Short answers a paragraph each

Provide a few examples of an addictive substance?

Why did this substance come to mind? What are the negative effects of this substance?

Talk about what you see at the key components of the biopsychosocial interview? What do you want to look for as a clinician in this process?

Pick an article from the website and tell me why you find. it intersting. http://www.samhsa.gov/

Chapter 4

The Biopsychosocial Interview

This is where you begin to develop the treatment plan
This is one of the most valuable times spent with patient
This where you fund out what the problems are and where they came from

All chemical dependency affects:

Biology
Cells
Psychology
Emotions, attitudes and behaviors
Sociology
Relationships

It will take time to become a skilled interviewer

Always begin the interview by telling the patient what you will be doing
Let the patient tell his or her story
Your job is to write it down
Guide the patient only when needed

The history of the problem must contain the following:

Age of onset
Duration of use
Patterns of use
Consequences of use
Previous treatment
Blackouts
Tolerance
Withdrawal symptoms

Past history of the patient from infancy to the present is next:

Place of birth
Date of birth
Developmental milestones
Raised with
Ethnic/cultural influences
Home of origin
Grade school
High School
College
Military history
Occupational history
Employment satisfaction
Financial history
Gambling
Sexual orientation
Sexual abuse
Physical abuse
Current sexual history
Relationship history
Social support for treatment
Spiritual orientation
Legal
Strengths/Weaknesses
Leisure
Depression
Mania
Anxiety disorders
Eating disorders

Medical history:

Illnesses
Hospitalizations
Allergies
Medications at present

Family history
Father
Mother
Other relatives with significant psychopathology

Mental status

Description of patient
Dress
Sensorium
Orientation
Attitude towards examiner
Motor behavior
Speech
Affect
Range of affect
Mood
Thought processes
Abstract thinking
Suicidal ideation
Homicidal ideation
Disorders of perception
Delusions
Obsessions
Compulsions
Intelligence
Concentration
Memory
Immediate memory
Recent memory
Remote memory
Impulse control
Judgment
Insight
Motivation for treatment

Summary and Impression

Begin with the patients childhood and summarize all that you have heard
Give your impression of where the patient stands on the following:
Acute intoxification or withdrawal complications
Biomedical conditions or complications
Emotional/behavioral complications
Treatment acceptance or resistance
Relapse potential
Recovery environment

Diagnosis

Diagnosis the problem by referencing the Diagnostic and Statistical Manual of Mental Disorders
Chapter Three
The Addicted Brain

1950's
We learned that if a certain part of the brain is electrically stimulated, an intensely pleasurable sensation occurs

1960's
Researchers began to find receptors in the brain for opiate-like substances
Later in the 1960's it was discovered that the brain produces opiate-like substances, which explains the presence of opiate receptors

The Pleasure Center
Alcohol and every major class of drugs of abuse interact with the same part of the brain in one fashion or another
The primary purpose of this part of the brain seems to be to produce a pleasurable sensation when stimulated and to make sure that higher parts of the brain remember what the stimulation was so that it will be repeated

Neurotransmitters
Brain cells communicate messages via chemicals in the brain called neurotransmitters
Mood altering drugs often override this system by tricking the nerve cells into thinking it is being stimulated by a natural neurotransmitter

What Are Addictive Substances?
All drugs of abuse alter mood and "fool" your brain
Mood altering drugs allow a person to avoid facing reality temporarily
If you have clinical depression or panic disorder, the part of your brain that handles emotions is not working correctly
Medications prescribed for these conditions work within brain cells to prompt them to function properly by increasing the person's sense of control and improving coping skills - mood altering drugs dont

Tolerance and Withdrawal
Tolerance is when the body develops an ability to tolerate the effects of drugs
The brain becomes hyperalert and hypersensitive in order to compensate
Another type of tolerance is a body's ability to metabolize a drug
Withdrawal symptoms emerge as the drug clears the system
Withdrawal symptoms for depressants include:
Shakiness, anxiety, irritability
Withdrawal symptoms for stimulants include:
Fatigue, sleepiness, depressed mood, increased appetite
The development for tolerance increases the dangerousness of the drug and creates a situation where the body becomes uncomfortable without it

Behavioral Conditioning and Craving
Instrumental learning is a type of learning that is conscious and intentional
Conditional learning is when the brain learns to associate a particular effect with a certain situation
An important part of treatment is teaching addicts how to deal with triggers and cravings