Substance Use Disorders (finished editing)

What is Substance Use Disorder (SUD)?

Continued use of substances like alcohol, tobacco, or medications not prescribed, despite significant disruption to meaningful activities and negative health consequences.

How is the severity of Substance Use Disorder classified?

- mild (2-3 symptoms)

- moderate (4-5 symptoms)

- severe (6 or more symptoms).

What is a Co-Occurring Disorder (COD)?

A condition where one or more Substance Use Disorders coexist with one or more mental illnesses, also known as Dual Diagnosis.

What are the four areas assessed in the DSM-5 criteria for SUD?

Impaired control, social impairment, risky use, and physical dependence.

According to the DSM-5, how many areas of symptoms need to be present across a time period?

1 or more areas within 12 month period

What symptoms indicate impaired control in SUD?

- Using more of a substance than intended

- inability to cut down or stop

- intense cravings

- spending excessive time on substance-related activities

What symptoms indicate physical dependence in SUD?

- Tolerance (needing more of the substance for the desired effect)

- withdrawal symptoms when not using the substance.

What social symptoms are associated with SUD?

- Neglecting responsibilities

- continuing use despite relationship problems

- giving up important social activities.

What are some risky use behaviors in SUD?

- Using substances in dangerous settings

- continuing use despite negative physical and mental health effects.

List some classes of substances associated with SUD.

- Alcohol

- opioids

- caffeine

- sedatives, hypnotics, and anxiolytics

- cannabis

- stimulants (prescription and street drugs)

- hallucinogens (dissociatives)

- tobacco

- inhalants

What neurobiological factors contribute to SUD?

Genetic predisposition and how individuals process drugs, leading to compulsive use.

What psychological factors are associated with SUD?

Certain personality traits and cognitive beliefs that interfere with effective coping mechanisms.

a person reports needing more of a drug to get the same effect they used to experience with a smaller dose. this describes:

tolerance

3 multiple choice options

an individual continues to use alcohol despite losing their job and damaging important relationships. Which DSM-5 symptom area best fits this situation?

social impairment

3 multiple choice options

What are common settings for treatment of SUD?

- Hospitalization for overdose or severe withdrawal

- residential treatment units

- outpatient programs

Why might a person be admitted into the hospital for SUD?

- overdosing

- risk of severe withdrawal

- medical comorbidities

- requires restricted access to drugs for detoxing

- psychiatric illness with suicidal ideation (harm to themselves)

Why might a person with SUD be sent to a residential treatment unit?

to have a temporary place to sleep, and are seeking rehab services

t/f the average LOS in a residential treatment unit is about 7-14 days, which is not long enough for recovery and puts the individual as high risk for relapse

true

Why might a person with SUD be sent to an outpatient program?

the person does not have any risks for medical or psych complications, and they are highly motivated to change

What is the goal of medical management in SUD treatment?

To treat co-occurring psychiatric disorders and associated medical conditions, while managing pain to reduce opioid use.

Why is pharmacological intervention still used for the medical management of SUD?

to manage withdrawal symptoms, and substitute harmful drugs for regulated and prescribed ones

How does SUD impact occupational performance?

- disrupts routines, which make it difficult to pursue occupational roles

- affects sleep quality

- impacts performance in school and work.

What sensory processing issues are observed in individuals with SUD?

Atypical sensory processing preferences, including sensitivity, avoidance, and low registration.

How does chronic substance use affect sensory processing?

changes how the brain responds to internal cues (interoception)

What role does Occupational Therapy play in SUD treatment?

- inquire about substance use as part of lifestyle assessments

- provide education

- referrals for safer choices

What should the OT do if the occupational profile reflects potentially risky heavy drinking?

follow up with a more formal screening, and referral to appropriate services

What should the OT do if the person reports hazardous incidents or occurrences of harm?

provide education and help the person make safer choices

What screening tools are used for assessing SUD?

- CAGE-AID

- suicide risk assessments

- Transtheoretical Model and MI for readiness to change

- Cognitive function evaluations

- COPM

What is CAGE-AID?

self-assessment screening tool for alcohol and drug use

Prolonged use of what kind of drugs would most need to assess cognitive function?

opioids and dissociatives

What interventions are commonly used in SUD treatment?

- Cognitive Behavioral Therapy (CBT)

- Motivational Interviewing

- skills training (coping, social, and life skills)

- leisure exploration.

- CO-OP for HO difficulties

- group and 1:1 services

How is motivational interviewing used for OT assessments and interventions?

assesses the readiness for change; and used as an intervention to progress the individual along the continuum of change

What kind of social skills would be the main target in social skills training?

interaction and assertiveness

When would you need to use the CO-OP method for people with SUD?

when the individual presents with higher-order cognitive difficulties, and to develop skills in problem-solving

What barriers to treatment are commonly faced by individuals with SUD?

- Comorbidities

- lack of readiness to stop using

- healthcare coverage issues

- stigma

- limited health literacy and mistrust

- access to tx or transportation

A 45 y/o client hospitalized after an opioid overdose is referred to OT. What is the OT's primary focus during the IP care?

ensure safety, establish routines and support medical stabilization

3 multiple choice options