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LCDC EXAM QUESTIONS AND
ANSWERS RATED A+
Two main types of cells in the nervous system (^) ✔✔glia and neurons
Glia ✔✔Cells that out number neurons, cannot process information like neurons, make up the
blood brain barrier that protects the brain from toxic chemicals in the blood
Nervous system ✔✔Consists of neurons, axons and receptors
Receptors ✔✔Proteins that help regulate activity of cells in the nervous system. Activation of receptors by neurotransmitters cause a change in activity of the target cell and many of the effects of psychoactive drugs are due to the ability to alter neurotransmitters.
Neurons ✔✔basic structural unit of the nervous system responsible for analyzing and
transmitting information. There are more than 100 billion neurons in the nervous system
Synapse ✔✔Typical point of communication, gap between neurons is called the synaptic cleft.
Two types of synapses ✔✔Excitatory and inhibitory synapse. The receiving region is called the
dendrite
Effects on receptors ✔✔Can be agonistic or antagonistic
Agonistic drugst ✔✔interact with the receptor and produce a response, agonist (a substance that fully activates the neuronal receptor that it attaches to) Imitates the action of neurotransmitter, is the use of a (usually) long-acting medication that stimulates the same brain receptors as the drug of addiction. The most obvious example is opioid agonist therapy for opioid addiction using methadone or buprenorphine. An agonist is a drug that activates certain receptors in the brain. Full agonist opioids activate the opioid receptors in the brain fully resulting in the full opioid effect. Examples of full agonists are heroin, oxycodone, methadone, hydrocodone, morphine, opium and others. Buprenorphine is a partial agonist meaning, it activates the opioid receptors in the brain, but to a much lesser degree than a full agonist. A pure opioid antagonist used in medicine is naloxone (not to be confused with naltrexone).
Antagonisitic ✔✔Drugs interact with the receptor but prevent a response, agonist drugs which
bind to the neurotransmitters in the brain, antagonist drugs do the opposite: they block the brain's neurotransmitters. The action of neurotransmitter is obstructed. Buprenorphine also acts as an
Naltrexone, ✔✔opioid antagonists that is a short acting opiate/alcohol blocking agent has been used for the last 30 years. Naltrexone blocks the pharmacological effects of 25 mg / in the introduction of heroin for 24 hours, a double dose (100 mg) acts within 48 hours, and 150 mg will affect during for 3 days. Long-term appointment does not cause tolerance and dependence. To cut the long story short, when comparing Naltrexone vs Naloxone it is obvious that Naltrexone is stronger for alcohol dependence but Naloxone acts faster and remains longer.
Acetylcholine (ACH), epinephrine, dopamine, serotonin and endorphins ✔✔Neurotransmitters
most likely altered by drug abuse
Somatic Nervous System ✔✔Carries sensory information from outside the body into the CNS
and motor information out.
Automatic nervous system (ANS) ✔✔cell bodies are located within the brain or spinal cord but
their axons project outside the CNS to involuntary muscles.
Automatic nervous system has two componenets ✔✔These componenents contest with each
other: sympathatheic (fight or flight) and parasympathetic (rest and digest).
Sympathetic System ✔✔speeds up hear and breathing rates is vasoconstrictor amphetamine
(Benzedrine) benzylpiperazine (BZP) cathine (found in Catha edulis) cathinone (found in
Catha edulis, khat) cocaine (found in Erythroxylum coca, coca) ephedrine (found in
Ephedra) lisdexamfetamine (Vyvanse) maprotiline (Ludiomil) MDMA (Ecstasy, Molly)
methamphetamine (Meth, Crank, Desoxyn) methcathinone methylenedioxypyrovalerone
(MDPV)
methylphenidate (Ritalin) 4-methylaminorex oxymetazoline (Afrin,
Vicks Sinex) pemoline (Cylert) phenmetrazine (Preludin) propylhexedrine (Benzedrex) pseudoephedrine (Sudafed, SudoGest, also found in Ephedra species)
GABA ✔✔inhibitory neurotransmitter, sedatives are dependent upon their binding to the GABA receptors (gamma-aminobutyric acid) is an inhibitory neurotransmitter that is very widely distributed in the neurons of the cortex. GABA contributes to motor control, vision, and many other cortical functions. It also regulates anxiety.
