alcohol and substance use disorders Flashcards
what do we mean by substance use
drugs
alcohol
misuse of prescribed medication
use of other legal substances for purposes ‘not consistent with legal or medical guidelines’
what is the DSM criteria for substance abuse disorder
• SUD criteria not to do with frequency / dose
– diagnosis relects the IMPACT of substance use on funcioning in every day life: the harm that is being done
what are the consequences of substance use on physical health
•Physical Health
–Direct: Liver, heart & lung damage, increased cancer risk
•New alcohol guidelines based on evidence that the risk of cancers, especially breast cancer increases directly in-line with consumpion of alcohol.
–Indirect: illness, injury, self neglect, harm from risky behaviours (hepaiis, HIV, overdose) - e.g. sexual activity, drive under the influence
what are the consequences of substance use on finance
–Cost of drug and alcohol use; lost income due to intoxicaion and after-efects (hangovers)
what are the consequences of substance use on social and interpersonal relationships
–Conlict with others (e.g. disapproving family members) –Exclusion / sigma –Poor educaional atainment –Homelessness --family breakdown
what are the consequences of substance use on mental health
– Transient psychosis (e.g. cannabis induced psychosis)
– Depression & Anxiety (e.g. depressant efects of alcohol)
– For people with established illness (e.g. psychosis)
• More / worse symptoms
• Poorer funcioning
• More relapses and hospitalisaions
• Increased suicidality; Aggression
– In 2019/20 there were 7,027 hospital admissions with a primary
diagnosis of drug-related mental health and behavioural disorders (135
people per week) - 21% higher that 2009-10 (but down slightly from the
previous year).
what are the consequences of substance use as a societal and economic burden
– Rising NHS costs & welfare costs. 358,000 admissions to hospital in 2018/19 where the main reason was due todrinking alcohol (almost 1,000 people per day) - 6% higher than 2017/18 and 19% higher than 2008/09
– Criminal acivity (e.g. public order ofences)
– Increased rates of mental health problems (e.g. psychosis)
due to substance use?
how common is SUD
- Esimates vary between sengs and geographical locaion (e.g. London versus Rural Wales)
- Comparisons hampered by methodological diferences (study design; sample; how substance use deined)
- UK: Not known how many people with SUD diagnosis
- AUD esimate = approx. 600,000 (1%)
what effects SUD in geographical locations
Availability social factors playing into the demographics of a neighbourhood e.g. whether drugs are available whether an area is more deprived or not whether its made up of old or young people
Hard to get an idea of what’s going on in the uk more generally
what is the prevalence of drugs in UK
2020 England and Wales Crime Survey (conidenial):
•35% of adults aged 16 to 59 had taken drugs at some point during their lifetime.
•1 in 11 (9%) adults aged 16 to 59 had taken an illicit drug in the last year (3.2 million
people).
•1 in 5 (21%) young adults aged 16 to 24 had taken an illicit drug in the last year;
4.3% classed as ‘frequent” drug users (at least monthly use)
•Drug use fell 1995-2013 but is now rising again, with a large porion of the increase
resuling from increased use of class A drugs in 16-24 year olds (largely
MDMA/ecstasy and powdered cocaine)
what is the prevalence of alcohol use in UK
–65% of men and 50% of women had drunk alcohol in past week
–Prevalence increases with age (up to 75)
–38% of men and 19% of women aged 55-64 drinking ‘above safe
limits’ (14 units +)
–More people ‘never’ drinking increasing and binge drinking decreasing, paricularly among young adults
why is there a difference in prevalence
• Some groups more likely to drink problemaically / use illicit substances than
others (young people, especially students;
people with mental health problems)
– Drug-related hospital admissions are ive imes
more likely in the most deprived areas.
does diversity effect substance use
yes religious and cultural background
what is comorbidity
Comorbidity: When two disorders or illnesses occur simultaneously in the same person
– Substance use and mental health problems are highly comorbid (occur frequently together)
what is dual diagnosis
Dual diagnosis: term used to describe people with both severe mental illness (mainly psychoic disorders) and problemaic drug and/or alcohol use - “Dually diagnosed”
