Addiction Medicine Flashcards
Withdrawal symptoms in the absence of a drug
Physical dependence
A neurobiologic disease with genetic and psychosocial contributions leading to compulsive use and cravings despite harmful consequences
Addiction
4 common themes in clinical practice that can lead to addiction
- Early exposure, depression, difficulty coping with loss
- Unsafe recovery environment
- Family history, childhood abuse, and neglect
- Inappropriate gateway prescription use, co-morbid mental illness
3rd leading preventable cause of death in the US
Alcohol
More than half of alcohol related deaths are linked to ___ ___
Binge drinking
Drinking 8 or more drinks 4 or more times/month
Binge drinking
Do all binge drinkers show all behaviors characteristic of a substance abuse disorder?
NO
What is the most critical time period in a patient receiving outpatient treatment for addiction?
The first few weeks
Relapse prevention is a form of?
CBT
Identifies cognitive, behavioral, and environmental risk factors for relapse, as well as rehearsing coping responses for those risk factors
Cognitive behavioral therapy
What is generally efficacious in reducing substance use and improving psychosocial outcomes when compared to other active treatments, no treatment, or other control conditions?
Relapse prevention
What is one factor that is commonly associated with relapse? (There are many but this one was bolded and italicized, so it must be important)
Low motivation for recovery
What are the two NTs associated with ETOH withdrawal?
GABA and Glutamate
GABA is a _____ NT
inhibitory
Glutamate is an ___ NT
excitatory
How do alcoholics function at an alcohol level that would normally induce sedation or coma?
EtOH binds to GABA receptors and supplements ordinary inhibitory signals
Sudden EtOH cessation leads to DECREASED ???
INHIBITORY tone
EtOH interferes with glutamate-triggered ____ receptor activation
NMDA
What happens to glutamate with sustained and increasing alcohol use?
Accommodation occurs and more glutamate receptors are produced
Sudden etOH cessation leds to INCREASED ???
EXCITATORY tone that is unopposed by the concurrent lack of inhibitory tone
What is the warning sign of minor withdrawal symptoms in patients who suffer from EtOH abuse?
BP, HR, and temp aberrations 6-36 hours after last drink
Alcohol withdrawal is a ___ diagnosis
Clinical
Peak symptoms of heroin withdrawal occur after?
3-4 days
How do you treat EtOH withdrawal?
IV fluids, vitamins/electrolytes, PRN medications, seizure/DT prophylaxis drugs (benzos, phenobarb, tegretol)
What is very prevalent among opiate users?
Hepatits C
Withdrawal characterized by: Increased anxiety, palpitations, tachycardia, restlessness, peripheral sensory disturbances
Benzodiazepine
Stopping benzodiazepines at high doses carries a risk for ?
Seizure
Benzodiazepines increase which neurotransmitter?
GABA
What can you use for a benzo detox?
Phenobarbital
Should you ever ask a patient struggling with substance abuse if they want to quit smoking at the same time as they are recovering from another drug?
NO leave them alone and let them have their sin sticks
