777 final SUD Flashcards

Question

Caffeine Withdrawal

Answer 1

Prolonged daily use Abrupt cessation with 3 or more in 24 hrs: Headache Marked fatigue/drowsiness Depressed/dysphoric mood or irritability Difficulty concentrating Flu-like symptoms (N/V, muscle pain/stiffness) Distress/impairment Not due to another medical condition or mental disorder

Answer 2

``` Cessation of heavy, prolonged use Three or more symptoms within a week: Irritability, anger or aggression Nervousness or anxiety Sleep difficulty Decreased appetite or weight loss Restlessness Depressed mood Abdominal pain, tremors, sweating, fever, chills or headache Distress/impairment Not due to another medical condition or mental disorder ```

Answer 3

Binds with opioid receptors and blocks dopamine reuptake Can be stored for weeks in fat tissue and brain Impairs ability to form memories, recall events, and shift attention from one thing to another Long-term marijuana use produces amotivational syndrome Most widely used addictive substance in the US, following tobacco and alcohol; most commonly used illicit drug in the US More than 16 million Americans use cannabis on a regular basis; most common age of onset falling during teenage years Prevalence rate of cannabis usage continues to rise

Answer 4

Cannabis contains 2 major psychoactive components: Delta-9-tetrahydrocannabinol (THC) Cannabidiol (CBD) THC & CBD act on the endocannabinoid system Comprised of cannabinoid receptors (CB1 & CB2) & endogenous ligands CB1 receptors found primarily in hippocampus, cerebral cortex, basal ganglia, & cerebellum CB2 receptors expressed by cells of immune system, especially B cells THC distributed throughout body tissues Due to its lipid solubility & redistribution into fatty tissue, THC has long half-life (30-60 hrs) THC metabolized by cytochrome P450 system About 1/3 eliminated renally, 2/3 through fecal excretion

Answer 5

Psychotropic effects - due to THC actions on cannabinoid receptors in brain & regulation of GABA, glutamate, dopamine, noradrenaline, serotonin, & acetylcholine

Answer 6

Originally used as an anesthetic for humans animal tranquilizer. Dangerous side effects > removal from market, except for veterinary use Easily synthesized by home chemist Intoxication People frequently arrive at ED in a psychotic, violent, and agitated state. The high appears about 5 minutes after taking drug and lasts 4-6 hours. Effects may last up to 48 hrs; may be recovered from the blood and urine for 7-10 days Diazepam used for muscle spasms, seizures, and agitation. Haloperidol for severe psychotic behavior. Do not use phenothiazines since PCP is anticholinergic. Depression, fatigue, memory loss, difficulty in concentration, & poor impulse control Psychologic symptoms – euphoria, psychomotor agitation, anxiety, grandiosity, disorientation swings, emotional lability, sensation of slowed time, synesthesias (seeing colors when a loud sound occurs), facial grimacing, muscle rigidity, hallucinations, paranoid ideation Physical symptoms – vertical & horizontal nystagmus, ↑blood pressure & HR, insensitivity to pain, dysarthria, ataxia, perspiration, salivation, vomiting Dangers – violence, hypertension, respiratory depression and arrest, stupor, coma, convulsions, death, suicide

Answer 7

Reduce (or block) signals to the conscious mind from other parts of the brain Ketamine, PCP (angel dust) Intoxication can last 4 to 6 hours Interventions to reduce stimuli, maintain a safe environment for the patient and others, manage behavior, and observe for medical and psychiatric complications

Answer 8

Codeine, fentanyl, heroin, morphine, oxycodone, & hydrocodone Effects are pleasure (or reward) and pain relief Physical dependence can develop rapidly Withdrawal syndrome includes rebound hyperexcitability Naloxone (Narcan) given in emergency treatment of opiate intoxication Drugs used to treat addiction: Methadone Naltrexone oral or depo (Vivitrol) Buprenorphine, Suboxone

Answer 9

Types of opioid receptors: Mu Kappa Delta Addictive effects of opioids occur through activation of mu receptors Role of kappa and delta receptors in addictive process not well defined

Answer 10

``` Morphine Heroin Methadone Hydromorphone Buprenorphine Codeine Oxycodone Fentanyl Hydrocodone ```

Answer 11

Buprenorphine (Suboxone) , methadone, and naltrexone are used to treat opioid use disorders to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. These MAT medications are safe to use for months, years, or even a lifetime.

