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Y4 PSYCH OSCEs / lecture week > Addiction and drugs of abuse > Flashcards

Addiction and drugs of abuse Flashcards

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1
Q

What is the psychoactive component in cannabis?

A

THC
Binds to CB1 receptors
(Leads to an indirect dopamine release)

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2
Q

How long does cannabis remain in the body?

A

Lipid soluble so remains in system for longer
Days in infrequent use / weeks in chronic use

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3
Q

What are the psychological effects of cannabis?

A

Relaxation
Euphoria
Altered perceptions
Irritability
Paranoia

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4
Q

What are the physical effects of cannabis?

A

Dry mouth
Dry eyes
Tachycardia
Hunger

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5
Q

What are the chronic / adverse effects of cannabis?

A

Low motivation
Depression
Anxiety (major factor in perpetuation of cycle of use)
Psychosis
Associated tobacco risks

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6
Q

What effects does MDMA have on the brain?

A

Blocks SEROTONIN reuptake so increases quantity of free serotonin at synapse
Increases dopamine (reward, pleasure) and noradrenaline (stimulant)

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7
Q

What are the psychological effects of MDMA?

A

Euphoria
Increased EMPATHY towards others
Increased energy
Altered perceptions eg SYNAESTHESIA

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8
Q

What are the physical effects of MDMA?

A

Hyperthermia
Dry mouth
MYDRIASIS
Hypertension
Tachycardia
BRUXISM (clenched / grinding jaw)

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9
Q

What are the chronic / adverse / come down effects of MDMA?

A

COME DOWN: anxiety, low mood, low energy
ADVERSE: low mood, anxiety, overdose, HYPONATRAEMIA secondary to water intoxication –> seizure –> DEATH

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10
Q

What effect do amphetamines have on the brain?

A

DISRUPTS STORAGE OF NEUROTRANSMITTERS such as dopamine, serotonin and noradrenaline in synaptic vesicles
Leads to increased amounts due to transporters running in reverse –> STIMULANT effect

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11
Q

What are the physical effects of amphetamines?

A

TACHYCARDIA
Hypertension
Increased resp rate
DECREASED HUNGER + NEED FOR SLEEP

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12
Q

What are the chronic / come down / withdrawal effects of amphetamines?

A

COME DOWN: low mood, lethargy
CHRONIC: psychosis, depression, anxiety, dependence
WITHDRAWAL: cravings, low mood, increased sleep, anhedonia

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13
Q

What effects does LSD have on the brain?

A

Binds to 5-HT receptors causing serotonin release
ALTERS SHAPE of receptor to form a stronger bind –> LONGER half-life and effect
Increased levels of dopamine and glutamte

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14
Q

What are the psychological effects of LSD?

A

Can vary
Altered perceptual states (synaesthesia, dissolution)
Visual and auditory hallucinations

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15
Q

What are the physical effects of LSD?

A

Mild tachycardia
Mild hyperthermia
Mydriasis

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16
Q

What are the come down / adverse effects of LSD?

A

COME DOWN: anxiety, reduced concentration, reduced appetite
ADVERSE: bad trip, risk of PSYCHOSIS in CHRONIC use but does not induce dependence
HPPD = Hallucinogen Persisting Perception Disorder - continuing to experience perceptual distortions months / years after stopping drug

17
Q

What effect does heroin have on the brain?

A

A PRO-DRUG - crosses blood-brain barrier and is converted to MORPHINE
Binds to MU-OPIOID receptors –> euphoria and analgesia
Inhibits GABA causing increased DOPAMINE

18
Q

What are the psychological effects of heroin?

A

Euphoria
Relaxation
Sense of COMFORT
Anxiolytic

19
Q

What are the physical effects of heroin?

A

REDUCED RESP RATE
Bradycardia
CNS depression
CONSTRICTED PUPILS

20
Q

What are the come down / adverse effects of heroin?

A

Tolerance soon develops –> dependence
DEATH due to RESPIRATORY DEPRESSION
Significant withdrawal features

21
Q

What are the effects of cocaine / crack on the brain?

A

Blocks MONOAMINE reuptake transporters
Leading to increased dopamine, noradrenaline and serotonin
Crack = short half-life (minutes), Cocaine = longer, less sharp high

22
Q

What are the psychological effects of cocaine / crack?

A

Elation
Increased ENERGY
CONFIDENCE

23
Q

What are the physical effects of cocaine / crack?

A

Dry mouth
MYRDIASIS
Vasoconstriction
TACHYCARDIA
Decreased appetite

24
Q

What are the come down / adverse effects of cocaine / crack?

A

COME DOWN: low mood, irritability, tremors, difficulty concentrating
ADVERSE: stroke, CARDIAC TOXICITY, ENT complications

25
Q

What are the biological treatment approaches for addiction and drugs of abuse?

A

ANTIDOTES –> naloxone (opioids), flumazenil (Benzos)
DETOXIFICATION –> methadone, diazepam
SUBSTATION –> methadone, buprenorphine
DETERRENCE –> disulfiram (alcohol)
ANTI-CRAVING –> acamprosate (maintenance of abstinence), naltrexone (for cutting down)

26
Q

What is the recommended psychological treatment for substance abuse?

A

Motivational interviewing - works to increase motivation to stop
Brief interventions
CBT
Contingency management
Self help

27
Q

What are the opiate replacement therapy options?

A

Both have long half-life and prevent withdrawals without giving an opiate high
METHADONE
-Liquid (luminous green, tablet / injection
-10-30mg/daily (starting dose)
-Maintenance up to 100mg daily under supervision
BUPRENORPHINE
-Tablet, sublingual or depot
-4mg/day (starting dose)
-Maintenance up to 8-16mg or 32mg under supervision
-Blocking action means illicit use does not produce a high

28
Q

What is important to remember when giving buprenorphine to an opiate user?

A

Has partial agonist and antagonist properties so can precipitate a WITHDRAWAL in those using high dose opiates

29
Q

What are the key symptoms of opiate withdrawal vs overdose?

A

OVERDOSE:
-RESP DEPRESSION
-Bradycardia
-Reduced GCS
-Pinpoint pupils
WITHDRAWAL:
-Muscle aches, lacrimation, agitation
-Excessive yawning, rhinorrhoea
- Sweating, tachycardia, HTN, sleep disturbance (autonomic hyperactivity, N+V+D, dysphoria, craving

30
Q

What is the treatment for overdoses?

A

NALOXONE
Competitive opiate antagonist (V SHORT HALF-LIFE so beware risk of further overdose in cases of long-acting high dose opiates)
IM and nasal spray

Y4 PSYCH OSCEs / lecture week (10 decks)

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