Addictive Behaviour

Question 1

Dependence Syndrome

Answer 1

Primary drug seeking behaviour with drug most important part of life.
Narrowing of substance repertoire/develop preference.
Tolerance to effects of substance.
Loss of control of drug consumption.
Withdrawal effects on abstinence.
Avoid withdrawal symptoms through continued use.
Continue consumption despite knowledge of negative effects.
Reinstatement of substance use after abstinence period.

Question 2

Withdrawal definition

Answer 2

Physical or psychological symptoms occurring after abstinence of a substance which has been consumed in high doses or for a prolonged period.

Question 3

Dependence definition

Answer 3

Physical, behavioural or cognitive effects which commonly lead to social dysfunction due to habitual drug taking.

Question 4

Tolerance definition

Answer 4

The degree of effect of a dose of a substance decrease with repeated use leading to the user consuming higher amounts to achieve the same level of effect.

Question 5

Alcohol short term effects

Answer 5

Disinhibition, diarrhoea, tachycardia, slurred speech, stupor, unsafe sex, dehydration, poor coordination, injury from violent behaviour or accident due to alcohol.

Question 6

Alcohol long term effects

Answer 6

Gynaecomastia, hypertension, liver damage/cirrhosis, infertility, throat, stomach, breast cancer, alcohol cardiomyopathy, depression.

Question 7

Alcohol screening tools

Answer 7

AUDIT, FAST, SADQ, CAGE.

Question 8

Weekly recommended alcohol allowance

Answer 8

14 units for both genders.

Question 9

Delirium tremens

Answer 9

Hyperadrenergic state.
Within 6hrs of last drink = GI upset, palpitations, anxiety, headache.
Within 12hrs+ of last drink = DELIRIUM TREMENS!! Tactile and visual hallucinations (Lilliputian, bugs on skin), coarse tremor, confusion, agitation, delusions.
36hrs+ = seizure.

Question 10

Wernicke’s Encephalopathy.

Answer 10

Thaimine deficiency.

Triad = confusion, ataxia + ophthalmoparesis and nystagmus.

Question 11

Korsakoff’s Psychosis

Answer 11

Retro and Antero grade amnesia, confabulation.

Question 12

Acute treatment for alcohol withdrawal

Answer 12

Pabrinex (thiamine). Benzodiaxepine e.g. chlordiapoxide.

Question 13

Treatment of chronic alcohol use

Answer 13

Antabuse = Disulfiram. 
Anticrave = Acamprosate.

Question 14

Aetiology/risk factors for substance misuse

Answer 14

Male gender, psych history, family history/genes, low socio-economic status, social isolation, peers with substance misuse, abuse/trauma, media influence, taxes and legal influence.

Question 15

Heroin acute treatment

Answer 15

Naloxone - acts really quickly so will come round and either still be high or massive withdrawal.

Question 16

Heroin use chronic treatment

Answer 16

Methadone regime

Question 17

Risks of heroin use

Answer 17

Infection (HIV, HepB, Staph aureus, TB), DVT, pulmonary embolism, crime, homelessness, dental hygiene, poor diet/malnutrition.

Question 18

Withdrawal of opioid symptoms

Answer 18

Insomnia, dilation of the pupils, piloerection, sweating, rhinorrhea, and muscle pain.

Question 19

First line treatment for delirum tremes

Answer 19

A-E including BM!

Benzodiazepine e.g. lorazepam or chlordiazopoxide

Question 20

Pathophys behind delirium tremens and alcohol withdrawal

Answer 20

Gives less GABA inhibition and more NMDA glutamate transmission (reversal of the effects of alcohol)