Question 1

Describe the stages of treatment when working with a client with a dual diagnosis that includes a SUD.

Accepted Answer

When working with a client who has a dual diagnosis that includes a Substance Use Disorder (SUD), the treatment process typically involves several stages.

The first stage is assessment and diagnosis, where the client's mental health and substance use issues are thoroughly evaluated to determine the extent of their dual diagnosis. This may involve conducting interviews, using standardized assessment tools, and gathering information from the client's medical history.

Once the assessment is complete, the next stage is developing a comprehensive treatment plan. This plan should address both the client's mental health and substance use issues, and may involve a combination of individual therapy, group therapy, medication management, and support groups.

The third stage is the implementation of the treatment plan, which may include detoxification for the substance use disorder, therapy for the mental health issues, and ongoing monitoring and support.

After the initial treatment phase, the client will enter the maintenance phase, where they continue to receive ongoing support and therapy to prevent relapse and maintain their mental health and sobriety.

Throughout the entire treatment process, it's important for the client to receive integrated care that addresses both their mental health and substance use issues simultaneously. This may involve collaboration between mental health professionals, addiction specialists, and other healthcare providers to ensure the client receives comprehensive and effective treatment for their dual diagnosis.

Question 2

Describe the complicated relationship between schizophrenia and SUDs regarding clients with co-occurring disorders.

Accepted Answer

The relationship between schizophrenia and substance use disorders (SUDs) in clients with co-occurring disorders is indeed complicated. Research has shown that there is a high prevalence of SUDs among individuals with schizophrenia, with estimates ranging from 40-50%. This high co-occurrence can be attributed to several factors.

First, individuals with schizophrenia may use substances as a form of self-medication to alleviate their symptoms. This can include using drugs or alcohol to cope with the distressing symptoms of schizophrenia, such as hallucinations or delusions. Additionally, substance use may be a way for individuals with schizophrenia to counteract the side effects of their antipsychotic medications or to alleviate the social isolation and stigma associated with their mental illness.

On the other hand, substance use can also exacerbate the symptoms of schizophrenia and interfere with the effectiveness of treatment. For example, substance use can worsen psychotic symptoms, increase the risk of relapse, and impair cognitive functioning. This can make it more challenging for individuals with co-occurring disorders to adhere to their treatment plans and achieve recovery.

Furthermore, the presence of both schizophrenia and SUDs can complicate the diagnosis and treatment of these individuals. Clinicians may struggle to differentiate between substance-induced symptoms and those caused by schizophrenia, leading to misdiagnosis and inappropriate treatment. Additionally, individuals with co-occurring disorders may face barriers to accessing appropriate care, as mental health and substance use treatment systems are often separate and may not effectively address the complex needs of these individuals.

In light of these complexities, it is crucial for clinicians to take a comprehensive and integrated approach to the treatment of individuals with co-occurring schizophrenia and SUDs. This may involve addressing both disorders simultaneously, providing evidence-based treatments that are tailored to the unique needs of these individuals, and integrating mental health and substance use services to ensure coordinated and effective care. Additionally, support from family members, peer support groups, and community resources can play a vital role in promoting recovery for individuals with co-occurring disorders.

Question 3

The more serious the individual's mental illness, the more

Accepted Answer

A) likely he or she is to fear losing entitlement payments such as Social Security. 
B) receptive he or she will be to an opportunity to supplement his or her income from entitlement payments by working "under the table." 
C) difficult it will be to abstain from alcohol or illicit drugs. 
D) likely it is that he or she will be able to return to society and resume his or her role as a productive citizen. 
A) likely he or she is to fear losing entitlement payments such as Social Security. 
B) receptive he or she will be to an opportunity to supplement his or her income from entitlement payments by working "under the table." 
C) difficult it will be to abstain from alcohol or illicit drugs. 
D) likely it is that he or she will be able to return to society and resume his or her role as a productive citizen. C

Question 4

According to your text, which of the following mental illnesses seems to have the highest lifetime prevalence rate with SUDs?

