Substance abuse abused substances

Mood disorders, hypochondriasis, personality disorders, alcohol/ substance abuse, alcohol/substance withdrawal, other anxiety disorders... 

A person can meet criteria for abuse or dependence for one drug and not others, although there is concern about what has been referred to as cross-addiction. Cross-addiction means that a person who is dependent upon one substance may be dependent upon another, very similar one. An example might be a person who is diagnosed as dependent upon tranquilizers and who, you may fear, is also addicted to a similar substance such as alcohol. However, the research is not entirely clear on whether cross-addiction occurs, and I have known clients who had very specific problems with one substance who did not generalize into problems with other, similar substances. A person also may meet criteria for abuse or dependence for multiple substances generally, this is referred to more simply as substance abuse or substance dependence. 

When diagnosing a substance use disorder, it is named in accordance with the substance that is being misused. Patients can be said to have alcohol abuse or dependence, cocaine abuse or dependence, opiate abuse or dependence, and so forth. In severe cases when the patient is misusing several substances, (s)he is diagnosed with polysubstance dependence. The complete list of DSM-IV substance use disorders is shown in Table 6.3. Although the diagnostic criteria for the specific substance use disorders are uniform from substance to substance, certain features of the addiction are specihc to the substance being misused. The typical age of onset, the course of the disorder, and the treatment of the disorder vary by substance. Nevertheless, many features of substance abuse and substance dependence are similar across substances. 

CenterforSubstanceAbuseTreatment. Methadone-associatedmortality report of a national assessment. May 8-9, 2003. Rockville (MD) CSAT Publication No. 28-03 Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration. 2004. 

Social workers should also screen the client with regard to any history of previous substance abuse. If substance abuse has occurred or is present, it may be more effective to recommend a medication like BuSpar that does not have the same addiction profile. 

Drug abuse in the healthcare field can go undetected because of the structure of the healthcare industry. Healthcare providers may be less supervised than in other industries. For example, physicians work independently and come under scrutiny only in a healthcare facility setting. Furthermore, healthcare professionals have the capabifity to self-diagnose and to self-treat and may not have another provider complete an objective assessment which might reveal substance abuse. Acknowledging substance abuse may put the individual at risk of suspension or revocation of the Mcense to practice. 

The overall goal of the activities in this area is to reduce the number of people with substance abuse or substance dependence disorders. This means that there would be a heavy emphasis on young people, but there would also be a focus on people who are using alcohol and other drugs but who have not developed an abuse or dependence disorder. 

Substance use disorders are defined by criteria in the Diagnostic and statistical manual of mental disorders developed by the American Psychiatric Association. There are substance abuse and substance dependence disorders, with the former being more severe than the later. 

CJ-Receptors are localized ia the brain stem and limbic stmcture, regions associated with endocrine function (76). In the periphery, CJ-receptors are found in the Hver, heart, ileum, vas deferens, and on lymphocytes and thymocytes. Although there is insufficient evidence to clearly define the functional role of CNS CJ-sites, based on the effects of PCP and the interaction of haloperidol with CJ-sites, CJ-receptor ligands may be antipsychotics or used for the treatment of substance abuse. Several CJ-receptor ligands have shown neuroprotective effects in vivo. Ifenprodil (315) and CNS 1102 (316) are being developed for treatment of stroke (Table 18). 

Is there an alcohol, drugs and substance abuse policy ... 

Check that there is an alcohol, drug and substance abuse policy that gives clear guidelines on handling the issues, dismissal, and rehabilitation. 

Benzodiazepines and other anxiolytics. Although benzodiazepines are widely used in the treatment of acute alcohol withdrawal, most nonmedical personnel involved in the treatment of alcoholism are opposed to the use of medications that can induce any variety of dependence to treat the anxiety, depression, and sleep disturbances that can persist for months following withdrawal. Researchers have debated the pros and cons of the use of benzodiazepines for the management of anxiety or insomnia in alcoholic patients and other substance abuse patients during the postwithdrawal period (Ciraulo and Nace 2000 Posternak and Mueller 2001). 

Ciraulo DA, Jaffe JH Tricyclic antidepressants in the treatment of depression associated with alcoholism. Clin Psychopharmacol 1 146—150, 1981 Ciraulo DA, Nace E Benzodiazepine treatment of anxiety or insomnia in substance abuse patients. Am J Addict 9 276—284, 2000 Ciraulo DA, Barnhill JG, Jaffe JH, et al Intravenous pharmacokinetics of 2-hydroxy-imipramine in alcoholics and normal controls. J StudAlcohol 51 366-372, 1990 Ciraulo DA, Knapp CM, LoCastro J, et al A benzodiazepine mood effect scale reliability and validity determined for alcohol-dependent subjects and adults with a parental history of alcoholism. Am J Drug Alcohol Abuse 27 339—347, 2001 Collins MA Tetrahydropapaveroline in Parkinson s disease and alcoholism a look back in honor of Merton Sandler. Neurotoxicology 25 117-120, 2004 COMBINE Study Research Group Testing combined pharmacotherapies and behavioral interventions in alcohol dependence rationale and methods. Alcohol Clin Exp Res 27 1107-1122, 2003a... 

Cowley DS Alcohol abuse, substance abuse, and panic disorder. Am J Med 92(suppl) 41S 8S, 1992... 

Kranzler HR, Rosenthal RN Dual diagnosis alcoholism and co-morbid psychiatric disorders. Am J Addict 12 (suppl 1) S26—S40, 2003 Kranzler HR, Tinsley JA (eds) Dual Diagnosis Substance Abuse andComorbid Medical and Psychiatric Disorders, 2nd Edition. New York, Marcel Dekker, 2004... 

Therapeutic communities are supervised communal drug-free living situations for opioid and nonopioid drug abusers. Because substance abuse is viewed as a disorder of the whole person, the goal is a dramatic alteration of the addict s entire lifestyle (DeLeon 1985). Addicts are expected to five in these communities for 6—18 months. Therefore, they are not indicated for people who have a strong intimate relationship or stable employment. The community is a surrogate fam-... 

Comparable findings for lifetime prevalence of psychiatric disorders were obtained in another study of 133 persons, which also found that 47% received a concurrent DSM-III diagnosis of substance abuse or dependence (Khantzian and Treece 1985). The most frequently abused substances were sedative-hypnotics (23%), alcohol (14%), and cannabis (13%). Similar rates of psychiatric disorders were found in other studies of drug abusers (Mirin et al. 1986 Woody et al. 1983). Although such diagnoses do not imply causality, and, in many cases, opioid dependence causes or exacerbates psychiatric problems, some causal link seems likely (Regier et al. 1990). 

Ciraulo DA, Ciraulo AN Substance abuse, in Handbook of Clinical Psychopharmacology. Edited by TupinJP, Shader RI, Harnett DS.Northvale,NJ, Jason Aronson, 1988, p 143... 

Jaffe JH Drug dependence opioids, nonnarcotics, nicotine (tobacco), and caffeine, in Comprehensive Textbook of Psychiatry, 5th Edition, Vol 1. Edited by Kaplan HI, Sadock BJ. Baltimore, Williams c Wilkins, 1989, pp 642-686 Jaffe J, Knapp CM, Ciraulo DA Opiates clinical aspects, in Substance Abuse A Comprehensive Textbook. Edited by Lowinson JH, Ruiz P, Millman RB, et al. New York, Lippincott Williams and Wilkins, 2004, pp 158—165 Jarvis MA, Schnoll SH Methadone use dming pregnancy. NIDA Res Monogr 149 58— 77, 1995... 

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