CASAC - Client, Family and Community Education

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Definitions from Texas Commission on Alcohol and Drug Abuse - The Licensed Chemical Dependency Counselor Written Exam: A Preparation Curriculum

etiology of substance related disorders

the study of the cause of substance related disorders, involving genetic factors, use of drugs as a means to self-medicate or cover up other issues.

sociocultural view of etiology

stressful socio-economic conditions or cultural differences that affect attitudes towards taking drugs

behavioral view of etiology

suggests the influence of both positive and negative reinforcement as causal factors for continued drug use.

pleasure pathway in the brain

mesolimbic dopamine system

GABA transmitters

located in the mesolimbic system stimulated by certain drugs

biological view of etiology

states that there is a difference between children of alcohol-dependent parents and those of non-dependent parents with respect to genetic predisopsition to drugs and alcohol

Alcohol flush syndrome

causes an individual to feel sick after consuming alcohol because of a lack of the enzyme aldehyde dehydrogenase.

aldehyde dehydrogenase

breaks down acetaldehyde, a by-product of alcohol .

Categories of substance use

non-use, moderate and non-problematic use, heavy and non-problematic use, heavy use with moderate life problems, heavy use with serious life problems, dependency with life and health problems

The treatment and recovery continuum of care

identification, assessment, stabilization, rehabilitation, relapse prevention and substance substitution (if necessary)

identification

can be through self, court order, a condition of probation or parole, or intervention. screening process helps determine the likelihood of a problem with drugs or alcohol

assessment

the collection of data from the individual and corroborative sources to determine the extent of the individual's problem and their strengths, weaknesses, and needs.

stabilization

includes the need for detoxification at an appropriate medical facility if needed.

rehabilitation/treatment programs

depends upon assessment and diagnosis and can range from providing education, an intensive outpatient program to an inpatient residential program.

relapse prevention program

a process whereby indentification of individualized triggers and a plan to confront those triggers is developed

drug substitution

a legal drug is substituted for an illegal one to assist the client in making positive life changes.

Stages of family response to drug and alcohol abuse

denial, attempts to eliminate the problem, disorganization and chaos, reorganization in spite of the problem, efforts to escape, family reorganization.

Dysfunctional family roles

family hero, mascot, scapegoat, lost child

pancreatitis

this occurs when swelling of the pancreatic duct causes a backup of digestive juices causing irritation and swelling of the pancreas.

acute fatty liver

this occurs when fat deposits build up in the normal liver cells and can develop in anyone who has been drinking heavily even for a short period of time.

acoholic hepatitis

occurs after a heavy or extended bout of alcohol use and can occur in non-alcohol dependent persons. An inflammation of the liver where metabolism is disrupted, jaundice, yellowing of the skin and whites of the eyes.

cirrhosis

permanent, widespread destruction of liver cells, which are replaced with nonfunctioning scar tissue. irreversible and fatal if alcohol continues to be used.

anemia

insufficient function or number of red blood cells.

alcoholic heart muscle disease or AHMD

a serious condition in which the heart does not pump the amount of blood needed to meet the demands of the body.

Beriberi heart disease

a reduction of vitamin B-1 that over time cause a normal heart to fail to keep up with an abnormally high metabolic need of the body.

Alcoholic dementia

an overall decline of intellect

Wernicke's disease

associated with Vitamin B1 deficiency and may be corrected nutritionally

Korsakoff's psychosis

apparently irreversible condition characterized by the individual's inability to learn new information and remember recent events.

Wernicke-Korsakoff syndrome

combined condition of Wernicke's encephalopathy and Korsakoff's syndrome - symptoms include nystagmus (abnormal eye movement), problems with gait, memory, confabulation, low Bi, low blood pressure, tremor. Often called wet brain.

blackout

an amnesia like state associated with alcohol dependence or a heavy intake of alcohol.

intoxication

a temporary change caused by a significant amount of drug entering the body affecting one's emotional, cognitive and/or psychomotor functioning.

dependence

a condition where, after using drugs, an individual finds it difficult or impossible to control use. Dependence usually involves a physical and or psychological need for the drug in order to function normally and it usually involves tolerance and withdrawal.

