NUR 668 STUDY GUIDE
Substance Use Disorders (SUDs) - Answers --Hallmark symptoms
• Behavioral, physical, & psychological dependence
-Behavioral dependence refers to substance-seeking activities & evidence of use
patterns
-Physical dependence refers to the physiologic effects of substance use
-Psychological dependence refers to the continuous or intermittent craving for the
substance
Dx of SUD - Answers --Dx of SUD indicated when:
• 2+ symptoms within 12 months
-Physical Symptoms
• Tolerance
Withdrawal (does not apply to inhalants and hallucinogens)
-Behavioral Symptoms
• Craving to use
• Using more than intended
• Stopping or reducing use is difficult
• Spending significant time devoted to the substance (using, obtaining, recovering)
• Using despite acknowledging associated health problems (physical, mental)
-Psychological Symptoms
• Using despite social, occupational, or other adverse consequences
• Neglecting other responsibilities because of use
• Neglecting other activities because of use
• Indulging in risky or dangerous behaviors or situations because of use
SUD Severity - Answers --eleven features to determine the severity of SUD
• hazardous use
• social or interpersonal problems related to use
• neglected major roles to use
• withdrawal
• tolerance
• used larger amounts/longer
• repeated attempts to control use or quit
• much time spent using
• physical or psychological problems related to use
• activities are given up to use
• craving
-Mild SUD: 2 or 3 of the features
-Moderate SUD: 4 or 5 of the features without loss of control
-Severe SUD: >6 of the features with loss of control
, other specifiers relate to SUDs - Answers --Early remission: criteria for SUD previously
met, but not for last 3 months.
-Sustained remission: criteria for SUD previously met, but not for last 12+ months.
-Controlled environment: substance access is restricted.
-Maintenance therapy: taking medication therapy to treat/reduce use.
Substance-induced disorders: Substance Intoxication - Answers --disturbances in
perception, wakefulness, attention, thinking, judgment, psychomotor behavior, &
interpersonal behavior.
-Acute may have different symptoms than chronic intoxication.
-Acute intoxication should only be used as the main dx when intoxication occurs without
a persistent SUD.
Substance-induced disorders: Substance Withdrawal - Answers --General features:
• development of a substance-specific behavioral change, with physical & psychological
symptoms, that is due to the cessation or intake reduction of a substance.
-usually, but not always, associated with a SUD.
Substance-induced disorders: Substance-Induced Mental Disorder - Answers --
potentially severe CNS syndromes that develop because of substance abuse, meds, or
toxins.
-diagnosed when:
• symptoms represent a mental disorder presentation
• evidence the substance used is capable of causing the disorder & the disorder
developed within a month of using the substance
• evidence the disorder is not likely explained better by the dx of an independent mental
condition
• disorder does not occur exclusively during delirium
• disorder causes significant social, occupational, or other impairment in functioning
Substance-induced disorders: Comorbidity - Answers --occurrence of 2+ psychiatric
disorders at the same time
-People seeking tx for alcohol, cocaine, or opioid dependence have a high prevalence
of having additional psychiatric disorders
• Specifically, antisocial personality disorder is one of the most common comorbidities
associated with illicit drug use disorder
Co-Occurring Disorders (COD): - Answers --when 1+ psychiatric disorders co-occur
with a substance use/dependency disorder
Tolerance - Answers -a state of adaption in which exposure to a drug induces changes
that result in a reduction of the drug's effects over time
Physical Dependence - Answers -A state of adaption manifested by a drug class
specific withdrawal syndrome that can be produced by quick cessation of the drug level
or by giving a drug antagonist
Substance Use Disorders (SUDs) - Answers --Hallmark symptoms
• Behavioral, physical, & psychological dependence
-Behavioral dependence refers to substance-seeking activities & evidence of use
patterns
-Physical dependence refers to the physiologic effects of substance use
-Psychological dependence refers to the continuous or intermittent craving for the
substance
Dx of SUD - Answers --Dx of SUD indicated when:
• 2+ symptoms within 12 months
-Physical Symptoms
• Tolerance
Withdrawal (does not apply to inhalants and hallucinogens)
-Behavioral Symptoms
• Craving to use
• Using more than intended
• Stopping or reducing use is difficult
• Spending significant time devoted to the substance (using, obtaining, recovering)
• Using despite acknowledging associated health problems (physical, mental)
-Psychological Symptoms
• Using despite social, occupational, or other adverse consequences
• Neglecting other responsibilities because of use
• Neglecting other activities because of use
• Indulging in risky or dangerous behaviors or situations because of use
SUD Severity - Answers --eleven features to determine the severity of SUD
• hazardous use
• social or interpersonal problems related to use
• neglected major roles to use
• withdrawal
• tolerance
• used larger amounts/longer
• repeated attempts to control use or quit
• much time spent using
• physical or psychological problems related to use
• activities are given up to use
• craving
-Mild SUD: 2 or 3 of the features
-Moderate SUD: 4 or 5 of the features without loss of control
-Severe SUD: >6 of the features with loss of control
, other specifiers relate to SUDs - Answers --Early remission: criteria for SUD previously
met, but not for last 3 months.
-Sustained remission: criteria for SUD previously met, but not for last 12+ months.
-Controlled environment: substance access is restricted.
-Maintenance therapy: taking medication therapy to treat/reduce use.
Substance-induced disorders: Substance Intoxication - Answers --disturbances in
perception, wakefulness, attention, thinking, judgment, psychomotor behavior, &
interpersonal behavior.
-Acute may have different symptoms than chronic intoxication.
-Acute intoxication should only be used as the main dx when intoxication occurs without
a persistent SUD.
Substance-induced disorders: Substance Withdrawal - Answers --General features:
• development of a substance-specific behavioral change, with physical & psychological
symptoms, that is due to the cessation or intake reduction of a substance.
-usually, but not always, associated with a SUD.
Substance-induced disorders: Substance-Induced Mental Disorder - Answers --
potentially severe CNS syndromes that develop because of substance abuse, meds, or
toxins.
-diagnosed when:
• symptoms represent a mental disorder presentation
• evidence the substance used is capable of causing the disorder & the disorder
developed within a month of using the substance
• evidence the disorder is not likely explained better by the dx of an independent mental
condition
• disorder does not occur exclusively during delirium
• disorder causes significant social, occupational, or other impairment in functioning
Substance-induced disorders: Comorbidity - Answers --occurrence of 2+ psychiatric
disorders at the same time
-People seeking tx for alcohol, cocaine, or opioid dependence have a high prevalence
of having additional psychiatric disorders
• Specifically, antisocial personality disorder is one of the most common comorbidities
associated with illicit drug use disorder
Co-Occurring Disorders (COD): - Answers --when 1+ psychiatric disorders co-occur
with a substance use/dependency disorder
Tolerance - Answers -a state of adaption in which exposure to a drug induces changes
that result in a reduction of the drug's effects over time
Physical Dependence - Answers -A state of adaption manifested by a drug class
specific withdrawal syndrome that can be produced by quick cessation of the drug level
or by giving a drug antagonist
