LCDC EXAM STUDY GUIDE WITH COMPLETE SOLUTIONS 2023

LCDC EXAM STUDY GUIDE WITH COMPLETE SOLUTIONS 2023 Two main types of cells in the nervous system - Correct answer-glia and neurons Glia - Correct answer-Cells that out number neurons, cannot process information like neurons, make up the blood brain barrier that protects the brain from toxic chemicals in the blood Nervous system - Correct answer-Consists of neurons, axons and receptors Receptors - Correct answer-Proteins that help regulate activity of cells in the nervous system. Activation of receptors by neurotransmitters cause a change in activity of the target cell and many of the effects of psychoactive drugs are due to the ability to alter neurotransmitters. Neurons - Correct answer-basic structural unit of the nervous system responsible for analyzing and transmitting information. There are more than 100 billion neurons in the nervous system Synapse - Correct answer-Typical point of communication, gap between neurons is called the synaptic cleft. Two types of synapses - Correct answer-Excitatory and inhibitory synapse. The receiving region is called the dendrite Effects on receptors - Correct answer-Can be agonistic or antagonistic Agonistic drugst - Correct answer-interact with the receptor and produce a response, agonist (a substance that fully activates the neuronal receptor that it attaches to) Imitates the action of neurotransmitter, is the use of a (usually) long-acting medication that stimulates the same brain receptors as the drug of addiction. The most obvious example is opioid agonist therapy for opioid addiction using methadone or buprenorphine. An agonist is a drug that activates certain receptors in the brain. Full agonist opioids activate the opioid receptors in the brain fully resulting in the full opioid effect. Examples of full agonists are heroin, oxycodone, methadone, hydrocodone, morphine, opium and others. Buprenorphine is a partial agonist meaning, it activates the opioid receptors in the brain, but to a much lesser degree than a full agonist. A pure opioid antagonist used in medicine is naloxone (not to be confused with naltrexone). Antagonisitic - Correct answer-Drugs interact with the receptor but prevent a response, agonist drugs which bind to the neurotransmitters in the brain, antagonist drugs do the opposite: they block the brain's neurotransmitters. The action of neurotransmitter is obstructed. Buprenorphine also acts as an antagonist, meaning it blocks other opioids, while allowing for some opioid effect of its own to suppress withdrawal symptoms and cravings. Agonist-antagonist opioids - Correct answer-In pharmacology the term agonistantagonist is used to refer to a drug which exhibits some properties of an agonist (a substance that fully activates the neuronal receptor that it attaches to) and some properties of an antagonist (a substance that attaches to a receptor but does not activate it or if it displaces an agonist at that receptor it seemingly deactivates it thereby reversing the effect of the agonist). Agonist-antagonist opioids[edit] The best known agonist-antagonists are opioids. Examples of such opioids are: buprenorphine[1] (Suboxone, Subutex) pentazocine butorphanol nalbuphine Naloxone (Narcan) - Correct answer-opioid antagonists that is a short acting drug which will bring a patient out of an opiate overdose by stripping the opiate from the opiate receptor and is a life saving drug. Naltrexone, - Correct answer-opioid antagonists that is a short acting opiate/alcohol blocking agent has been used for the last 30 years. Naltrexone blocks the pharmacological effects of 25 mg / in the introduction of heroin for 24 hours, a double dose (100 mg) acts within 48 hours, and 150 mg will affect during for 3 days. Long-term appointment does not cause tolerance and dependence. To cut the long story short, when comparing Naltrexone vs Naloxone it is obvious that Naltrexone is stronger for alcohol dependence but Naloxone acts faster and remains longer. Acetylcholine (ACH), epinephrine, dopamine, serotonin and endorphins - Correct answer-Neurotransmitters most likely altered by drug abuse Somatic Nervous System - Correct answer-Carries sensory information from outside the body into the CNS and motor information out. Automatic nervous system (ANS) - Correct answer-cell bodies are located within the brain or spinal cord but their axons project outside the CNS to involuntary muscles. Automatic nervous system has two componenets - Correct answer-These componenents contest with each other: sympathatheic (fight or flight) and parasympathetic (rest and digest). Sympathetic System - Correct answer-speeds up hear and breathing rates is vasoconstrictor amphetamine (Benzedrine) benzylpiperazine (BZP) cathine (found in Catha edulis) cathinone (found in Catha edulis, khat) cocaine (found in Erythroxylum coca, coca) ephedrine (found in Ephedra) lisdexamfetamine (Vyvanse) maprotiline (Ludiomil) MDMA (Ecstasy, Molly) methamphetamine (Meth, Crank, Desoxyn) methcathinone methylenedioxypyrovalerone (MDPV) methylphenidate (Ritalin) 4-methylaminorex oxymetazoline (Afrin, Vicks Sinex) pemoline (Cylert) phenmetrazine (Preludin) propylhexedrine (Benzedrex) pseudoephedrine (Sudafed, SudoGest, also found in Ephedra species) GABA - Correct answer-inhibitory neurotransmitter, sedatives are dependent upon their binding to the GABA receptors (gamma-aminobutyric acid) is an inhibitory neurotransmitter that is very widely distributed in the neurons of the cortex. GABA contributes to motor control, vision, and many other cortical functions. It also regulates anxiety. Depressants - Correct answer-Depressants/sedative-hypnotics (central nervous system depressants). Drugs in this class slow/depress the activity of the central nervous system. Examples of drugs in this classification include, but are not limited to, alcohol, benzodiazepines, and barbiturates. They are usually taken orally. The desired effects are a reduction of anxiety with possible elation secondary to decreased alertness and judgment. Other acute effects include sedation, impaired judgment, impaired ability to operate vehicles or machinery, or respiratory and cardiac depression with overdose. The action of sedative-hypnotics is a depression of the activity at all excitable tissues; in general, it binds to GABA (inhibitory) receptors resulting in sedation Stimulants - Correct answer-Drugs in this class increase central nervous system activity. This classification includes cocaine, amphetamines, methamphetamines, and methylphenidate (Ritalin). Routes of administration vary, powered cocaine is snorted intranasally, can be liquified and injected intravenously, or it can be smoked as freebase or, more often, as crack. Amphetamines can be taken orally, injected intravenously, or smoked. Methylphenidate (Ritalin) is taken orall Hallucinogens/dissociatives. - Correct answer-These drugs change sensory perception and have the ability to alter reality and produce hallucination-like effects. This classification includes naturally occurring and synthetically prepared drugs that include LSD, mescaline, psilocybin, psilocin, MDMA (ecstasy), PCP, and ketamine MDMA effects - Correct answer-can include nausea, clenching of the jaw and teeth, muscle tension, blurred vision, panic attacks, confusion, depression, anxiety, paranoid psychosis, increased body temperature, and cardiac arrest . Acts on several different neurotransmitter sites to produce effects like LSD hallucinations and amphetamine-like arousal LSD - Correct answer-can include panic attacks, increased blood pressure, heart palpitations, tremors, nausea, muscle weakness, increased body temperature, ataxia, and in some cases accidental death is structurally related to serotonin and many of the behavioral effects are probably related to their binding to the serotonin receptors. PCP - Correct answer-can include psychotic reactions, bizarre behavior, outbursts of hostility and violence, and feelings of severe anxiety, doom, or impending death Ketamine - Correct answer-can include a frightening experience of complete sensory detachment, explained as a near-death experience, paranoia, boredom, and possible coma Cannabinoids/cannabinols - Correct answer-his category includes marijuana, hashish, and THC. The usual route of administration is smoking or oral. Its usual length of action 78 from smoking is 2 to 4 hours and through oral means is 5 to 12 hours. The desired effects are a sense of relaxation and well-being, euphoria, detachment, altered level of consciousness, altered perceptions, altered sense of time, and possible sexual arousal Effects of cannabinoid use - Correct answer-re slowed reaction time, altered perceptions, panic, anxiety, nausea, dizziness, depersonalization, paranoid thoughts, and trouble expressing thoughts. The effects are believed to be caused by the binding of the drug at specific THC receptor sites in the brain. Intoxication may cause increases in respiration and heart rate and a slight increase in body temperature. Upon examination, the users may exhibit red eyes, mild dilation of pupils, mild tremors, decreased coordination, decreased strength, less ability to perform complex motor tasks, and dry mouth. Mentally, the user may express feelings of depersonalization, an alteration in mood, disorganization, anxiety, panic, problems with memory, paranoid thoughts, and possible hallucinations Long-term, chronic canabinoid use - Correct answer-can lead to problems such as dependence, panic, anxiety, paranoid thoughts, etc. They may also include respiratory problems, the possibility of an impaired immune system, possible reproductive problems, including low birth weight infants, and amotivational syndrome. Withdrawal usually consists of cravings, anxiety, irritability, nausea, anorexia, agitation, restlessness, tremors, and depression Inhalants - Correct answer-These drugs consist mainly of chemicals that can be legally