1 screening for addictive disorders developed by data of ri through a grant from the ri department...

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Screening for Addictive Screening for Addictive DisordersDisorders

Developed by DATA of RI through Developed by DATA of RI through a grant from the RI Department of a grant from the RI Department of

Human ServicesHuman Services

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Group Discussion Questions: Group Discussion Questions: AddictionAddiction

What is an addiction?What is an addiction?

Are there different types of addictions?Are there different types of addictions?

Who becomes an addict?Who becomes an addict?

Is addiction treatable?Is addiction treatable?

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Types of AddictionsTypes of Addictions

Substance AddictionsSubstance Addictions

Legal drugsLegal drugs

Illegal drugsIllegal drugs

Over the counter Over the counter drugsdrugs

TobaccoTobacco

CaffeineCaffeine

FoodFood

Process AddictionsProcess Addictions

GamblingGambling

ExerciseExercise

WorkWork

InternetInternet

PornographyPornography

ShoppingShopping

SexSex

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What is an Addiction?What is an Addiction?

1.1. ObsessionObsession

2.2. Negative ConsequencesNegative Consequences

3.3. DenialDenial

4.4. Loss of ControlLoss of Control

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Continuum of AddictionContinuum of Addiction

0 1 2 3 4

Total abstinence

from use

Rare/social use Heavy social use

early problem use

Heavy problem

use

early addiction

to drugs

Clear addiction

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Relationship Between Alcohol & Drug Use and Alcohol & Drug Problems

None

LightModerate

Heavy

None

SmallModerate

Severe

Alcohol & Drug Problems

Alcohol & Drug Use

Low Risk At Risk Problem Dependent

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How Do People Get Addicted?How Do People Get Addicted?Stage I: Infatuation – early experiences with drugs or Stage I: Infatuation – early experiences with drugs or activities leave an imprint of positive or negative effectsactivities leave an imprint of positive or negative effectsStage 2: Honeymoon – under stress people seek out Stage 2: Honeymoon – under stress people seek out that remembered experience for comfort or relief; get that remembered experience for comfort or relief; get only positive effects & expect them to last.only positive effects & expect them to last.Stage 3: Betrayal – drug or activity turns on the addict; Stage 3: Betrayal – drug or activity turns on the addict; they no longer get “high” from itthey no longer get “high” from itStage 4: On the Rocks – ignoring mounting evidence of Stage 4: On the Rocks – ignoring mounting evidence of the drug or activity’s negative effects, addict attempts to the drug or activity’s negative effects, addict attempts to recapture the honeymoon by increasing involvement with recapture the honeymoon by increasing involvement with ititStage 5: Trapped – now as the addict struggles to break Stage 5: Trapped – now as the addict struggles to break the addiction by willpower alone, the tighter its grip the addiction by willpower alone, the tighter its grip becomesbecomes

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How Drugs WorkHow Drugs Work

A drug is nothing but a chemical A drug is nothing but a chemical substance until it comes into contact substance until it comes into contact with a living organism.with a living organism.

Drugs are psychoactive because Drugs are psychoactive because they alter ongoing brain functions.they alter ongoing brain functions.

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CLASSIFICATION OF DRUGSCLASSIFICATION OF DRUGSA.A. AlcoholAlcohol

B.B. Sedative hypnoticsSedative hypnotics

C.C. Narcotic analgesicsNarcotic analgesics

D.D. StimulantsStimulants

E.E. HallucinogenicsHallucinogenics

F.F. InhalantsInhalants

G.G.SteroidsSteroids

H.H. OtherOther

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ALCOHOLALCOHOL• Last month, 109 million Americans had at least Last month, 109 million Americans had at least

one drink. one drink. • Alcohol is the oldest and most widely used Alcohol is the oldest and most widely used

psychoactive drug. psychoactive drug. • Central nervous system depressantCentral nervous system depressant

Legal, socially acceptable,& readily availableLegal, socially acceptable,& readily availableMost commonly abused legal drugMost commonly abused legal drugMost common first recreational drug of Most common first recreational drug of exposureexposure

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Standard Drink MeasureStandard Drink Measure

