1. Substance Related Disorders

2. Organization of the section USEINDUCED AbuseIntoxication DependenceWithdrawal Intoxication delirium Withdrawal delirium Dementia Amnestic Psychotic Mood Anxiety Sexual Sleep

3. See for yourself 1.What is the difference between the “use” and “induced” disorders? 2.How are abuse and dependence different? 3.What does the chart on page 193 tell you? Find a substance that does NOT cause anxiety disorders. 4.Where will you find the symptoms of cannabis intoxication? 5.What are five symptoms of cocaine intoxication? ***turn in your own individual notes

4. Intoxication vs. Induced vs. COD Typical symptoms of the substance = intoxication/withdrawal More severe symptoms = induced Stand alone symptoms = psychiatric diagnosis

5. Post Acute Withdrawal Symptoms Can last 6-18 months (sometimes longer) Results from neural damage + stress of sober lifestyle Symptoms occur in several domains: –Sleep –Memory –Thought process: concentration, abstract, clarity, confusion –Anxiety & hyper sensitive to stress –Emotional instability/mood swings –Poor physical coordination

6. Assessing William As you watch the fish bowl role play, 1.Make observations for an MSE. 2.Note information that will help you assess S-R disorders. 3.Jot down questions you would like to ask to assess further.

7. Stages of Change and Motivational Interviewing 1.Motivation as a state, not a trait. What does this mean in re: to William? 2.Different stages for different problems. What changes could he make? 3.General approaches: Express empathy Develop discrepancies Roll with resistance Support self-efficacy

8. Stages of change Precontemplation Contemplation Preparation Action Maintenance Relapse

9. EVALUATING COSTS AND BENEFITS OF CONTINUED SUBSTANCE USE Benefits of not using Costs of not using Benefits of using Costs of using

10. EVALUATING COSTS AND BENEFITS OF TAKING MEDICAITON Benefits of medication Costs of medication Benefits of no meds Costs of no meds