Depressants ✔✔Depressants/sedative-hypnotics (central nervous system depressants). Drugs in
this class slow/depress the activity of the central nervous system. Examples of drugs in this classification include, but are not limited to, alcohol, benzodiazepines, and barbiturates. They are usually taken orally. The desired effects are a reduction of anxiety with possible elation secondary to decreased alertness and judgment. Other acute effects include sedation, impaired
LSD ✔✔can include panic attacks, increased blood pressure, heart palpitations, tremors, nausea, muscle weakness, increased body temperature, ataxia, and in some cases accidental death is structurally related to serotonin and many of the behavioral effects are probably related to their binding to the serotonin receptors.
PCP ✔✔can include psychotic reactions, bizarre behavior, outbursts of hostility and violence,
and feelings of severe anxiety, doom, or impending death
Ketamine ✔✔can include a frightening experience of complete sensory detachment,
explained as a near-death experience, paranoia, boredom, and possible coma Cannabinoids/cannabinols ✔✔his category includes marijuana, hashish, and THC.
The usual route of administration is smoking or oral. Its usual length of action 78 from smoking
is 2 to 4 hours and through oral means is 5 to 12 hours. The desired effects are a sense of relaxation and well-being, euphoria, detachment, altered level of consciousness, altered perceptions, altered sense of time, and possible sexual arousal
Effects of cannabinoid use ✔✔re slowed reaction time, altered perceptions, panic, anxiety,
nausea, dizziness, depersonalization, paranoid thoughts, and trouble expressing thoughts. The
effects are believed to be caused by the binding of the drug at specific THC receptor sites in the brain. Intoxication may cause increases in respiration and heart rate and a slight increase in body temperature.
Upon examination, the users may exhibit red eyes, mild dilation of pupils, mild tremors, decreased coordination, decreased strength, less ability to perform complex motor tasks, and dry mouth. Mentally, the user may express feelings of depersonalization, an alteration in mood, disorganization, anxiety, panic, problems with memory, paranoid thoughts, and possible hallucinations
Long-term, chronic canabinoid use ✔✔can lead to problems such as dependence, panic, anxiety, paranoid thoughts, etc. They may also include respiratory problems, the
possibility of an impaired immune system, possible reproductive problems, including low birth weight infants, and amotivational syndrome. Withdrawal usually consists of cravings, anxiety, irritability, nausea, anorexia, agitation, restlessness, tremors, and depression
Inhalants ✔✔These drugs consist mainly of chemicals that can be legally purchased and that are normally used for nonrecreational purposes. These include industrial solvents and aerosol sprays that include, but are not limited to, gasoline, kerosene, airplane glue, lacquer thinner, acetone, nail polish remover, lighter fluid, metallic paints, and typewriter correction fluids. Also included are amyl, butyl and isobutyl nitrite, and nitrous oxide gas
Drugs in this classification include Depo-Testosterone, Durabolin, Danocrine, and Halotestin. Some anabolic steroids used for veterinary medicine are illicitly sold for human use and may be sold legally outside of the United States
Effects of steroids ✔✔Anabolic steroids are either injected or taken orally. Combining oral and
injectable steroids is known as "stacking". These drugs increase muscle strength, reduce body mass, and increase aggressiveness, competitiveness, and combativeness there is no immediate danger of death or serious medical problems from high dosage levels of anabolic steroids; there are serious complications from long-term use. There is no evidence that one can develop tolerance to anabolic steroids. Physical and psychological dependence on anabolic steroids does occur, and there are withdrawal symptoms. Withdrawal symptoms include depression, fatigue, restlessness, insomnia, loss of appetite, and decreased interest in sex. Some of the acute and chronic effects of anabolic steroids on males include atrophy of testicles, impaired production of sperm, infertility, early baldness, acne, and enlargement of the breasts. For females, there are masculizing effects including increased facial and body hair, lowered voice, and irregular or the stopping of the menstrual cycle. There is an increased risk of coronary artery disease. Anabolic steroids may cause jaundice and liver tumors. Mood swings with periods of unreasonable and uncontrolled anger and violence may be noted
Ethics ✔✔Ethics are the rules of conduct recognized in a particular profession, the shared standards of what is good practice. Note that the ethicalness and the legality of an action are two
different things, and occasionally they are in conflict. Ethical codes delineate mandatory ethics, the minimal standard of conduct that is acceptable. Ideally, counselors practice aspirational ethics, which focus on the spirit behind the code. For example, mandatory ethics permit a counselor to have a romantic relationship with a former client 2 years after the client's treatment ends. Aspirational ethics suggest that doing so even after 2 years is inadvisable.