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Blood Alcohol Level EffectsBlood Alcohol Level Effects 1 drink: 0.02-0.03%-1 drink: 0.02-0.03%-No overt effects, slight mood elevationNo overt effects, slight mood elevation 2 drinks: 0.05-0.06%-2 drinks: 0.05-0.06%-Feelings of relaxation, warmth, slight Feelings of relaxation, warmth, slight

decrease in reaction time and in fine muscle coordinationdecrease in reaction time and in fine muscle coordination 3 drinks: 0.08-0.09%-3 drinks: 0.08-0.09%-Balance, speech, vision, hearing slightly Balance, speech, vision, hearing slightly

impaired; feelings of euphoria; increased confidence; loss of motor impaired; feelings of euphoria; increased confidence; loss of motor controlcontrol

4 drinks: 0.11-0.12%-4 drinks: 0.11-0.12%-Coordination and balance becoming difficult; Coordination and balance becoming difficult; distinct impairment of mental faculties, judgementdistinct impairment of mental faculties, judgement

5 drinks: 0.14-0.15%-5 drinks: 0.14-0.15%-Major impairment of mental and physical Major impairment of mental and physical control; slurred speech, blurred vision, lack of motor skillscontrol; slurred speech, blurred vision, lack of motor skills

7 drinks: 7 drinks: 0.20%-Loss of motor control-must have assistance to 0.20%-Loss of motor control-must have assistance to move aboutmove about

10 drinks: 0.30%-10 drinks: 0.30%-Severe intoxicationSevere intoxication 14 drinks: 0.40%-14 drinks: 0.40%-Unconsciousness, threshold of comaUnconsciousness, threshold of coma 17 drinks: 0.50%-17 drinks: 0.50%-Deep coma-Respiratory failureDeep coma-Respiratory failure

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How Alcoholism Affects UsHow Alcoholism Affects Us

Assaults: 72% of Offenders & 79% of VictimsAssaults: 72% of Offenders & 79% of Victims Robberies: 72% of OffendersRobberies: 72% of Offenders Murder: 86% of Offenders & 50% of VictimsMurder: 86% of Offenders & 50% of Victims Rape: 50% of Perpetrators Rape: 50% of Perpetrators Suicide: 64% of Attempts (10,000 + deaths)Suicide: 64% of Attempts (10,000 + deaths) Fire: 83% of Fire and Burn VictimsFire: 83% of Fire and Burn Victims Drownings: 69% of VictimsDrownings: 69% of Victims Highway Deaths: 20,000Highway Deaths: 20,000 Job Accidents: 18,000 Deaths, Millions of InjuriesJob Accidents: 18,000 Deaths, Millions of Injuries Domestic Violence: 27% of females and 57% of males involved in Domestic Violence: 27% of females and 57% of males involved in

marital violencemarital violence Child Abuse: 83% of child welfare casesChild Abuse: 83% of child welfare cases Bottom Line: alcoholism accounts for 85% of drug addiction Bottom Line: alcoholism accounts for 85% of drug addiction

problems in the USproblems in the US

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Effects of Alcohol Use:Effects of Alcohol Use:

Short TermShort Term

Mild sense of relaxationMild sense of relaxation

Slurred speech, loss of Slurred speech, loss of some motor controlsome motor control

Decrease in blood Decrease in blood pressure, heart rate, pressure, heart rate, appetiteappetite

Increase in urine output, Increase in urine output, and gastric acid secretion, and gastric acid secretion, and sleepand sleep

Long TermLong Term

Damage to every vital Damage to every vital organorgan

Increased risk of cancer, Increased risk of cancer, malnutrition, organic brain malnutrition, organic brain syndromes, sexual syndromes, sexual dysfunction, and high dysfunction, and high blood pressureblood pressure

Lowered resistance to Lowered resistance to diseasesdiseases

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SEDATIVE HYPNOTICSSEDATIVE HYPNOTICSGeneral Properties & EffectsGeneral Properties & Effects

Sedative:Sedative: a drug that eases anxiety and relaxes the a drug that eases anxiety and relaxes the body and mind; also called “tranquilizers” and “muscle body and mind; also called “tranquilizers” and “muscle relaxants.”relaxants.”Sedative-hypnotic: Sedative-hypnotic: any drug that either relaxes and any drug that either relaxes and soothes the body and mind, eases anxiety, or induces soothes the body and mind, eases anxiety, or induces sleep. The two main categories are benzodiazepines, sleep. The two main categories are benzodiazepines, such as Xanax® and Klonopin®, and barbiturates, like such as Xanax® and Klonopin®, and barbiturates, like phenobarbital.phenobarbital.Tranquilizers: Tranquilizers: drugs that have antianxiety or drugs that have antianxiety or antipsychotic properties but don’t induce sleep; also antipsychotic properties but don’t induce sleep; also prescribed as muscle relaxants.prescribed as muscle relaxants.

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SEDATIVE HYPNOTICS USESSEDATIVE HYPNOTICS USES

Treat anxietyTreat anxiety

Treat panic attacksTreat panic attacks

Treat sleep problemsTreat sleep problems

Control skeletal muscular spasmsControl skeletal muscular spasms

Control acute alcohol withdrawal symptomsControl acute alcohol withdrawal symptoms

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NARCOTIC ANALGESICSNARCOTIC ANALGESICSGeneral Properties & EffectsGeneral Properties & Effects

Narcotic:Narcotic: this term from the Greek this term from the Greek narkotikosnarkotikos, , meaning “benumbing”; originally used to meaning “benumbing”; originally used to describe any derivative of opium but came to describe any derivative of opium but came to refer to any drug that induced sleep or reduce refer to any drug that induced sleep or reduce painpainAnalgesic:Analgesic: a painkiller that works by changing a painkiller that works by changing the perception of the pain rather than truly the perception of the pain rather than truly deadening the nerves as an anesthetic would.deadening the nerves as an anesthetic would.Antitussive:Antitussive: any medication that relieves any medication that relieves coughing, such as codeine.coughing, such as codeine.Most Common..Codiene, morphine, oxycontin, Most Common..Codiene, morphine, oxycontin, vicodin, heroin, vicodin, heroin,

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NARCOTIC ANALGESICS USESNARCOTIC ANALGESICS USES

MedicalMedical Deaden painDeaden pain Control coughingControl coughing Stop diarrheaStop diarrhea

Non-medicalNon-medical Drown out emotional painDrown out emotional pain Get a rushGet a rush Induce euphoriaInduce euphoria Prevent withdrawal symptomsPrevent withdrawal symptoms

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STIMULANTSSTIMULANTSGeneral properties & effectsGeneral properties & effects stimulant:stimulant:

Any substance, including cocaine, amphetamines, Any substance, including cocaine, amphetamines, diet pills, coffee, khat, betel nuts, ephedra, and diet pills, coffee, khat, betel nuts, ephedra, and tobacco, that forces the release of epinephrine and tobacco, that forces the release of epinephrine and norepinephrine, the body’s own stimulants. norepinephrine, the body’s own stimulants.

They stimulate the nervous system by increasing the They stimulate the nervous system by increasing the electrical and chemical activity of the brain.electrical and chemical activity of the brain.

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STIMULANTS USESTIMULANTS USEMedicalMedical NarcolepsyNarcolepsy ObesityObesity AAD/ADHDAAD/ADHD

Non-medicalNon-medical Keep awakeKeep awake Feel energizedFeel energized Increase confidenceIncrease confidence Induce euphoriaInduce euphoria

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HALLUCINOGENICSHALLUCINOGENICS

General properties & effectsGeneral properties & effects

hallucinogen: hallucinogen: a substance that produces a substance that produces hallucinations e.g., LSD, mescaline, hallucinations e.g., LSD, mescaline, peyote, DMT, psilocybin, and potent peyote, DMT, psilocybin, and potent marijuana; a term often used marijuana; a term often used interchangeably with psychedelic, interchangeably with psychedelic, stimulates sympathetic nervous system.stimulates sympathetic nervous system.

