Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NB3 > Addiction Medicine > Flashcards

Addiction Medicine Flashcards

1
Q

What are the hallucinogens & related substances?

A 
• Hallucinogens
• Lysergic acid
diethylamide
• Mescaline (cactus)
• Psilocybin (mushroom)
• Cannabis
• Marijuana
• Dissociative anesthetics
• Ketamine • PCP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are opioids?

A 
Heroin
• Morphine
• Codeine
• Methadone 
• Oxycodone 
• Fentanyl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Classify the hallucinogens?

A 
Classic hallucinogens
• Lysergic Acid Diethylamide (LSD) 
• Mescaline
• Psilocybin (Magic Mushroom)
Above cause Hallucinations

Cannabis
• Marijuana
• Hashish

Above cause Distortions

Dissociative Anesthetics
• Phencyclidine (PCP)
• Ketamine
Above cause Depersonalization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What’s the impact of hallucinogens and related substances?

A

Physical alterations
• Sympathomimetic drugs

Perceptual alterations
• Visual distortions (colors, trails, palinopsia)
• Auditory distortions (intensification and
echo)

Cognitive alterations
• Distorted thinking
• Trouble concentrating, working memory
impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What’s the effect of classic hallucinogens (LSD, Mescaline, Psilocybin)?

A

High potency (effects from 25 micrograms)

  • No known direct deaths from overdose
  • Effects last 8-12 hours
  • No known withdrawal symptoms
  • Low addiction rates

• Intoxication profile: increased heart rate, increased BP,
sweating, mydriasis, dehydration, euphoria, paranoia, sensory distortion, visual hallucinations, reduced appetite, wakefulness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What’s the impact of LSD in schizophrenia?

A
  • LSD likely plays a role in precipitating the onset of acute psychosis in healthy individuals with risk of schizophrenia (family history)
  • People with severe schizophrenia = higher likelihood of experiencing adverse effects from LSD

• Potential persistent psychosis
• Hallucinogen Persisting Perception Disorder (HPPD)
• Flashbacks of visual hallucinations / distortions experienced
during a previous hallucinogenic drug experience

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the side effects of classic hallucinogens?

A

Negative experiences (“bad trips”) produce intense negative emotions:

  • Irrational fears
  • Anxiety
  • Panic attacks
  • Paranoia
  • Rapid mood swings
  • Hopelessness
  • Intrusive thoughts of harming others
  • Suicidal ideation

No predictive factors for bad trips

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What classic hallucinogens are therapeutics?

A

• Current research is examining hallucinogens as treatment for intractable trauma/stress disorders and anxiety disorders

• Breakdown of “Ego” by introducing “impermanence of reality”
and separation of the self from thoughts and feelings
• Dissociation
• Hallucinations
• Cognitive distortions
• Time distortion

• Skilled psychotherapeutic guidance required when someone
is having a bad trip or under therapeutic circumstances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is cannabis?

A
  • Naturally-grown plant, number of species disputed:
  • Cannabis sativa
  • Cannabis indica
  • Cannabis ruderalis
  • Fourth most used recreational substance worldwide, after alcohol, caffeine, and tobacco
  • 100 million+ Americans have tried cannabis at least once
  • 25 million+ Americans used Cannabis within the past year
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe general cannabis

A

Cannabis: 460+ chemical compounds, 80+ are cannabinoids

  • Well-studied:
  • Tetrahydrocannabinol (THC)
  • Cannabidiol (CBD)
  • Cannabinol (CBN)
• Triphasic psychoactive effects:
1. Relaxation and slight euphoria
2. Introspection & metacognition
(also anxiety & paranoia)
3. Increased heart rate and appetite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where are the cannabis receptors located?

A

• CB1/CB2 cannabinoid receptors = effects of cannabinoids

• CB1 receptors mostly in the brain = psychoactive effects
• CB2 receptors mostly peripherally throughout the body =
modulate pain and inflammation

  • Effects last 2-4 hours (if smoked)
  • Effective in chemotherapy-induced nausea and vomiting
  • More data needed on chronic pain & inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How are cannabis side effects similar to LSD?

A

Similar to LSD:
• Low addiction potential

• “Bad trips” produce intense negative emotions

• May precipitate the onset of acute psychosis in healthy
individuals with risk of schizophrenia (family history)

• People with severe schizophrenia = higher likelihood of
experiencing adverse effects from cannabis

• No evidence of long-term cognitive impairment
• Intoxication profile: Conjunctival injection, dry mouth, increased
appetite, poor muscle coordination, delayed reaction times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe cannabis withdrawal symptoms

A 
Psychological
• Irritability,nervous
• Dysphoricmood
• Sleepdisturbance(insomnia,vividdreams) 
• Decreased appetite

Physical
• Headaches, night sweats, stomach cramps
• Shakiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the intoxication symptoms of dissociative symptoms(PCP, Ketamine)?