Physical dependence

a state of functional adaptation to a drug in which the presence of a foreign chemical becomes normal and necessary, and the absence of the drug would present an abnormal state.

Psychological dependence

when the individual has a strong desire to continue to use the drug for emotional reasons and is related to the rewarding effects of the drug. There are no physical withdrawal symptoms with the discontinuation of use.

Cross-dependence

this is evident when a person who is physically dependent on one drug can lessen or prevent withdrawal symptoms by using other drugs from the same or similar classification.

Tolerance

an altered physiological state that develops after repeated drug use when the body becomes accustomed and adapts to the presence of the drug and functions normally. Evidence of this is when the drug has less of an effect when using the same dose, or when a larger dose must be used to get the desired effect.

Pharmacodynamic tolerance

when the nerve cells become less sensitive to the effects of the drug over time and repeated use

metabolic tolerance

when the liver adapts to the presence of a drug over time and may produce more of the enzyme needed to break down the drug.

behavioral tolerance

when after a period of time and repeated drug use, the users are able to modify their behavior in hopes that others will not notice they are intoxicated

cross-tolerance

when the tolerance to a drug develops and the individual may also show an increased tolerance to the effects of another drug in the same class.

reverse tolerance

when the individual can become more sensitive to the drug's effects rather than less sensitive. Also known as the kindling effect.

withdrawal

negative symptoms that result from the abrupt discontinuation of the drug. The presence of withdrawal symptoms reveals physical dependence. The withdrawal symptoms of a particular drug usually involve the opposite reaction on the body than the drug's effects.

dose

the amount of drug that is taken at any particular time.

half-life

the length of time a drug remains in the body and continues to affect the user.

threshold dose

the smallest amount of a drug that can produce a detectable response

Maximum effect

the greatest response from a drug no matter the dose given or taken

effective dose

the amount of a drug necessary to get the desired effect in about 50 percent of those who use the drug

lethal dose

the dose of a drug that results in death

therapeutic index

the dose determined to be safe for use and get the desired effect; determined by dividing the lethal dose by the effective dose

potency

the amount of a drug necessary to produce the desired effect.

drug interaction classifications

addititive, synergistic, antagonistic

additive effects

two or more drugs are used at the same time and the results are equal to the sum of the actions of the drugs used.

synergistic interactions

when two or more drugs are used at the same time, and the results are greater that the sum of the actions of the drugs used.

antagonistic interactions

occur when two or more drugs are used at the same time, and the results are less than the sum of the actions of the drugs or the drugs cancel out the effects of each other.

Routes of administration

how a person takes substances into the body

oral administration

taken by mouth and swallowed into the stomach.

injected

using a needle and syringe

subcutaneously

skin-popping, injecting in the fatty layer just under the external skin.

intramuscularly

injected into the large muscles

intravenously

injected directly into a vein

inhalation

substances can be inhaled into the lungs by smoking or huffing

snorting

drugs can be inhaled into the nose and absorbed through the mucous membranes.

transdermal

the drug is absorbed through the skin from a patch.

buccal administration

the drug is absorbed through the mucous membranes in the mouth.

rectal administration

Drugs are administered by inserting them into he body through the rectum and are absorbed through the intestinal lining.

neorotransmitters

GABA, norepinephrine, dopamine, serotonin, acetylcholine.

GABA

relates to inhibitory factors and slows communication.

Norepinephrine

associated with arousal reactions and moods.

Dopamine

associated with feeling of pleasure.

Serotonin

associated with feelings of anxiety, depression and aggressiveness.

Acetylcholine

associated with arousal reactions or inhibitory factors.

Pleasure/reward center of the brain

made up of the ventral tegmental area (VTA), nucleus accumbens and other structures of the brain.

