CARN-AP flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

AUDIT-C positive thresholds

AUDIT-C scores of 3 or more in women and 4 or more in men are positive, indicating hazardous drinking and need for further assessment.

CAGE score meaning

Two or more affirmative CAGE answers suggest a clinically significant alcohol problem; the tool is a screening aid and does not establish a diagnosis.

DSM-5-TR SUD severity

Two or three of eleven criteria indicate mild substance use disorder, four or five indicate moderate, and six or more indicate severe disorder within a twelve-month period.

CIWA-Ar score interpretation

CIWA-Ar scores of 8 to 15 indicate moderate alcohol withdrawal, while scores above 15 indicate severe withdrawal with increased risk of seizures and delirium.

COWS score interpretation

COWS scores of 13 to 24 indicate moderate opioid withdrawal, 25 to 36 moderately severe, and above 36 severe; buprenorphine induction often starts at 8 to 12.

EtG detection window

Urine ethyl glucuronide remains detectable for about 80 hours after alcohol is eliminated, indicating recent alcohol exposure rather than current intoxication or impairment.

Naltrexone induction requirement

Naltrexone requires seven to ten opioid-free days before starting; it is contraindicated during current opioid use and requires liver enzyme monitoring.

Buprenorphine precipitated withdrawal

Buprenorphine is a partial mu-opioid agonist; administering it while full agonists remain bound can abruptly precipitate withdrawal, so induction is timed to COWS scores of 8 to 12.

Acamprosate dosing

Acamprosate is typically dosed at 666 mg three times daily; the dose is reduced in moderate renal impairment and avoided in severe renal impairment.

Disulfiram contraindications

Disulfiram is contraindicated in severe myocardial disease, psychosis, pregnancy, and recent alcohol or disulfiram-like substance use; baseline liver tests are required.

Thiamine before glucose

In patients at risk for Wernicke encephalopathy, thiamine should be given before or with glucose because glucose administration can worsen thiamine deficiency.

Naloxone repeat dosing

Naloxone may be repeated every two to three minutes until respiratory drive returns; it can precipitate acute opioid withdrawal but is not harmful in opioid-naive patients.

OARS in motivational interviewing

OARS stands for open questions, affirmations, reflections, and summaries; these skills evoke change talk and strengthen the therapeutic alliance in motivational interviewing.

Change talk versus sustain talk

Change talk expresses desire, ability, reasons, or need for change, while sustain talk favors continued use; clinicians reflect change talk and avoid arguing with sustain talk.

Contingency management

Contingency management provides tangible reinforcers such as vouchers for verified abstinence; it has strong evidence for stimulant use disorders and improves treatment retention.

CRAFT family intervention

CRAFT teaches family members to reinforce abstinence and reduce enabling behaviors; it improves treatment engagement compared with confrontation-based family approaches.

Relapse prevention high-risk situations

Relapse prevention identifies high-risk situations, automatic thoughts, and coping responses; it treats a lapse as a learning event rather than a failure.

42 CFR Part 2 protection

42 CFR Part 2 protects substance use disorder treatment records more strictly than HIPAA; redisclosure generally requires written patient consent unless a specific exception applies.

ASAM level 3.7

ASAM level 3.7 is medically managed intensive inpatient treatment for severe withdrawal or medical instability requiring twenty-four-hour physician and nursing care.

Warm handoff

A warm handoff transfers care directly between clinicians with the patient present; it improves engagement and reduces dropout compared with fax-only or electronic referrals.

MAT Act and X-waiver

The MAT Act eliminated the X-waiver for buprenorphine; prescribers still need a DEA registration and must meet state licensure, training, and attestation requirements.

SBIRT model

SBIRT means screening, brief intervention, and referral to treatment; brief intervention suits risky use, while moderate-to-severe disorders require referral.

Recovery capital

Recovery capital is the sum of social, physical, human, and cultural resources that support sustained remission and is assessed during treatment and recovery planning.

Syringe services programs

Syringe services programs provide sterile injection equipment and reduce HIV and hepatitis C transmission without increasing injection frequency or crime.

PrEP eligibility

PrEP with tenofovir/emtricitabine reduces HIV acquisition; eligibility includes ongoing injection drug use with needle sharing or high-risk sexual behavior.

HALT relapse framework

HALT stands for hungry, angry, lonely, and tired; it is a self-monitoring framework for identifying vulnerability states that raise relapse risk.

Peer recovery specialist role

Peer recovery specialists use lived experience to support engagement, linkage, and recovery planning; they complement but do not replace licensed clinical assessment and treatment.

Tarasoff duty

The Tarasoff duty requires clinicians to warn or protect an identifiable third party when a patient poses a serious threat; the scope varies by state law.

Mandated reporting

Mandated reporting laws require clinicians to report suspected child abuse or neglect to the designated agency; the report is not made to the family.

Informed consent elements

Informed consent requires capacity, disclosure of risks and alternatives, voluntariness, and documentation; it is an ongoing process rather than a one-time signature.

Dual relationship risk

A dual relationship occurs when a clinician has a secondary role with a patient; it risks exploitation and impaired judgment and is generally avoided when possible.

PDMP check purpose

Prescription drug monitoring programs identify multiple prescribers, overlapping controlled substances, and high-risk combinations; checks are required or recommended before prescribing controlled substances.