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HALLUCINOGENICS USEHALLUCINOGENICS USE

Induces hallucinationsInduces hallucinations

Alters sensory perceptionAlters sensory perception

Alters moodAlters mood

Impairs concentrationImpairs concentration

Religious worshipReligious worship

Spiritual experiencesSpiritual experiences

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OTHER DRUGSOTHER DRUGSInhalantsInhalants

Inhalant: Inhalant: any substance that is vaporized, misted, or any substance that is vaporized, misted, or gaseous that is inhaled and absorbed through the gaseous that is inhaled and absorbed through the capillaries in the alveoli of the lungs.capillaries in the alveoli of the lungs.Volatile solvents: Volatile solvents: petroleum distillates that are abused petroleum distillates that are abused as inhalants. as inhalants. Whippets®: Whippets®: small metal canisters containing nitrous small metal canisters containing nitrous oxide (laughing gas). They are sold as whipped cream oxide (laughing gas). They are sold as whipped cream propellants but abused as an inhalant. propellants but abused as an inhalant. Toluene:Toluene: a liquid hydrocarbon solvent that is used as an a liquid hydrocarbon solvent that is used as an intoxicating inhalant. It is found in many household intoxicating inhalant. It is found in many household products and glues. products and glues. Trichlorethylene (TCE): Trichlorethylene (TCE): a commonly used organic a commonly used organic solvent found in typewriter correction fluids, paints, and solvent found in typewriter correction fluids, paints, and spot removers.spot removers.

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OTHER DRUGSOTHER DRUGSSteroidsSteroids

Anabolic-androgenic steroid: Anabolic-androgenic steroid: a steroid a steroid that builds muscles and strength; that builds muscles and strength; pharmacologically similar to testosterone; pharmacologically similar to testosterone; it also induces male sexual characteristics.it also induces male sexual characteristics.

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OTHER DRUGSOTHER DRUGSClub DrugsClub Drugs

Club drugs: Club drugs: drugs used at music parties, often called “raves,” that drugs used at music parties, often called “raves,” that include MDMA (ecstasy), ketamine, GHB, GBL, Rohypnol®, and include MDMA (ecstasy), ketamine, GHB, GBL, Rohypnol®, and nitrous oxide.nitrous oxide.Date-rape drug:Date-rape drug: drugs like Rohypnol (flunitrazepam), a strong drugs like Rohypnol (flunitrazepam), a strong sedative-hypnotic that can induce amnesia, and GHB are slipped sedative-hypnotic that can induce amnesia, and GHB are slipped into a drink so that a date can be assaulted while in a stupor and not into a drink so that a date can be assaulted while in a stupor and not remember what happened. It is now banned in the United States. remember what happened. It is now banned in the United States. Designer drugs (analogues):Designer drugs (analogues): drugs formulated by street chemists drugs formulated by street chemists that are similar to controlled drugs. There are designer that are similar to controlled drugs. There are designer amphetamines that act partly like psychedelics (e.g., MDMA, MDA) amphetamines that act partly like psychedelics (e.g., MDMA, MDA) and designer heroin (e.g. MPPP).and designer heroin (e.g. MPPP).EcstasyEcstasy (MDMA, “X”):(MDMA, “X”): commonly known as “X” or “ecstasy,” a commonly known as “X” or “ecstasy,” a stimulant/hallucinogen first synthesized in the early 1900s and stimulant/hallucinogen first synthesized in the early 1900s and popularized in the 1980s.popularized in the 1980s.Ketamine:Ketamine: used as a recreational club drug, it is an anesthetic that used as a recreational club drug, it is an anesthetic that produces catatonia and deep analgesia; side effects include excess produces catatonia and deep analgesia; side effects include excess saliva, dysphoria, and hallucinations. Its chemistry and effects are saliva, dysphoria, and hallucinations. Its chemistry and effects are very similar to PCP.very similar to PCP.

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BREAK TIMEBREAK TIME

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Quick SummaryQuick Summary

Discussed What is an addictionDiscussed What is an addiction

There different types of addictionThere different types of addiction

Persons with disabilities are at higher risk than Persons with disabilities are at higher risk than he general population of developing addiction he general population of developing addiction problemsproblems

QuestionsQuestions

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ScreeningScreening

Purpose: is to elevated risk of a Purpose: is to elevated risk of a problem or the existence of a problem or the existence of a potential problem and what would potential problem and what would be the important next step if there be the important next step if there is a potential problem.is a potential problem.

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Collateral InformationCollateral Information

Our decision to ask questions may be Our decision to ask questions may be informed by other information such as: informed by other information such as: problems or complaints, appearance, problems or complaints, appearance, smell, direct observation or past history. smell, direct observation or past history.

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Why Ask?Why Ask?

