1. Addictionfb(p.fb311):fbisfbafbchronic,fbrelapsingfbbrainfbdiseasefbcharacterizedfbbyfbcompulsivefbdrug-
seekingfbbehaviorfbmotivatedfbbyfbcravings,fbdespitefbharmfulfbconsequences,fbandfbbyfblong-
lastingfbchangesfbinfbthefbbrain
2. AlcoholfbWithdrawalfbSyndromefb(AWS)fbSymptoms:fbAutonomic:fbElevatedfbbloodfbpressurefb(BP)
,fbpulse,fbtemperature,fbdiaphoresis,fbnausea/vomiting,fbdiarrhea
• Motor:fbhandfbtremor,fbtremulousness,fbhyperreflexia,fbdysarthria,fbataxia,fbseizures
• Awareness:fbagitation,fbirritability,fbinsomnia,fbdisorientation,fbdelirium
• Psychiatric:fbanxiety,fbhallucinations,fbillusions,fbparanoiafbandfbdelusions,fbdisinhibition,fbcombativeness
3. Al-Anon,fbAlateen,fbAlcoholicsfbAnonymous:fb-fbSelffbhelpfbgroupsfbforfbadultsfbandfbteenagers
- believesfbthatfbtogether,fbthefbfamiliesfbandfbfriendsfboffbthosefbwithfbanfbSUDfbcanfbprovidefbhopefbtofbonefbanotherfbandfbhelpfb
solvefbthefbvariousfbproblemsfbtheyfbmayfbface.
- AAfbisfbafbtwelvefbstepfbprogram
4. AlcoholfbUsefbDisorderfb(AUD):fbisfbthefbmostfbcommonfbsubstancefbusefbproblemfbinfbthefbUnitedfbStates.
fbItfbinvolvesfbafb"problematicfbpatternfboffbalcoholfbuse"fb(APA,fb2013,fbp.fb490),fbleadingfbtofbsomefbtypefboffbimpairmentfbo
rfbdistress
5. Alternative-to-
disciplinefbprogramsfb(ATD):fbshouldfbbefbadoptedfbbyfbhealthfbcarefbfacilitiesfbandfbnursingfbschoolsfbinfborderfbto
fbtreatfbnursesfbandfbnursingfbstudentsfbwithfbSUDs,fbwithfbthefbaimsfboffbretention,fbrehabilitation,fbandfbreentryfbintofbsafe,fbpr
ofessionalfbpractice.fbDrugfbdiversionfbshouldfbbefbviewedfbmainlyfbasfbafbsymptomfboffbafbseriousfbandfbtreatablefbdisease,fbno
tfbjustfbafbcrime.
6. amotivationalfbsyndrome:fbthisfbsyndromefbisfbcharacterizedfbbyfbapathy,fblossfboffbachievementfbmotivation,f
bdecreasefbinfbproductivity,fbdiflcultyfbwithfblearningfbandfbmemory,fbimpairedfbconcentration,fblackfboffbpersonalfbhygiene,fba
ndfbpreoccupationfbwithfbthefbdrug.fbItfbalsofbmayfbnegativelyfbattectfbthefbstill-
maturingfbbrainfboffbthefbadolescent/youngfbadult.fbItfbhasfbbeenfbsuggestedfbthatfbtherefbisfbafblossfboffbIQfbwithfbchronicfbuse.
7. Antiagonisticfbeffects:fb thesefboccurfbwhenfbonefbdrugfbisfbtakenfbtofbweakenfborfbinhibitfbthefbettectfboffbanotherfbdr
ug.fbForfbexample,fbafb"speedball"fbisfbheroinfb(CNSfbdepressant)fbthatfbisfbmixedfbwithfbcocainefb(afbCNSfbstimulant)fbtofbsoftenfbthef
bintensefbletdownfboffbwithdrawalfbfromfbcocaine.fbNaloxonefb(opioidfbantagonist)fbisfbgivenfbtofbinhibitfborfbreversefbthefbettectsfb
offbanfbopioidfboverdose.
8. Cathinones,fbmorefbcommonlyfbknownfbasfbbathfbsalts:fb-bfArefbhuman-madefbstimulant-
typefbdrugs.fbThesefbrelativelyfbnewfbmind-
alteringfbdrugsfbcalledfbnewfbpsychoactivefbsubstancesfb(NPSs)fbarefbunregulatedfbandfbeasilyfbpurchased.
