Addictions

Question 1

Benzo withdrawal symptoms

Answer 1

Anxiety
Irritability
Restlessness
Tremor
Sweating
Insomnia
Confusion
Appetite disturbance
Convulsions
Psychosis

Question 2

Benzo toxicity symptoms

Answer 2

Ataxia
Slurred speech
Reduced consciousness
Hypotension
Bradycardia
Respiratory depression

Question 3

Mx for immediate TOXICITY of benzos

Answer 3

Flumazenil and management by GP or addiction services

Question 4

Management of benzo withdrawal

Answer 4

Convert benzo dose to equivalent dose of diazepam, for a daily dose

Question 5

What are the 6 diagnostic criteria for dependence syndrome - ICD 10

Answer 5

A strong desire to take substance

Difficulty in controlling substance taking behaviour - onset, levels etc

Physiological withdrawal state

Evidence of tolerance

Progressive neglect of alternative pleasures

Persisting with substance

3/6 of these

Question 6

How would you explain dependence

Answer 6

Your body has adjusted to the drug, but when the drug is removed, the balance your body has created is threatened

Question 7

Who came up with the change model?

Answer 7

Prochaska and DiClemente’s stages of change model

Question 8

List the stages of change

Answer 8

Precontemplation - happy users of the substance
Contemplation
Preparation
Action
Maintenance
Relapse

Question 9

What framework can you use to talk to someone who is the precontemplation phase of cutting down on an addictive substance?

Answer 9

FRAMES

Feedback about risk
Responsilibity placed on the pt
Advice to change
Menu of alternative self help
Empathy
Self efficacy/optimistic empowerment

Miller and Sanchez 1993

Question 10

Screening questionnaires for alcohol problems

Answer 10

AUDIT

If you score betwen 8-15 - FRAMES intervention

16 or more - serious convo

20 or more - referral for alcohol team

Also CAGE, CIWA for withdrawal

Question 11

Important question to ask when talking about alcohol to the pt

Answer 11

Safeguarding concerns

Question 12

how do you calculate alcohol units

Answer 12

volume in mls x alcohol by volume abv (percentage) / 1000

Question 13

fancy phrase for when you only use certain

Answer 13

narrowing of alcohol beverage repertoire

Question 14

alchol dependence mx

Answer 14

Encourage them to contact DVLA - but tell pt you are going to inform if not, that you might need to break confidentiality
Referral to hepatology
Liver scan