Alcohol and substance misuse Flashcards
define substance misuse
The ICD-10 classifies substance misuse disorders according to the type of substance & the type of disorder
Name substances that are commonly misused, and understand how they are taken (8)
what is the most commonyl consumed illegal drug?
Barbie’s a CHAV
Cannabis –> PO, smoked
Hallucinogens (magic mushrooms, LSD)–> PO
Anabolic Steroids (Testosterone, androstenedione,danazol)>PO,IM
Volatile solvents (Aerosols, paint, glue, petrol)–> inhaled
Opiates (morphine PO/ IV, heroin IN/IV/ smoke, codeine)
sedative hypnotics (benzos, barbituates)–> PO/IV
stimulants (cocaine/ crack IN/IV, smoked, ecstasy PO, amphetamine)
Volatile solvents (Aerosols, paint, glue, petrol )
History taking in substance misuse patients
Some are not honest, so take a collateral Hx
TRAP QS WC TKmaxx
Type, Route, Amount, Pattern
Quantity
Side effects
Withdrawl symptoms
Control
Tolerance
Knowledge of Harm
ICD criteria for substance misuse
Physical:
Psychological:
Social:
Complications of substance misuse
Physical: death, infection (HIV ,HEP, Staph A, groups A strep, Clostidrium, TB), endocarditis, DVT, PE
Psychological: craving, anxiety, cog disturbances, drug-induced psychosis
Social: crimes, homless, prison, relationship problems
Investigations of substance misuse?
Bloods: HIV screen, HEP b&c, TB testing–> risk of bloodborne is sharing needles
- U&E’s–> renal function
- LFT’s & clotting–> hepatic function
- Drug levels
Urinalysis–> drug metabolites (eg: cannabis,opiods)
ECG--> arrhythmias
ECHO if endocarditis suspected (secondary to needle sharing
feautres that makes up dependence syndrome?
Drug Problems Will Continue To Harm:
- Desire/compulsion to consume substance,
- Preoccupation with substance (neglect of alternative pleasures)
- Withdrawal effects
- Control impaired
- Tolerance increased,
- Harmful effects known but continues to persist.
A diagnosis of dependence syndrome can be made if at least 3/6
toxic and withdrawal effects of commonly misused substances.
Describe the psychological, social and pharmacological management, including detoxification of substance misuse.
Which illicit drugs may produce a schizophrenia-like state?
- Cannabinoids
- Stimulants
- Hallucinogens
- Anabolic steroids
Which illicit drugs have an anti-psychotic effect?
Opiates
Detoxification vs. maintenance
Detoxification is a process in which the effects of the drugs r eliminated in a safely manner (a replacement drug is weaned) so that withdrawal symptoms are avoided!! in an attempt to attain abstinence
In maintenance therapy abstinence is not the priority, rather the aim is to minimize harm (e.g. from IV drug use).
managment of Opioid dependence