Accepted Answer

A) Bipolar affective disorder 
B) Schizophrenia 
C) Posttraumatic stress disorder 
D) Antisocial personality disorder 
A) Bipolar affective disorder 
B) Schizophrenia 
C) Posttraumatic stress disorder 
D) Antisocial personality disorder

Question 5

For years it has wrongly been assumed that clients with co-occurring disorders

Accepted Answer

A) who are addicted share the same motivational traits as persons without a psychiatric problem who are addicted. 
B) who abuse chemicals have the same motivational traits as persons who are addicted to chemicals. 
C) who have a job are less motivated to quit than those without a job, since their stress level is higher. 
D) do not abuse chemicals for the same reason(s) over the years. 
A) who are addicted share the same motivational traits as persons without a psychiatric problem who are addicted. 
B) who abuse chemicals have the same motivational traits as persons who are addicted to chemicals. 
C) who have a job are less motivated to quit than those without a job, since their stress level is higher. 
D) do not abuse chemicals for the same reason(s) over the years.

Question 6

Emergency room physicians commonly attribute symptoms in patients with co-occurring disorders to their SUDs with the exclusion of psychiatric disorders.

Accepted Answer

A) True 
 B)False

Question 7

Which of the following is NOT true of clients with co-occurring disorders?

Accepted Answer

A) They appear to experience a different cocaine withdrawal syndrome than other people. 
B) Cocaine abusing patients with schizophrenia are at higher risk for the development of a movement disorder known as tardive dyskinesia. 
C) Illicit substance use is associated with a later onset of the symptoms of schizophrenia. 
D) They use drugs to offset the side-effects of their prescription medications. 
A) They appear to experience a different cocaine withdrawal syndrome than other people. 
B) Cocaine abusing patients with schizophrenia are at higher risk for the development of a movement disorder known as tardive dyskinesia. 
C) Illicit substance use is associated with a later onset of the symptoms of schizophrenia. 
D) They use drugs to offset the side-effects of their prescription medications.

Question 8

It has been estimated that the suicide risk in those with co-occurring disorders is 200-300 times higher than the general population.

Accepted Answer

A) True 
 B)False

Question 9

Discuss how the presence of a traumatic brain injury can complicate the diagnosis and treatment of a client with a substance abuse disorder as well as another mental health condition.

Accepted Answer

The presence of a traumatic brain injury

Question 10

Persons with a bipolar disorder tend to abuse drugs (except alcohol) during

Accepted Answer

A) the depressed phase of their disorder. 
B) the period of stability before the next phase of their disorder. 
C) the manic phase of their disorder. 
D) all phases of their disorder equally. 
A) the depressed phase of their disorder. 
B) the period of stability before the next phase of their disorder. 
C) the manic phase of their disorder. 
D) all phases of their disorder equally.

Question 11

What is described as being essential if a clinician is to accurately distinguish between substance-induced versus actual psychiatric problems?

Accepted Answer

A) Thorough clinical history 
B) Performing the "CAGE" assessment 
C) Detoxification medication 
D) Significant levels of shame in the patient 
A) Thorough clinical history 
B) Performing the "CAGE" assessment 
C) Detoxification medication 
D) Significant levels of shame in the patient

Question 12

Which of the following statements is NOT true about clients with co-occurring disorders?

Accepted Answer

A) They have higher rates of suicide. 
B) They tend to have stronger support networks. 
C) They have increased risk of being homeless. 
D) They are less able to handle personal finances. 
A) They have higher rates of suicide. 
B) They tend to have stronger support networks. 
C) They have increased risk of being homeless. 
D) They are less able to handle personal finances.

Question 13

Available evidence would suggest which of the following about persons with ADHD?

Accepted Answer

A) If their ADHD symptoms are well controlled, they are at a lower risk for CNS stimulant misuse. 
B) They are less prone to alcohol-related disinhibition than normal persons. 
C) The issue of impulsiveness and ADHD are entirely separate conditions and cannot be assumed to be connected. 
D) They tend to remain intoxicated for a longer period of time after consuming a given amount of alcohol when compared with a normal person. 
A) If their ADHD symptoms are well controlled, they are at a lower risk for CNS stimulant misuse. 
B) They are less prone to alcohol-related disinhibition than normal persons. 
C) The issue of impulsiveness and ADHD are entirely separate conditions and cannot be assumed to be connected. 
D) They tend to remain intoxicated for a longer period of time after consuming a given amount of alcohol when compared with a normal person.