Answer 12

Naloxone is used to prevent opioid overdose by reversing the toxic effects of the overdose. According to the World Health Organization (WHO), naloxone is one of several medications considered essential to a functioning health care system.

Answer 13

…. is an opioid used for opioid maintenance therapy in opioid dependence and for chronic pain management. Detoxification using methadone can be accomplished in less than a month, or it may be done gradually over as long as six months. ***The half-life isfrom 8 to 59 hours***.

Answer 14

Buprenorphine is known as a partial opioid agonist and the effect is weaker than full agonists like heroin and methadone. It will prevent intoxication by opioids taken concurrently. Buprenorphine, sold under the brand name Subutex, among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain. It can be used under the tongue, in the cheek, by injection, as a skin patch, or as an implant. ****The half-life can vary from 24 to 60 hours***

Answer 15

Highly addictive drugs that cause people to feel euphoric, yet relaxed Prescribed for pain, anxiety, sleep CNS depressant Psychological symptoms: Euphoria, mood lability, loquacity, irritability, anxiety, impaired attention and memory, aggressiveness Physical symptoms Drowsiness, slurred speech, fever, long periods of sleep, vomiting, postural hypotension, lack of coordination, unsteady gait Withdrawal N/V, malaise/weakness, autonomic hyperactivity, tachycardia, sweating, ↑ BP, anxiety, depression, irritability, orthosatic hypotension, coarse temor of hands, tongue, and eyelids, painful muscle contractions, convulsions, status epilepticus, hallucinations Dangers: CNS depression, overdose and death, esp if mixed with alcohol

Answer 16

``` More than 100 different hallucinogens Psilocybin (mushroom) D-lysergic acid diethylamide (LSD) Mescaline Numerous amphetamine derivatives Produce euphoria or dysphoria, altered body image, distorted or sharpened visual and auditory perception, confusion, incoordination, and impaired judgment and memory ```

Answer 17

LSD, Mescaline, Mushrooms How Consumed swallowed, smoked Effects ↑ body temperature, HR, BP, loss of appetite, sleeplessness, numbness, weakness, tremors, altered states of perception and feeling, nausea Consequences persisting perception disorder (flashbacks)

Answer 18

↑ irritability and aggression Behavioral effects: euphoria, ↑ energy, sexual arousal, mood swings, distractibility, forgetfulness, and confusion ↑ risk for heart attacks and strokes, blood clotting, cholesterol changes, hypertension, depressed mood, fatigue, restlessness, loss of appetite, insomnia, reduced libido, muscle and joint pain, and severe liver problems ↓ sperm production, shrinking of testes, difficulty or pain in urinating Breast enlargement in men and masculinization in women

Answer 19

MDMA (Ecstasy, Molly) Stimulant Euphoria, energy Tachycardia, ↓ serotonin GHB Sedative Relaxation/well-being Post-use anxiety Rohypnol (Roofies ) Benzodiazepine Relaxation/loss of consciousness Post-use amnesia Ketamine (Special K) NMDA antagonist Vivid dreams & hallucinations Dissociation Methamphetamine (crystal) Stimulant Euphoria, hyperactivity Post-use depression & violence LSD (Acid) Hallucinogen Hallucinations Post-use flashbacks

Answer 20

Types: Glue, solvents, aerosol sprays, paint thinners Symptoms: slurred speech, lack of coordination, euphoria, dizziness, lightheadedness, hallucinations, delusions Repeated inhalant abuse may result in loss of inhibitions, lack of control, drowsy feelings that last several hours, lingering headache, confusion, N/V Effects: Heart failure and death within minutes after repeated inhalation, known as sudden sniffing death; can result from a single session of inhalant use by an otherwise healthy person. In case of an inhalant addiction, risk ↑ substantially Many people inhale vapors from common inhalants, referred to as huffing, not knowing that serious health problems can result. Side effects include: Hearing loss (spray paints, glues, dewaxers, dry-cleaning chemicals, correction fluids) Peripheral neuropathies resulting in difficulty with moving hands and feet or limb spasms (glues, gasoline, whipped cream dispensers, gas cylinders) CNS damage (spray paints, glues, dewaxers) Bone marrow damage (gasoline) Liver and kidney damage (correction fluids, dry-cleaning fluids) Blood oxygen depletion (varnish removers, paint thinners)

Answer 21

Gambling Disorder Reclassified from Pathological Gambling in DSM-IV Reflects increasing & consistent evidence that some behaviors, such as gambling, activate the brain reward system with effects similar to those of drugs of abuse and gambling disorder symptoms resemble substance use disorders to a certain extent. 4 of 9 symptoms (versus 5 or more of 10 in DSM IV) Removed criterion: “has committed illegal acts to finance gambling” 12 month period added

Answer 22

Dependency: unable to cope by themselves, but resent authority and the people they depend upon Impulsive: need immediate gratification because of low frustration tolerance; drink on impulse to relieve frustration and escape uncomfortable feelings Difficulty in identifying and expressing feeling Dominant and critical with underlying self-doubts and passivity Tendency to be aggressive and domineering; uses anger and hostility to distance and control Difficulty with intimacy and interpersonal relationships Irresponsible and avoidant: don’t take responsibility for actions

Answer 23

Conflict and violence is common Dysfunctional family patterns: involve all family members tend to be transmitted through the generations View that 1st problem person in family is the alcoholic, and then family tries to adapt to the changes One fundamental flaw is that there is no healthy way to adapt to alcoholism Therefore, as family tries to adapt to ↑ pressures and problems, they too become as sick as the alcoholic. Since alcoholism is a progressive disease, the family’s disease also becomes progressive.

Answer 24

