SUD Exam #1

"We need to consider social, biological, and psychological factors when working with individuals who experience substance use disorders (SUDs)." This statement is most likely to be espoused by someone who believes in the ________ theory of substance use.

Integrated

The concept of public health developed out of __________ and emphasizes the health of the public as a whole over that of the individual.

epidemiology

What are two ways of reporting prevalence?

As a proportion/percentage (E.g., 50% of people (age 12 or older) used alcohol in the past month in 2020) and as the number of the persons in a population (E.g., 138.5M people (age 12 or older) used alcohol in the past month in 2020)

Why was the Master's of Addiction Counseling (MAC) certification created?

In response to the inconsistency of educational and experiential requirements to become a SUD counselor

What are some personal risk factors in developing an SUD?

Peer use early, mental health disorders/learning disabilities, early emergence of problem behavior, and early age of use

What is not a risk factor of e-cigarette use?

Favorable parental attitude

What is not a protective factor of e-cigarette use?

Positive family management

The Burrow-Sanchez et al., (2022) article found that risk and protective factors operate _________ on alcohol, cannabis, e-cigarettes.

differently, depending on the substance

"A substance use disorder (SUD) is generally considered a chronic condition and relapses are the norm rather than the exception." This viewpoint would most likely come from someone espousing the ______ theory of substance use.

Medical

"If you just had stronger will power, you could stop drinking!" This statement is most likely to be espoused by someone who believes in the ________ theory of substance use.

Moral

The article by Romer et al., (2017) indicates that the difference in adolescent brain development between the limbic regions and the prefrontal cortex is generally referred to as the ________ model.

Imbalance

As described in the reading from the DiClemente (2020), chapter Screening, Brief Intervention, and Referral to Treatment (SBIRT) can flexibly be used in many settings. Overall, SBIRT is a ________ approach for substance use disorders (SUDs).

public health

According to the Schaus (2020) chapter on Screening for Alcohol Misuse, the sensitivity of a screening instrument refers to its ability to ______________ people in the population who ______ the disorder.

Correctly identify; have

As part of the assessment process for a substance use disorder (SUD), a clinician may refer the client to a _________ evaluation.

medical

In general, substance use _________ occurs in the context of other problems the client is experiencing such as anxiety, depression, job issues, family concerns and so forth.

typically

A key point made in the Schmidt-Owens (2020) chapter on screening/intervention for tobacco use is that tobacco dependence is a ________ disease that often requires __________ and ________ attempts to quit.

chronic; repeated intervention; multiple

Project D.A.R.E. spread rapidly in the 1980's as a joint effort between schools and police departments; this program has been shown to________.

lack effectiveness when researched

According to the Onrust et al., (2016) article; their study demonstrated that it makes good sense to consider a ____________ when designing and offering preventative interventions for substance use in youth.

developmental perspective

According to the APA (2008) article on zero tolerance; the practices of zero tolerance have ________.

not improved school climate or safety

After hearing a lecture on what we know and don't know about the risks of vaping, a young person thinks to themselves, "I vape and could be at risk for hurting my lungs if I continue doing this." Based on the health belief model (as described in Skinner et al., 2015) this thought would most likely correspond to ____________.

Perceived susceptibility

How can you obtain data on the prevalence of substance use?

Surveys to extrapolate data from

Prevalence

Number of people who exhibit the behavior over a period

of time

What are the three most common substances?

1. Alcohol 2. Tobacco/Vaping 3. Marihuana

With people with SUDs, what are the reasons for not receiving treatment?

1. No healthcare coverage or not being able to afford the cost of treatment 2. Not finding a program that offered the type of treatment they wanted 3. Concerned that obtaining

treatment may cause others (e.g., neighbors or community) to have a negative opinion of them.

Of the 8.9 million people who sought SUD treatment, what are the three that make up 56% (5 million)?

1. Self-help group, 2. Outpatient rehabilitation, and 3. Outpatient mental health center

When working with SUDs, what are three relevant laws?

1. 42 CFR, 2. HIPPA, and 3. FERPA

Where should you have a knowledge of ethical/legal standards?

1. Profession, 2. State, and 3. Work setting

What are three counseling behaviors that are important ethical considerations for working with SUDs?

1. Confidentiality, 2. Relationship/Boundaries,, and 3. competence

Historically, SUD counselors required what?

Experience with SUD and recovery rather than coursework

To be a SUD counselor, what training do you usually need?

An associate's degree and some clinical hours. In some states, you only require a high school diploma/GED and some experience

Despite different substances, most enhance the central nervous system via what?