Question 14

Which of the following statements is true about the relationship between borderline personality disorder (BPD) and SUDs?

Accepted Answer

A) People with BPD tend to use drugs or alcohol to intensify their emotions. 
B) Substance abuse treatment for people with BPD is quite straightforward. 
C) It is estimated that around 30-50% of people with a SUD will also have BPD. 
D) Relaxation training seems to be the most effective form of treatment for individuals with BPD and SUD. 
A) People with BPD tend to use drugs or alcohol to intensify their emotions. 
B) Substance abuse treatment for people with BPD is quite straightforward. 
C) It is estimated that around 30-50% of people with a SUD will also have BPD. 
D) Relaxation training seems to be the most effective form of treatment for individuals with BPD and SUD.

Question 15

Which of the following statements is NOT true about the treatment of bipolar disorder and SUDs?

Accepted Answer

A) Manic symptoms can be easily mistaken as "progress" by rehabilitation staff, leading to increased rate of premature release from treatment. 
B) It is hypothesized that bipolar patients might use CNS stimulants to simulate the manic phase of their disorder. 
C) The alcohol-dependent patient with bipolar disorder is more likely to use alcohol during the manic phase of the disorder. 
D) Symptoms of bipolar disorder can be exacerbated by the abuse of many compounds. 
A) Manic symptoms can be easily mistaken as "progress" by rehabilitation staff, leading to increased rate of premature release from treatment. 
B) It is hypothesized that bipolar patients might use CNS stimulants to simulate the manic phase of their disorder. 
C) The alcohol-dependent patient with bipolar disorder is more likely to use alcohol during the manic phase of the disorder. 
D) Symptoms of bipolar disorder can be exacerbated by the abuse of many compounds.

Question 16

Adolescent girls with an eating disorder might use

Accepted Answer

A) alcohol to suppress their appetites. 
B) CNS depressants to allow them to avoid becoming manic from the lack of adequate caloric intake. 
C) alcohol to maintain a minimal degree of caloric intake to avoid loss of consciousness from lack of eating. 
D) marijuana to stimulate their appetites. 
A) alcohol to suppress their appetites. 
B) CNS depressants to allow them to avoid becoming manic from the lack of adequate caloric intake. 
C) alcohol to maintain a minimal degree of caloric intake to avoid loss of consciousness from lack of eating. 
D) marijuana to stimulate their appetites.

Question 17

The majority of individuals who would have been referred to a state hospital in the mid-1900s would, at the start of the 21st century, have been

Accepted Answer

A) able to be referred to community treatment centers. 
B) able to call upon large numbers of social support agencies in the community following treatment. 
C) more likely to be homeless or incarcerated. 
D) able to budget their funds without help from representative payees. 
A) able to be referred to community treatment centers. 
B) able to call upon large numbers of social support agencies in the community following treatment. 
C) more likely to be homeless or incarcerated. 
D) able to budget their funds without help from representative payees.

Question 18

The term "dual diagnosis" refers to individuals who have

Accepted Answer

A) an addiction to two or more chemicals at the same time. 
B) a person with both a mental health disorder and a substance use disorder at the same time. 
C) a person who had a substance use disorder, recovered from that condition, and then developed a mental health disorder. 
D) a clearly defined psychiatric condition with proven treatment modalities. 
A) an addiction to two or more chemicals at the same time. 
B) a person with both a mental health disorder and a substance use disorder at the same time. 
C) a person who had a substance use disorder, recovered from that condition, and then developed a mental health disorder. 
D) a clearly defined psychiatric condition with proven treatment modalities.

Question 19

Which of the following statements about persons who suffer from obsessive-compulsive disorder (OCD) is most true?

Accepted Answer

A) They apparently have no preference for a specific compound. 
B) They tend to prefer CNS depressants such as the benzodiazepines. 
C) They tend to prefer CNS stimulants such as methylphenidate or ephedrine. 
D) They tend not to abuse chemicals at all because they fear the loss of control that substance abuse might bring, and persons with OCD are heavily invested in control. 
A) They apparently have no preference for a specific compound. 
B) They tend to prefer CNS depressants such as the benzodiazepines. 
C) They tend to prefer CNS stimulants such as methylphenidate or ephedrine. 
D) They tend not to abuse chemicals at all because they fear the loss of control that substance abuse might bring, and persons with OCD are heavily invested in control.

