Behavioral Health and Recovery New Directions
Patient Handout Session 1 – Glossary
Addiction is a primary, chronic, and progressive condition with genetic, psychosocial, and environmental factors influencing its development and outcome. It involves compulsion, loss of control, continued use despite negative consequences, and other symptoms. Addiction is used to describe severe problems related to the compulsive and habitual use of mood-altering substances. It is often called a biopsychosocial disorder.
Cross-tolerance occurs when two drugs have similar physical effects. One is often substituted for the other when it, usually the primary drug of choice, is not available. If the secondary drug has the same drug effect and can keep withdrawal symptoms from occurring, the primary and secondary drugs are cross-tolerant.
Denial is a psychological defense mechanism that protects people from seeing the harsh realities of their addiction.
Drug switching occurs when the user replaces his or her primary drug with a secondary drug that is not cross-tolerant, such as cocaine and alcohol, which have different physical effects.
Neurotransmitters are naturally occurring chemicals in the brain that carry messages between special cells called neurons (which make up nerves).
Physical dependence results from prolonged exposure to a mood-altering drug. The cells in the body become accustomed to the drug and begin to adapt to the presence of that drug. When this happens, the body appears to be in balance only when the drug is present.
Primary drug effects are the effects that a drug has on a person shortly after the drug is taken.
Psychoactive drugs are substances that can change people’s moods or feelings. These include stimulants, depressants (including alcohol), and hallucinogens.
Reverse tolerance, also known as kindling, occurs when the user’s body becomes extremely sensitive to a drug, causing an extreme reaction, such as a seizure or a psychotic episode.
Secondary drug effects are those actions that occur when a person takes a large amount of a drug or takes a drug over a long period of time. For example, secondary cocaine effects include overstimulation, paranoia, agitation and violence, sleep and eating disruptions, and hallucinations.
Substance use disorder is the use of mood-altering drugs that interferes with or has a negative effect on a person’s life. Substance use disorders are ranked from mild to severe, depending on the number of symptoms identified for a person. Severe disorders may also be referred to as addiction.
Tolerance is a process in which the same amount of a drug begins to have less effect or when the amount of a drug needs to be increased to have the same effect as before.
Upper-downer cycle occurs when individuals use both a primary drug and one or more secondary drugs, frequently taking depressants and stimulants together. Because the stimulant and the depressant counteract each other, individuals with large amounts of both drugs may not feel very intoxicated and can consume very large amounts of both drugs, with potentially dangerous effects.
1 Adapted from “Living in Balance”
U002185 (0319) Behavioral Health and Recovery New Directions
Withdrawal symptoms occur when individuals with physical dependence to alcohol or other drugs cut down or stop taking the drug and experience symptoms that are typically the opposite of the effect produced by the drug.
2 Adapted from “Living in Balance” Behavioral Health and Recovery New Directions
Optional Patient Handout Session 1 – Psychedelic and Hallucinogenic Drugs
1. What kinds of psychedelic drugs have you taken? What were your experiences like? ______2. If you’ve used psychedelics, what are some of the ways you’ve found their effects to be unpredictable? ______3. Please check the answer that seems most true: Psychedelic drugs Are influenced by many factors Can heighten feelings and senses Distort senses and the ways people feel and think Can do all of the above 4. What additional factors might influence the effects of a psychedelic drug? ______5. What are some examples of how psychedelics distort senses? ______6. Please check the answer that seems most true: LSD psychedelics Distort and confuse people’s senses Affect mood and emotions Can cause fear, panic, and anxiety Can do all of the above 7. What are some of the ways in which LSD can distort brain messages about the senses? ______
1 Adapted from “Living in Balance”
Behavioral Health and Recovery New Directions
8. Have you ever had a bad trip? If so, what was it like? ______9. Please check the answer that seems most true: Amphetamine-related psychedelics Have properties of both psychedelics and stimulants Can promote anxiety and agitation Can promote hallucinations Can do all of the above 10. Have you ever taken ecstasy or a related drug? If so, did you take it alone or with other drugs? ______11. Have you ever known people who took “too much” ecstasy or related drugs. If so, what happened? ______12. Please check the answer that seems most true: PCP Can promote a disconnection of the body and the mind Can cause a mild euphoric effect Can produce frightening hallucinations Can promote violent behaviors Can do all of the above 13. What has your experience been with PCP? ______14. What do you think happens when the mind and body are temporarily disconnected? ______
2 Adapted from “Living in Balance”
Behavioral Health and Recovery New Directions
15. Please check the answer that seems most true: Marijuana Can produce a psychedelic effect Can cause a depressant effect Can cause some stimulant effects Can do all of the above 16. If you have smoked marijuana, did you use it in combination with other drugs? If so, did you have a favorite combination with other drugs? ______17. If you used marijuana or spice, what effects were you looking for when you smoked it? ______
3 Adapted from “Living in Balance”
Behavioral Health and Recovery New Directions
Patient Handout Session 1 – Self-Assessment Exercise The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the primary guide used by health care professionals for the diagnosis of substance use disorders. Its fifth edition, DSM-5, rates substance use disorders in terms of severity, from mild to severe. According to the DSM, a substance use disorder is defined as a pattern of alcohol or other drug use in which an individual continues to use despite problems caused by that drug use. The following series of questions will help you better understand the severity of problems and physical symptoms related to your past use of alcohol and other drugs.
Note: You will need to look inside of yourself and honestly address the ways that substance use has affected your life. This will take courage, but this understanding can help you take back control of your life. You don’t need to share this assessment with others unless you wish to.
