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Alcoholics Anonymous does not believe in disease …?
The ‘R’ in the D.A.R.E. program stands for Respect?
The drugs that are often treated with
inpatient detoxification as a result of their risk in detoxification or for the level of discomfort experience are:
Both A & B
Which substance consistently ends up near the
top of both categories of DAWN for the last 20 years?
Alcohol in combination
Physical dependence is most likely to occur when the drug leaves the body more rapidly than the body can adapt, and
psychological dependence is most likely to occur when the drug has a rapid onset of action.
- Ricky Ross- dealer of crack
- Meth is easier to make compared to crack
- Tommy Chong was arrested for receiving a glass pipe in the mail in a city where that is illegal
- Man arrested for being naked and sticking ice up his butt in a restaurant (on pcp)
- poor are being targeted for bringing in drugs to the us
What were opium wars largely a result of?
- drug being smuggled in from India.It was so profitable,
- This profit, along with opium being illegal, led to the war between China and England (whose company
- was the British East India Company).
Earliest writer on opium
Thomas de Quincy
How do you turn morphine into heroin?
two acetyl groups were attached to morphine, yielding the brand name heroin.
Highly addictive, no medicinal value
Schedule I drug
Heroin in this country is a schedule 1 drug but how does that relate to other countries?
Medically used in other countries, but Schedule 1 drug in US
What did average heroin addict looked like before Harrison Act?
Heroin was looked at as a vice
Typical addict was a 30 to 50 y/o white woman.
What Vietnam war taught us about heroine and opioids
- under the right circumstances, many will use it
- Not only IV users get addicted.
- Even occasional users can become opioid dependent.
- Many of those dependent stopped upon returning to the States.
Symptoms of opiod withdrawl
- Development of a tolerance.
- Symptoms: Craving,Yawning, runny nose, teary eyes, insomnia, increased blood pressure and pulse and respiration, restlessness, nausea, fetal position, vomiting,
- diarrhea, spontaneous ejaculation or orgasm, increased blood sugar.
The needle habit- get high just from putting the needle into arm even if there is not drugs inside the needle.
DAWN stands for:
Drug Abuse Warning Network
Illegal to possess or use
Not common within a social group, and disapproved of by the majority.
overusing a prescription drug or using it for the affect rather than the typical use (antihistamines).
What does DAWN record?
Records only that a substance was involved in a hospital visit, not the cause.
(Monitors emergency rooms in major metropolitan areas for visits involving substances from charting, as well as on drug related deaths from coroners)
recent study of IV users in 6 US cities resulted in rates of infection between 3 and almost 30%.
infection in IV users ranges from 50 to 80%.
infection in IV users ranges from 66 to 93%.
US government approach to drugs in 1800s
Laissez-Faire- The US governments attitude toward substances prior to the early 1900’s was described by this expression
If the seller wants to sell it, and the buyer wants to buy it, let them.
Problems with studying substance abuse:
- Illicit drugs difficult to get accurate data-It is illegal, and therefore sales can not be looked at accurately.
- Even alcohol and prescription drug sales statistics have drawbacks.-Unused medications, home brewed beer
When repeated exposure to the same dose of a drug results in less effect
Limitations in monitoring the future reports:
high school dropouts, If a stranger is asking the questions, one has to wonder about accuracy in reporting.
The DSM does not use the word addiction, what words does it use?
A variable that occurs before some event such as the initiation of drug use.
(Longitudinal studies provide antecedents)
Males who are either “shy” or “aggressive” in first grade are more likely to be _____
Study indicating typical sequence of drug involvement.
Gateway drug theory
Stages of gateway drug theory:
- 1st stage- beer or wine
- 2nd stage- cigarettes, hard liquor, or both
- 3rd stage- marijuana use
- only after these stages are hard drugs tried.
Motives for substance use:
- Attraction to deviant subculture
- signalling rebellion
- effects of drugs are reinforcing
- seeking altered states of consciousness
No further substance use
Reduction in intake, or change type of intake (methadone maintenance)
- Better quality of life.
- less consequences, less frequent, less intense use.
Stages of change:
Precontemplation, contemplation, preparation, action, and maintenance.
Clinician matches intervention to these stages focusing on motivating client to enter the next stage.
Stages of change
Motivational enhancement therapy
Relatively new treatment approach, challenges the “must hit bottom” standard.
Attempts to shift the focus toward motivation to change.
Cognitive therapy techniques and behavioral skills training to identify and change behaviors that may contribute to substance use
(Limitation is it places greater demands on the client.)
Rewards for abstinence demonstrated by negative UDS.
(Negative UDS means no drugs in urine)
- Contingency management
- (Limitation is cost of rewards and return to old behavior in absence of rewards following completion of the program.)
Intervention to ease the suffering and possible serious complications of the withdrawal syndrome from a substance.
- Withdrawl treatment
Medical intervention to reduce craving and / or reduce risk or illegal behavior.
- Maintenance treatment
Which drugs require inpatient detox?
17% residential (inpatient)
- Alcohol 40%, opioids 18% (77% were for heroin) marijuana 16%, and cocaine 14%
- (72% were for crack).
Treatment is daily during the week. The client spends a large part of the day 6-8 hours at the facility receiving various forms of therapy (group, individual,recreational).
At least 9 hours of therapy weekly. Treatment usually consists of three – 3 hour groups weekly. Educational, psychotherapy groups, individual therapy.
Less than 9 hours of therapy weekly. Can consist of as little as a one hour individual session biweekly.
Still getting nicotine, but in a safer fashion
Transdermal nicotine patch, nasal spray, inhaler, gum, lozenge.
Nicotine replacement therapy
Bupropion- Zyban, Wellbutrin
Gradually decreasses cigarette craving
newest drug on the market, appears to be more effective than Bupropion.
antagonist punishment treatment.
opioid antagonist demonstrated to reduce alcohol consumption for those in study.
helped reduce alcohol relapse.
methadone given and reduced, or buprenorphine (suboxone) (newer safer treatment).
Other medications may be given as well, to sedate the patient or reduce other symptoms.
used in maintenance as well as detoxification.
Maintenance may be long term, spanning several years
Drug Abuse Resistance Education
Aimed at those who have not yet tried the substance.
Abstinence or attitudes toward drug is the goal.
Aimed at those who have tried substances.
The goal is usually prevention of the use of more dangerous drugs, or prevention of more dangerous forms of substances already used.
Program for an entire population.
(Ex. School children.)
High risk groups in the population.
(Ex. Poor neighborhoods.)
Individuals showing signs of developing problems.
The belief increased knowledge would lead to attitude changes which would affect behavior.
Didn't bring abstinence, but better decision making in regard to substances
Knowledge attitude behavioral model
Information provided to the parents regarding substances, what to look for, current substances of abuse, etc
Communication, decision making skills, setting goals and limits, and saying no to your child.
Families work together as a unit to examine,discuss, and confront substance related issues.
Tends to improve family communication and strengthens parent’s knowledge and skill
All businesses that obtain grants or contracts from the government must adopt a drug free workplace plan.
Plans are up to the company, and are meant to prevent drug use by letting it be known that substance use is not condoned.
Most consistent feature of workplace drug prevention programs
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