NCAC flashcards

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

Tolerance

A pharmacological criterion of substance use disorder in which a person needs markedly more of a substance to achieve the same effect, or experiences less effect from the usual amount.

Withdrawal

A substance-specific syndrome of physical and psychological symptoms that follows reduction or cessation of heavy or prolonged use; it is one of the eleven DSM-5 criteria.

Nucleus accumbens

A key structure of the brain's reward circuit that receives dopamine from the ventral tegmental area and mediates the reinforcing effects of addictive drugs.

DSM-5 severity thresholds

Two or three criteria indicate mild substance use disorder, four or five indicate moderate, and six or more indicate severe, counted from eleven criteria within twelve months.

Craving

An intense desire or urge to use a substance; it was added as a criterion in DSM-5 and is grouped under impaired control over use.

Early remission

At least three but less than twelve months during which no substance use disorder criteria are met, except craving, after the person previously met criteria.

Biopsychosocial model

A framework explaining addiction as the product of interacting biological, psychological, and social factors, which together guide assessment and treatment planning.

Co-occurring disorders

The presence of both a substance use disorder and another mental health condition in the same person; integrated treatment addressing both simultaneously is the recommended standard.

ASAM Criteria dimensions

Six dimensions used to match patients to levels of care: intoxication and withdrawal, biomedical conditions, psychiatric and cognitive conditions, readiness to change, relapse potential, and recovery environment.

Stages of change

Prochaska and DiClemente's model of precontemplation, contemplation, preparation, action, and maintenance, with relapse cycling back; interventions are matched to the person's current stage.

OARS skills

The four core motivational interviewing skills: open-ended questions, affirmations, reflective listening, and summarizing; they support evocation rather than advice-giving.

Buprenorphine ceiling effect

Because buprenorphine is a partial mu-opioid agonist, its respiratory-depressant and euphoric effects plateau at higher doses, improving safety relative to full agonists such as methadone.

Naltrexone induction timing

Naltrexone is an opioid antagonist that can precipitate withdrawal, so patients must be opioid-free for roughly seven to ten days before the first dose.

Disulfiram mechanism

Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation with flushing, nausea, and tachycardia if alcohol is consumed; it works best with supervised dosing.

Acamprosate

An FDA-approved medication for alcohol use disorder that reduces craving and supports abstinence; it is renally excreted and dosed according to kidney function.

Contingency management

A behavioral treatment that provides tangible, often voucher-based rewards for verified abstinence or other target behaviors, grounded in operant conditioning principles.

42 CFR Part 2

Federal regulations governing confidentiality of substance use disorder treatment records; they require specific written patient consent for disclosure and are more restrictive than HIPAA in most circumstances.

Tarasoff duty

The legal duty, established in Tarasoff v. Regents of California, to take reasonable steps to protect an identifiable third party from a client's serious threat of violence.

SOAP note

A progress note format with four sections: Subjective reports, Objective observations, Assessment or clinical interpretation, and Plan for the next steps of care.

Measurable treatment objective

A treatment plan statement that specifies a behavior, the conditions under which it occurs, and a timeframe, so progress can be objectively evaluated.

Screening versus assessment

Screening uses brief instruments to detect possible problems; assessment is a comprehensive, ongoing biopsychosocial process that establishes diagnosis and guides treatment planning.

Trauma-informed care principles

Six principles: safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment and choice; and attention to cultural, historical, and gender issues.

Mandated reporting

A legal obligation on counselors to report suspected child abuse or neglect, and often elder or dependent-adult abuse, to designated authorities, overriding ordinary confidentiality.

Reflective listening

A counseling skill in which the counselor restates the client's expressed content or feeling in their own words to demonstrate understanding and encourage further exploration.

Nonmaleficence

The ethical principle of doing no harm, which obligates counselors to avoid interventions likely to injure clients and to choose the least harmful effective option.

Dual relationship

A situation in which a counselor holds another significant role with a client, such as social, financial, or familial, that risks impairing judgment and exploiting the client.

Informed consent elements

Disclosure of the nature of services, risks and benefits, fees, confidentiality and its limits, the counselor's qualifications, and the client's right to refuse or withdraw.

Scope of practice

The range of services a counselor is trained, qualified, and legally authorized to provide; services outside that range require referral or additional supervision.

Documentation correction

Errors in clinical records are corrected with a single line through the entry, plus initials, date, and a brief explanation; original text is never erased or obliterated.

Impaired professional

A counselor whose substance use or mental health condition interferes with professional functioning must refrain from practicing and seek help through treatment or peer assistance programs.

Clinical supervision

Ongoing documented oversight of a counselor's clinical work by a qualified supervisor, focused on skill development, ethical practice, and protection of client welfare.

Veracity

The ethical principle requiring counselors to be truthful with clients, colleagues, and the public, including honest representation of credentials, services, and treatment outcomes.