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 only affects physical health
• BIt always prevents 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?

• AAlways prescription medications, given by a doctor for conditions such as narcolepsy or attention problems
• BMedications only for ADHD
• CDrugs that increase alertness and energy, including cocaine, methamphetamine, and excessive caffeine✓
• DOnly legally available substances such as caffeine, nicotine and the energy drinks sold in ordinary shops

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
• 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 at all, whether it is used occasionally or every day over many years
• CIt always improves mental health
• 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 only 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✓
• DAny use of alcohol at all, including a single drink taken with a meal

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

What are depressant drugs?

• AOnly prescription antidepressants, which are thought to slow the nervous system down over several weeks
• BMedications prescribed for depression only, such as the tablets a GP gives for persistent low mood
• CDrugs that slow the central nervous system, including alcohol, benzodiazepines, and opioids✓
• DOnly illegal drugs, since no legally available substance is able to slow the central nervous system

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

What is 'substance dependence'?

• ATaking prescription medications as 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 shy or quiet
• 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
• DFocus only on substance use

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✓
• DAcceptance of substance use

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 Addaction, Turning Point), and community services✓
• BOnly the NHS, since charities are not permitted to offer this kind of help
• COnly charities, because the NHS does not provide any substance use services in the UK
• DSupport is available only from private clinics, which charge for every session

Answer: UK support includes NHS addiction services, community drug/alcohol teams, and charities like 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 judgment, listen without lecturing, and offer supportive resources and professional help.

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

• AOne condition must always be worse than the other, and only that one is treated
• BYes, integrated treatment addressing both is effective✓
• COnly mental health can be treated
• DOnly substance use can be treated

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