Chemical Dependency

• Course Outline

Learning Objectives

After completing this course, you will be able to:

Alcohol: What You Don't Know Can Harm You

1. Describe the consequences of drinking in terms of ability to drive, interactions with medicines, interpersonal problems, alcohol-related birth defects, and long-term health problems.

2. List signs and symptoms of alcohol use and intoxication, and withdrawal.

Epidemiology of Alcoholism

3. Compile and analyze the information gathered from epidemiology studies of alcoholism.

Screening for Alcoholism

4. Distinguish between two types of alcoholism-screening instruments and describe the application and effectiveness of various tests in detecting alcoholism.

Moderate Drinking

5. Define moderate drinking

6. Explain to the patient risks and benefits of moderate drinking

Alcohol and Women

7. Compare and contrast the impact of gender in the prevalence, cause and effects of alcohol abuse.

8. Describe how alcohol affects women differently than men physiologically and psychologically.

Are Women More Vulnerable to Alcohol's Effects?

9. Explain why women are more vulnerable to the effects of alcohol.

10. Identify the consequences of alcohol use on women in terms of liver damage, brain damage, heart disease, breast cancer, violent victimization and traffic crashes.

11. List 3 major risk factors for women's alcohol use.

Fetal Alcohol Syndrome

12. List the three criteria that define fetal alcohol syndrome.

13. Formulate a recommendation for pregnant women on the use of alcohol during pregnancy.

Children of Alcoholics: Are they Different?

14. List the negative consequences in terms of cognitive, emotional and behavioral problems in the children of alcoholics.

Alcohol and Minorities

15. Explain the genetic influence of "flushing" on certain minority groups that helps them from becoming alcoholic.

Alcohol and the Workplace

16. List 5 factors that contribute to employee drinking in the workplace.

17. Describe alcohol-related job performance problems caused by on-the-job drinking and drinking outside of work.

18. Articulate strategies to prevent and manage alcohol problems in the workplace.

Alcohol and Tobacco

19. Explain the co-occurrence of alcoholism and smoking.

20. Outline addictions treatment for smoking alcoholics.

Alcoholism and Co-occurring Disorders

21. Identify 5 ways in which alcoholism and other disorders might be related.

22. Discuss medical conditions and psychiatric disorders that are comorbid with alcoholism.

Alcohol and Coronary Heart Disease

23. Discuss the epidemiologic and clinical evidence between moderate alcoholic consumption and lower risk for CHD.

24. Discuss whether the role played by alcohol on lowering the risk for CHD is causal or incidental.

Alcohol and the Liver

25. Identify factors that influence vulnerability to alcohol-induced liver damage.

26. Explain how alcohol damages the liver

27. Discuss the three alcohol-induced liver conditions: fatty liver, alcohol hepatitis, and cirrhosis.

28. Describe the damage to the liver as a result of alcoholism, extent of the problem, factors that play a part in causing the damage to the liver, and the treatment.

Alcohol and Cancer

29. Explain the association between alcohol consumption and development of certain types of cancer.

Alcohol and AIDS

30. Explain the connection between alcohol, HIV infection and AIDS.

Alcohol and Tolerance

31. Distinguish between functional and metabolic tolerance.

32. Describe different types of functional tolerances and the factors influencing their development.

33. Compare and contrast among acute tolerance, environment-dependent tolerance, learned tolerance and environment-independent tolerance.

Alcohol and Cognition

34. List the reasons for neuropsychological impairment in alcoholics.

35. Describe the effects of alcohol on cognition.

Alcohol and Stress

36. Explain the connection between alcohol and stress.

37. Answer questions: Does stress influence drinking? Does drinking reduce or induce stress?

Alcohol and Sleep

38. Summarize some basic features of normal sleep including sleep structure, onset and arousal.

39. Elaborate on the effect of alcohol on sleep in those without alcoholism and in those with alcoholism.

40. Make the connection between alcohol and breathing disorders, such as obstructive sleep apnea.

Alcohol and Aging

41. Describe the drinking prevalence and patterns among the elderly.

42. List the combined effects of alcohol and aging and prescribe the treatment of alcoholism in the elderly.

Drug Awareness Quiz

43. Answer some common questions about drugs, drug abuse and associated adverse physical and mental effects.

44. Conduct a self-test for cocaine addiction.

45. List 38 tell-tale signs of drug abuse.

Drug Use in America

46. Describe the trends and prevalence of drug use in America.

Alcohol, Tobacco, and Other Drugs in the Workplace

47. Describe the prevalence of ATOD in the workplace.

48. List 6 signs that may indicate substance abuse in the workplace.

49. List 3 steps one can take to reduce substance abuse in the workplace.

Sex, Violence and Domestic Violence

50. Describe the interconnection between risky sexual behavior, violence and crime and domestic violence and alcohol and other drugs.

Cocaine Abuse and Addiction

51. Describe the scope of cocaine use in the United States.

52. Explain the mechanism through which cocaine affects deep structures in the brain.

53. Indicate the short-term and long-term effects of cocaine use.

54. Describe the cardiovascular, respiratory, neurological and gastrointestinal complications of cocaine abuse.

55. Describe the pharmacological and behavioral treatments for cocaine abusers.

Heroin Abuse in the United States

56. Describe the prevalence and patterns of heroine use in the United States.

Dangerous Drugs

57. Describe the pharmacology and use of methamphetamine, marijuana, LSD, MDMA (Ecstasty), PCP, Ketamine, GHB, methylphenidate, steroids, flunitrazepam and inhalants.

Principles of Drug Addiction Treatment

58. Enunciate 13 principles of effective drug addiction treatment.

Frequently Asked Questions

59. Answer several frequently asked questions about drug addiction treatment and its effectiveness.

Drug Addiction Treatment in the Unites States

60. Describe general categories of drug addiction treatment programs and list their characteristics, treatment approach and target population.

Scientifically Based Approach to Drug Addiction Treatment

61. List various scientifically based approaches to drug addiction treatment and elaborate on their main components, particularly relapse prevention, supportive-expressive psychotherapy, individualized drug counseling, motivational enhancement therapy, behavioral therapy for adolescents, multidimensional family therapy for adolescents, multisystemic therapy, combined behavioral and nicotine replacement therapy for nicotine addiction, community reinforcement approach plus vouchers, voucher-based reinforcement therapy in methadone treatment, day treatment with abstinence contingencies and vouchers and the matrix model.

Rate and Duration of Drug Activity

61. Describe the roles played by the rate and duration of drug activity in drug abuse addiction and treatment.

62. Explain how the method of drug administration influences the rate of action.

Treatment Methods for Women

63. List the consequences of drug use for women.

64. Explain why many drug-using women do not seek treatment.

Lessons from Prevention Research

65. Identify "protective factors" and "risk factors" that should be incorporated in drug abuse prevention programs.

Effectiveness of Drug Abuse Treatment

66. Describe the application of four common types of drug abuse treatment: outpatient methadone programs, long-term residential programs, outpatient drug-free programs and short-term inpatient programs.

Brief Intervention for Alcohol Problems

67. Describe the brief intervention treatment programs for alcohol problems, and its effectiveness for non-alcohol-dependent and alcohol-dependent patients.

68. List 9 common elements of brief intervention treatment for alcohol problems.

Evaluation of Individual Objectives

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.

Contents Outline

1. Alcohol Abuse

Alcohol: What You Don’t Know Can Harm You

• Drinking and Driving

• Interactions With Medications

• Interpersonal Problems

• Alcohol-Related Birth Defects

• Long-Term Health Problems

• Research Directions

• Resources

Epidemiology of Alcoholism

• Alcohol Use and Abuse: Where Do the Numbers Come From?

• Conclusion

• References

Screening for Alcoholism

• Alcoholism-Screening Instruments

• Conclusion

• References

Moderate Drinking

• Definition of Moderate Drinking

• Benefits of Moderate Drinking

• Risks of Moderate Drinking

• Conclusion

• References

Alcohol and Women

• Conclusion

• References

Are Women More Vulnerable to Alcohol's Effects?