purchased and that are normally used for nonrecreational purposes. These include industrial solvents and aerosol sprays that include, but are not limited to, gasoline, kerosene, airplane glue, lacquer thinner, acetone, nail polish remover, lighter fluid, metallic paints, and typewriter correction fluids. Also included are amyl, butyl and isobutyl nitrite, and nitrous oxide gas Inhalants effects - Correct answer-Inhalants reduce inhibition and produce euphoria, dizziness, slurred speech, an unsteady gait, and drowsiness. Nystagmus, the constant involuntary movement of the eyes, may be noted. The nitrites alter consciousness and enhance sexual pleasure. The individual may experience giddiness, headaches, and a sense that the user is about to pass out.An overdose of these substances may produce hallucinations, muscle spasms, headaches, dizziness, loss of balance, irregular heartbeat, and coma from lack of oxygen Inhalants other effects - Correct answer-An overdose of these substances may produce hallucinations, muscle spasms, headaches, dizziness, loss of balance, irregular heartbeat, and coma from lack of oxygen . Tolerance does not seem to develop with inhalants with the exception of nitrous oxide for which tolerance can develop. There does not seem to be withdrawal symptoms from these substances, which indicate there is not physical dependence. The critical acute effect of inhalants results from the method of administration, which can result in loss of consciousness, coma, or death from lack of oxygen. Respiratory arrest, cardiac arrhythmia, or asphyxiation may occur. Many of these substances are highly toxic, and chronic use may cause damage to the liver, kidneys, brain, and lungs. Anabolic steroids - Correct answer-Anabolic steroids are synthetic illicit drugs that are used to increase muscle mass and improve athletic performance. These drugs resemble the male sex hormone, testosterone. Some anabolic steroids are approved for medical use and are classified as schedule III drugs. Drugs in this classification include Depo-Testosterone, Durabolin, Danocrine, and Halotestin. Some anabolic steroids used for veterinary medicine are illicitly sold for human use and may be sold legally outside of the United States Effects of steroids - Correct answer-Anabolic steroids are either injected or taken orally. Combining oral and injectable steroids is known as "stacking". These drugs increase muscle strength, reduce body mass, and increase aggressiveness, competitiveness, and combativeness there is no immediate danger of death or serious medical problems from high dosage levels of anabolic steroids; there are serious complications from long-term use. There is no evidence that one can develop tolerance to anabolic steroids. Physical and psychological dependence on anabolic steroids does occur, and there are withdrawal symptoms. Withdrawal symptoms include depression, fatigue, restlessness, insomnia, loss of appetite, and decreased interest in sex. Some of the acute and chronic effects of anabolic steroids on males include atrophy of testicles, impaired production of sperm, infertility, early baldness, acne, and enlargement of the breasts. For females, there are masculizing effects including increased facial and body hair, lowered voice, and irregular or the stopping of the menstrual cycle. There is an increased risk of coronary artery disease. Anabolic steroids may cause jaundice and liver tumors. Mood swings with periods of unreasonable and uncontrolled anger and violence may be noted Ethics - Correct answer-Ethics are the rules of conduct recognized in a particular profession, the shared standards of what is good practice. Note that the ethicalness and the legality of an action are two different things, and occasionally they are in conflict. Ethical codes delineate mandatory ethics, the minimal standard of conduct that is acceptable. Ideally, counselors practice aspirational ethics, which focus on the spirit behind the code. For example, mandatory ethics permit a counselor to have a romantic relationship with a former client 2 years after the client's treatment ends. Aspirational ethics suggest that doing so even after 2 years is inadvisable. Decision-making Models - Correct answer-Decision-making models provide a framework for systematically choosing a course of action when ethical codes do not specify how to act in a particular situation. The steps of one decision-making model are identify the problem, review the code of ethics and relevant laws, consult with another professional, consider possible courses of action and their consequences, choose a course of action, and evaluate the results Fundamental Ethical Principles - Correct answer-Autonomy. Respect the client's independence and self-determination. Nonmaleficence. Do not harm the client. Beneficence. Provide benefit for the client. Justice. Be fair to the client. Fidelity. Be faithful to the client. Veracity. Be truthful with the client. The NAADAC Principles - Correct answer-The National Association of Alcoholism and Drug Abuse Counselors (NAADAC) is a professional association that offers certification in substance abuse counseling. The principles (NAADAC, 1995) address nondiscrimination, responsibility, competence, legal and moral standards, public statements, publication credit, client welfare, confidentiality, client relationships, interprofessional relationships, remuneration, and societal obligations. Ethical Standards - Correct answer-The ethical standards for LCDCs appear in the Texas Administrative Code and as LCDC Rule 150.121. The ethical standards address these important topics: applicants and licensed counselors' responsibility to comply with the standards, nondiscrimination, maintaining high quality service to clients, protecting the profession from unqualified or unethical persons, counselor sobriety, upholding the law and conducting oneself in a professional manner, documentation, publication credit, client welfare, privacy and confidentiality, dual relationships, relationships with other professionals, and fees. Actions against a license for violating the ethical standards are described in LCDC Rule 150.122. They include refusal to issue or renew a license, suspension or revocation of a license, placing a counselor on probation if the counselor's license has been suspended, and reprimand of a license holder. 42 CFR - Correct answer-refers specifically to information that can be used to identify a person as an alcohol or drug abuser, or the recipient of a substance related diagnosis, referral, or treatment. Federal law (42 Code of Federal Regulations, Part 2) prohibits counselors from divulging the fact that someone is in treatment or any details of their treatment without the client's written consent, when the client is in a clear state of mind. This applies to former clients, deceased clients, and those who merely applied to a treatment program but never attended. HIPAA - Correct answer-covers all personal health information that can be used to identify an individual. Exceptions to confidentiality - Correct answer-Confidentiality is not absolute; there are circumstances in which releases of information are not required to disclose client information. Clients should be told of these circumstances as part of the process of securing their informed consent for treatment. In every case, only the information required by law is to be disclosed. Some exceptions include instances in which information necessary to provide services may be shared among staff of a program, reporting child abuse or neglect (Public Law 99-401), threatening to harm another person, threatening suicide, committing or threatening a crime on program property or against program staff, medical emergencies, elder abuse, and court orders. Privilege - Correct answer-a legal concept that refers to a client's right to keep confidential information out of legal proceedings. Technically, the client holds the privilege, so counselors may not disclose information in legal proceedings unless the client waives privilege or certain other conditions, which vary from State to State, are met. Informed consent and releases of information - Correct answer-Client consents to release information about their treatment must contain certain specific information. This includes, but is not limited to, the purpose of the disclosure, the person to receive the disclosed information, and the date or condition under which the consent will expire. The consent may be revoked in writing or verbally, at the client's discretion. Counselors have to obtain consent from minor clients before releasing information. By law, releases of information must include a statement that the recipient of the disclosure cannot make subsequent disclosures unless federal regulations permit them to do so. Duty to warn - Correct answer-a client threatens to harm another person who is reasonably identifiable, the counselor has a duty to warn the appropriate authorities of that threat. In Texas, counselors do not have a duty to warn the intended victim. In some States, counselors do have that duty, which originated in the California Supreme Court decision in Tarasoff v. Regents of the University of California Suicide threat - Correct answer-Counselors may have to enlist the help of others when a client threatens self-harm. Counselors have the right to disclose the minimum amount of confidential information necessary to help prevent a client's suicide. This right exists because it is ethical, in terms of presumably serving the best interests of the client, not because there is a legal duty to do so. Nonvoluntary Clients - Correct answer-Clients who have not sought treatment voluntarily should be given all of the information necessary to give informed consent for treatment, even if the consent is not, in the purest sense, voluntary. For example, they should be informed of the potential risks of treatment, duration and cost of