A
  • First synthesized in 1926 and brought to market as an anesthetic medication in the 1950s.
  • Removed from market in 1965 due to hallucinatory (and other) side effects
  • Intoxication symptoms:
  • Depersonalization & Decreased responsiveness to pain
  • Increased heart rate, blood pressure, and respiration
  • Agitation, belligerence, confusion
  • Impulsivity, unpredictability
  • Nystagmus, hyperacusis
  • Ataxia, muscle rigidity, seizure, coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is PCP intoxication treated?

A

Psychiatric emergency if individual is violent & unpredictable

  • Treatment of PCP Intoxication:
  • Benzodiazepines/antipsychotics
  • Reduce environmental stimulation
  • Restraints if needed

• No withdrawal syndrome is recognized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the commonalities of hallucinogens and related substances?

A

Commonalities: Perceptual changes and no withdrawal syndrome EXCEPT cannabis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe LSD effect

A

Hallucinations

Moderate symptoms severity

Eyes: dilated

Calm Behavior

18
Q

Describe cannabis

A

Distortions

Mild symptom severity

Red eyes

Amotivated behavior

19
Q

Describe PCP

A

Depersonalized perceptions

Severe symptom severity

Nystagmus eyes

Volatile behavior

20
Q

What are the opioids examples?

A
  • Heroin
  • Morphine
  • Codeine
  • Methadone
  • Oxycodone
  • Fentanyl
21
Q

What are opioids?

A
  • Morphine (naturally derived from poppy plants)
    • Heroin (derived from morphine)
    • Codeine (derived from morphine)
  • Oxycodone (naturally derived from poppy plants, similar to morphine)
  • Buprenorphine (naturally derived from poppy plants, similar to morphine)
  • Fentanyl (synthetic opioid developed by Janssen in 1960)
  • Methadone (synthetic opioid developed in Germany 1937)
22
Q

What 8s the intoxication profiler of opioids?

A

Analgesics to reduce pain

  • Side effects / Intoxication profile:
  • Euphoria of varying intensity
  • Decreased respiration
  • Low blood pressure
  • Constipation
  • Drowsiness
  • Impaired cognitive function
  • Unconsciousness
  • Miosis
23
Q

What are the opioid withdrawal symptoms?

A 
Withdrawal symptoms:
• Dysphoria
• Nausea, vomiting, diarrhea
• Muscle aches
• Lacrimation, rhinorrhea
• Piloerection, sweating, fever
• Yawning
• Pupil dilation

Usually non-life threatening, but very uncomfortable, potentially leading to continued use. Overdose potentially deadly

24
Q

How is an opioid overdose treated?

A 
Naloxone
• Short acting opioid receptor
antagonist
• Used for acute overdose
• Not used for treatment of
addiction
• Reverses respiratory and
CNS depression
25
Q

How can we treat opioid addiction?

A
  1. Abstinence based therapy (Requires complete abstinence)
    • Naltrexone
    • Long-acting opioid receptor antagonist
    • Block opioid effects if relapse occurs
    • Does not treat physical symptoms of abstinence
    • Protracted abstinence syndrome: Anhedonia from
    downregulation of dopamine and opioid receptors
    • Person feels physically unwell
    • 90%+ failure rate
  2. Replacement therapy (Reduces severe risk of harm)
    • More successful that abstinence-based therapy because it avoids anhedonia and physical discomfort during withdrawal as seen with abstinence
    • Special restrictions when used to treat opioid addiction
    • Not a “silver bullet”
    • Does not resolve mental health and social-environmental
    systems that increase risk of addiction
    • Why is the addict taking the drug in the first place?
2. Replacement therapy (Reduces severe risk of harm)
• Methadone
• Full opioid agonist
• Addictive and potentially dangerous
• Available at regulated Opioid
Treatment Program (OTP)
• Not prescribed – only administered
26
Q

How can replacement therapy treat opioid addiction?

A

Replacement therapy (Reduces severe risk of harm)
• More successful that abstinence-based therapy because it avoids anhedonia and physical discomfort during withdrawal as seen with abstinence
• Special restrictions when used to treat opioid addiction
• Not a “silver bullet”
• Does not resolve mental health and social-environmental
systems that increase risk of addiction
• Why is the addict taking the drug in the first place?