• Prevalence of Women's Drinking

• Metabolism

• Consequences of Alcohol Use

• Risk Factors for Women's Alcohol Use

• Conclusion

• References

Fetal Alcohol Syndrome

• Conclusion

• References

Children of Alcoholics

• Children of Alcoholics: Important Facts Alcoholism affects the entire family

• Many people report being exposed to alcoholism in their families

• There is strong evidence that alcoholism tends to run in families

• Children of alcoholics are more at risk for alcoholism and other
  drug abuse than children of non-alcoholics

• Alcoholism usually has strong negative effects on marital relationships

• Alcoholism is associated with a substantial proportion of human violence,
  and perpetrators are often under the influence of alcohol

• Based on clinical observations and preliminary research, a relationship between parental alcoholism and child abuse is indicated in a large proportion of child abuse cases

• Children of alcoholics exhibit symptoms of depression and anxiety more than children of non-alcoholics

• Children of alcoholics experience greater physical and mental health problems and higher health care costs than children from non-alcoholic families

• Children of alcoholics score lower on tests measuring verbal ability

• Children of alcoholics often have difficulties in school

• Children of alcoholics have greater difficulty with abstraction and conceptual reasoning

• Children of alcoholics may benefit from adult efforts

• Children can be protected from many problems associated with growing up in an alcoholic family

• Maternal alcohol consumption during any time of pregnancy can cause alcohol-related birth defects or alcohol-related neurological deficits

• COA Resources Information

Children of Alcoholics: Are They Different?

• References

Alcohol and Minorities

• Medical Consequences and Alcohol-Related Trauma

• Fetal Alcohol Syndrome (FAS)

• Genetic Influences

• Influence of Acculturation

• Identification and Treatment

• Prevention

• Conclusion

• References

Alcohol and the Workplace

• Factors Contributing to Employee Drinking

• Effects of Employee Drinking

• Conclusion

• References

Alcohol and Tobacco

• The Co-occurrence of Alcoholism and Smoking

• Why Are Alcohol and Tobacco Used Together?

• What Is the Risk of Cancer From Alcohol and Tobacco?

• How Do Alcohol and Tobacco Increase Cancer Risk?
  Addictions Treatment for Smoking Alcoholics

• Conclusion

• References

Alcoholism and Co-occurring Disorders

• Medical Conditions

• Conclusion

• References

Alcohol and Coronary Heart Disease

• Epidemiologic Evidence

• Is Alcohol's Role Casual or Incidental?

• The Role of Beverage Choice

• How Might Alcohol Lower Risk for CHD

• Risk and Benefits

• Conclusion

• References

Alcohol and the Liver

• The Normal Liver

• Alcoholic Liver Disease

• Extent of the Problem

• How Does Alcohol Damage the Liver

• Factors That Influence Vulnerability to ALD

• Treatment Effectiveness

• Prospects for Future Treatment

• Conclusion

• References

Alcohol and Cancer

• What Is Cancer?

• Alcohol's Link to Cancer

• Epidemiologic Research

• Mechanisms of Alcohol-Related Cancers

• Summary

• Conclusion

• References

Alcohol and AIDS

• Alcohol and the Immune System

• Alcohol and Sexual Behavior

• Conclusion

• References

Alcohol and Tolerance

• Functional Tolerance

• Metabolic Tolerance

• Tolerance and the Predisposition to Alcoholism

• Conclusion

• References

Alcohol and Cognition

• Conclusion

• References

Alcohol and Stress

• The Stress Response

• Does Stress Influence Drinking?

• Does Drinking Reduce or Induce Stress?

• Stress, Alcoholism, and Relapse

• Conclusion

• References

Alcohol and Sleep

• Sleep Structure, Onset, and Arousal

• Alcohol and Sleep in Those Without Alcoholism

• Alcohol and Breathing Disorders

• Age-Related Effects and the Impact of Drinking

• Effects of Alcohol on Sleep in Those With Alcoholism

• Conclusion

• References

Alcohol and Aging

• Drinking Prevalence and Patterns Among the Elderly

• Combined Effects of Alcohol and Aging

• Does Aging Increase Sensitivity to Alcohol?

• Aging, Alcohol, and the Brain

• Treatment of Alcoholism in the Elderly

• Conclusion

• References

2. Drug Abuse

Drug Awareness Quiz

• Answers to the Drug Awareness Quiz

A Self-Test for Cocaine Addiction

Tell-Tale Signs of Drug Abuse

Drug Use in America

Alcohol, Tobacco, and Other Drugs in the Workplace

Why Worry About Drugs and Alcohol in the Workplace

• What is substance abuse?

• Does it threaten jobs?

• What are the signs of abuse?

• How can it be prevented?

• What can you do?