We ask questions about the quantity We ask questions about the quantity and frequency of alcohol & drug use and frequency of alcohol & drug use or abuse because it is:or abuse because it is: CommonCommon SensitiveSensitive Related to a continuum of riskRelated to a continuum of risk

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Defining “At-Risk” Drinking & Defining “At-Risk” Drinking & DruggingDrugging

REMEMBER THAT RISKREMEMBER THAT RISKDiffers by ageDiffers by ageDiffers by genderDiffers by genderDiffers by pregnancy statusDiffers by pregnancy statusDiffers by health/medication statusDiffers by health/medication statusDiffers by family history of alcoholismDiffers by family history of alcoholism

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Group Discussion Question: Group Discussion Question: Substance Abuse AssessmentSubstance Abuse Assessment

What are 25 questions that could be used What are 25 questions that could be used in the SA screening process to produce the in the SA screening process to produce the most valuable information?most valuable information?

Avoid Avoid demographic datademographic data for this discussion for this discussion

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Use of Screening ToolsUse of Screening ToolsSimpleSimple screening tests ask about screening tests ask about quantity/frequency and binge use of alcohol & quantity/frequency and binge use of alcohol & drugs and help determine levels of risk:drugs and help determine levels of risk:— CAGECAGE— AUDIT (Alcohol Use Disorders Identification AUDIT (Alcohol Use Disorders Identification

Test)Test)— TACETACE— TWEAKTWEAK— CHARMCHARM

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CAGECAGE

Asks client about the past year:Asks client about the past year:C = Cutting down on drinking or drugging C = Cutting down on drinking or drugging

considered?considered?A = Annoyed you by criticizing drinking or A = Annoyed you by criticizing drinking or

drugging?drugging?G = Guilt about your drinking or drugging?G = Guilt about your drinking or drugging?E = Eye openers necessary?E = Eye openers necessary?

Designed to detect alcohol or drug dependenceDesigned to detect alcohol or drug dependence

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AUDITAUDITAlcohol Use Disorders Identification TestAlcohol Use Disorders Identification TestDeveloped by World Health OrganizationDeveloped by World Health OrganizationIntroduction: Tell client that you will be Introduction: Tell client that you will be asking questions about his/her use of asking questions about his/her use of alcoholic beverages during the past year.alcoholic beverages during the past year.Circle the number that comes closest to Circle the number that comes closest to client’s answer.client’s answer.

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AUDIT AUDIT (continued)(continued)

1. How often do you have a drink containing 1. How often do you have a drink containing alcohol?alcohol?

(0) never (1) monthly or less (2) 2-4 times/month (3) 2-3 (0) never (1) monthly or less (2) 2-4 times/month (3) 2-3 times/week (4) 4 or more times/weektimes/week (4) 4 or more times/week

2. How many drinks containing alcohol do you have 2. How many drinks containing alcohol do you have on a typical day when you are drinking? [number on a typical day when you are drinking? [number of standard drinks]of standard drinks] (0) 1-2 (1) 3-4 (2) 5-6 (3) 7-9 (4) 10 or more(0) 1-2 (1) 3-4 (2) 5-6 (3) 7-9 (4) 10 or more

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3. How often do you have six or more drinks on 3. How often do you have six or more drinks on one occasion?one occasion? (0) never (1) less than monthly (2) monthly(0) never (1) less than monthly (2) monthly

(3) weekly (4) daily or almost daily(3) weekly (4) daily or almost daily

4.4. How often during the last year have you How often during the last year have you found that you were not able to stop drinking found that you were not able to stop drinking once you had started?once you had started?

(0) never (1) less than monthly (2) monthly(0) never (1) less than monthly (2) monthly


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5. How often during the last year have you failed to 5. How often during the last year have you failed to do what was normally expected from you do what was normally expected from you because of drinking?because of drinking?

(0) never (1) less than monthly (2) monthly(0) never (1) less than monthly (2) monthly (3) weekly (4) daily or almost daily(3) weekly (4) daily or almost daily

6. How often during the last year have you needed 6. How often during the last year have you needed a first drink in the morning to get yourself going a first drink in the morning to get yourself going after a heavy drinking session?after a heavy drinking session?


