RHAB 397 1st EditionExam # 2 Study GuideFrom Crunk to Drunk Most Common Psychoactive Substances SUBSTANCE EFFECTSAlcohol (liquor, beer, wine)euphoria, stimulation, relaxation, lower inhibitions, drowsinessCannabinoids (marijuana, hashish)euphoria, relaxations, slowed reaction time, distorted perceptionOpioids (heroin, opium, many pain meds)euphoria, drowsiness, sedationStimulants (cocaine, methamphetamine)exhilaration, energyClub Drugs (MDMA/Ecstasy, GHB)hallucinations, tactile sensitivity, lowered inhibitionDissociative Drugs (Ketamine, PCP, DXM)feel separated from body, delirium, impaired motor functionHallucinogens(LSD, Mescaline)hallucinations, altered perceptionDesigner Drugs •Easily available on the street or retail outlets•Tend to be cheap, usually $20 or less•Intense and quick effects that can last anywhere from 15 minutes to several hours•Undetectable using standard drug test•Strong perception that they are “safer” than other drugsEffects of K2•work just like marijuana•Appetite•Mood•Memory•Pain Sensation•Habit forming, slightly addictive and can cause hallucinations•severe agitation•elevated heart rate•elevated blood pressure•red eyes•mood alteration•paranoiaWhat are Bath Salts? •MDPV is structurally related to cathinone, an active alkaloid found in the khat plant, which is illegalin the United States. •Mephedrone and MDPV are stimulants that act much like Methamphetamine and Cocaine, but produce the added effect of hallucinations. Crunk and Purple Drank •mixing cough syrup with either alcohol or non-alcoholic beverages. •Purple Drank uses codeine/promethazine cough syrup and is usually mixed with Sprite or Mountain Dew and produces a purple color.Taming the Addicted Brain Dysregulation = continued exposure of the pleasure system, or mesolimbic dopamine system (MDS)pathways to a drug leads to changes(adaptations) in nerve function Pre-frontal Cortex—mythological location of addiction (located in the midbrain)Addiction= Chemical dependence is a chronic, progressive, brain-based disease.- Addiction disables the system that is designed to protect the person from the addiction-Stages Of Recovery- Withdrawal- Honeymoon- Rebound—”The Wall” 45 to 75 days- 90 Day –Final clearing of the drug’s influence- 120 Days—body is clear of most drug residual- Post Acute Withdrawal:- First Year—risk management- Second Year—completes post acute withdrawalMotivational Interviewing Motivational Interviewing is a client-centered, directive method for enhancing intrinsic motivation to change, by exploring and resolving ambivalence.MethodsEMPATHY: ACCEPTANCE FACILITATES CHANGE. NON-JUDGMENTAL, NO BLAMING: NECESSITATES UNDERSTANDING THAT ADDICTION IS NOT A MORAL FAILURE OR WEAKNESS OF CHARACTERUNDERSTOOD IN THE CONTEXT OF HOW PHYSIOLOGICAL RESPONSE WAS TRIGGERED.DISCREPANCY: CLIENT SHOULD PRESENT THE ARGUMENTS FOR CHANGE. CHANGE IS MOTIVATED BY A PERCEIVED DISCREPANCY BETWEEN CURRENT BEHAVIOR AND IMPORTANT PERSONAL GOALS OR VALUES.ROLL WITH RESISTANCE: AVOID ARGUING FOR CHANGE—”AS A PERSON ARGUES ON BEHALF OF ONE POSITION, HE OR SHE BECOMES MORE COMMITTED TO IT.”RESISTANCE IS NOT DIRECTLY OPPOSED.NEW PERSPECTIVES ARE INVITED BUT NOT IMPOSED.RESISTANCE IS A SIGNAL TO THE THERAPIST TO RESPOND DIFFERENTLY.SUPPORT SELF-EFFICACY: PERSON’S BELIEF IN THE POSSIBILITY OF CHANGE VERY IMPORTANT CLIENT, NOT CLINICIAN, IS RESPONSIBLE FOR CHOOSING AND CARRYING OUT CHANGE. COUNSELORS OWN BELIEF IN PERSON’S ABILITY TO CHANGE HAS A SIGNIFICANT INFLUENCE (SELF-FULFILLING PROPHECY).Methods to Avoid Expert trap: clinician controls session, patient responds with short answers. Moves patients to passive role.Series of open-ended questions: avoid asking three questions in a row (without adequate number of reflections per question.Taking sides: elicits “no problem”, oppositional arguments from patient.Premature focus: directing patient away from their most pressing concerns—doesn’t mean you cannot return, particularly if patient is attempting to de-focus on an uncomfortable topic.Blaming trap: be especially careful when tired—less apt to be empathic.Cross Addictions Addicted to two or more drugs or one, two or more drugs and behavioral