Maya was diagnosed with OCD nomophobia disconnect from cell phone fear of detachment Slide 1 Substance Related Disorders adverse social behavior psychological or physiological effects behavioral addiction SOCW 6140 July 23 2014 Slide 2 alcohol caffeine Cannabis hallucinogens Inhalants opioids sedatives Stimulants Tobacco Slide 4 underlying change in brain circuitry 4 groups impaired control social impairment risky use and pharmacological criteria Slide 3 Other Behavioral Addictions shopping sex internet use exercise Slide 5 Alcohol Use Disorders Alcohol Intoxication Alcohol Withdrawal p 482 in Book Silde 6 Alcohol use Disorder problematic pattern of alcohol use leading to clinically significant distress or impairment 12 month period need 2 symptoms want to control use but can t tolerance increase withdrawal tremors anxiety shaking seizures etc Slide 7 Substance use Disorders 1 Dependence more severe need the substance 2 Abuse use does not necessarily control life completely no compulsive use or withdrawal Diagnose by severity controlled environment non use Use misuse abuse mild maladaptive pattern or use recurrent consequences dependence intoxication withdrawal Slide 8 Negative Consequences legal issues substance use is physically hazardous using regardless of social responsibility Slide 9 Polysubstance Dependence pattern of using multiple substances 3 different groups cannot identify drug of choice DSM 4 only Slide 10 Substance Induced Disorder 3 Requirements 1 Evidence that Symptom occurred during intoxication or withdrawal 2 Beyond expected course of what would be expected from substance withdrawal 3 Not better accounted for by underlying mental or medical condition Slide 11 Intoxication being under the influence reversible May cause personality changes Slide 12 Withdrawal happens after long period of use can cause clinical levels of distress or impaired psychosocial functioning Slide 13 Dually Diagnosed Co occuring Disorders one or more substance disorders in addition to one or more mental disorders 41 65 of people with a lifetime substance abuse also had a mental health issue Slide 14 Problems with Co Occuring Disorders higher rates of relapse in both illnesses multiple losses more health and social issues 4 Quadrants 1 Locus of care primary health care setting low severity mild mental and physical disorder 2 Locus of care mental health system 3 Locus of care Substance Abuse system 4 Locus of care State hospitals jails emergency rooms etc Slide 15 Assessment use Prochaska s Stages of Change assess client s current motivation Jason Jason smokes marijuana He smokes to reduce stress and believes he can stop whenever he wants Jason is a 35 year old male He is recently single lives with his mom and Caucasian His mother forced him to seek help He smokes marijuana frequently and stinks up the house Jason does construction and owns his own business a dry wall company He lies about his usage to his ex girlfriend and his mom He cannot afford to live on his own because of his expensive habit Jason grows his own marijuana and he can quit whenever It helps him sleep Smokes instead of taking sleeping pills I diagnosed as Cannabis Abuse Disorder Moderate 20 year history of use II 799 9 diagnosis deferred III none reported IV multiple problems related to employment relationship distress with partner V GAF 54 63