Template for Assessing a Client s Substance Use Developed by Cynthia Glidden-Tracey, Ph.D.
|
|
|
- Jared Boyd
- 8 years ago
- Views:
Transcription
1 Template for Assessing a Client s Substance Use Developed by Cynthia Glidden-Tracey, Ph.D. Client s Name Date and circumstances of Assessment a. Client s Reason for Seeking Assessment b. Substance Use History (Note: AOD is an acronym for Alcohol and Other Drugs) Category of Drug First use? Pattern of use over time? Frequency of use in past month? Date/Amount of most recent use? Alcohol Caffeine Marijuana/Cannabis CNS Stimulants or Uppers e.g. Cocaine, Ritalin Methamphetamine Anxiolytics/Sedatives/Hypnotics ContinuingEdCourses.Net Page 1
2 Category of Drug or Downers Barbituates Secobarbital/ Quaaludes Benzodiazepines Valium (diazepam) Xanax (alprazolam) Rohypnol First use? Pattern of use over time? Frequency of use in past month? Date/Amount of most recent use? Opiates or Painkillers Heroin/Morphine/ Methadone/Oxycodone Hallucinogens LSD/PCP/Ecstasy Inhalants/aerosols Steroids Cigarettes/Nicotine/Tobacco Have you ever used any of these drugs in combination? ContinuingEdCourses.Net Page 2
3 c. Physical Consequences (past/present) d. Psychological symptoms (past/present/aod cause?) Headaches a,b,h / Concentration difficulties a,c,e,f,g,h / / Nausea a,c,f,g / Memory loss/lapses / / Nosebleeds / Disorganized thinking a,b,g,i / / Tolerance a,b,c,d,e,f,g / Hallucinations a,d,g / / Sweating a,c,d,f,g / Bad dreams b,c / / Increased appetite b,c,e / Flashbacks d / / Fatigue c,h / Irritability b,e,h / / Vomiting a,c,f,g / Anxiety a,b,d,e,g,h / / Using to avoid / Restlessness b,e,h / / withdrawal symptoms Rapid pulse rate a,b,d,g,h Low mood b,c,e,f,h / / Decreased heart rate c,e / Depression d / / Chronic cough / Mood changes a,g / / Hand tremors a,b,d,g,h,i / Sedation a,g / / Insomnia a,cb,c,e,f,g,h / Suicidal thoughts / / Hypersomnia a,c / Suicidal gestures / / Hangovers Anger b,e,i / / Blackouts a / Paranoia c,d / / Passing out/stupor a,c,f,g,i / Homicidal thoughts / / Psychomotor agitation a,c,d,f,g,h / Violent behaviors / / Psychomotor retardation c,f,i / Inability to care for self / / Seizures a,c,d,g / Other / / Muscle aches f /weakness c,i / Lacrimation/rhinorrhea f / Diarrhea f / Yawning f / Fever b,f / Superscripts indicate the category of substance with which each symptom is associated in the DSM-5: a alcohol, b cannabis, c stimulants, d hallucinogens, e tobacco/nicotine, f opioids, g sedative/hypnotic/anxiolytics, h caffeine, i inhalants ContinuingEdCourses.Net Page 3
4 e. Medical concerns f. Treatment history Past Problem(s)? Outpatient therapy (incidence/outcomes) For substance use? For mental health concerns? Medications? (prescription or OTC) Other? Were providers aware of your AOD use? Current Problem(s)? Inpatient treatment/hospitalization (incidence/outcomes) For substance use? For mental health concerns? Medications? (prescription or OTC) Other? Were providers aware of your AOD use? (For women) Are you Pregnant? (If Pregnant) Are you receiving prenatal care? g. Environmental factors Residential situation Anyone else living with you? Anyone else in your residence an alcohol or other drug (AOD) user? Is your living situation safe? Social support system Whom do you count on for support? ContinuingEdCourses.Net Page 4
5 Anyone in your social network an AOD user? Has your AOD use interfered with any of your relationships with people? Family and Developmental History and Cultural Factors Messages received growing up about AOD use? Anyone in your family an AOD user? Has your AOD use affected your family? How so? Any mental health concerns in your family? Significant events during childhood? Perspective on AOD use in the culture(s) with which you identify? Educational/Vocational factors Relevant history (if student, indicate status: Full-time/Part-time) Has your AOD use interfered with any of your school/work obligations or goals? Financial factors How much would you estimate you spend on alcohol and/or drugs per week? Has your AOD use contributed to any financial problems? ContinuingEdCourses.Net Page 5