Decision-making Models ✔✔Decision-making models provide a framework for systematically choosing a course of action when ethical codes do not specify how to act in a particular situation. The steps of one decision-making model are identify the problem, review the code of ethics and relevant laws, consult with another professional, consider possible courses of action and their consequences, choose a course of action, and evaluate the results
Fundamental Ethical Principles ✔✔Autonomy. Respect the client's independence and
selfdetermination. Nonmaleficence. Do not harm the client. Beneficence. Provide benefit for the client. Justice. Be fair to the client. Fidelity. Be faithful to the client. Veracity. Be truthful with the client.
The NAADAC Principles ✔✔The National Association of Alcoholism and Drug Abuse
42 CFR ✔✔refers specifically to information that can be used to identify a person as an alcohol
or drug abuser, or the recipient of a substance related diagnosis, referral, or treatment. Federal law (42 Code of Federal Regulations, Part 2) prohibits counselors from divulging
the fact that someone is in treatment or any details of their treatment without the client's written consent, when the client is in a clear state of mind. This applies to former clients, deceased clients, and those who merely applied to a treatment program but never attended.
HIPAA ✔✔covers all personal health information that can be used to identify an individual.
Exceptions to confidentiality ✔✔Confidentiality is not absolute; there are circumstances in
which releases of information are not required to disclose client information. Clients should be told of these circumstances as part of the process of securing their informed consent for treatment. In every case, only the information required by law is to be disclosed. Some exceptions include instances in which information necessary to provide services may be shared among staff of a program, reporting child abuse or neglect (Public Law 99-401), threatening to harm another person, threatening suicide, committing or threatening a crime on program property or against program staff, medical emergencies, elder abuse, and court orders.
Privilege ✔✔a legal concept that refers to a client's right to keep confidential information out
of legal proceedings. Technically, the client holds the privilege, so counselors may not disclose information in legal proceedings unless the client waives privilege or certain other conditions, which vary from State to State, are met.
Informed consent and releases of information ✔✔Client consents to release information about
their treatment must contain certain specific information. This includes, but is not limited to, the purpose of the disclosure, the person to receive the disclosed information, and the date or condition under which the consent will expire. The consent may be revoked in writing or verbally, at the client's discretion. Counselors have to obtain consent from minor clients before releasing information. By law, releases of information must include a statement that the recipient of the disclosure cannot make subsequent disclosures unless federal regulations permit them to do so.
