ASBHDS II - Session 6 - Lecture 1 - Substance Misuse

Question 1

1 - Topic

Answer 1

Substance misuse
Adherence and Concordance

{IMG - man smoking and drinking (tobacco and alcohol)
cocaine, MDMA/ecstasy, weed. top left? bottom right?}

Question 2

2 - Learning Objectives

Answer 2

This session aims to develop knowledge and to promote professional behaviour towards individuals with problems of addiction, incorporating a non-judgmental compassionate approach and respect for a patient’s autonomy.

The session will:

Provide a definition of substance misuse and outline associated epidemiology;

Describe mechanisms of dependence (both physical and psychological), tolerance, withdrawal and addictive behavior and models of addiction;

Describe the common treatment regimes for various types of addictions and withdrawal states;

Describe the variety of UK agencies to which patients with addiction problems can be referred.

{Worksheets available on Bb - access both about local service here in Leics, national services as well – NICE guidelines for treatment/management of addiction issues}

Question 3

3 - Definition of substance misuse

Answer 3

Definition of substance misuse

Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. Psychoactive substance use can lead to dependence syndrome - a cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state. (World Health Organization. http://www.who.int/topics/substance_abuse/en/)

{Key things to pick up here are around harmful and hazardous use – so not everybody who engages in SM ends up with a harmful or hazardous use of that substance, but some people will.

Also remember alcohol is included – not just illicit drugs such as heroin, but actually from SM POV and from a burden POV alcohol is a huge issue – particularly in this country.

The other thing to draw your attention to is this word here – dependence and dependence syndrome – gives def. of dependence but hard to get a real grasp of it if you’ve never actually been dependent on something e.g. Russell Brand had a serious alcohol and drug issue for many years – been clean for a no of years now – but he watches himself on video taking heroin 10 years ago, and says - I sit there and watch myself, and even though now I’m clean and have fantastic wealth and family – I am jealous of that person I was 10 years ago bc deep down all I really want is to be a drug addict.}

Question 4

4 - Types of substances

Answer 4

Types of substances

Stimulants: These substances make you feel more alert and like you have more energy and confidence. Examples include tobacco, cocaine, amphetamine (speed) and mephedrone.

Hallucinogens: These substances are sometimes described as ‘mind-altering’ as they can change/impact your perceptions, mood and your senses. Examples include LSD and magic mushrooms (note that sometimes drugs have mixed effects – ecstasy for example is sometimes described as a stimulant hallucinogen).

Depressants: These substances make you feel relaxed - examples include alcohol, heroin, tranquillisers and cannabis.

{3 broad areas:
1. on a night out, person wants to share their life story and are irritating. tobacco (not illicit)

IMG - cocaine, MDMA/ecstasy, weed. top left? bottom right?

smoking/tobacco}

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