Substance Use & Mental Health

What is 'dual diagnosis'?

• AAlways having serious conditions
• BTwo separate diagnoses unrelated to each other
• CHaving a mental health condition and a substance use disorder✓
• DHaving two psychiatric conditions

Answer: Dual diagnosis (or co-occurring conditions) refers to someone experiencing both a mental health condition and a substance use disorder.

How does alcohol misuse affect mental health?

• AIt affects physical health, not mood
• BIt protects against mental illness because it helps people relax and sleep better
• CIt improves mood temporarily but increases depression and anxiety long-term✓
• DIt has no effect on mental health

Answer: Alcohol can temporarily reduce anxiety but worsens depression and anxiety over time, disrupts sleep, and can trigger or worsen mental health conditions.

What are stimulant drugs?

• ADrugs whose main effect is to cause hallucinations and distort perception, such as LSD and magic mushrooms
• BSubstances used in a clinical setting to sedate patients
• CDrugs that increase alertness and energy, including cocaine, methamphetamine, and excessive caffeine✓
• DDrugs that relieve pain by blocking pain signals, such as codeine, morphine and other opioid painkillers

Answer: Stimulants increase alertness and arousal. They include prescription medications (for ADHD), cocaine, methamphetamine, and excessive caffeine.

What is 'self-medication'?

• ATaking over-the-counter medications
• BUsing substances to manage mental health symptoms without professional guidance✓
• CSeeing a doctor
• DTaking prescribed medication exactly as directed by the doctor who prescribed it for you

Answer: Self-medication is using drugs or alcohol to manage difficult emotions or mental health symptoms, which typically worsens outcomes.

What is 'harm reduction'?

• APractical strategies to minimise the negative impacts of substance use✓
• BIgnoring substance use problems
• CStopping all substance use immediately and completely
• DEncouraging substance use

Answer: Harm reduction involves practical strategies to reduce the harmful effects of substance use, such as needle exchange, supervised consumption, or gradual reduction.

What is cannabis's potential impact on mental health?

• AIt can trigger psychosis, worsen anxiety, and impair memory, especially with regular use or in vulnerable people✓
• BIt has no effect on mental health, whether it is used occasionally or daily over many years
• CIt is a proven treatment for anxiety
• DIt's safe for everyone

Answer: Cannabis can trigger or exacerbate psychosis, increase anxiety, impair concentration, and worsen depression, particularly with heavy or early-life use.

What is alcohol use disorder (AUD)?

• ADrinking wine rather than beer or spirits, on a regular basis at home
• BDrinking occasionally at weekends and on special occasions with friends
• CA pattern of alcohol use causing significant impairment or distress✓
• DDrinking more than 14 units in a week, on at least one occasion in the past year

Answer: AUD is a medical condition characterised by inability to control drinking, continued use despite problems, and withdrawal symptoms.

What are depressant drugs?

• APrescription antidepressants, which are thought to slow the nervous system down over several weeks
• BSubstances that cause a person to feel depressed, whatever their effect on the nervous system
• CDrugs that slow the central nervous system, including alcohol, benzodiazepines, and opioids✓
• DIllegal drugs such as heroin, since legal substances like alcohol do not slow the nervous system

Answer: Depressants slow brain activity. They include alcohol, benzodiazepines, sedatives, and opioids.

What is 'substance dependence'?

• ATaking prescription medications exactly as they were directed
• BPsychological or physical need for a substance causing withdrawal when stopping✓
• CUsing a substance once
• DTrying any illegal drug

Answer: Dependence involves physical or psychological need for a substance, often with tolerance (needing more) and withdrawal symptoms when stopping.

What is 'withdrawal' from substances?

• APhysical and psychological symptoms when stopping substance use after dependence✓
• BGiving up a substance easily and without any lasting effect on the body or the mood
• CBeing withdrawn or quiet in social situations
• DBeing unable to get hold of enough of a substance to last until more can be bought

Answer: Withdrawal involves uncomfortable physical and psychological symptoms when stopping substance use after dependence - symptoms vary by substance.

