Lecture 3

Lecture 3 - Lecture 3 Case Presentation & Introduction...

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Lecture 3 – Case Presentation & Introduction to Alcohol KEY CONCEPTS DSM-IV diagnostic criteria methods of screening for alcohol/drug abuse historical issues – A Nation of Drunkards alcohol as a commodity (rum, slave trade) Intemperance Temperance Prohibition
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Drug/alcohol use pattern: daily use of alcohol (10+ standard drinks), Ativan (lorazepam, 2+mg). Progressive increase in amounts of each drug. Has tried to cut down (failed) Salient signs and symptoms: sweating, shakes, increased anxiety, poor concentration, low libido, weight-loss, insomnia, irritable, hopeless Important additional information: serious work and family problems, disability leave, taking antidepressant (Paxil), drives while drunk, hiding use from wife Possible concurrent disorders? Anxiety disorder ?, Substance-induced depression? Sedative-hypnotic dependence (severe, inpatient detoxification required?)
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DSM-IV Diagnostic Criteria For Substance Dependence A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period : Specifiers: With or without physiological dependence (tolerance or withdrawal)
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Development of tolerance and withdrawal 1. a need for markedly increased amounts of the substance to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount of the substance 2. withdrawal is manifested by either of the following: a) the characteristic withdrawal syndrome for the substance b) the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms
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Compulsion to obtain and take the drug 3. the substance is often taken in larger amounts
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Lecture 3 - Lecture 3 Case Presentation & Introduction...

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