Addiction + substance misuse Flashcards
What is the Stage Model of Processes of Change (Prochaska & DiClemente, 1982)?
Societies attitude to alcohol and drug stigma:
1- What alternatives can you use instead of calling someone an abuser/addict?
2- What is an alternative to drug?
3- Alternatives to calling individuals clean/dirty?
4- Alternatives to lapse/ relapse/slip?
1- Person first language e/g/ he/she suffers from addiction
2- Medication or Non-medically used psychoactive substance
3- Proper medical terms for +/- results
4- Use mortally neutral terms like resumed or experienced a reoccurrence of symptoms.
What alternatives can we use instead of calling an individual an addict to alcohol?
What are the alcohol basic guidelines?
“ABC”
A= mount: 2-3 units/day > 14 units/week
B=inges: don’t drink double the recommended daily intake in 1 day
C=ut out: TWO ALCOHOL FREE DAYS PER WEEK
What is the definition of Alcohol use disorder?
- Using alcohol in either a hazardous, harmful or dependent fashion
How do healthcare professionals assess alcohol misuse? What do they do afterwards?
Audit screening tool
- Max score = 40 > 4 points per question
Audit score 20 or above dependence is likely
- Depending on audit score the relevant interventions can be introduced which include: (look at image)
For all psychoactive substances in the dependent syndrome 3 or more of the following should be present at some point in the last 12 months name them…. (ALCOWAR)
A - A narrowing of repertoire (an additional feature to main 6)
L - Levels of use change with changes in tolerance
C - Compulsion to use substance
O - Other interests dwindle
W - Withdrawal State (physiological)
A - Inability to control use
R - Risks of misuse are ignored.
Summarise what addict/dependence and abuse mean?
- Addict = life controlled by drugs
- Dependence = life significantly impaired by drug
- Abuse = life interrupted by drugs.
What is physiological dependence and physical dependence?
- Psychological dependence involves feelings of satisfaction and a desire to repeat the administration of the drug to produce pleasure or avoid discomfort.
- Physical (or physiological) dependence is defined as a state of adaptation to a drug accompanied by development of tolerance and manifested by a withdrawal or abstinence syndrome
Define tolerance:
- The need to take more and more of a drug to attain the same physical or mental effect.
> Tolerance develops over a period of time, as either the liver becomes more efficient at breaking down the drug or the body’s tissues become less sensitive to it.”
What are withdrawal symptoms?
- “A group of distressing mental and physical effects experienced by a person who stops using a drug.”
Describe the timeline of alcohol detoxification.
1- Roughly 8 hours after first drink:The first stage withdrawal symptoms may begin.
2- After 24-72 hours: Symptoms generally peak in this time period, and stage 2 and 3 symptoms can rapidly manifest.
3- 5-7 days later: Symptoms may start to taper off and decrease in intensity.
4- Beyond the first week:Some side effects, particularly the psychological ones, may continue for several weeks without treatment.
Name some physical + psychological withdrawal symptoms from alcohol detoxification.
List some less common symptoms too…
- Common Physical Withdrawal Symptoms
shakes, sweats, sickness, seizures - Common Psychological Withdrawal Symptoms
sleep disturbance, scared, sadness - Less Common Symptoms
DELIRIUM TREMENS
WERNICKE’S ENCEPHALOPATHY
KORSAKOFF’S PSYCHOSIS
How can we manage withdrawal symptoms?
- OVERVIEW OF DETOX
- Benzo regime
- Thiamine
- Food/care
- Identify any co-morbidities
- Planning for post detox
What are the 3 opiate receptor subtypes?
How does this relate to drug related deaths?
- Opiate use, either alone or in combination with other drugs, has been implicated in 60% of drug related deaths
