Addiction Flashcards
ICD-10 criteria of dependence
- strong desire to take substance
- difficulties controlling substance use
- physiological withdrawal state
- tolerance
- neglect of alternative pleasures
- persistent despite evidence of harm
what is tolerance and how does it develop?
repeated dopamine release, receptors down-regulate so threshold is increased and normal experiences don’t evoke pleasure response
define lapse
single event
define relapse
falling into old pattern of behaviour
define conditioning
process of behaviour modification where an individual associates a desired behaviour with a previously unrelated stimulus
two types of conditioning
pavlov= classical conditioning skinner= operant conditioning
define reinforcement
increases frequency of behaviour
positive reinforcement
positive reward e.g. feeling more relaxed after using
negative reinforcement
getting rid of withdrawals
positive punishment
being shouted at
negative punishment
losing family or home
define habit
acquired pattern of behaviour regularly followed until it becomes almost involuntary
thinking errors/ unhelpful ideas
permission-giving minimisation rationalisation denial blame
what is the biopsychosocial model?
basic formation consists of presenting problems, predisposing, precipitating, protective and maintaining factors to do with addiction
define hazardous drinking
drinking alcohol in a way that increases risk of harm (>14 units/week)
define harmful drinking
drinking >35 units/week
calculate alcohol units
strength (ABV %) x volume (ml) divided by 1,000
screening for alcohol use
FAST
AUDIT
CAGE (dependence)
management of alcohol dependence
brief interventions e.g. services
motivational interveiwing
what causes alcohol withdrawal
CNS depression from alcohol
what does a sudden stop in alcohol intake cause?
unopposed excitation with decreased GABA and increased glutamate that is toxic to cells
presentation of alcohol withdrawal
24-48 hours restlessness tremor sweating N&V insomnia tachycardia hypertension generalised seizures
presentation of DTs
confusion hypertension fever hallucinations paranoid ideation cardiovascular collapse infection
management of alcohol withdrawal
BZDs
analgesics, adequate hydration, antiemetics, treat concurrent
relapse prevention
