Short answers a paragraph each...

Provide a few examples of an addictive substance?

1. Why did this substance come to mind? What are the negative effects of this substance?
2. Talk about what you see at the key components of the biopsychosocial interview? What do you want to look for as a clinician in this process?
3. Pick an article from the website and tell me why you find. it intersting. http://www.samhsa.gov/

Chapter 4

The Biopsychosocial Interview

 

• This is where you begin to develop the treatment plan
• This is one of the most valuable times spent with patient
• This where you fund out what the problems are and where they came from

 

All chemical dependency affects:

Biology

Cells

Psychology

Emotions, attitudes and behaviors

Sociology

Relationships

 

• It will take time to become a skilled interviewer
• Always begin the interview by telling the patient what you will be doing
• Let the patient tell his or her story
• Your job is to write it down
• Guide the patient only when needed

 

The history of the problem must contain the following:

• Age of onset
• Duration of use
• Patterns of use
• Consequences of use
• Previous treatment
• Blackouts
• Tolerance
• Withdrawal symptoms

 

Past history of the patient from infancy to the present is next:

• Place of birth
• Date of birth
• Developmental milestones
• Raised with
• Ethnic/cultural influences
• Home of origin
• Grade school
• High School
• College
• Military history
• Occupational history
• Employment satisfaction
• Financial history
• Gambling
• Sexual orientation
• Sexual abuse
• Physical abuse
• Current sexual history
• Relationship history
• Social support for treatment
• Spiritual orientation
• Legal
• Strengths/Weaknesses
• Leisure
• Depression
• Mania
• Anxiety disorders
• Eating disorders

 

Medical history:

• Illnesses
• Hospitalizations
• Allergies
• Medications at present

 

Family history

• Father
• Mother
• Other relatives with significant psychopathology

 

Mental status

 

• Description of patient
• Dress
• Sensorium
• Orientation
• Attitude towards examiner
• Motor behavior
• Speech
• Affect
• Range of affect
• Mood
• Thought processes
• Abstract thinking
• Suicidal ideation
• Homicidal ideation
• Disorders of perception
• Delusions
• Obsessions
• Compulsions
• Intelligence
• Concentration
• Memory
• Immediate memory
• Recent memory
• Remote memory
• Impulse control
• Judgment
• Insight
• Motivation for treatment

 

 

 

 

 

Summary and Impression

 

• Begin with the patients childhood and summarize all that you have heard
• Give your impression of where the patient stands on the following:
• Acute intoxification or withdrawal complications
• Biomedical conditions or complications
• Emotional/behavioral complications
• Treatment acceptance or resistance
• Relapse potential
• Recovery environment

 

 

 

Diagnosis

 

• Diagnosis the problem by referencing the Diagnostic and Statistical Manual of Mental Disorders

Chapter Three

The Addicted Brain

 

1950's

• We learned that if a certain part of the brain is electrically stimulated, an intensely pleasurable sensation occurs

1960's

• Researchers began to find receptors in the brain for opiate-like substances
• Later in the 1960's it was discovered that the brain produces opiate-like substances, which explains the presence of opiate receptors

The Pleasure Center

• Alcohol and every major class of drugs of abuse interact with the same part of the brain in one fashion or another
• The primary purpose of this part of the brain seems to be to produce a pleasurable sensation when stimulated and to make sure that higher parts of the brain remember what the stimulation was so that it will be repeated

Neurotransmitters

• Brain cells communicate messages via chemicals in the brain called neurotransmitters
• Mood altering drugs often override this system by tricking the nerve cells into thinking it is being stimulated by a natural neurotransmitter

What Are Addictive Substances?

• All drugs of abuse alter mood and "fool" your brain
• Mood altering drugs allow a person to avoid facing reality temporarily
• If you have clinical depression or panic disorder, the part of your brain that handles emotions is not working correctly
• Medications prescribed for these conditions work within brain cells to prompt them to function properly by increasing the person's sense of control and improving coping skills - mood altering drugs dont

Tolerance and Withdrawal

• Tolerance is when the body develops an ability to tolerate the effects of drugs
• The brain becomes hyperalert and hypersensitive in order to compensate
• Another type of tolerance is a body's ability to metabolize a drug
• Withdrawal symptoms emerge as the drug clears the system
• Withdrawal symptoms for depressants include:
• Shakiness, anxiety, irritability
• Withdrawal symptoms for stimulants include:
• Fatigue, sleepiness, depressed mood, increased appetite
• The development for tolerance increases the dangerousness of the drug and creates a situation where the body becomes uncomfortable without it

Behavioral Conditioning and Craving

• Instrumental learning is a type of learning that is conscious and intentional
• Conditional learning is when the brain learns to associate a particular effect with a certain situation
• An important part of treatment is teaching addicts how to deal with triggers and cravings