6 Transportation factors How did you get here today? Do you have a valid driver s license? Do you have access to a car or other vehicle? Have you ever driven under the influence of alcohol or drugs? If so, how many times in the past year? Legal concerns Ever been arrested? Number of times/reasons? Charges/Disposition? Any other legal issues? ContinuingEdCourses.Net Page 6
7 h. Motivation for treatment Do you think you have a drug or alcohol problem? Do you plan to stop or reduce your AOD use? If yes, how confident are you that you will be able to do so? Do you think you need treatment? Has anyone urged or required you to get an assessment or treatment? Who? Do you have any questions about AOD assessment and/or treatment? ContinuingEdCourses.Net Page 7
8 Therapist s signature Date Supervisor s signature Date (if required) ContinuingEdCourses.Net Page 8
Alcohol Use Scale-Revised {AUS-R)
FORM C2 Alcohol Use Scale-Revised {AUS-R) Client name: ~ Rater: Date: INSTRUCTIONS This scale pertains to your client's use of alcohol over the past 6 months. Rate the worst period of alcohol use during
Opioid Agreement for Center for Pain Management S.C.
Opioid Agreement for Center for Pain Management S.C. Patient Name: DOB: I am the patient named above. I have agreed to use pain medication as part of my treatment for chronic pain. I understand that these
SUBSTANCE USE QUESTIONNAIRE. Name: Date: Ever Used? Ever a Problem? Age of 1 st Use When last used?
SUBSTANCE USE QUESTIONNAIRE Name: Date: Part I. Substance Abuse History Ever Used? Ever a Problem? Age of 1 st Use When last used? Alcohol Yes No Yes No Barbiturates or Yes No Yes No other sleeping pills
Levels of Care Guide
Levels of Care Guide What Type of Drug Rehab Is Right for You? A Guide to Understanding Levels of Care in Addiction Treatment Looking for help for yourself or a loved one? Congratulations! You are on the
CO-OCCURRING DISORDERS. Michaelene Spence MA LADC 8/8/12
CO-OCCURRING DISORDERS Michaelene Spence MA LADC 8/8/12 Activity Chemical Health? Mental Health? Video- What is Addiction HBO Terminology MI/CD: Mental Illness/Chemical Dependency IDDT: Integrated Dual
Feeling that you have to use the drug regularly this can be daily or even several times a day. Failing in your attempts to stop using the drug
Drug addiction Definition Drug addiction is a dependence on an illegal drug or a medication. When you're addicted, you may not be able to control your drug use and you may continue using the drug despite
Kanawha Valley Fellowship Home
Kanawha Valley Fellowship Home Client Assessment Form Date: Time: Assessment Taken Caller s Name: Agency (if applicable) Address: County: Relationship to Patient: Phone # Client s Name: Age: D.O.B.: Current
General Information. Age: Date of Birth: Gender (circle one) Male Female. Address: City: State: Zip Code: Telephone Numbers: (day) (evening)
Kelly Bernstein, MS, LCDC, LPC Medical Center Psychological Services 7272 Wurzbach Road, Suite 1504 San Antonio, Texas 78240 Office: (210) 522-1187 Fax: (210) 647-7805 Functional Assessment Tool The purpose
And, despite the numbers, for many people, the Facts About Drugs are not clear.
According to the National Survey on Drug Use and Health (NSDUH), an estimated 20 million Americans aged 12 or older used an illegal drug in the past 30 days. This estimate represents 8% percent of the
opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 Ranked #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380
opiates alcohol 27 opiates and alcohol 30 April 2016 drug addiction signs 42 ed #1 123 Drug Rehab Centers in New Jersey 100 Top 10 380 effects of alcohol in the brain 100 Top 30 698 heroin addiction 100
Prescription Drug Abuse
Prescription Drug Abuse Introduction Most people take medicines only for the reasons their health care providers prescribe them. But millions of people around the world have used prescription drugs for
What Is a Withdrawal Syndrome?
