Co-Occurring Substance Use Flashcards

A client discloses opioid use to manage chronic pain but denies any anger problems. Their spouse reports frequent rage episodes at home. The CART therapist's best next step is:

Answer: Explore the discrepancy between self-report and collateral information with the client

Exploring discrepancies between self-report and collateral information in a non-confrontational manner is central to motivational and ethical clinical practice.

Cannabis use is associated with anger in some clients primarily because of:

Answer: Paradoxical disinhibition and increased paranoia in certain users

While cannabis has calming effects for many users, it can cause paradoxical disinhibition, anxiety, and paranoia in some, triggering or worsening anger responses.

Which of the following best describes 'telescoping' in the context of substance use and anger?

Answer: A more rapid progression of substance use disorder in certain populations

Telescoping refers to the accelerated progression of substance use disorder seen in some populations (often women), moving faster from first use to dependence.

When treating co-occurring anger and stimulant use disorder, which coping skill addresses both the physiological arousal of anger and drug craving simultaneously?

Answer: Diaphragmatic breathing and progressive muscle relaxation

Diaphragmatic breathing and progressive muscle relaxation reduce physiological arousal that underlies both anger escalation and craving responses.

A CART therapist notices a client frequently cancels sessions the day after reported heavy drinking. The most appropriate response is to:

Answer: Address the pattern collaboratively and adjust treatment structure

Addressing attendance patterns collaboratively allows therapists to adapt the treatment plan to the client's actual capacity and reduce barriers to engagement.

Which of the following best explains why benzodiazepine withdrawal can trigger intense anger in clients?

Answer: GABA suppression during withdrawal increases CNS excitability and irritability

Benzodiazepine withdrawal suppresses GABA, causing CNS hyperexcitability, anxiety, and heightened irritability that can manifest as intense anger.

Trauma-informed care in the context of co-occurring anger and substance use recognizes that:

Answer: Substance use and anger are often trauma responses rather than character flaws

Trauma-informed care views both substance use and anger as adaptive responses to traumatic experiences, reducing stigma and improving therapeutic engagement.