Question 20

Which of the following serves as a powerful "relapse trigger" for dual diagnosis clients trying to quit abusing substances?

Accepted Answer

A) Untreated psychiatric symptoms 
B) Going to jail 
C) Being with friends 
D) Walking by familiar drinking establishments or places where they formerly used substances 
A) Untreated psychiatric symptoms 
B) Going to jail 
C) Being with friends 
D) Walking by familiar drinking establishments or places where they formerly used substances

Exam 25: The Client With Co-Occurring Disorders: Substance Use Disorders and Mental Illness

Describe the stages of treatment when working with a client with a dual diagnosis that includes a SUD.

Describe the complicated relationship between schizophrenia and SUDs regarding clients with co-occurring disorders.

The more serious the individual's mental illness, the more

According to your text, which of the following mental illnesses seems to have the highest lifetime prevalence rate with SUDs?

For years it has wrongly been assumed that clients with co-occurring disorders

Emergency room physicians commonly attribute symptoms in patients with co-occurring disorders to their SUDs with the exclusion of psychiatric disorders.

Which of the following is NOT true of clients with co-occurring disorders?

It has been estimated that the suicide risk in those with co-occurring disorders is 200-300 times higher than the general population.

Discuss how the presence of a traumatic brain injury can complicate the diagnosis and treatment of a client with a substance abuse disorder as well as another mental health condition.

Persons with a bipolar disorder tend to abuse drugs (except alcohol) during

What is described as being essential if a clinician is to accurately distinguish between substance-induced versus actual psychiatric problems?

Which of the following statements is NOT true about clients with co-occurring disorders?

Available evidence would suggest which of the following about persons with ADHD?

Which of the following statements is true about the relationship between borderline personality disorder (BPD) and SUDs?

Which of the following statements is NOT true about the treatment of bipolar disorder and SUDs?

Adolescent girls with an eating disorder might use

The majority of individuals who would have been referred to a state hospital in the mid-1900s would, at the start of the 21st century, have been

The term "dual diagnosis" refers to individuals who have

Which of the following statements about persons who suffer from obsessive-compulsive disorder (OCD) is most true?

Which of the following serves as a powerful "relapse trigger" for dual diagnosis clients trying to quit abusing substances?

Why Worry About Substance Misuse or Substance Use Disorders

The Nature of the Beast

A Brief Introduction to the Science of Pharmacology

An Introduction to Alcohol: Mans Oldest Recreational Chemical

The Alcohol Use Disorders

Misuse of Barbiturates and Barbiturate-Like Compounds

Misuse of Benzodiazepines and Similar Agents

Misuse of Central Nervous System Stimulants and Stimulant Use Disorders

Cocaine Misuse and Cocaine Use Disorder

Marijuana Misuse and Cannabis Use Disorder

Opioid Use and Misuse

Hallucinogen Misuse

Misuse of Inhalants and Aerosols

The Under-Recognized Problem of Steroid Misuse

Tobacco Products and Tobacco Use Disorder

Over the Counter Analgesics

Chemicals and the Neonate

Gender and Substance Use Disorders

Hidden Faces of Substance Use Disorders

Substance Misuse by Children and Adolescents

Substance Use and Substance Use Disorders in College Students

Substance Use Disorders and the Older Adult

Substance Use Disorders and the Family

Codependency and Enabling

The Biopsychosocial Model of the Substance Use Disorders

The Substance Use Disorders As a Disease of the Human Spirit

The Assessment of Suspected Substance Use Disorders

Intervention

Treatment Settings

Treatment Formats

The Process of Treatment

Pharmacological Interventions for Substance Use Disorders

Relapse and Other Problems Frequently Encountered in Substance Rehabilitation

Support Groups to Promote and Sustain Recovery

Substance Use Disorders and Infectious Disease

The Relationship Between Drugs and Crime

The Debate Over Legalization

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