Chapter 8 What Is a Withdrawal Syndrome? T Well, I ve been 7 days without Vicodin after taking 10-18 pills per day for about 2 years. It was not fun. Sweats, bad stomach problems, depression, pain, and
34 th Judicial District Substance Abuse Study Guide
34 th Judicial District Substance Abuse Study Guide What is Drug Addiction? 2 It is characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that
Santa Fe Sage Counseling Center
Couple/Family Client Intake Date: Names: Partner/Parent/Child (circle one) Partner/Parent/Child (circle one) Parent/Child (circle one) Parent/Child (circle one) Parent/Child (circle one) Insurance ID #:
Assessment and Management of Opioid, Benzodiazepine, and Sedative-Hypnotic Withdrawal
Assessment and Management of Opioid, Benzodiazepine, and Sedative-Hypnotic Withdrawal Roger Cicala, M. D. Assistant Medical Director Tennessee Physician s Wellness Program Step 1 Don t 1 It is legal in
Drug addiction. These factors increase the likelihood of your having an addiction to a legal or an illegal drug:
Drug addiction You may be hooked emotionally and psychologically. You may have a physical dependence, too. If you're addicted to a drug whether it's legal or illegal you have intense cravings for it. You
Methamphetamine. Like heroin, meth is a drug that is illegal in some areas of the world. Meth is a highly addictive drug.
Methamphetamine Introduction Methamphetamine is a very addictive stimulant drug. People who use it can form a strong addiction. Addiction is when a drug user can t stop taking a drug, even when he or she
How To Treat A Drug Addiction
1 About drugs Drugs are substances that change a person s physical or mental state. The vast majority of drugs are used to treat medical conditions, both physical and mental. Some, however, are used outside
Atlanta Center For Positive Change Karen Kallis, M.Ed., LAPC, NCC 333 Sandy Springs Circle, Atlanta, GA 30328
Atlanta Center For Positive Change Karen Kallis, M.Ed., LAPC, NCC 333 Sandy Springs Circle, Atlanta, GA 30328 An important part of the helping relationship is understanding the expectations of the relationship.
Benzodiazepines. Understanding psychiatric medications. Information for consumers, families and friends. Titles in the
Titles in the Understanding psychiatric medications series include: Antidepressants Antipsychotics Benzodiazepines Mood Stabilizers Understanding psychiatric medications Benzodiazepines For more information
Addiction Medical Clinic LLC
Chief Complaint and Symptom: Substance Abused: Current amount per use and Frequency/day used: Last use: Date & Time: Route: Current and in the past: Duration of Use: Both Current and Lifetime: Have you
Withdrawal Symptoms: How Long Do They Last?
Withdrawal Symptoms: How Long Do They Last? Posted by First Step Medical Detox on November 24, 2015 When considering stopping drugs or alcohol, many addicts and alcoholics are concerned about the withdrawal
JACKSON RECOVERY CENTERS Initial Substance Abuse Assessment Form. Substance used: Method: Age started: Last used: Frequency/progression of use:
JACKSON RECOVERY CENTERS Initial Substance Abuse Assessment Form PRESENTING PROBLEM DRUGS OF CHOICE Substance used: Method: Age started: Last used: Frequency/progression of use: Indicators of Addiction:
Substance Abuse Protracted Withdrawal. Kate Speck, PhD, MAC, LADC
Substance Abuse Protracted Withdrawal Kate Speck, PhD, MAC, LADC 1 Overview 1. Acute and Protracted Withdrawal 2. Withdrawal Potential 3. Recovery Reinforcers 2 Addiction Addiction is a primary, chronic,
Young Adult Prescription Drug Use and Co-Occurring Mental Health Disorders Presenter: Jonathan Beazley, LADC LMFT Moderator: Cindy Rodgers
Young Adult Prescription Drug Use and Co-Occurring Mental Health Disorders Presenter: Jonathan Beazley, LADC LMFT Moderator: Cindy Rodgers Audio will begin at 2:00 PM ET. You can listen through your computer
Routes of Use. Overdose and EMS. Injection. Ingestion. Inhalation. Absorption 1/2/2013. Injection Ingestion Inhalation Absorption.
Routes of Use Overdose and EMS Injection Ingestion Inhalation Absorption Shaun Pitts, AEMT Venomous bites Common drugs Heroin Cocaine Meth Injection Ingestion Cleaning solutions Household plants Medications
Alcohol. Do You Know... What is it? Where does alcohol come from?