2. Replacement therapy (Reduces severe risk of harm)
• Methadone
• Full opioid agonist
• Addictive and potentially dangerous
• Available at regulated Opioid
Treatment Program (OTP)
• Not prescribed – only administered

Replacement therapy (Reduces severe risk of harm)
• Buprenorphine
• Partial opioid agonist
• Less addictive and dangerous
• Available from physician (prescribed, administered,
dispensed)
• Buprenorphine + naloxone*
* Naloxone counteracts buprenorphine if it is abused (e.g., injected)

2. Replacement therapy (Reduces severe risk of harm)
• Duration and Benefits
• Usually continues for at least 1-2 years
• Oral administration
• Stable drug levels
• Less euphoria and less drowsiness
• Improved overall health, productivity
• Reduced crime
27
Q

Summarize pupil response of drugs known

A
28
Q

How can we screen for alcohol and drug use?

A

Summary of pupil response

Miosis (pupil constriction):
• Opioid intoxication (pinpoint)
• Stimulant withdrawal

Mydriasis (pupil dilation):
• Stimulant intoxication
• LSD intoxication
• Opioid withdrawal

29
Q

How can we screen for alcohol and drug use?

A 
• Used in primary care:
1.History taking
2.Screening Tools (e.g., CAGE, AUDIT, NDA-Modified
ASSIST) 
3. Advising
30
Q

What are the CAGE questions?

A

CAGE
– Have you ever felt you should Cut down your drinking?
– Have people Annoyed you by criticizing your drinking?
– Have you ever felt bad or Guilty about your drinking?
– Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?

2 or more YES = clinically significant: Follow-up

31
Q

What is the AUDIT?

A
32
Q

What is the NIDA-Modified ASISST?

A
33
Q

How should patient advising be held for the screeningif alcohol and drug use?

A
34
Q

How should do drug rehabilitation occur?

A

Patient Advising:
• Review screening results

• Based on risk level:
– Review potential drug-related health consequences
– Recommend reducing/quitting drug use (with or without medical supervision)
– Evaluate for co-existing problems (e.g., depression, anxiety, infectious diseases)
– Refer for a comprehensive alcohol/drug assessment (screening tools do not provide a diagnosis)
– Educate about treatment options
– Assist in making changes, if patient is ready to change (goal setting, Rx meds)

35
Q

Describe the acute treatment of drug rehabilitation

A

• In-patient setting for maximal environmental structure
• Usually 90+ days
• No “cure” - ongoing management
• Fraction receive help (20.7 million people (age 12+) needed
treatment for a SUD; 4 million (19%) received it (2017)

  • Acute treatment phase:
  • Detoxification and management of withdrawal symptoms/cravings • Treat associated medical problems
  • Plan to address comorbid psychiatric illnesses
36
Q

Explain the nuances of the rehabilitation of drug abuse

A

• Treating SUDs is complex
• Substance use can impact frontal cortex (executive functions):
• Impulse control & inhibition
• Judgement & Decision-making
• Planning
• Reward pathway, tolerance, withdrawal, craving
• Behavior conflict can cause justifications: denial, minimization, defiance,
rationalization

• “Replacement” of the frontal cortex (proxy executive
functions) followed by resilience-building to life stressors
• Just “suck it up and do it” not likely to work

37
Q

Describe the recovery phase of drug rehabilitation

A

Recovery Phase – medium environmental structure
• Goal is to prevent relapse
• Avoid the Abstinence Violation Effect

• Multi-modal approach
• Cognitive therapy (identify & correct self-defeating thoughts)
• Behavioral therapy (remove/recondition cues, contingency
management)
• Community groups (12-step programs) for impulse control (sponsors)
• Family therapy
• Medication-assisted treatment to decrease craving or replacement
therapy (e.g., naltrexone, buprenorphine, disulfiram)

38
Q

How can self help groups aid in drug rehabilitation?

A

Self-Help Groups for Relatives/Friends

  • Forum to share experiences (challenges and successes) regarding loved- one’s addiction
  • Learn effective ways to cope with loved-one’s addiction - avoidance of enabling behaviors:
  • Actions and/or reactions to the addicted person that perpetuate the addictive behavior
39
Q

What is gambling disorder?

A

Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting 4+ of the following (9 symptoms) in a 12-month period

  • Not due to manic episode
  • Related to impulse control
40
Q

What are the symptoms of gambling disorder?

A
  • Preoccupationwithgambling
  • Gambling increasing amounts of money to achieve excitement
  • Unable to control ,cut back or stop
  • Used to escape from problems
  • Gambling to recoup losses
  • Lying to conceal extent of gambling
  • Illegal acts to finance gambling
  • Jeopardizing or losing relationships
  • Reliant on others for money to pay debts
41
Q

How can we manage gambling disorders?

A

SSRIs, opioid antagonists
• To control gambling “cravings”

Cognitive behavioral therapy
• Understand stress triggers
• Relaxation techniques to manage cravings

Gamblers anonymous
• 12-step process to admit and understand underlying contributing factors
Family therapy
• Support of loved ones for stress managemen

NB3 (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions