Substance Use Disorder (SUD) Basics
A chronic condition characterized by problematic substance use that causes significant impairment or distress.
Substance Use Disorder (SUD)?
The brain chemical strongly associated with reward, reinforcement, and motivation in addiction.
What is dopamine?
A clinical presentation where an individual meets criteria for both a substance use disorder and another psychiatric condition, requiring assessment of how each condition impacts the other.
What are co-occurring disorders (dual diagnosis)
A client states, “I can stop anytime, I just don’t want to right now,” but continues using daily and experiencing consequences.
What is denial/minimization
A medication commonly used to treat opioid use disorder by reducing withdrawal and cravings.
What is Methadone or Buprenorphine?
A pattern of needing more of a substance over time to achieve the same effect.
What is tolerance?
The brain system involved in emotional responses, stress, and reward learning that is affected by addiction.
What is the limbic system?
A trauma-related symptom where a person attempts to avoid thoughts, feelings, memories, people, or situations connected to a distressing event, which may increase reliance on substances as a coping strategy.
What is experiential avoidance?
A client reports suicidal thoughts, substance use, and access to weapons. The priority concern is this.
What is immediate safety/risk assessment
A therapy approach that focuses on identifying distorted thoughts and replacing them with healthier thinking patterns.
What is Cognitive Behavioral Therapy (CBT)?
A clinician assesses family history, genetics, environment, trauma, and social supports when completing this type of assessment.
What is a biopsychosocial assessment?
The brain region responsible for decision-making, impulse control, and judgment that is impacted by chronic substance use.
What is the prefrontal cortex?
A treatment approach that recognizes substance use and mental health symptoms interact with each other and are addressed simultaneously rather than through separate systems of care.
What is integrated treatment for co-occurring disorders?
A client receiving medication for opioid use disorder states, “I’m not really in recovery because I’m still taking medication.” The clinician explains that recovery is based on improved functioning, reduced harm, and meeting personal goals rather than simply being medication-free.
Recovery understanding of Medication for opiod use disorder
A counseling method based on expressing empathy, developing discrepancy, and supporting self-efficacy.
What is Motivational Interviewing?
A pattern where substance use begins in adolescence, increases over time, and becomes associated with worsening functioning.
What is a progressive course of addiction?
The process where repeated substance exposure changes brain functioning and increases vulnerability to relapse.
What is neuroadaptation?
A client reports at least two weeks of persistent depressed mood most of the day, diminished interest or pleasure in activities, significant sleep disturbance, fatigue, feelings of worthlessness, and impaired concentration. These symptoms are present independent of substance intoxication or withdrawal and are causing clinically significant distress and functional impairment.
Major Depressive Disorder
A client has multiple relapses, unstable housing, and limited supports. A clinician focuses on strengths, engagement, and small achievable goals.
What is a recovery-oriented, person-centered approach
A stage of behavior change in which a client is aware their substance use is problematic, is actively weighing the pros and cons of change, but has not yet committed to taking action.
What is the contemplation stage of the Stages of Change (Transtheoretical Model)?
The DSM-5 severity levels for SUD are based on the number of criteria met. what are the levels of criteria
What are mild (2–3), moderate (4–5), and severe (6+) criteria?
A client experiences an intense urge to use after returning to a neighborhood where they previously used substances, even though they had no planned intention to relapse. The environment activates memories, emotions, and learned associations connected to past use.
What is a conditioned trigger/cue (environmental cue)
A client presents with a long-standing pattern of unstable relationships, intense fear of abandonment, emotional dysregulation, impulsive behaviors, chronic feelings of emptiness, and a history of self-harm. The client also has a substance use disorder, and substances are often used to cope with overwhelming emotions.
What is Borderline Personality Disorder (BPD) with a co-occurring Substance Use Disorder?
A client with multiple treatment attempts presents with opioid use disorder, PTSD, borderline personality traits, repeated self-harm behaviors, unstable relationships, and intense emotional reactions. The client frequently leaves treatment when feeling rejected or misunderstood. The clinician prioritizes maintaining the therapeutic relationship, validating emotions, increasing coping skills, and reducing high-risk behaviors. what is the appropriate treatment approach
What is a dialectical behavior therapy (DBT) / trauma-informed approach
A treatment principle that emphasizes coordinated care addressing substance use, mental health symptoms, and psychosocial functioning simultaneously rather than sequentially or in isolation.
What is integration?