Do You Know... See also Do You Know... Alcohol, Other Drugs and Driving Alcohol What is it? Alcohol is a depressant drug. That means it slows down the parts of your brain that affect your thinking and
Benzodiazepines. And Sleeping Pills. Psychological Medicine
Benzodiazepines And Sleeping Pills Psychological Medicine Introduction Benzodiazepines are a type of medication prescribed by doctors for its therapeutic actions in various conditions such as stress and
Policy. Drug- Free School and Communities Act
Policy In keeping with Mid- America Christian University s (MACU) commitment to provide a safe and healthy academic and work environment, the University maintains a drug and alcohol free campus. The University
The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic criteria for research
The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic criteria for research World Health Organization F10-F19 Mental and behavioural disorders due to psychoactive substance use F10.-
Drug and Alcohol Abuse Training revised: October 2015
Drug and Alcohol Abuse Training revised: October 2015 FMCSA is considering going to a seven panel and possibly ten panel. Hair testing may also be acceptable. What is a Drug? A substance which
SUBSTANCE ABUSE ASSESSMENT FORM
SUBSTANCE ABUSE ASSESSMENT FORM Please make copies as needed and please type or print legibly. Instructions for use: Complete this form and use these questions to guide the EAP client interview when conducting
MEDICATION GUIDE WELLBUTRIN (WELL byu-trin) (bupropion hydrochloride) Tablets
MEDICATION GUIDE WELLBUTRIN (WELL byu-trin) (bupropion hydrochloride) Tablets Read this Medication Guide carefully before you start using WELLBUTRIN and each time you get a refill. There may be new information.
How To Prevent Alcohol And Drug Abuse At Stanford
STANFORD UNIVERSITY Office for Campus Relations Stanford Help Center Alcohol and Drug Abuse Prevention at Stanford Information for Faculty and Staff Phone: 650-723-4577 or Email: helpcenter@lists.stanford.edu
New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery
New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery USING THE 48 HOUR OBSERVATION BED USING THE 48 HOUR OBSERVATION BED Detoxification
SMU Drug Free Schools and Campuses Information for New Employees
SMU Drug Free Schools and Campuses Information for New Employees UNIVERSITY POLICIES: Student Code of Conduct Human Resources - Controlled Substance Abuse in the Workplace Employee Assistance RISKS ASSOCIATED
INTAKE ASSESSMENT. 1. Print out the Intake Assessment or call ARISE Alcohol Recovery to have an assessment mailed to you.
INTAKE ASSESSMENT Directions: Please complete all sections of the attached Intake Assessment form with as much accuracy as possible. You may have someone who knows you well assist you with completing the
Identifying Individuals with a Dual Diagnosis and Substance Misuse
Identifying Individuals with a Dual Diagnosis and Substance Misuse Presented by the Dual Diagnosis Substance Misuse Committee 1 Goal of Presentation To raise awareness To assist staff to identify individuals
SMART DISCHARGE. Client s Name: Client ID: Partial Hospitalization Clinically Managed Medium Intensity Residential Treatment
SMART DISCHARGE Client s Name: Client ID: DATE OF DISCHARGE: Reason for Discharge Completed Treatment no further treatment needed Completed Treatment Plan/Referred Incomplete Client Left Before Completing
CONTROLLED SUBSTANCE CONTRACT
CONTROLLED SUBSTANCE CONTRACT The purpose of this contract is to protect my access to controlled substances and to protect our ability to prescribe for you. The long-term use of substances such as opiates
Intake Form. Marital Status: Date of Birth: Street Address: City: State: Zip: Home Phone: Cell Phone: Work Phone: Social Security #:
Intake Form PATIENT INFORMATION Patient Last Name: First Name: Marital Status: Date of Birth: Street Address: City: State: Zip: Home Phone: Cell Phone: Work Phone: Social Security #: Gender: Employer:
OTC Abuse. Dr. Eman Said Abd-Elkhalek Lecturer of Pharmacology & Toxicology Faculty of Pharmacy Mansoura University
OTC Abuse Dr. Eman Said Abd-Elkhalek Lecturer of Pharmacology & Toxicology Faculty of Pharmacy Mansoura University Opiates Abuse Opioids are a group of natural, partially synthetic, or synthetic drugs
Reintegration. Recovery. Medication-Assisted Treatment for Alcohol Dependence. Reintegration. Resilience
Reintegration Recovery Medication-Assisted Treatment for Alcohol Dependence Reintegration Resilience 02 How do you free yourself from the stress and risks of alcohol dependence? Most people cannot do it
CHAPTER 5 MENTAL, BEHAVIOR AND NEURODEVELOPMENT DISORDERS (F01-F99) March 2014. 2014 MVP Health Care, Inc.