``` Growing up in an addicted family creates certain patterns: Guessing at what normal is Judging self harshly Difficulty with intimacy Feeling different Super responsible or irresponsible Loyal even when undeserved Seeking crisis Avoiding conflict Fearing rejection and abandonment Cannot prioritize or manage time ```

Answer 25

An emotional dysfunction present in families with an alcoholic member Member who alternately rescues (enables) & blames (persecutes) alcoholic Characteristics: ``` Super responsible Overachiever and workaholic Caretaker Highly organized Competent Resilient with a high tolerance for pain Energetic and not easily fatigued Able to defer gratification indefinitely Skilled at crisis intervention Strongly moral – sense of right and wrong crucial to this person’s thinking Loyal and willing to put the needs of an important group before own needs Out of touch with needs and feelings Hypochondria Powerlessness Self-blame ****Adult Children of Alcoholics (or other substances)**** ```

Answer 26

In a family with a member with SUD... Roles of Children: Hero – Actively parents the parents and siblings, covers up for them, and works to promote harmony and to placate in a volatile dysfunctional family. Scapegoat – Behaves in negative ways so as to deflect blame from the alcoholic parent. Lost Child – Escapes into fantasy and also is at high risk for addiction. Mascot – Plays the role of the clown and diverts attention from the parents.

Answer 27

Brief Intervention Advising how to reduce client’s drug use Providing harm reduction info and/or relevant self-help manuals Give client information about: The consequences of a drug conviction on travel and employment The consequences of further or heavier drug charges Discussing harm reduction strategies especially those relating to Overdose Violence Driving under the influence Safe practices (e.g., safe injecting, safe sex) Offering and arranging a follow-up visit

Answer 28

Enmeshed family systems where user feels dependent, inadequate, and fearful of separation Substance user strives to preserve stability of the entangled family and keeps family in crisis and focused on problems brought about by the substance use If user improves and begins to individuate and separate from the family, the underlying familial problems emerge Thus, family has a stake in keeping the user addicted Drug use allows the addict to pseudoindividuate – to be both in and out of the family Families with alcoholic members suffer guilt, remorse, and alienation

Answer 29

``` Cognitive or psychoeducational groups Behavioral therapy Group psychotherapy Individual therapy Family therapy Relapse prevention Harm-reduction strategies Pharmacologic modalities ```

Answer 30

A support group for alcoholics, addicts etc. Al-Anon and Al-Ateen are groups for spouses, parents, and teenagers who are involved with alcoholics. The focus is on helping these non-alcoholics learn to live and work effectively with alcoholics. The underlying belief is that family members often assume the role of enablers or co-alcoholics, perpetuating the alcoholic’s drinking patterns. As the family attempts to adjust to the alcoholic’s lifestyle, they develop behavioral and emotional problems. Protected by the enabler, the alcoholic is spared the consequences of his or her alcoholism. The alcoholic blames he enabler and the enabler feels guilty and attempts to control family life and the behaviors of the alcoholic, e.g., throwing out liquor, taking the car keys. This does not work. Consequently, enablers feel worthless and helpless because they are unsuccessful in terminating the alcoholism. NA is Narcotics Anonymous and WFS is Women for Sobriety. 12 Steps of AA