Duty to warn ✔✔a client threatens to harm another person who is reasonably identifiable, the counselor has a duty to warn the appropriate authorities of that threat. In Texas, counselors do not have a duty to warn the intended victim. In some States, counselors do have that duty, which originated in the California Supreme Court decision in Tarasoff v. Regents of the University of California
Supervision ✔✔The purposes of supervision are to promote the counselor's growth, protect the
welfare of clients, monitor counselor performance, and empower the counselor to self-supervise and carry out their responsibilities as an independent professional. Powell (1998) describes four emphases of supervision: administrative, evaluative, clinical, and supportive
Consultation ✔✔A counselor seeks consultation in order to apply the expertise of another person
toward better serving a client. Examples of people with whom LCDCs might consult are a client's physician, a marriage and family therapist, an AA sponsor, or a religious leader.
Consultation between professionals within the same organization is called internal consultation. If the consultant and the consultee do not belong to the same organization it is called external consultation.
Referrals ✔✔n order to make proper referrals, LCDCs need to be able to recognize symptoms in
clients that require assessment by other professionals such as physicians, psychologists, or licensed professional counselors. They also need to be familiar with services available in the community such as legal services, emergency services, and Alcoholics Anonymous and other self-help groups. It is good practice to be personally familiar with the philosophy, programs, and personnel of the services to which clients are referred and to be active in the referral
Advocacy ✔✔Advocacy is any activity designed to obtain a service, practical help, support, or
information for a client. Examples of advocacy are obtaining practical help such as money to pay for travel to treatment and securing an adolescent client's school counselor's support for treatment. Advocacy requires that counselors maintain effective relationships with other professionals,
government organizations, and groups in the community that might be helpful to their clients' recovery.
Six stages that occur as a family deals with addiction ✔✔1. Denial usually takes place
early on when the occasional excessive drinking episodes are explained away by both partners as isolated instances with no reason for concern.
- Attempts to eliminate the problem may occur when the user's partner realizes that the using behaviors are not normal and tries to pressure the user to control/cut down or quit substance use.
- Disorganization and chaos occurs when the normal family operations have broken down and the user's partner has to deal with the critical situations that occur on a more frequent basis.
Assessments ✔✔Treatment and recovery continuum of care is the collection of data from the individual and corroborative sources to determine the extent of the individual's problem and their strengths, weaknesses, and needs. This information is used to formulate the plan of treatment to include goals and methods and resources to be used
Stabilization ✔✔Treatment and recovery continuum of care includes the need for detoxification
at an appropriate medical facility if needed.
Rehabilitation/treatment programs ✔✔Treatment and recovery continuum of care-will vary from
setting to setting with the primary focus on the care of the client. The continuum of treatment depends on the assessment and diagnosis of the client and can range from providing education, an intensive outpatient program, to an inpatient residential program.
Substance abuse and associated treatment services should be individualized and be of the type and intensity appropriate to meet the needs of the client.
Relapse prevention ✔✔Treatment and recovery continuum of care-an important part of treatment
from the time services are first provided. Counseling/treatment is basically working on problems and concerns that have played a role in the client's using behavior and to learn to make decisions and choices that do not facilitate relapse. Recovery and relapse are both ongoing processes not an event. Thus relapse prevention should be approached as a process with the identification of
individualized triggers and a plan to confront those triggers should they occur. Relapse prevention should be made a valuable part of the client's aftercare program and discharge goals
Abstinence violation effect ( Treatment, recovery continuum of care) ✔✔refers to the tendency
for some people to use substances problematically when they believe abstinence is too difficult a goal to achieve or maintain. AVE relates to what happens when a person attempting to abstain from a negative habitual behavior, such as drug use, engages in the behavior and then faces conflict and guilt by making internal attributions to explain why he or she did it, thus making the individual more likely to continue using the drug, for instance, in order to cope with self-blame and guilt
Drug substitution ✔✔is the substitution of a legal drug for an illegal one to assist the client in
making positive life changes. An example of this would be a methadone program.
Primary prevention ✔✔intended mainly for the young who have little or no experience with
drugs, and this approach tries to anticipate and prevent initial drug use by:
- Promoting abstinence
- Developing refusal skills
- Educating the young about the dangers of drugs