CHAPTER 5 MENTAL, BEHAVIOR AND NEURODEVELOPMENT DISORDERS (F01-F99) March 2014 2014 MVP Health Care, Inc. CHAPTER 5 CHAPTER SPECIFIC CATEGORY CODE BLOCKS F01-F09 Mental disorders due to known physiological
OSU INSTITUTE OF TECHNOLOGY POLICY & PROCEDURES
Drug Free Campus 1-018 ADMINISTRATION July 2014 POLICY 1.01 The Drug Free Schools and Communities Act Amendments of 1989 require an institution of higher education to certify to the U.S. Department of
Employee Drug-Free Workplace Education
Employee Drug-Free Workplace Education Rock Staffing and You for an Alcohol- and Drug-Free Workplace Provided by the Office of the Assistant Secretary for Policy U.S. Department of Labor and Rock Staffing
Teen Misuse and Abuse of Alcohol and Prescription Drugs. Information for Parents
Teen Misuse and Abuse of Alcohol and Prescription Drugs Information for Parents Terminology Misuse: Using a drug in a way in which it was not intended Example: Using a higher dose of medication than was
Substance Use Disorder Overview. Presented By Ecole J. Barrow-Brooks M.Ed & Darlene D. Owens MBA, LBSW, CADC, ADS
Substance Use Disorder Overview Presented By Ecole J. Barrow-Brooks M.Ed & Darlene D. Owens MBA, LBSW, CADC, ADS 1 National Issue There continues to be a large treatment gap in the U.S. In 2013, an estimated
Alcohol Withdrawal Recognition and Treatment
Alcohol Withdrawal Recognition and Treatment Thomas Meyer BS EMS, MICP SREMSC Page 1 Purpose As EMTs a mantle of responsibility is placed upon you to ensure the safety and well-being of those in your charge
Alcohol and nicotine are widely abused substances and are often used together One study showed that 15% of patients visiting a primary care practice
Dr IM Joubert Alcohol and nicotine are widely abused substances and are often used together One study showed that 15% of patients visiting a primary care practice for any reason had either an at-risk pattern
Downers/Depressants (pages 40-50)
Downers/Depressants (pages 40-50) Read pages 49-54, 59-60, and 78-79 of the booklet, Street Drugs. Pages 40-50 of the text. Narcotics: Prescription Origin: Southeast Asia, Southwest Asia, and in the Western
Cocaine. Like heroin, cocaine is a drug that is illegal in some areas of the world. Cocaine is a commonly abused drug.
Cocaine Introduction Cocaine is a powerful drug that stimulates the brain. People who use it can form a strong addiction. Addiction is when a drug user can t stop taking a drug, even when he or she wants
MANAGING DEPRESSIVE SYMPTOMS IN SUBSTANCE ABUSE CLIENTS DURING EARLY RECOVERY
MANAGING DEPRESSIVE SYMPTOMS IN SUBSTANCE ABUSE CLIENTS DURING EARLY RECOVERY Presented by: William L. Mock, Ph.D., LISW,LICDC, SAP Professional Training Associates Inc North Ridgeville, Ohio 1 (216) 299-9506
Prescription Drug Addiction
Prescription Drug Addiction Dr Gilbert Whitton FAChAM Clinical Director Drug & Alcohol Loddon Mallee Murray Medicare Local Deniliquin 14 th May 2014 Prescription Drug Addiction Overview History Benzodiazepines
Provider Attestation (Expedited Requests Only) Clinical justification for expedited review:
Inpatient Treatment Request Fax completed form to: 866 949 4846 Fill out completely to avoid delays Date: / / Request Type (Check one): Standard Expedited (additional information required below) Provider
Like cocaine, heroin is a drug that is illegal in some areas of the world. Heroin is highly addictive.