The neurotransmitter dopamine

What is dopamine particularly related to?

Fear, pleasure, emotion, and cognitive functions

What does the prefrontal cortex do?

Judgment, sensation, and movement

What does the limbic system do?

Emotion (Amygdala: fear, anger; hippocampus: new memories; hypothalamus: hormones)

What does the brain stem do?

Keeps us alive

Adolescents engage in what?

Sensation-seeking behavior/risk-taking behavior more than older/younger age groups.

What correlates with adolescent risk taking?

Impulsivity

Why are adolescents more likely to be impulsive?

Emotional rather than cognitive processes

What is cognitive control?

Consequential thinking, decision making, and problem solving

In adolescence, which area of the brain is more developed?

The limbic regions (emotions) are more developed than the prefrontal cortex (cognitive control)

What are the different theories of substance abuse?

Moral, disease/medical, genetic, behavioral/psychological, sociocultural, and integrated

What are some natural ways of activating the reward pathway?

Food, water, sex, and nurturing

Drugs of abuse target what?

The brain's pleasure (dopamine) pathways

Drugs of abuse increase what?

Dopamine

What are the reward pathways important for?

Natural rewards, such as sex, music, and food

Typically, dopamine increases in response to what?

Natural rewards, such as food

When drugs of abuse (e.g., cocaine) are taken, dopamine increases are what?

Exaggerated and communication is altered

How does an SUD typically develop?

1. Initiation of drug use (usually associated with a positive experience), 2. Drug use influences neurochemical changes in brain (Tolerance: more of drug needed over time to experience intoxication effects), and 3.Increased drug use needed to sustain neurochemical changes (Withdrawal: taking drug to avoid negative effects of non-use).

What are some personal protective factors in not developing an SUD?

Later age of use, good social skills/problem-solving, good mental health/lack of learning disabilities, and non-using peers

What are some family risk factors in developing an SUD?

Parental use/older sibling use, ineffective parenting practices, high family conflict/low stability, and permissive parental attitudes

What are some family protective factors in not developing a SUD?

Non-using family members, effective parenting practices, low family conflict/high stability, and clear parental attitudes

What are some school risk factors in developing an SUD?

Poor academic performance, low commitment/negative attitudes, negative interactions/discipline referrals/suspensions, and disruptive behaviors/learning disabilities.

What are some school protective factors in not developing an SUD?

Good academic performance, high commitment/positive attitudes, positive interaction/positive involvement, good behavioral self-control/ lack of learning disabilities.

What are some community risk factors in developing an SUD?

high levels of disorganization, permissive or favorable norms, high availability, and low levels of "community"

What are some community protective factors in not developing an SUD?

Highly organized, clear and non-favorable norms, low availability, and high levels of "community"

What is a good strategy to prevent substance abuse?

Promote protective factors

What are three protective factors you can promote, and which substances are those protective factors effective for?

1) Provide factual information on risks of using substances (e.g., Can, E-Cig) 2) Promote Positive Family Interactions such as Family Communication, Clear Rules and Expectations (e.g., Alc, Can) 3) Provide Opportunities to Be Recognized for Participation in non-substance using activities such as sports, or extracurriculars (e.g., Alc, E-Cig)

Providing factual information on risks of using substances is an effective protective factor for what substances?

Cannabis and E-cigarettes

Promoting Positive Family Interactions such as Family Communication, Clear Rules and Expectations is an effective protective factor for what substances?

Alcohol and Cannabis

Providing Opportunities to Be Recognized for Participation in non-substance using activities such as sports, or extracurriculars is an effective protective factor for what substances?

Alcohol and e-cigarettes

What are some risk factors for alcohol consumption?

Favorable attitudes, peer use, favorable parental attitude, and perceived availability

What are some risk factors of cannabis use?

Favorable attitudes, peer use, and perceived availability

What are some risk factors of e-cigarette use?

Favorable attitudes, peer use, and perceived availability

What is not a risk factor of cannabis use?

Favorable parental attitude

What are some protective factors of alcohol use?

Positive family management and prosocial rewards

What are some protective factors of cannabis use?

Perceived risk, prosocial peers, and positive family management

What is not a protective factor of cannabis use?

Prosocial rewards

What are not protective factors of alcohol consumption?

Perceived risk and prosocial peers

What are some protective factors of e-cigarette use?

Perceived risk, prosocial peers, and prosocial rewards

What is the moral theory of substance use?

The idea that people who cannot stop drinking/using or control their behavior while under the influence are morally corrupt.

