Behav. Sci. Addiction 2

Question 1

abstinence

Answer 1

must stop all drugs, not use at all ever, 12 step model (example)

Question 2

what are the stages of change?

Answer 2

precontemplation, contemplation, preparation, action, maintenance

Question 3

precontemplation to contemplation

Answer 3

consciousness raising, emotional arousal/dramatic release, social liberation/environmental reevaluation

Question 4

contemplation to preparation

Answer 4

self-reevaluation

Question 5

preparation to action

Answer 5

self-liberation/commitment

Question 6

action to maintenance

Answer 6

countering/counterconditioning, environmental control, rewards, helping relationships

Question 7

what is the goal of harm reduction?

Answer 7

• achieve a change in the patient’s maladaptive addictive behavior and to gain a remission of the substance use disorder
• abstinence approaches are proven therapeutic
• harm reduction ones as well

Question 8

alcohol and smoking screening and intervention ranked higher than what for awesome preventive services?

Answer 8

screenign for BP, cholesterol, breast, cervical, colon cancer, adult flu, pneumonia, tetanus immunization, sexually transmitted infection screening, all nutritional advice/supplementation, osteoporosis, vision and hearing screen

Question 9

what do smokers die of?

Answer 9

50% from tobacco-caused disease

• lung cancer, COPD (die 14 yr early), 2X death from stoke/CAD
• also: oral, esophagus, cervix, bladder, pancreas

Question 10

pharmacotherapy for cessation of smoking

Answer 10

goal is to describe the currently available drugs used to increase smoking cessation rates

Question 11

nicotine patch/gum

Answer 11

harm reduction, replace harmful inhaled tobacco smoke with nicotine (full agonist), prevents withdrawal, easier withdrawal

Question 12

buproprion

Answer 12

antidepressant

• blocks neuronal reuptake/recycling of NE and DA improving alertness, attention, concentration, motivation
• by blocking DA specifically, desensitize DA reward circuitry so cigarette based activation is not missed by the patients (as well as above actions)
• aids in smoking cessation

Question 13

side effects of buproprion

Answer 13

• psychiatric worsening, agitation, depression, anxiety suicidality (if less than 25)
• induction of seizures in epilepsy or eating disorder
• dry mouth, insomnia, nausea, tremor, rash

Question 14

varenicline mechanism

Answer 14

partial nicotine receptor agonist (replacing full agonist nicotine) - avoids most withdrawal

Question 15

side effects of varenicline

Answer 15

insomnia, vomiting, constipation, headache, abnormal dreams

-also agitation, depression, psychosis, suicidal behavior

Question 16

what is the most effective treatment for smoking cessation?

Answer 16

varenicline + higher NRT (nicotine replacement therapy)