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Assessment of Problem
ADDICTION AND SUBSTANCE ABUSE




    Generally speaking, the problems people experience with alcohol and other drugs may be divided into three categories: First, those with no use or some use, but with no significant problems. Secondly, substance abuse occurs when a person’s use causes problems for them, their friends and family, such as one DUI or a single drug possession charge. The final one is chemical dependency or addiction. This occurs when at least three or more of seven diagnostic categories are met. A chemically dependent person suffers a loss of control over their use and continues– or even escalates use– in spite of ever increasing negative consequences.

    Both substance abuse and chemical dependency require the assistance of a professional trained in treatment for addictions. More severe addictions may require detoxification, inpatient treatment and subsequent outpatient treatment, group and individual therapy and the diagnosis and treatment of any contributing mental health difficulties. When possible, the involvement of family and friends can be very helpful in the person’s recovery.

     The following screening tools are for information only and are not intended to diagnose or to be a substitute for professional assessment and treatment. For a comprehensive and formal assessment of the following--and any other problems you or someone else may be experiencing-- please contact me and schedule an appointment and assessment.


    CAGE SCREENING (for alcohol problems)



1. Have you ever felt you should cut down on your drinking?

    Yes
    No

2. Have people annoyed you by criticising your drinking?

    Yes
    No

3. Have you ever felt bad or guilty about your drinking?

    Yes
    No

4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?

    Yes
    No


    A “yes” answer on two or more of the foregoing questions has a high correlation with alcohol abuse or dependence.


    DAST SCREENING (for problems with drugs other than alcohol)



1. Have you used drugs other than those required for medical reasons?

    Yes
    No

2. Have you abused prescription drugs?

    Yes
    No

3. Do you abuse more than one drug at a time?

    Yes
    No

4. Can you get through the week without using drugs?

    Yes
    No

5. Are you always able to stop using drugs when you want to?

    Yes
    No

6. Have you had “blackouts” or “flashbacks” as a result of drug use?

    Yes
    No

7. Do you ever feel bad or guilty about your drug use?

    Yes
    No

8. Does your spouse (or parents) ever complain about your involvement with drugs?

    Yes
    No

9. Has drug abuse created problems between you and your spouse or your parents?

    Yes
    No

10. Have you lost friends because of your use of drugs?

    Yes
    No

11. Have you neglected your family because of your use of drugs?

    Yes
    No

12. Have you been in trouble at work because of your use of drugs?

    Yes
    No

13. Have you lost a job because of drug abuse?

    Yes
    No

14. Have you gotten into fights when under the influence of drugs?

    Yes
    No

15. Have you engaged in illegal activities in order to obtain drugs?

    Yes
    No

16. Have you been arrested for possession of illegal drugs?

    Yes
    No

17. Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?

    Yes
    No

18. Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)?

    Yes
    No

19. Have you gone to anyone for help for a drug problem?

    Yes
    No

20. Have you been involved in a treatment program especially related to drug use?

    Yes
    No


    Score one point for each answer of “yes,” except for questions 4 & 5, which score one point for “no.”

    1-5   indicate a low level of substance abuse;
    6-10   indicate a moderate level of substance abuse;
    11-15   indicate a substantial level of substance abuse;
    16-20   indicate a high level of substance abuse;


    IF YOU OR SOMEONE YOU KNOW HAS A PROBLEM WITH ALCOHOL OR OTHER DRUGS, PLEASE GET HELP IMMEDIATELY.






























    PTSD


    Most people today are familiar with the term “PTSD;” however, there are many misconceptions and myths about PTSD, many of which may be obstacles to someone seeking treatment. PTSD is not related to “toughness” or lack thereof. Prior traumatic exposure increases the risk for developing PTSD later in life. Repeated exposure, trauma that has a human design or source, the lack of a “safe” place during the exposure are all factors that aggravate PTSD symptoms. A person who is caring and compassionate toward others is more likely to develop PTSD than a person without those traits. “Toughing it out” doesn’t work and the failure to seek professional assistance can, and often does, have disastrous results.

    Posttraumatic Stress Disorder (PTSD) is part of a group of anxiety disorders, including Acute Stress Disorder (ACS). PTSD is not limited to military service, but also occurs in other setting where physical violence, civilian combat or sexual abuse occur. If the person, as a result of exposure to extreme stress, develops ACS, approximately 50% of the time the symptoms greatly decrease before six months. If the symptoms persist more than six months, the diagnosis becomes PTSD. Getting professional help as early as possible is one of the very most important aspects of recovery from PTSD.

    Some of the symptoms of PTSD include the following (all relating to the traumatic experiences): recurrent distressing thoughts and nightmares, avoidance of things that remind one of the trauma (avoidance can also include avoiding getting help), numbing of emotions and sensations, dissociation, hypervigilence and exaggerated startle response. The foregoing recitation is not exhaustive as there are other symptoms as well. PTSD symptoms can be powerfully triggered by symbolic cues, often without the person even being aware of the source. PTSD, if untreated, can lead to severe family and relationship problems, substance abuse and addiction, divorce, incarceration, homelessness and even suicide.

    Since 1980, much research and clinical knowledge has been obtained by PTSD professionals which have been proven to help people manage their PTSD symptoms and to recover and enjoy happy and fulfilling lives. Perhaps the saddest part of all this is so many people can be helped to recover by PTSD if they only sought professional help. If you or someone you know may have PTSD or ACS, please get professional help immediately.

The following screening tools are for information only and are not intended to diagnose or to be a substitute for professional assessment and treatment.



    THE PRIMARY CARE PTSD SCREEN (PC-PTSD) 
    (Prins, Ouimette, Kimerling, et al., 2003)


    In you life, have you ever had any experience that was so frightening, horrible or upsetting that, in the past month, you:


    1.    Have had nightmares about it or thought about it when you did not want to?

                        Yes/ No

    2.    Tried hard not to think about it or went out of your way to avoid situations that reminded you of it?

                        Yes/ No

    3.    Were constantly on guard, watchful or easily startled?

                        Yes/ No

    4.    Felt numb or detached from others, activities or your surroundings?

                        Yes/  No


    Current research suggests a high correlation between PTSD and answers of “yes” to three or more of the foregoing questions.  If you or someone you love answered “yes” to one or more questions, a professional assessment is recommended.
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