Class 6 Flashcards
Blackouts
anesthetize the hippocampus
First 24h ROH withdrawal
tremors (6-8h), sweating, anxiety, autonomic instability, GI sx
day 2 roh withdrawal
seizures
Day 3 roh withdrawal
autonomic instability, disorientation, confusion, delirium tremens
CAGE
cutting down, annoyed by your drinking, guilt, eye-opener
genetics and roh
ROH, 4x more, accounts 40-60%. Gene for SERT: short version = SUD, mood and anxiety dis, genes that metabolize alcohol
How to break down alcohol: alcohol dehydrogenase = acid aldehyde (flushing) = broken down by aldehyde dehydrogenase
High risk drinking
doesn’t fill criteria for SUD, but puts person at high risk of negative consequences if she continues. 50-60% risk that it will continue to SUD
Alcohol use disorder:
Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
Recurrent substance use in situations in which it is physically hazardous.
Continued substance use despite having persistent and recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
Withdrawal
Important social, occupational, or recreational activities are given up or reduced because of substance use.
Labs ROH
High uric acid, triglycerides, AST, ALT, MCV, γ-glutamyl transpeptidase
What mental health disorders are commonly co-morbid with Substance Use Disorders?
MDD, GAD, personality disorder
Cocaine withdrawal
After stimulant intoxication, a “crash” occurs with symptoms of anxiety, tremulousness, dysphoric mood, lethargy, fatigue, nightmares (accompanied by rebound rapid eyemovement [REM] sleep), headache, profuse sweating, muscle cramps, stomach cramps, and insatiable hunger. The withdrawal symptoms generally peak in 2 to 4 days and are resolved in 1 week. The most serious withdrawal symptom is depression, which can be particularly severe after the sustained use of high doses of stimulants and which can be associated with suicidal ideation or behavior. A person in the state of withdrawal can experience powerful and intense cravings for cocaine, especially because taking cocaine can eliminate the unpleasant withdrawal symptoms. Persons experiencing cocaine withdrawal often attempt to self-medicate with alcohol,
sedatives, hypnotics, or antianxiety agents such as diazepam (Valium).
Untreated, DTs has a mortality rate
of 20 percent, usually as a result of an intercurrent medical illness such as pneumonia, renal disease, hepatic insufficiency, or heart failure.
DT
The essential feature of the syndrome is delirium occurring within 1 week after a person stops drinking or reduces the intake of alcohol. In addition to the symptoms of delirium, the features of alcohol intoxication delirium include autonomic hyperactivity such as tachycardia, diaphoresis, fever, anxiety, insomnia, and hypertension; perceptual distortions, most frequently visual or tactile hallucinations; and fluctuating levels of psychomotor activity, ranging from hyperexcitability to lethargy. About 5 percent of persons with alcohol-related disorders who are hospitalized have DTs. Because the syndrome usually develops on the third hospital day, a patient admitted for an unrelated condition may unexpectedly have an episode of delirium, the first sign of a previously undiagnosed alcohol-related disorder. Episodes of DTs usually begin in a patient’s 30s or 40s after 5 to 15 years of heavy drinking, typically of the binge type. Physical illness (e.g., hepatitis or pancreatitis) predisposes to the syndrome; a person in good physical health rarely has DTs during alcohol withdrawal.
Cannabis prevalence Canada
6.1%
Effects cannabis timeline
When cannabis is smoked, the euphoric effects appear within minutes, peak in about 30 minutes, and last 2 to 4 hours. Some motor and cognitive effects last 5 to 12 hours.