Exercise
Please respond “yes” or “no” to the following statements. If yes, please provide examples:
1. Sometimes I have use more substances and for longer periods than I meant to. ______
2. I have tried (or wanted to try) to cut down or control the amount of my alcohol or other drug use. ______
3. I have spent a great amount of time getting alcohol or other drugs, using them, and recovering from their effects. ______
4. I have experienced many cravings and urges to use alcohol or other drugs. ______
5. My home, work, or school life has been negatively affected by my use. ______
1 Adapted from “Living in Balance” Behavioral Health and Recovery New Directions
6. Even though my use has caused problems in relationships, I continue to use. ______
7. Because of my alcohol or other drug use, I have given up or reduced my involvement in important social, occupational, or recreational activities. ______
8. Despite realizing that my substance use was putting me in danger, I continued to use. ______
9. Despite realizing that my alcohol or other drug use was causing physical and psychological problems (or making such problems worse), I continued to use. ______
10. I consistently need more of the substance to get the same effect. ______
11. I have experienced withdrawal symptoms after stopping my use. ______
The previous self-assessment questions are adapted from the diagnostic criteria developed by the American Psychiatric Association (APA).
These questions helped you identify the type and severity of problems and physical symptoms related to your past use of alcohol or other drugs. The DSM says that agreement with four to five of these statements suggests that the individual meets the criteria for a moderate substance use disorder. Generally a higher level of problems related to substance use means a higher level of severity of the substance use disorder.
2 Adapted from “Living in Balance” Behavioral Health and Recovery New Directions
Optional Patient Handout Session 1 – Stimulant Drugs
1. Please check the answer that seems most true: Stimulants can make people feel… alert and awake excited and energized tense and agitated violent and paranoid all of the above
2. What stimulants, if any, have you routinely used? ______3. What effects were you looking for when you used stimulants? ______4. If you’ve used stimulants, what different effects have you noticed when taking these drugs in different ways (shooting, smoking, snorting, or eating)? ______5. Have you ever taken a large dose of a weaker stimulant because you wanted a strong effect? If so, what happened to you when you did? ______
6. If you’ve used stimulants, have you experienced a very rapid heartbeat? Yes No
7. If you’ve used stimulants, did you experience periods of physical excitement, especially uncontrollable physical activity? If so, what did it feel like?
1 Adapted from “Living in Balance”
Behavioral Health and Recovery New Directions
______8. After taking stimulants, did you ever experience inner tension and anxiety? If yes, please explain. ______9. What kinds of stimulant-induced medical effects were you already aware of? ______10. If you’ve used stimulants, how did they affect your mood when you were high? ______11. Have you ever stopped taking the drug and then felt depressed and anxious? ______
12. Have you ever experienced any of the altered mental states we’ve discussed because of stimulant use? Yes No
13. If you’ve used stimulants, was there ever a time when using them did not make your mood better? ______14. Can you describe an episode of sensory overload caused by stimulants? If yes, please explain. ______
2 Adapted from “Living in Balance”
Behavioral Health and Recovery New Directions
______15. What kinds of personality changes have you experienced after using stimulants? What have other people said about those changes? ______16. If you’ve used stimulants, have you experienced any stimulant-induced hallucinations or illusions? If so, what were the circumstances? ______17. If you have, what hallucinations or illusions did you experience? ______18. Have you ever become violent while using stimulants? If yes, please explain. ______19. Have you, or others you’ve known, experienced stimulant psychosis? If yes, please explain. ______20. While using stimulants, have you ever felt that bugs were crawling on or under your skin? ______21. Did you realize this was a type of hallucination that was felt rather than seen or hear? If yes, please explain. ______
3 Adapted from “Living in Balance”
Behavioral Health and Recovery New Directions
22. If you have used stimulants, what is the most severe symptom that you’ve experienced during withdrawal? ______23. How long did the withdrawal last? ______24. How have you tried to cope with stimulant withdrawal symptoms? ______
4 Adapted from “Living in Balance”
Behavioral Health and Recovery New Directions
Optional Patient Handout Session 1 – Depressant Drugs
1. Has your ability to think clearly ever been impaired by depressants? Yes No
2. If you have used depressants, what kinds and what amounts would you regularly use during a one-week period? ______
3. What effect were you looking for when you took depressants? ______
4. Please check the answer that seems most true: Opioids Reduce or stop pain Reduce anxiety Cause a surge of pleasure Cause constipation Do all of the above
5. Have you ever used opioids? If so, did you use them in combination with other drug? ______
6. Have you ever taken opioids for pain or a bad cough? If so, did they make you high? ______7. Have you ever experienced opioid withdrawal symptoms? Yes No
1 Adapted from “Living in Balance”
Behavioral Health and Recovery New Directions
8. Please check the answer that seems most true: The group of drugs called sedative-hypnotics includes Alcohol (such as wine, beer, and vodka) Prescription sedatives (such as Valium and Xanax) GH B (liquid ecstasy) All of the above
9. If you have used sedative-hypnotics, which ones did you regularly use? ______
10. Have you ever used sedative-hypnotics to help you sleep? To calm you down? Or just to get high? If so, which ones have you used for these purposes? ______
11. Have you ever done things under the influence of alcohol or other drugs that you wouldn’t normally do? Yes No
12. Have you ever consumed alcohol and became agitated, explosive, and aggressive, instead of calm and relaxed? If so, please explain. ______
13. Have you ever experienced memory gaps or foggy memory because of sedative-hypnotic use? If yes, please explain. ______
2 Adapted from “Living in Balance”
Behavioral Health and Recovery New Directions
14. Have you ever experienced agitation, insomnia, nausea, or tremors after discontinuing alcohol or other drug use? Yes No
15. Have you ever experienced withdrawal from sedative-hypnotics such as alcohol? If so, what happened? ______
16. Have you ever used other drugs during withdrawal from sedative-hypnotics? If so, what happened? ______
3 Adapted from “Living in Balance”