treatment, the counseling approach to be used, their rights, and the limits to confidentiality. As always, decisions should be made in the best interests of the client, and the client should be informed of what may appear to be potentially conflicting loyalties that the counselor may have (e.g., to the client's employer, probation officer). Nonvoluntary clients should be allowed to exercise as much choice as possible regarding their treatment. Professional Development - Correct answer-Professional development is an ongoing responsibility. It is accomplished through engaging in continuing education, selfevaluation, supervision, and consultation. Supervision - Correct answer-The purposes of supervision are to promote the counselor's growth, protect the welfare of clients, monitor counselor performance, and empower the counselor to self-supervise and carry out their responsibilities as an independent professional. Powell (1998) describes four emphases of supervision: administrative, evaluative, clinical, and supportive Consultation - Correct answer-A counselor seeks consultation in order to apply the expertise of another person toward better serving a client. Examples of people with whom LCDCs might consult are a client's physician, a marriage and family therapist, an AA sponsor, or a religious leader. Consultation between professionals within the same organization is called internal consultation. If the consultant and the consultee do not belong to the same organization it is called external consultation. Referrals - Correct answer-n order to make proper referrals, LCDCs need to be able to recognize symptoms in clients that require assessment by other professionals such as physicians, psychologists, or licensed professional counselors. They also need to be familiar with services available in the community such as legal services, emergency services, and Alcoholics Anonymous and other self-help groups. It is good practice to be personally familiar with the philosophy, programs, and personnel of the services to which clients are referred and to be active in the referral Advocacy - Correct answer-Advocacy is any activity designed to obtain a service, practical help, support, or information for a client. Examples of advocacy are obtaining practical help such as money to pay for travel to treatment and securing an adolescent client's school counselor's support for treatment. Advocacy requires that counselors maintain effective relationships with other professionals, government organizations, and groups in the community that might be helpful to their clients' recovery. Six stages that occur as a family deals with addiction - Correct answer-1. Denial usually takes place early on when the occasional excessive drinking episodes are explained away by both partners as isolated instances with no reason for concern. 2. Attempts to eliminate the problem may occur when the user's partner realizes that the using behaviors are not normal and tries to pressure the user to control/cut down or quit substance use. 3. Disorganization and chaos occurs when the normal family operations have broken down and the user's partner has to deal with the critical situations that occur on a more frequent basis. 4. Reorganization in spite of the problem occurs when the user's partner takes charge and redirects her/his main focus away from the user and on to maintaining a family life in spite of the chemical use. 5. Efforts to escape may take the form of a separation or attempted divorce; however, if the family remains together, family life continues despite the user. 6. Family reorganization is when a separation occurs and the family reorganizes without the user. Reconciliation may take place but only with both partners making adjustments Treatment and recovery continuum of care - Correct answer-identification, assessment, stabilization, rehabilitation, relapse prevention, and substance substitution if necessary. Identification - Correct answer-Treatment and recovery continuum of care-an individual can be made through many different channels, self-identification, court order, a condition of one's probation or parole, and/or through appropriate intervention techniques. This could involve the screening process used to help determine the likelihood that an individual has a problem with drugs or alcohol Assessments - Correct answer-Treatment and recovery continuum of care is the collection of data from the individual and corroborative sources to determine the extent of the individual's problem and their strengths, weaknesses, and needs. This information is used to formulate the plan of treatment to include goals and methods and resources to be used Stabilization - Correct answer-Treatment and recovery continuum of care includes the need for detoxification at an appropriate medical facility if needed. Rehabilitation/treatment programs - Correct answer-Treatment and recovery continuum of care-will vary from setting to setting with the primary focus on