How should you support someone with dual diagnosis?

• AIntegrate treatment addressing both conditions together✓
• BTell them to choose which problem to tackle first and deal with the other one later
• CFocus only on the mental health condition and ignore the substance use
• DTreat the two conditions in separate services

Answer: Integrated treatment addressing both mental health and substance use simultaneously is most effective for dual diagnosis.

What is 'binge drinking'?

• ADrinking a single glass of wine with a meal on several evenings a week over a long period of time at home
• BDrinking beer at a pub
• CConsuming large amounts of alcohol in a short period (typically 6+ units for women, 8+ for men)✓
• DHaving a drink once a week

Answer: Binge drinking is consuming large quantities of alcohol in a short timeframe, typically defined as 6+ units (women) or 8+ units (men) in one session.

What is the recommended alcohol limit for UK adults according to government guidance?

• A21 units for men, 14 for women
• B30 units per week
• C14 units per week for both men and women✓
• DNo safe limit

Answer: UK government guidance recommends 14 units per week for both men and women, spread over the week with alcohol-free days.

What does 'tolerance' mean in substance use?

• ABeing free of any problems from substance use, however much of it is taken
• BUnderstanding how other people's substance use affects the family around them
• CNeeding increasing amounts of a substance to achieve the same effect✓
• DAccepting that a person uses substances

Answer: Tolerance develops when the body adapts to a substance, requiring larger doses to achieve the same effect.

What organisations in the UK provide support for substance use and mental health?

• ANHS, charities (like We Are With You, Turning Point), and community services✓
• BThe NHS, since charities are not permitted to offer this kind of help in the UK
• CCharities, because the NHS does not provide substance use services in the UK
• DPrivate clinics, since NHS and charity services are for people under 18

Answer: UK support includes NHS addiction services, community drug and alcohol teams, and charities such as We Are With You (formerly Addaction), Turning Point and Alcoholics Anonymous.

What is the relationship between opioids and mental health?

• AOpioids improve mental health by lifting mood and reducing anxiety in the long term
• BOpioids can cause depression, anxiety, and have high addiction potential✓
• COpioid use and a person's mental health are entirely unrelated to one another
• DOpioids cure mental illness, and are prescribed as a first-line treatment for depression

Answer: Opioid misuse is associated with depression, anxiety, and high risk of dependence and overdose.

True or False: Someone with substance use problems should completely avoid all support until they are 'ready' to quit.

• ATrue, forcing support is unhelpful
• BFalse, but only for legal substances
• CFalse, harm reduction and support can be offered at any stage✓
• DTrue, they'll never recover without motivation

Answer: Support can be offered at any stage through harm reduction approaches. Delaying intervention until someone reaches 'rock bottom' often prevents life-saving support from being provided earlier.

What is the impact of social isolation on substance use and mental health?

• ASocial connection increases substance use, so people do better when they are on their own
• BA neutral factor
• CIsolation increases risk of both substance misuse and worsening mental health✓
• DIsolation helps people recover

Answer: Social isolation increases vulnerability to substance misuse and worsens mental health outcomes, making connection crucial for recovery.

What should you do if you're concerned about someone's substance use?

• AExpress concern in a non-judgmental way and offer support/resources✓
• BReport them to the police straight away, whatever the substance and whatever the circumstances
• CConfront them aggressively in front of others so that they have to face it
• DIgnore it and hope that it improves by itself once their circumstances change

Answer: Express genuine concern without judgement, listen without lecturing, and offer supportive resources and professional help.

Can mental health conditions and substance use both be treated successfully?

• ANo, the substance use has to be treated first and the mental health left until later
• BYes, integrated treatment addressing both is effective✓
• CSubstance use cannot be treated
• DMental health cannot be treated

Answer: Yes, integrated treatment approaches addressing both conditions simultaneously have high success rates and better long-term outcomes.