-fbSymptomsfboffbusefbincludefbhallucinogenic-
,delusionalfbproperties,fbdissociation,fbincreasedfbsexfbdrive,fbextremefbagitation,fbandfbfeelingsfboffbsuperhumanfbstrengthfban
dfbcombativeness.fbThesefbdrugsfbcanfbbecomefbaddictive,fbwithfbdepression,fbanxiety,fbsleepfbdisturbance,fbandfbparanoiafba
sfbwithdrawalfbsymptoms
, 9. Clubf b drugs:f b arefbafbgroupfboffbpsychoactivefbdrugsfbthatfbactfbonfbthefbCNSfbandfbcanfbcausefbchangesfbinfbmood,fbawaren
ess,fbandfbbehaviorfb(Tablefb19.8).fbThesefbdrugsfbtendfbtofbbefbusedfbbyfbyoungfbadultsfb(agefb13fbthroughfb20s)fbinfbgroupfbsett
ingsfblikefball-nightfbdancefbparties,fbdancefbclubs,fbandfbbars.fbTheyfbincludefbthefbfollowing:
• Methylenedioxymethamphetaminefb(MDMA),fbalsofbknownfbasfbecstasy,fbXTC,fbX,fbE,fbAdam,fbMolly,fbhugfbbeans,fbandfblovefbdrug
• γ-Hydroxybutyratefb(GHB),fbalsofbknownfbasfbG,fbliquidfbecstasy,fbandfbsoap
• Ketamine,fbalsofbknownfbasfbspecialfbK,fbK,fbvitaminfbK,fbandfbjet
• Rohypnol,fbalsofbknownfbasfbroofies
• Methamphetamine,fbalsofbknownfbasfbspeed,fbice,fbchalk,fbmeth,fbcrystal,fbcrank,fbandfbglass
• LSD,fbalsofbknownfbasfbacid,fbblotter,fbandfbdotsfb(NIDA,fbn.d.)
10. Cognititivef b impairment:f b changesfbinfbthefbabilityfbtofbremember,fblearn,fbconcentrate,fborfbmakefbdecisions.
11. Crossfbtolerence:fboccursfbwhenfbonefbbuildsfbupfbafbtolerancefbforfbonefbdrugfbwhilefbalsofbbuildingfbupfbafbtolerancefbf
orfbanotherfbdrugfbinfbthefbsamefborfbafbchemicallyfbsimilarfbclassfboffbdrugs.
12. Duelfb diagnosis:fb thefbcoexistencefboffbSUDsfbalongfbwithfbonefborfbmorefbadditionalfbmentalfbdisorders.
13. Enabling:fbrotectingfbafblovedfbonefbfromfbthefbconsequencesfboffbdestructivefbbehavior,fblabeledfbenabling,fbmayfbsee
mfbsupportivefbbutfbactuallyfbmakesfbitfbeasierfbforfbthefbaddictedfbpersonfbtofbmaintainfbthefbaddiction.
14. Flashbacks:f b transitoryfbrecurrencesfboffbafbperceptualfbdisturbancefbcausedfbbyfbafbperson'sfbearlierfbhallucinoge
nicfbdrugfbuse.fbFlashbacksfboccurfbwhilefbinfbafbdrug-
freefbstate.fbVisualfbdistortions,fbtimefbexpansion,fblossfboffbegofbboundaries,fbandfbintensefbemotionsfbarefbreported.fbFlashb
acksfbcanfbbefbmildfbandfbpleasantfborfbcanfbbefbafbrecurrencefboffbfrighteningfbimagesfborfbterrifyingfbideasfbfromfbwhatfbisfblabel
edfbafb"badfbtrip."
15. Medication-assistedf b treatment:f b isfbthefbusefboffbFDA-
approvedfbmedicationsfbinfbcombinationfbwithfbcoun-fbselingfbandfbbehavioralfbtherapiesfbtofbprovidefbafb"whole-
patient"fbapproachfbtofbthefbtreatmentfboffbSUDs.fbDrugsfbusedfbinfbhelpingfbindividualsfbmaintainfbabstinencefbfromfbalcoholfba
refbbasedfbonfbthreefbstrategies:fbmakingfbalcoholfbusefbunpleasant,fbreducingfbpsychophysiologicalfbsymptomsfbassociatedfbwi
thfbwithdrawal,fbandfbreducingfbthefbreinforcingfbqualitiesfboffbdrug/alcoholfbuse.
16. motivationalfbinterviewing:fbisfbanfbevidence-
basedfbcounselingfbapproach.fbBasedfbonfbanfbunderstandingfboffbthefbthoughtsfbandfbbehaviorfbassociatedfbwithfbthefb
stagesfboffbchange,fbitfbemphasizesfbthefbusefboffbafbdirective,fbpatient-
centeredfbstylefboffbinteractionfbtofbpromotefbbehavioralfbchange.fbTherapeuticfbcommunicationfbtechniquesfbarefbindividualiz
edfbdependingfbuponfbthefbpatient'sfbcurrentfbstagefboffbchange.fbMotivationalfbinterviewingfbisfbguidedfbbyfbfourfbprinciplesfbt
ofbevokefbchange:
1. Expressfbempathyfb(e.g.,fb"Ifbcanfbunderstandfbwhyfbusingfbdrugsfbseemsfbappealingfbinfbsomefbsituations").
seekingfbbehaviorfbmotivatedfbbyfbcravings,fbdespitefbharmfulfbconsequences,fbandfbbyfblong-
lastingfbchangesfbinfbthefbbrain
2. AlcoholfbWithdrawalfbSyndromefb(AWS)fbSymptoms:fbAutonomic:fbElevatedfbbloodfbpressurefb(BP)
,fbpulse,fbtemperature,fbdiaphoresis,fbnausea/vomiting,fbdiarrhea
• Motor:fbhandfbtremor,fbtremulousness,fbhyperreflexia,fbdysarthria,fbataxia,fbseizures
• Awareness:fbagitation,fbirritability,fbinsomnia,fbdisorientation,fbdelirium
• Psychiatric:fbanxiety,fbhallucinations,fbillusions,fbparanoiafbandfbdelusions,fbdisinhibition,fbcombativeness
3. Al-Anon,fbAlateen,fbAlcoholicsfbAnonymous:fb-fbSelffbhelpfbgroupsfbforfbadultsfbandfbteenagers
- believesfbthatfbtogether,fbthefbfamiliesfbandfbfriendsfboffbthosefbwithfbanfbSUDfbcanfbprovidefbhopefbtofbonefbanotherfbandfbhelpfb
solvefbthefbvariousfbproblemsfbtheyfbmayfbface.
- AAfbisfbafbtwelvefbstepfbprogram
4. AlcoholfbUsefbDisorderfb(AUD):fbisfbthefbmostfbcommonfbsubstancefbusefbproblemfbinfbthefbUnitedfbStates.
fbItfbinvolvesfbafb"problematicfbpatternfboffbalcoholfbuse"fb(APA,fb2013,fbp.fb490),fbleadingfbtofbsomefbtypefboffbimpairmentfbo
rfbdistress
5. Alternative-to-
disciplinefbprogramsfb(ATD):fbshouldfbbefbadoptedfbbyfbhealthfbcarefbfacilitiesfbandfbnursingfbschoolsfbinfborderfbto
fbtreatfbnursesfbandfbnursingfbstudentsfbwithfbSUDs,fbwithfbthefbaimsfboffbretention,fbrehabilitation,fbandfbreentryfbintofbsafe,fbpr
ofessionalfbpractice.fbDrugfbdiversionfbshouldfbbefbviewedfbmainlyfbasfbafbsymptomfboffbafbseriousfbandfbtreatablefbdisease,fbno
tfbjustfbafbcrime.
6. amotivationalfbsyndrome:fbthisfbsyndromefbisfbcharacterizedfbbyfbapathy,fblossfboffbachievementfbmotivation,f
bdecreasefbinfbproductivity,fbdiflcultyfbwithfblearningfbandfbmemory,fbimpairedfbconcentration,fblackfboffbpersonalfbhygiene,fba
ndfbpreoccupationfbwithfbthefbdrug.fbItfbalsofbmayfbnegativelyfbattectfbthefbstill-
maturingfbbrainfboffbthefbadolescent/youngfbadult.fbItfbhasfbbeenfbsuggestedfbthatfbtherefbisfbafblossfboffbIQfbwithfbchronicfbuse.
7. Antiagonisticfbeffects:fb thesefboccurfbwhenfbonefbdrugfbisfbtakenfbtofbweakenfborfbinhibitfbthefbettectfboffbanotherfbdr
ug.fbForfbexample,fbafb"speedball"fbisfbheroinfb(CNSfbdepressant)fbthatfbisfbmixedfbwithfbcocainefb(afbCNSfbstimulant)fbtofbsoftenfbthef
bintensefbletdownfboffbwithdrawalfbfromfbcocaine.fbNaloxonefb(opioidfbantagonist)fbisfbgivenfbtofbinhibitfborfbreversefbthefbettectsfb
offbanfbopioidfboverdose.
8. Cathinones,fbmorefbcommonlyfbknownfbasfbbathfbsalts:fb-bfArefbhuman-madefbstimulant-
typefbdrugs.fbThesefbrelativelyfbnewfbmind-
alteringfbdrugsfbcalledfbnewfbpsychoactivefbsubstancesfb(NPSs)fbarefbunregulatedfbandfbeasilyfbpurchased.