Heroin Introduction Heroin is a powerful drug that affects the brain. People who use it can form a strong addiction. Addiction is when a drug user can t stop taking a drug, even when he or she wants to.
DRUG AND ALCOHOL ABUSE PREVENTION POLICY
DRUG AND ALCOHOL ABUSE PREVENTION POLICY The University of Houston (the University ) prohibits the unlawful possession, use, manufacture, or distribution of illicit drugs in the workplace, on the campus,
How To Know If You Should Be Treated
Comprehensive ehavioral Care, Inc. delivery system that does not include sufficient alternatives to a particular LOC and a particular patient. Therefore, CompCare considers at least the following factors
Amphetamines Addiction
Introduction Amphetamines, which are classified as stimulants, work by using the dopamine reward system of the brain. When these drugs are used, the user s central nervous system is simulated which causes
DRUG AND ALCOHOL ABUSE PREVENTION POLICY
1 DRUG AND ALCOHOL ABUSE PREVENTION POLICY The University of Houston (the University ) prohibits the unlawful possession, use, manufacture, or distribution of illicit drugs in the workplace, on the campus,
Benzodiazepines: A Model for Central Nervous System (CNS) Depressants
Benzodiazepines: A Model for Central Nervous System (CNS) Depressants Objectives Summarize the basic mechanism by which benzodiazepines work in the brain. Describe two strategies for reducing and/or eliminating
DSM-5 Do Not Use ICD -10 Codes
DSM-5 Do Not Use ICD -10 Codes There are ICD-10 codes that DSM 5 is not compatible with. This spreadsheet details the ICD-10 codes that are NOT compatible with DSM 5. ICD10_DX_CD ICD10_DX_DESC F03.90 Unspecified
Drug-Free Policy In Accordance with the Drug-Free Schools and Communities Act Amendments of 1989 (Public Law 101-226)
Drug-Free Policy In Accordance with the Drug-Free Schools and Communities Act Amendments of 1989 (Public Law 101-226) The unlawful possession, use, or distribution of illicit drugs, prescription medication,
HEALTH RISKS AND EFFECTS OF DRUG USAGE AND PENALTIES UNDER FEDERAL AND STATE LAW
HEALTH RISKS AND EFFECTS OF DRUG USAGE AND PENALTIES UNDER FEDERAL AND STATE LAW A. Health Risks Associated With Drug Use Using drugs carries risks. A variety of literature and resources are available
Drug and Alcohol Abuse Prevention Program
Drug and Alcohol Abuse Prevention Program The Office of Human Resources FY 2014/2015 Austin Community College Drug and Alcohol Abuse Prevention Program The Austin Community College District (ACC) is dedicated
PRESCRIPTION DRUG ABUSE prevention
PRESCRIPTION DRUG ABUSE prevention Understanding Drug Addiction Many people do not understand how someone could abuse drugs even when their life seems to be falling apart. It is often assumed that those
Revised April 1, 2015 Page 1 of 5
Interview Date: Community Treatment Center 1215 Lake Drive Cocoa, Florida 32922 Phone: 321-632-5958 Fax: 321-632-2533 Do you have a substance abuse problem? Yes No Do you have a mental health diagnosis?