Fat-soluble drugs

These store in the fatty areas of the body and can have longer lasting traces in the body that water-soluble drugs do not.

Abuse potential

generally related to the drug's speed of action and how long the effects last.

Contolled Substance Act

Law which places drugs in 1 of 5 schedule categories, depending on their abuse potential, potential for dependence/addiction, and currently accepted medical use.

Schedule I

Any drug included here has a high level of abuse/dependence. Also, there is no accepted medical use. Include are heroin, LSD and marijuana.

Schedule II

Drugs in this category are essentially similar to Schedule I, but with an accepted medical use. There are restrictions on manufacture and distribution via production quotas and import/export controls. Non-refillable meds. Include methadone, morphine, methamphetamine and cocaine.

Schedule III

Drugs in this category are considered to be at moderate or low risk for physical dependence, and with current reasons for medical use. Includes anabolic steroids, most barbituates and ketamine.

Schedule IV

Drugs in this category are considered to be at low risk for physical dependence but moderate risk for psychological dependence and have a currently accepted medical use. Includes Xanax, Barbital and chloral hydrate.

Schedule V

Drugs in this category are considered to be at low risk for either physical dependence or psychological dependence, and with current indications for medical use. Includes medical mixtures using small amounts of opium or codeine.

Depressants/Sedative-hypnotics

These drugs are central nervous system depressants. Include but are not limited to: alcohol, benzodiazepines and barbituates. In general these drugs bind to GABA receptors resulting in sedation.

Stimulants

Drugs in this class increase cental nervous system activity. Includes cocaine, amphetamines, methamphetamines, and methylphenidate.

Hallucinogens/Dissociatives

These drugs change sensory perception and have the ability to alter reality and produce hallucination-like effects. Includes naturally occuring and synthetic drugs such as: LSD, mescaline, psylocybin, psilocin, MDMA, PCP and ketamine.

Cannabinoids/cannabinols

Includes marijuana, hashish and THC

Inhalants

Chemicals that can be legally purchased and that are normally used for non-recreational purposes. Includes industrial solvents and aerosol sprays and include, but are not limited to: gasoline, kerosene, airplane glue, acetone, lighter fluid, metallic paints, correction flids, amyl, butyl and isobutyl nitrite and nitrous oxide.

Anabolic steroids

Synthetic illicit drugs that are used to increase muscle mass and improve athletic performance. Include Depo-testosterone, Durabolin, Danocrine, and Halotestin. Some are approved for veterinary medicine and sold illicitly for human use.

Stacking

combining oral and injectable steroids.

Symptoms of Depressant intoxication

decreased inhibition, slowed reaction times, memory impairment, possible decrease in respirations, slurred speech, ataxia,

Symptoms of Stimulant intoxication

increased heart rate, elevated blood pressure and temperature, decreased respiration. dilated pupils, dry mouth, cardiac arrhythmias, twitching tremors, impaired judgment, confusion, disinhibited behavior, paranoid thoughts, hypervigilance, hallucinations, elation.

Symptoms of PCP adverse reactions

psychotic reactions, bizarre behavior, outbursts of hostility and violence, severe anxiety, doom or impending death.

Adverse Ketamine reacation

Completed sensory detachment, explained as a near-death experience, paranoia, boredom and possible coma.

Symptoms of cannabinoid intoxication

slowed reaction time, altered perceptions, panic, anxiety, nausea, dizziness, depersonalization, paranoid thoughts, trouble expressing thoughts. May cause increases in respiration and heart rate and a slight increase in body temperature. Red eyes, mild dilation, mild tremors, decreased coordination, decreased strength, less ability to perform complex motor tasks and dry mouth.

Symptoms of Inhalant intoxication

reduction of inhibition and euphoria, dizziness, slurred speech, unsteady gait and drowsiness. Nystagmus may be noted, altered consciousness and enhanced sexual pleasure.

Nystagmus

the constant involuntary movement of the eyes.

Ataxia

impaired gait

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