NCRS flashcards
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32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- DSM-5-TR SUD severity
- Counting 11 criteria in 12 months: 2-3 criteria is mild, 4-5 is moderate, and 6 or more is severe substance use disorder.
- Tolerance and withdrawal exception
- For sedatives, stimulants, and opioids, tolerance and withdrawal criteria do not count when the drug is used only as medically prescribed.
- AUDIT-C scoring
- Three-item alcohol screen scored 0-12; a positive result is 4 or more in men and 3 or more in women for unhealthy alcohol use.
- CIWA-Ar threshold
- Ten-item alcohol withdrawal scale scored 0-67; 8-15 suggests mild withdrawal and above 15 signals risk of severe withdrawal needing medical care.
- COWS induction threshold
- Eleven-item opioid withdrawal scale scored 0-48; scores of 13 or higher generally support starting buprenorphine induction.
- CRAFFT screen
- Six-item adolescent substance screen; two or more yes answers indicate high risk and prompt further assessment or brief intervention.
- Motivational interviewing processes
- Four overlapping processes: engaging, focusing, evoking, and planning, guided by partnership, acceptance, compassion, and evocation.
- Stages of change
- Precontemplation, contemplation, preparation, action, and maintenance; relapse is treated as a return to an earlier stage, not treatment failure.
- Contingency management
- Providing tangible, verifiable reinforcers for demonstrated abstinence; strongest evidence is for stimulant use disorder, which lacks approved medication.
- Twelve-step facilitation
- A manualized clinician-delivered approach that actively links clients to AA or NA; it performed well in Project MATCH outpatient outcomes.
- Buprenorphine prescribing rules
- Since 2023, any DEA-registered practitioner with schedule III authority may prescribe buprenorphine for opioid use disorder without a separate waiver.
- Acamprosate versus naltrexone
- Acamprosate supports abstinence and is renally cleared; naltrexone reduces heavy drinking and requires an opioid-free period before starting.
- Lapse versus relapse
- A lapse is a single return to use; a relapse is resumption of the prior pattern, requiring re-engagement with coping and support plans.
- 42 CFR Part 2
- Federal rule protecting substance use disorder records more strictly than HIPAA; release generally requires written consent or a qualifying court order.
- Subpoena limits
- A subpoena alone does not authorize release of protected substance use records; valid consent or a compliant court order is needed.
- Mandated reporting
- Child abuse or neglect reporting duties override confidentiality; the clinician reports to the designated state authority without conducting an investigation.
- Informed consent elements
- Disclosure of service nature, risks, benefits, alternatives, fees, and confidentiality limits, documented before treatment begins.
- Duty to protect
- Tarasoff-type duty triggered by serious danger to an identifiable person; responses may include warning, police notification, or hospitalization per state law.
- Client abandonment
- Terminating treatment without adequate notice, referral options, or transition planning; it is an ethical and licensure violation.
- Prevention continuum
- Universal targets whole populations, selective targets at-risk groups, and indicated targets individuals with early signs but no diagnosis.
- Recovery dimensions
- SAMHSA describes recovery through health, home, purpose, and community, framed as an ongoing process rather than a fixed endpoint.
- Recovery capital
- Resources supporting recovery: social relationships, physical health and housing, human skills and knowledge, and cultural belonging.
- Naloxone action
- An opioid antagonist that reverses opioid overdose; it does not reverse non-opioid overdose and may precipitate withdrawal in dependent people.
- SBIRT components
- Screening, brief intervention of roughly 5-15 minutes using motivational methods, and referral to treatment for risky substance use.
- Peer recovery specialist role
- A worker using lived experience to support engagement and recovery; not a clinician, requiring clear boundaries, supervision, and role definition.
- Co-occurring disorder definition
- The presence of at least one substance use disorder plus at least one mental health disorder; integrated treatment is the evidence-based approach.
- Integrated treatment
- Substance use and mental health services delivered by one team in one setting with a unified plan; stronger outcomes than sequential or parallel models.
- Four-quadrant model
- A dual-diagnosis framework plotting severity of mental illness against severity of substance use to guide service intensity and setting.
- Fatal withdrawal risks
- Alcohol and benzodiazepine withdrawal can cause seizures and delirium tremens and be fatal; opioid withdrawal is distressing but rarely life-threatening.
- Opioid use in pregnancy
- Methadone or buprenorphine is recommended; untreated opioid use disorder carries greater maternal and fetal risk than medication treatment.
- Trauma-informed care principles
- Assumes widespread trauma and emphasizes safety, trustworthiness, peer support, choice, collaboration, empowerment, and avoidance of re-traumatization.
- Older adult considerations
- Slower metabolism and polypharmacy increase sensitivity to alcohol, benzodiazepines, and opioids; screening should include falls and drug interactions.