• Substance Abuse Prevention In the Workplace

Sex Under the Influence of Alcohol and Other Drugs

Violence and Crime & Alcohol and Other Drugs

Domestic Violence & Alcohol and Other Drugs

Cocaine Abuse and Addiction

• What is cocaine?

• What is crack?

• What is the scope of cocaine use in the United States?

• How is cocaine used?

• How does cocaine produce effects?

• What are the short-term effects of cocaine use?

• What are the long-term effects of cocaine use?

• What are the medical complications of cocaine abuse?

• Are cocaine abusers at risk for contracting HIV/AIDS and hepatitis B and C?

• What is the effect of maternal cocaine use?

• What treatments are effective for cocaine abusers?

• Where can I get further scientific information about cocaine addiction?

• Glossary

• References

Heroin Abuse in the United States

• Description of Heroin and Effects of Use

• Prevalence of Heroin Use

• Characteristics of Heroin Users

• Patterns of Use

• Trends in Heroin Use

• References

Methamphetamine

• Pharmacology

• Use

Marijuana

• Pharmacology Use

• Availability

Dangerous Drugs

Lysergic Acid Diethylamide (LSD)

MDMA (Ecstasy)

Phencyclidine (PCP)

Ketamine

Gamma Hydroxybutyrate (GHB)

Methylphenidate (Ritalin®)

Steroids

Flunitrazepam (Rohypnol®)

Inhalants

Resources

3. Drug Addiction Treatment

Principles of Drug Addiction Treatment

• Preface

• Principles of Effective Treatment

• Reviewers

• Resources

Frequently Asked Questions

• What is drug addiction treatment?

• Why can't drug addicts quit on their own?

• How effective is drug addiction treatment?

• How long does drug addiction treatment usually last?

• What helps people stay in treatment?

• Is the use of medications like methadone simply replacing one drug addiction with another?

• What role can the criminal justice system play in the treatment of drug addiction?

• How does drug addiction treatment help reduce the spread of HIV/AIDS and other infectious diseases?

• Where do -step or self-help programs fit into drug addiction treatment?

• How can families and friends make a difference in the life of someone needing treatment?

• Is drug addiction treatment worth its cost?

Drug Addiction Treatment in the United States

• Behavioral Change Through Treatment

• General Categories of Treatment Programs

• Treating Criminal Justice-Involved Drug Abusers and Addicts

• Prison-based treatment programs

• Community-based treatment for criminal justice populations

Scientifically Based Approaches to Drug Addiction Treatment

• Relapse Prevention

• Supportive-Expressive Psychotherapy

• Individualized Drug Counseling

• Motivational Enhancement Therapy

• Behavioral Therapy for Adolescents

• Multidimensional Family Therapy (MDFT) for Adolescents
  Multisystemic Therapy (MSP)

• Combined Behavioral and Nicotine Replacement Therapy for Nicotine Addiction

• Community Reinforcement Approach (CRA) Plus Vouchers

• Voucher-Based Reinforcement Therapy in Methadone Maintenance

• Treatment

• Day Treatment With Abstinence Contingencies and Vouchers

• The Matrix Model

Rate and Duration for Drug Activity Play Major Roles in Drug Abuse, Addiction, and Treatment Rate of Action

• Why Does Rate of Action Affect the Brain?

• Method of Drug Administration Affects Rate of Action

• Duration of Action

• Developing a Cocaine Treatment Medication

• How Does Method of Administration Influence Rate of Action?

• Sources

Treatment Methods for Women

• Understanding Women Who Use Drugs

• Consequences of Drug Use for Women

• Drug Abuse and HIV/AIDS

• Treatment for Women

• Extent of Use

Lessons from Prevention Research

Effectiveness of Drug Abuse Treatment

• Four Common Types of Drug Abuse Treatment

• Highlights From the Study

• Keeping Patients in Treatment

• Sources

Brief Intervention for Alcohol Problems Screening for Alcohol Problems

• Common Elements of Brief Intervention

• Feedback of person risk Responsibility of the patient

• Advice to change Menu of ways to reduce drinking Empathetic counseling style Self-efficacy or optimism of the patient

• Establishing a drinking goal

• Follow-up

• Timing

• Effectiveness of Brief Intervention

• For non-alcohol-dependent patients

• For alcohol-dependent patients

• Conclusion

• References

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