Co-Occurring Substance Use Flashcards

Which ethical obligation applies when a client with co-occurring anger and substance use disorder discloses intent to harm a specific person while intoxicated?

Answer: Apply Tarasoff duty to warn/protect while following state-specific legal requirements

The Tarasoff duty to warn requires therapists to take reasonable steps to protect identifiable third parties from credible threats, regardless of co-occurring substance use.

Nicotine use among clients with anger issues is clinically significant because:

Answer: Nicotine withdrawal significantly increases irritability and anger between uses

Nicotine withdrawal between cigarettes causes measurable increases in irritability and anger, which are then temporarily relieved by smoking, reinforcing the cycle.

A client with opioid use disorder and explosive anger disorder is most likely to benefit from which combined pharmacological and behavioral approach?

Answer: Buprenorphine/naloxone combined with anger-focused CBT

Buprenorphine/naloxone for opioid use disorder combined with anger-focused CBT addresses both conditions simultaneously with strong evidence for each component.

Which stage of change (Prochaska & DiClemente) is a client in when they say, 'I know my drinking makes my temper worse, but I'm not ready to quit yet'?

Answer: Contemplation

The client recognizes the problem (awareness) but has not committed to change, which defines the contemplation stage of the transtheoretical model.

A CART therapist working with a client who uses heroin to 'numb rage' should prioritize which intervention in the FIRST session?

Answer: Safety assessment, rapport building, and exploring the function of substance use in managing anger

Safety assessment, rapport building, and understanding the emotional function of substance use are foundational first-session priorities before any formal intervention begins.

Research on domestic violence and substance use indicates that:

Answer: Substance use is a co-occurring risk factor that lowers inhibition, but anger and control issues must be addressed separately

Substance use lowers inhibition and increases violence risk, but underlying anger and control issues require direct intervention even after achieving sobriety.

Which relapse prevention strategy specifically addresses the anger-substance use cycle?

Answer: HALT (Hungry, Angry, Lonely, Tired) check-ins as early warning signals

HALT is a relapse prevention tool that prompts clients to check for Hungry, Angry, Lonely, or Tired states — all known triggers for substance use relapse.