1. Substance Dependence

1. tolerance
2. withdrawal
3. substance is often taken in larger amounts or over longer period
4. persistent desire or unsuccessful efforts to cut down
5. great deal of time in obtaining substance
6. social, occupational, recreational activities are given up
7. use continued despite knowledge of persistent or recurrent physical or

psychological problems.

1. Substance Abuse

1. recurrent use results in failure to fulfill role obligations
2. recurrent use in situations that are physically hazardous
3. recurrent substance-related legal problems
4. continued use despite persistent/recurrent social/interpersonal problems

1. Substance Intoxication

1. development of a reversible substance-specified syndrome
2. significant maladaptive behavioral/psychological changes
3. symptoms not due to medical condition

1. Substance Withdrawal

1. 1. development of substance specific syndrome due to cessation/reduction of use

2. syndrome causes significant distress/impairment in social, occupational

functioning

3. not due to medical condition

1. Assessment Issues

1. Diagnosis
2. Route of Administration
3. Speed of onset within a class of substance
4. Duration of Effects
5. Use of Multiple Substances
6. Laboratory Findings
7. Associated Physical Examination Findings and General Medical Conditions
8. Associated Mental Disorders

1. Assessment

1. CAGE

1. Cutback
2. Anger
3. Guilt
4. Eye Opener

1. Addiction

1. Amount
2. Frequency
3. Nature of Use

1. Questions to Ask
2. Addiction Cycle

1. Selected Substances

1. Alcohol
2. Nicotine
3. Cannabis
4. Inhalants
5. Hallucinogens