DRUGS OF ABUSE CLASSIFICATION AND EFFECTS
Drug and Drug use DRUGS OF ABUSE CLASSIFICATION AND EFFECTS A pharmaceutical preparation or a naturally occurring substance used primarily to bring about a change in the existing process or state (physiological,
Prescription Drugs: Abuse and Addiction
EAP Drug Free Workplace Newsletter March 2014 Prescription Drugs: Abuse and Addiction What are some of the commonly abused prescription drugs? Although many prescription drugs can be abused or misused,
DRUG AND ALCHOL ABUSE POLICY AND PREVENTION
DRUG AND ALCHOL ABUSE POLICY AND PREVENTION DATE DEVELOPED: DECEMBER 2012 DATE REVISED: NOVEMBER 2013 Florida Institute of Recording Sound and Technology 2309 Silver Star Rd. Orlando FL. 32804 P:407.316.8310
DRUGS AND ALCOHOL. Intent
DRUGS AND ALCOHOL Intent With the health, safety and welfare of our students of paramount importance, Health and Drug Education Programs have been designed to assist students make responsible and informed
Medications Used in the Treatment of Addiction Developed by Randall Webber, MPH. Alcohol Withdrawal
Medications Used in the Treatment of Addiction Developed by Randall Webber, MPH Alcohol Withdrawal MEDICATION Long/intermediateacting benzodiazepines (e.g., chlordiazepoxide/ Librium, diazepam/valium)
Drug and Alcohol Assessment
Drug and Alcohol Assessment Engagement the first step What is engagement? building a working relationship Showing that you care (do you?) Working towards mutually acceptable goals building rapport building
- UNDERSTANDING - Dual Diagnosis
- UNDERSTANDING - Dual Diagnosis TABLE OF CONTENTS Introduction 3 The Link Between Mental Illness and Substance Abuse 4 Characteristics of an Effective Dual Diagnosis Treatment Plan 6 Dual Diagnosis Treatment
What Parents Need to Know
What Parents Need to Know About Prescription Drug Abuse Office of District Attorney Jonathan W. Blodgett A Message From the District Attorney Prescription drug abuse is a growing problem. According to
Date of Current Marriage/Separation: Highest Level of Education:
ADULT INTAKE FORM Name: Date: Social Security: Home Address: City, State, Zip: Home Phone: Work Phone: Cell Phone: May we call you and leave messages at home? Yes No May we call you and leave messages
Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT
Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT Please fax with CCHP prior authorization form to 608-252-0853
Drug Abuse and Addiction
Drug Abuse and Addiction Introduction A drug is a chemical substance that can change how your body and mind work. People may abuse drugs to get high or change how they feel. Addiction is when a drug user
Health Information Sheet
Health Information Sheet What is depression? Depression -- How Medicine Can Help Depression is a medical illness like diabetes or high blood pressure. It affects about 17% of people at some time in their
Drug and Alcohol Abuse Prevention Program
Drug and Alcohol Abuse Prevention Program of Bethany Global University Bethany Global University (BGU) has adopted the following policy in compliance with the Drug Free Workplace Act of 1988 and the subsequent
Information About Benzodiazepines
Information About Benzodiazepines What are benzodiazepines? Benzodiazepines are psycho tropic drugs - drugs that affect the mind and are mood altering. They are commonly known as minor tranquillisers and
Medication Allergies and Reactions: Please do not leave blank, write none if no allergies.
Please answer these questions as completely as you can. We realize that this form is long, but the information in this form will be extremely valuable to us in providing you the best possible care. Today
UNDERSTANDING ADDICTION to BENZOS
Alan Stevens, MSW, LSW, ACSW UNDERSTANDING ADDICTION to BENZOS UNDERSTANDING ADDICTION TO BENZOS Alan Stevens, MSW, LSW, ACSW Copyright 2013 Behavioral Health of the Palm Beaches Publisher: Mary Pomerantz
What you need for Your to know Safety about longterm. opioid pain care. What you need to know about long-term opioid
What you need to know about longterm opioid pain care. What you need to know about long-term opioid and the Safety of Others pain care. TAKING What you OPIOIDS need to know about long-term RESPONSIBLY
Outline. Drug and Alcohol Counseling 1 Module 1 Basics of Abuse & Addiction
Outline Drug and Alcohol Counseling 1 Module 1 Basics of Abuse & Addiction About Substance Abuse The Cost of Chemical Abuse/Addiction Society's Response The Continuum of Chemical Use Definitions of Terms
WYOMING PROFESSIONAL ASSISTANCE PROGRAM APPLICATION FOR PARTICIPATION NAME: SOC. SEC. # HOME ADDRESS: PHONE # CITY: STATE: ZIP:
WYOMING PROFESSIONAL ASSISTANCE PROGRAM APPLICATION FOR PARTICIPATION NAME: SOC. SEC. # HOME ADDRESS: PHONE # CITY: STATE: ZIP: BIRTHDATE: AGE: SEX: ( M ) ( F ) RACE: MARITAL STATUS: Married ( ) Separated
California Healing Arts College
California Healing Arts College Drug & Alcohol Abuse Prevention Policy Under the Drug- Free Schools and Communities Act Amendment of 1989, California Healing Arts College is required to annually distribute
Science and Treatment Prescription Drug Addiction Treatment. Karen Miotto, M.D. David Geffen School of Medicine kmiotto@mednet.ucla.