-fbSymptomsfboffbusefbincludefbhallucinogenic-
,delusionalfbproperties,fbdissociation,fbincreasedfbsexfbdrive,fbextremefbagitation,fbandfbfeelingsfboffbsuperhumanfbstrengthfban
dfbcombativeness.fbThesefbdrugsfbcanfbbecomefbaddictive,fbwithfbdepression,fbanxiety,fbsleepfbdisturbance,fbandfbparanoiafba
sfbwithdrawalfbsymptoms
, 9. Clubf b drugs:f b arefbafbgroupfboffbpsychoactivefbdrugsfbthatfbactfbonfbthefbCNSfbandfbcanfbcausefbchangesfbinfbmood,fbawaren
ess,fbandfbbehaviorfb(Tablefb19.8).fbThesefbdrugsfbtendfbtofbbefbusedfbbyfbyoungfbadultsfb(agefb13fbthroughfb20s)fbinfbgroupfbsett
ingsfblikefball-nightfbdancefbparties,fbdancefbclubs,fbandfbbars.fbTheyfbincludefbthefbfollowing:
• Methylenedioxymethamphetaminefb(MDMA),fbalsofbknownfbasfbecstasy,fbXTC,fbX,fbE,fbAdam,fbMolly,fbhugfbbeans,fbandfblovefbdrug
• γ-Hydroxybutyratefb(GHB),fbalsofbknownfbasfbG,fbliquidfbecstasy,fbandfbsoap
• Ketamine,fbalsofbknownfbasfbspecialfbK,fbK,fbvitaminfbK,fbandfbjet
• Rohypnol,fbalsofbknownfbasfbroofies
• Methamphetamine,fbalsofbknownfbasfbspeed,fbice,fbchalk,fbmeth,fbcrystal,fbcrank,fbandfbglass
• LSD,fbalsofbknownfbasfbacid,fbblotter,fbandfbdotsfb(NIDA,fbn.d.)
10. Cognititivef b impairment:f b changesfbinfbthefbabilityfbtofbremember,fblearn,fbconcentrate,fborfbmakefbdecisions.
11. Crossfbtolerence:fboccursfbwhenfbonefbbuildsfbupfbafbtolerancefbforfbonefbdrugfbwhilefbalsofbbuildingfbupfbafbtolerancefbf
orfbanotherfbdrugfbinfbthefbsamefborfbafbchemicallyfbsimilarfbclassfboffbdrugs.
12. Duelfb diagnosis:fb thefbcoexistencefboffbSUDsfbalongfbwithfbonefborfbmorefbadditionalfbmentalfbdisorders.
13. Enabling:fbrotectingfbafblovedfbonefbfromfbthefbconsequencesfboffbdestructivefbbehavior,fblabeledfbenabling,fbmayfbsee
mfbsupportivefbbutfbactuallyfbmakesfbitfbeasierfbforfbthefbaddictedfbpersonfbtofbmaintainfbthefbaddiction.
14. Flashbacks:f b transitoryfbrecurrencesfboffbafbperceptualfbdisturbancefbcausedfbbyfbafbperson'sfbearlierfbhallucinoge
nicfbdrugfbuse.fbFlashbacksfboccurfbwhilefbinfbafbdrug-
freefbstate.fbVisualfbdistortions,fbtimefbexpansion,fblossfboffbegofbboundaries,fbandfbintensefbemotionsfbarefbreported.fbFlashb
acksfbcanfbbefbmildfbandfbpleasantfborfbcanfbbefbafbrecurrencefboffbfrighteningfbimagesfborfbterrifyingfbideasfbfromfbwhatfbisfblabel
edfbafb"badfbtrip."
15. Medication-assistedf b treatment:f b isfbthefbusefboffbFDA-
approvedfbmedicationsfbinfbcombinationfbwithfbcoun-fbselingfbandfbbehavioralfbtherapiesfbtofbprovidefbafb"whole-
patient"fbapproachfbtofbthefbtreatmentfboffbSUDs.fbDrugsfbusedfbinfbhelpingfbindividualsfbmaintainfbabstinencefbfromfbalcoholfba
refbbasedfbonfbthreefbstrategies:fbmakingfbalcoholfbusefbunpleasant,fbreducingfbpsychophysiologicalfbsymptomsfbassociatedfbwi
thfbwithdrawal,fbandfbreducingfbthefbreinforcingfbqualitiesfboffbdrug/alcoholfbuse.
16. motivationalfbinterviewing:fbisfbanfbevidence-
basedfbcounselingfbapproach.fbBasedfbonfbanfbunderstandingfboffbthefbthoughtsfbandfbbehaviorfbassociatedfbwithfbthefb
stagesfboffbchange,fbitfbemphasizesfbthefbusefboffbafbdirective,fbpatient-
centeredfbstylefboffbinteractionfbtofbpromotefbbehavioralfbchange.fbTherapeuticfbcommunicationfbtechniquesfbarefbindividualiz
edfbdependingfbuponfbthefbpatient'sfbcurrentfbstagefboffbchange.fbMotivationalfbinterviewingfbisfbguidedfbbyfbfourfbprinciplesfbt
ofbevokefbchange:
1. Expressfbempathyfb(e.g.,fb"Ifbcanfbunderstandfbwhyfbusingfbdrugsfbseemsfbappealingfbinfbsomefbsituations").