the care of the client. The continuum of treatment depends on the assessment and diagnosis of the client and can range from providing education, an intensive outpatient program, to an inpatient residential program. Substance abuse and associated treatment services should be individualized and be of the type and intensity appropriate to meet the needs of the client. Relapse prevention - Correct answer-Treatment and recovery continuum of care-an important part of treatment from the time services are first provided. Counseling/treatment is basically working on problems and concerns that have played a role in the client's using behavior and to learn to make decisions and choices that do not facilitate relapse. Recovery and relapse are both ongoing processes not an event. Thus relapse prevention should be approached as a process with the identification of individualized triggers and a plan to confront those triggers should they occur. Relapse prevention should be made a valuable part of the client's aftercare program and discharge goals Abstinence violation effect ( Treatment, recovery continuum of care) - Correct answerrefers to the tendency for some people to use substances problematically when they believe abstinence is too difficult a goal to achieve or maintain. AVE relates to what happens when a person attempting to abstain from a negative habitual behavior, such as drug use, engages in the behavior and then faces conflict and guilt by making internal attributions to explain why he or she did it, thus making the individual more likely to continue using the drug, for instance, in order to cope with self-blame and guilt Drug substitution - Correct answer-is the substitution of a legal drug for an illegal one to assist the client in making positive life changes. An example of this would be a methadone program. Primary prevention - Correct answer-intended mainly for the young who have little or no experience with drugs, and this approach tries to anticipate and prevent initial drug use by: • Promoting abstinence • Developing refusal skills • Educating the young about the dangers of drugs • Increasing the age of legal use (of alcohol and tobacco) • Promoting viable alternatives, activities that do not include drug use Secondary prevention - Correct answer-seeks to stop the experimental, social/recreational, and habitual use and abuse from turning into addiction by acting when the symptoms are first recognized. Secondary prevention incorporates intervention, education, and skill building to provide skills to avoid future use and promote abstinence. Instead of jail, drug diversion programs direct first-time offenders into education and rehabilitation programs Tertiary prevention - Correct answer-focuses on stopping the progressive damage of drug use and assisting drug abusers back to a healthier state. Tertiary prevention incorporates the following strategies: group intervention as a means to get people into treatment that includes detoxification, abstinence, and recovery; desensitize the drug user to the people, places, or things that trigger use; use of family therapy, group therapy, and residential therapeutic communities; use of pharmacological strategies such as methadone maintenance; promotion of healthier life styles, and use of aftercare support systems, usually utilizing 12-step programs The Treatment and Recovery Continuum Categories - Correct answer-•Nonuse • Moderate and non-problematic use • Heavy and non-problematic use • Heavy use with moderate life problems • Heavy use with serious life problems • Dependency/addiction with life and health problems Case finding and pretreatment - Correct answer-Case finding refers to how treatment programs get clients. For example, the program may have a relationship with law enforcement authorities, public welfare agencies, or managed care companies. At this phase, the case manager tries to remove barriers that would keep the potential client from entering treatment. Examples of barriers to treatment include lack of transportation, childcare, or money Primary treatment - Correct answer-At this phase, the case manager orients the client to the program and may help the client resolve immediate problems that would keep him/her from focusing on treatment. The case manager makes a plan for resource acquisition to meet the client's short-term needs. The case manager also organizes the timing and application of services, provides support during transitions, promotes client independence, intervenes to avoid or respond to crises, and develops external support structures to facilitate community integration Aftercare - Correct answer-Aftercare, sometimes called continuing care, follows discharge. At this phase, case managers help clients transition out of treatment and take responsibility for their lives. The client may need housing, a source of income, or a social support system. Disengagement - Correct answer-Ideally, disengagement can take place over time. The case