Science and Treatment Prescription Drug Addiction Treatment Karen Miotto, M.D. David Geffen School of Medicine kmiotto@mednet.ucla.edu Presentation Objectives Examine drugs: effects, toxicities, withdrawal
The University of Toledo - Main Campus Policy
The University of Toledo - Main Campus Policy IV-12 3360-30-12 Alcohol and Substance Abuse. (A) Alcohol and drug abuse policy statement The University of Toledo is committed to promoting and maintaining
The Opiate Treatment Index (OTI)
The Opiate Treatment Index (OTI) (Drug use, criminality and health status components) Adapted from: Darke, S., Ward, J., Hall, W., Heather, N. & Wodak, A. (1991). The Opiate Treatment Index (OTI) Researcher's
Comprehensive Behavioral Care, Inc. Level of Care Guidelines Substance Abuse Children/Adolescents
Medical Necessity In considering the appropriateness of any level of care, the four basic elements of Medical Necessity should be met: 1. A diagnosis as defined by standard diagnosis nomenclatures (DSM
Treatments for drug misuse
Understanding NICE guidance Information for people who use NHS services Treatments for drug misuse NICE clinical guidelines advise the NHS on caring for people with specific conditions or diseases and
CHAPTER 4 DRUGS. Although it has already been discussed in Chapter 1, the relevant portion of the DUI statute relating to drugs is as follows:
CHAPTER 4 DRUGS 4.1 GENERALLY 4.2 DUI 4.2.1 DEFENSE NOT AVAILABLE 4.3 DRIVING WITH A MEASURABLE AMOUNT 4.3.1 PENALTIES 4.3.2 DEFENSES 4.3.3 LESSER INCLUDED OFFENSE 4.4 DRUG RECOGNITION EXAM PROCEDURES
OVERVIEW WHAT IS POLyDRUG USE? Different examples of polydrug use
Petrol, paint and other Polydrug inhalants use 237 11 Polydrug use Overview What is polydrug use? Reasons for polydrug use What are the harms of polydrug use? How to assess a person who uses several drugs
New Venture Christian Fellowship Therapy Introduction to Individual Counseling
New Venture Christian Fellowship Therapy Introduction to Individual Counseling Welcome to counseling. We look forward to meeting with you and getting started. People and their situations are often very
MEDICAL HISTORY AND SCREENING FORM
MEDICAL HISTORY AND SCREENING FORM The purpose of preventive exams is to screen for potential health problems and provide education to promote optimal health. It is best practice for chronic health problems
Drug and Alcohol Abuse Prevention Information
Drug and Alcohol Abuse Prevention Information In accordance with the Drug-Free Schools and Communities Act Amendments of 1989, Grace School of Theology provides the following information to provide a campus
Assessment and Diagnosis of DSM-5 Substance-Related Disorders
Assessment and Diagnosis of DSM-5 Substance-Related Disorders Jason H. King, PhD (listed on p. 914 of DSM-5 as a Collaborative Investigator) j.king@lecutah.com or 801-404-8733 www.lecutah.com D I S C L
VA/DoD Clinical Practice Guideline Management of Substance Use Disorder (SUD) in the Primary Care Setting page 1
VA/DoD Clinical Practice Guideline Management of Substance Use Disorder (SUD) in the Primary Care Setting page 1 BRIEF INTERVENTION Give feedback about screening results, relating the risks of negative
-- No equivalent DSM-IV code disorders 303 Alcohol dependence syndrome -- No equivalent DSM-IV code 303.9 [0-3]*
![-- No equivalent DSM-IV code disorders 303 Alcohol dependence syndrome -- No equivalent DSM-IV code 303.9 [0-3]*](/thumbs/26/8764864.jpg "-- No equivalent DSM-IV code disorders 303 Alcohol dependence syndrome -- No equivalent DSM-IV code 303.9 [0-3]*")
Substance Use Disorder Covered Diagnoses ICD-9 DSM-IV Alcohol Use Disorders 291 Alcohol-induced mental -- No equivalent DSM-IV code s 303 Alcohol syndrome -- No equivalent DSM-IV code 303.9 [0-3]* Other