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SOCW 6140July 23, 2014Maya was diagnosed with OCD.-nomophobia: disconnect from cell phone, fear of detachment Slide 1Substance Related Disorders-adverse social behavior-psychological or physiological effects -behavioral addiction Slide 2 -alcohol-caffeine-Cannabis-hallucinogens-Inhalants-opioids-sedatives-Stimulants-Tobacco Slide 3 Other Behavioral Addictions-shopping-sex-internet use-exerciseSlide 4-underlying change in brain circuitry-4 groups: impaired control, social impairment, risky use, and pharmacological criteriaSlide 5-Alcohol Use Disorders-Alcohol Intoxication-Alcohol Withdrawal-p.482 in BookSilde 6Alcohol 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 Disorders1. Dependence-more severe, need the substance2. 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-withdrawalSlide 8 Negative Consequences-legal issues-substance use is physically hazardous -using regardless of social responsibilitySlide 9 Polysubstance Dependence -pattern of using multiple substances (3 different groups)-cannot identify drug of choice-DSM 4 only Slide 10 Substance-Induced Disorder3 Requirements:1. Evidence that Symptom occurred during intoxication or withdrawal2. Beyond expected course of what would be expected from substance withdrawal3. Not better accounted for by underlying “mental” or “medical” conditionSlide 11 Intoxication-being under the influence, reversible. -May cause personality changesSlide 12 Withdrawal-happens after long period of use-can cause clinical levels of distress or impaired psychosocial functioningSlide 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 issueSlide 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 system4. Locus of care: State hospitals, jails, emergency rooms, etc.Slide 15 Assessment-use Prochaska’s Stages of Change -assess client’s current motivationJason-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 deferredIII. none reportedIV. multiple problems related to employment, relationship distress with partnerV.

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UT SOCW 6140 - Maya

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