxiety
Changed appetite
Cramps in stomach
Cravings for more
Depersonalization
Depression
Insomnia
Mood Swings/Irritable
Nausea
Sweating
Headaches

Early symptoms (think about what its like to have the flu)
-Agitation
-Anxiety
-Muscle aches
-Insomnia
-Runny Nose
-Sweating

Late symptoms of withdrawal (think food poisoning)
-Abdominal cramping
-Diarrhea
-Dilated pupils
-Goose bumps
-Nausea
-Vomiting

Anhedonia
-Meth increases dopamine and decreases dopamine receptors, without it they can struggle to feel joy at all
During withdrawal - less dopamine
Recovering person will - Eat and sleep, not much else
-Depressed mood

Outpatient
-client is able to manage withdrawal symptoms
-Client is able to remain safe
-Client is moving through stages of change

IOP (Intensive Outpatient)
-Client requires more monitoring to remain safe
-Client attends group therapy frequently during the week

Partial Hospitalization

Detoxification - client needs medical attention to safely stop using

Inpatient treatment
-Client cannot remain safe
-Environment needs strict control

Ethically

-Least restrictive environment that is necessary

-Allow client to have autonomy and choice in their care

-Can be difficult, especially if the client is a harm to themselves

-Do not hospitalize anyone against their will for substance use

motivational interviewing - increase client insight and awareness regarding substance use
-Efficient
-Client creates goals
-Client focused

FRAMES

Screening - > Brief Intervention - > Referral and Treatment

Designed to be used in clinical settings

Clinical Questions

Self-Reports

Biological Markers

25 item short self-screening test

Helps identify abuse, but not diagnose

You ask the same questions regarding use history, patterns, and consequences

Find out frequency and quantity of use, reason of use, onset of use, and family use

URICA

32 item scale for each 4 stages of change

Socrates

Measures change readiness and treatment eagerness
Measures commitment to sobriety

1. Taking substance in larger amounts or for longer than you meant to
2. Wanting to cut down or stop use but not being able to
3. Spending a lot of time getting, using, and recovering from the substance use
4. Cravings and urges to use the substance

5. Not managing to do what you should at work, home, or school because of substance
6. Continuing use when it causes relationship problems
7. Giving up important social, occupational, or recreational activities because of substance use

8. Using substance even when it puts you in danger
9. Continuing to use even when you know you have a physical or psychological problem that could have been made worse by substance
10. Tolerance
11. Withdrawal