Alcohol and Drugs Flashcards
ICD-10 definition of substance withdrawal
- Physical and/or psychological effects
- From complete/partial cessation of a substance
- after prolonged, repeated or high level of use
6 signs of substance addiction
Drug Problems Will Continue To Harm
- Strong Desire to consume substance
- Preoccupation with substance
- Withdrawal if stopped
- Cannot control behaviour
- Tolerance to substance (so need to take more)
- Continuing use despite Harmful effects
ICD-10 3 general criteria for alcohol intoxication
- Clear evidence of substance use at high dose levels
- Change in consciousness, cognition, perception or behaviour
- Not accounted for by medical or mental disorder
ICD-10 evidence of dysfunctional behaviour in alcohol intoxication
- Unsteady gait
- Difficulty standing
- Slurred speech
- Nystagmus
- Flushing, red eyes
- Reduced Consciousness
ICD-10 features of alcohol withdrawal (any 3 of the following)
- Tremor
- Sweating
- Nausea, Vomiting
- Tachycardia/ increased BP
- Headache
- Psychomotor agitation
- Insomnia
- Malaise
- Transient hallucinations
- Grand mal convulsions
What drugs may cause drowsiness/ decreased coordination
- opiates
- cannabis
- solvents (glue, petrol)
- LSD
- BZDs, barbiturates
What drugs may cause increased aggression
- cocaine
- ecstasy
- amphetamines
- solvents
- steroids
- BZDs, barbiturates
What drugs may cause paranoia/ hallucinations
- LSD
- cocaine
- ecstasy
- amphetamines
- steroids
- cannabis
Why do drunk people get visual hallucinations
Alcohol affects optic chiasma and corpus callosum
Signs of severe alcohol intoxication
- Hypoglycaemia
- Coma
In alcohol withdrawal, when is the peak incidence of delirium tremens
72h after withdrawal
Features of delirium tremens
o Dehydration o Electrolyte disturbance o Cognitive impairment o Hallucinations/ illusions o Paranoid delusions o Tremor o Autonomic arousal: tachycardia, fever, pupil dilation, sweating
Wernicke’s encephalopathy or Korsakoff’s psychosis
-which is permanent
Korsakoff’s psychosis is PERMANENT
Must treat Wernicke’s ASAP to prevent progression to this
What vitamin deficiency causes Wernicke’s encephalopathy
Thiamine deficiency (Vit B1)
Classic triad in Wernicke’s encephalopathy
- Ocular motor anomalies: nystagmus, opthalmoplegia
- Cerebellar dysfunction eg ataxia
- Altered mental state
What is the alcohol limit
14units for both genders
Describe some equivalents of 1 unit
- 1 shot
- 1/3 beer or cider
- 1/10 bottle of wine
What 2 drugs are given in an opioid detox
- Methadone
- Buprenorphine (Subutex)
What drug is given in an opioid overdose
Naloxone (opioid antagonist)
During what periods are addicts at greatest risk of overdose during a detox
- 1st week of titration (taking both heroin and methadone)
- After just getting out of prison (taking same dose despite now reduced tolerance)
What drug is given in an alcohol detox
High dose BZDs eg chlordiazepoxide, diazepam
What drug can be given to cause unpleasant effects when drinking alcohol.
How does this work
Disulfuram
Inactivates liver ALDH -> causes buildup of acetaldehyde when drinking leading to unpleasant symptoms eg flushing
What drug can be given to reduce pleasurable effects of alcohol
Naltrexone (opioid receptor antagonist)
What drug can be given to reduce alcohol cravings
Acamprosate (enhances GABA transmission)