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AUDIT AUDIT (continued)(continued)7. 7. How often during the last year have you had How often during the last year have you had

a feeling of guilt or remorse after drinking?a feeling of guilt or remorse after drinking? (0) never (1) less than monthly (2) monthly(0) never (1) less than monthly (2) monthly


8.8. How often during the last year have you been How often during the last year have you been unable to remember what happened the night unable to remember what happened the night before because you had been drinking?before because you had been drinking?


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9. 9. Have you or someone else been injured Have you or someone else been injured as a result of your drinking?as a result of your drinking?

(0) No (2) Yes, but not in the last year (0) No (2) Yes, but not in the last year (4) Yes, during the last year(4) Yes, during the last year

10. 10. Has a relative or friend or doctor or Has a relative or friend or doctor or other health worker been concerned other health worker been concerned about your drinking or suggested you cut about your drinking or suggested you cut down?down?

(0) No (2) Yes, but not in the last year (0) No (2) Yes, but not in the last year (4) Yes, during the last year(4) Yes, during the last year

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Record sum of individual item scores:___ Record sum of individual item scores:___ A score of 8 or greater may indicate the need A score of 8 or greater may indicate the need for a more in-depth assessmentfor a more in-depth assessment

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Screening in PracticeScreening in Practice

Screening OpportunitiesScreening Opportunities

Intake interviewsIntake interviews

Home visitsHome visits

Office visitsOffice visits

Telephone contactsTelephone contacts

Family member visitsFamily member visits

Connected to a problemConnected to a problem

Increasing AccuracyIncreasing Accuracy

Consider the contextConsider the context

Use a sensitive Use a sensitive approachapproach

Be alert to Be alert to nonverbal cuesnonverbal cues

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Evidence of active use or Evidence of active use or intoxicationintoxication

SmellSmellSlurred wordsSlurred wordsUnsteady gateUnsteady gateConfusionConfusionEuphoriaEuphoriaLabile MoodLabile MoodFlushed faceFlushed faceOthersOthers

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Assessing Related Health Assessing Related Health ProblemsProblems

Liver dysfunctionLiver dysfunctionHypertensionHypertensionChronic abdominal painChronic abdominal painDepressionDepressionSexually transmitted Sexually transmitted diseasedisease

Ask about alcohol or drug-related health

Problem if there is there a history of…

• Headaches• Suicide ideation• Trauma• Anxiety or panic

attacks• Sleeping problems• Pancreatitis

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Related Family, Social, and Related Family, Social, and Employment ProblemsEmployment Problems

Have you ever been arrested for driving while under the Have you ever been arrested for driving while under the influence of alcohol or drugs?influence of alcohol or drugs?

Have any family members, friends, or people at work ever Have any family members, friends, or people at work ever asked you to change your drinking or drugging habits?asked you to change your drinking or drugging habits?

Has your drinking or drugging caused problems in your Has your drinking or drugging caused problems in your life?life?

Have you ever participated in a work-related alcohol or Have you ever participated in a work-related alcohol or drug treatment program?drug treatment program?

Have you ever had a problem with your job because of Have you ever had a problem with your job because of drinking or drugging?drinking or drugging?

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Evidence of Physical Evidence of Physical DependenceDependence

• Do you ever drink or drug in the morning to get Do you ever drink or drug in the morning to get over a bad hangover?over a bad hangover?

• Do you develop shakes when you stop drinking Do you develop shakes when you stop drinking or drugging for more than a day?or drugging for more than a day?

• Have you ever been in DTs, been detoxed, or Have you ever been in DTs, been detoxed, or had an alcohol or drug withdrawal seizure?had an alcohol or drug withdrawal seizure?

• Have you ever been treated for alcohol or drug Have you ever been treated for alcohol or drug withdrawal?withdrawal?

• How many days a week do you drink or drug in How many days a week do you drink or drug in the morning?the morning?

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A. Biological IllnessA. Biological IllnessB. HereditaryB. HereditaryC. ChronicityC. ChronicityD. IncurabilityD. IncurabilityE. Lends to loss of control of emotions and behaviorsE. Lends to loss of control of emotions and behaviorsF. Affects the whole family systemF. Affects the whole family systemG. Symptoms can be controlled with tx.G. Symptoms can be controlled with tx.H. Illness progress without treatmentH. Illness progress without treatmentI. Diseases of denialI. Diseases of denialJ. Judge as “moral issues or a personal weakness” rather than J. Judge as “moral issues or a personal weakness” rather than

biologicalbiologicalK. Feelings of guilt & failureK. Feelings of guilt & failureL. Feelings of shame & stigmaL. Feelings of shame & stigmaM. Physical, emotional, & social effectsM. Physical, emotional, & social effects

Parallels Between Mental Parallels Between Mental Illness & AddictionIllness & Addiction

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Comparison of Psychiatric & Comparison of Psychiatric & Drug DisordersDrug Disorders

Lifetime Prevalence of SA DisordersLifetime Prevalence of SA Disorders

Tobacco 24% Tobacco 24% Alcohol 14%Alcohol 14% All other drugs 7.5%All other drugs 7.5%

Cannabis 4.2%Cannabis 4.2% Cocaine 2.7%Cocaine 2.7% Stimulants 1.7%Stimulants 1.7% Sedatives 1.2%Sedatives 1.2% Heroin 0.4%Heroin 0.4%

Lifetime Prevalence of PsychiatricLifetime Prevalence of Psychiatric DisordersDisorders

Major Depression 17%Major Depression 17%Social phobia 13%Social phobia 13%Simple phobia 11%Simple phobia 11%Generalized Anxiety Disorder 5.1%Generalized Anxiety Disorder 5.1%Panic Disorder 3.5%Panic Disorder 3.5%Antisocial Personality Disorder 3.5%Antisocial Personality Disorder 3.5%Bipolar 1.6%Bipolar 1.6%Schizophrenia 1.2%Schizophrenia 1.2%

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Demonstration of Screening Demonstration of Screening InterviewInterview

Use of collateral informationUse of collateral information

Open questionsOpen questions

Use of Screening toolsUse of Screening tools

Motivational InterventionMotivational Intervention

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Questions?Questions?

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Closing ExerciseClosing Exercise

1.1. Something I liked?Something I liked?

2.2. Something I’ll use?Something I’ll use?

3.3. This training will help me?This training will help me?

4.4. Something more I wanted more of?Something more I wanted more of?

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Suggested Articles or ReadingsSuggested Articles or ReadingsBarbor, T. & Grant, M. (1989). From Clinical Research to Secondary Barbor, T. & Grant, M. (1989). From Clinical Research to Secondary

Prevention: International Collaboration in the Development of the Prevention: International Collaboration in the Development of the Alcohol Use Disorders Identification Test (AUDIT). Alcohol Use Disorders Identification Test (AUDIT). Alcohol Alcohol Health & World Research. Vol. 13Health & World Research. Vol. 13, (4), 371-374., (4), 371-374.

Dweiko, H. (2006). Dweiko, H. (2006). Concepts of Chemical DependencyConcepts of Chemical Dependency. Pacific Grove, . Pacific Grove, CA: Brooks/Cole Publications CA: Brooks/Cole Publications

McCrady, B. & Epstein, E. (1999). Addictions: A Comprehensive McCrady, B. & Epstein, E. (1999). Addictions: A Comprehensive Guidebook. NYC, NY: Oxford University Press.Guidebook. NYC, NY: Oxford University Press.

Ray, O. & Ksir, C. (2006). Ray, O. & Ksir, C. (2006). Drugs, Society and Human BehaviorDrugs, Society and Human Behavior. . Mosby. Mosby.

Van Wormer, K. & Rae Davis, D. (2003). Van Wormer, K. & Rae Davis, D. (2003). Addiction Treatment: A Addiction Treatment: A Strengths Perspective.Strengths Perspective. Pacific Grove, CA: Brooks/Cole- Thomson Pacific Grove, CA: Brooks/Cole- Thomson Learning. (ISBN 0-534-59670-3)Learning. (ISBN 0-534-59670-3)

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Suggested WebsitesSuggested WebsitesNational Institute on Alcohol Abuse and Alcoholism (NIAAA),National Institute on Alcohol Abuse and Alcoholism (NIAAA),

((http://www.niaaa.nih.govhttp://www.niaaa.nih.gov))

National Institute on Drug Abuse (NIDA), National Institute on Drug Abuse (NIDA),

((http://http://www.nida.nih.govwww.nida.nih.gov ) )

Substance Abuse Mental Health Services AdministrationSubstance Abuse Mental Health Services Administration

http://www.samhsa.gov/http://www.samhsa.gov/

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