How does moral theory view substance use?

As sinful and morally wrong

According to the moral theory of substance use, why do people start using substances?

Because they are bad people with little moral strength

Moral theory considers addiction and behavior to be a what?

A choice

According to moral theory, why does addiction occur?

Because bad people are making bad choices

According to moral theory, people continue to use addictive substances because they lack what?

Willpower. Thus, addiction is because they choose to be addicted.

In moral theory, what is rarely considered?

Change

What does treatment look like in moral theory?

Punishment

According to moral theory, when does recovery happen?

When a person chooses to stop using and change their moral belief system

According to moral theory, when does relapse occur?

When a person chooses to forgo moral choices and use addictive substances again. Relapse is the result of a lack of willpower and moral standards

What is the most prevalent of all treatment models of SUDs?

The disease/medical model

What is the disease/medical model of substance abuse?

The disease model of substance abuse sees addiction as a chronic brain disease characterized by compulsive drug use despite negative consequences. It suggests that addiction is caused by genetics, environment, and neurological factors, and should be treated as a medical condition, not a moral failing.

According to the disease/medical model, how should SUDs be treated?

According to the disease/medical model of substance abuse, SUDs (Substance Use Disorders) should be treated through medical interventions, such as detoxification, medication-assisted treatment, and counseling or therapy. The focus is on treating the underlying physiological and psychological factors contributing to addiction.

According to the disease/medical model, what causes SUDs?

According to the disease/medical model, Substance Use Disorders (SUDs) are believed to be caused by a combination of genetic, environmental, and neurological factors.

What is the genetic theory on substance abuse?

The genetic theory of substance abuse suggests a genetic component to its development. Research shows specific genetic variations that increase susceptibility.

According to the disease/medical model, why do people continue to abuse substances?

Because addiction is a chronic, relapsing brain disease. This model suggests that individuals have a biological predisposition to addiction, which leads to compulsive substance use despite negative consequences. It emphasizes the role of genetic, neurobiological, and environmental factors in substance abuse.

According to the disease/medical model of substance abuse, how does change occur?

According to the disease/medical model of substance abuse, change occurs through the recognition of addiction as a chronic disease that requires medical treatment and intervention. This model emphasizes the role of genetics, brain chemistry, and physiological factors in substance abuse, suggesting that individuals need medical interventions, such as medication and therapy, to overcome addiction.

What is the behavioral theory of substance abuse?

The behavioral theory of substance abuse suggests that addictive behaviors are learned through conditioning and reinforcement. It emphasizes environmental factors in shaping and maintaining substance abuse behaviors. This theory focuses on the individual's thoughts, emotions, and behaviors, and their interaction with the environment in contributing to substance abuse.

According to behavioral theory, why do people continue to abuse substances?

Behavioral theory suggests that substance abuse persists due to the positive reinforcement individuals receive from pleasurable outcomes or relief from negative emotions. Environmental factors, such as peer influence and substance availability, also contribute to the continuation of substance abuse.

What are some sociocultural influences on substance abuse?

Gender, race/ethnicity, SES, and socialization

How does gender influence drug abuse?

Gender can influence drug abuse in several ways. Research suggests that men are more likely than women to engage in drug abuse, including alcohol and illicit drugs. However, women may be more susceptible to the addictive effects of certain substances, such as cocaine. Additionally, societal factors, such as gender roles and expectations, can contribute to differences in drug abuse patterns between genders. For example, men may face more pressure to engage in risky behaviors, including substance abuse, as a way to demonstrate masculinity.

What are risk factors for women developing an SUD?

Women are more likely be sexual victims and drinking over the long term causes more health problems than men even if the amount is less;

Are men or women more likely to abuse substances?

Men

What are subgroups of women who have elevated rates of heavy drinking?

Younger women, those lacking social roles or occupying unwanted social status, women in untraditional jobs, cohabitating women, and ethnic minority women experiencing rapid acculturation.

In 2013, populations differed in illicit drug use between racial groups. What was the order?

1. Blacks, 2. Whites, 3. Hispanics, and 4. Asians (Multicultural had the highest.)

What is social inequality a strong predictor of?

Alcohol and drug use

Which population has an over-represented number of individuals who abuse drugs?

Those in lower SES

Individuals who are unemployed are more likely to what?

Engage in illicit drug use

Adolescents are more likely to abuse drugs if they are what? Adults?

In a low SES. Adults are more likely in a high SES.

Alcohol use increases in relation to what for white people but not for black people?

Income

What is the relationship between drug use and education?

As educational levels increase, drug use decreases.