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SUBSTANCE CLASSES. Major Stimulants Minor Stims Depressants Alcohol Inhalants Hallucinogens Cannabinoids Opioids. SUBSTANCE RELATED DISORDERS. DSM-IV CRITERIA FOR SUBSTANCE DEPENDENCE - need at least 3 of the following within 12-month period
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SUBSTANCE CLASSES • Major Stimulants • Minor Stims • Depressants • Alcohol • Inhalants • Hallucinogens • Cannabinoids • Opioids
SUBSTANCE RELATED DISORDERS • DSM-IV CRITERIA FOR SUBSTANCE DEPENDENCE • - need at least 3 of the following within 12-month period • - symptoms present at least 1 month or occur repeatedly over time • Tolerance (physical dependence present) • Withdrawal • Substance taken in larger amounts or over a longer period than intended (loss of control) • Persistent desire, or unsuccessful efforts, to cut down or control substance use
SUBSTANCE RELATED DISORDERS • CRITERIA FOR SUBSTANCE DEPENDENCE • Much time spent in activities needed to obtain, use, and recover from the substance • Important social, family, school, work, or recreational activities are given up or reduced because of the substance use • Substance use is continued despite knowing that physical or psychological problems are likely to be caused or exacerbated by the substance
SUBSTANCE RELATED DISORDERS • SUBSTANCE DEPENDENCE – Course Specifiers • Early full remission: > 1 month < 12 months • Early partial remission: > 1 month < 12 months; one or more criteria for dependence or abuse met, but full criteria not met • Sustained full remission: > 12 months • Sustained partial remission: > 12 months, but 1 or more criteria met • On agonist therapy • In controlled environment
SUBSTANCE RELATED DISORDERS • DSM-IV CRITERIA FOR SUBSTANCE ABUSE • - need at least 1 of the following within 12-month period • - symptoms have never met criteria for Dependence for this class of substance • Failure to fulfill role obligations at school, work, or home • Recurrent use in physically hazardous situations • Recurrent legal problems • Continued use despite persistent social, interpersonal problems
SUBSTANCE RELATED DISORDERS • Intoxication (see table on p. 193) • Withdrawal • Polysubstance Dependence
SUBSTANCE RELATED DISORDERS • Assessment Tools • Semi-structured interviews / intakes • Structured Clinical Interviews for the DSM (SCID) • Survey instruments (e.g., AUI) • Brief Screens (e.g., CAGE)
SUBSTANCE RELATED DISORDERS • Assessment Tools • Alcohol Use Inventory (AUI) • AUDIT • DRINC-2R – Drinker Inventory of Consequences • MAST; DAST • CAGE