Controlled Drug, Opioid Misuse + Opioid Substitution Therapy Flashcards
Can drugs be not deliberately misused?
YES
= didn’t know medicine was addictive
What drugs are misused?
OTC
Prescription
Plant material
Caffeine
Tobacco
What are some OTCs?
Valoid tablets - cyclizine
Sudafed
Senna
Co-codamol
Cyclizine
Anti-sickness
Antihistamine
Grounded up + IV = euphoric effect
Sudafed
Pseudoephedrine
Precursor for meth
Senna
Stimulant laxative
Eating disorders
Co-codamol
Analgesic
Paracetamol + codeine
= opioid = addictive
Methylated spirit
Methanol = alcoholic effect
BUT can make you blind
How do they treat methanol poisoning?
Treat by giving ethanol
= metabolism of ethanol will compete with metabolism of ethanol
Solvents
eg. glue
Sniff = high BUT sensitise body to adrenaline
Describe opioids
Ver addictive
Derived from opium poppy
What are the alkaloids of opium?
Morphine
Codeine
Papaverine = erectile disfunction
Noscapine = cough suppressant
Describe heroin
Diamorphine
Semi-synthetic derivative
Sch 2
What is heroin structure?
Same as morphine BUT OH groups replaced by CH3
= more lipophilic
= get to brain quicker
= 2x more potent
Why can you overdose quite easily with heroin?
Don’t know how much active ingredient is present
= drug cut with citric acid/baking powder
= make more soluble
How can heroin cause loss of limbs?
Contain small insoluble particles (drug cut with)
= block blood vessels
= tissue necrosis
Describe cocaine
Local anaesthetic
Hydrochloride cocaine
Coke
= snorted
Alkaloid base cocaine
Crack
= vapour inhaled
How does cocaine work?
Massive release of catecholamine transmitters
What damage can cocaine cause?
To nasal mucosa
What are amphetamines used to treat?
Narcolepsy or ADHD
What are the different amphetamines?
Atomoxetine
Dexamfetamine
Methylphenidate
ALL STIMULANTS
How is crystal meth taken?
Smoked
Snorted
Taken orally
Injected
What is 3,4-methlenedioxymethamphetamine?
MDMA
How can meth be made?
Pseudoephedrine
What is the RPS advice for pseudoephedrine?
Limit max pack size to 720mg = 12 tablets
Describe benzodiazepines
Medication on prescription
All contain benzene
Relive anxiety
What are some examples of benzodiazepines?
Lorazepam = short acting = reduces anxiety
Temazepam = long acting = promote sleep
What is the guidance on prescription of benzodiazepines?
Treat insomnia or short-term relief anxiety ONLY if severe, disabling or unacceptable stress
Benzodiazepines at high dose
High
Which benzodiazepines is particularly abused?
Temazepam
= used to be liquid-filled capsule = injected
= changed to gel-filled
BUT gel extracted + heated
BUT when gel cools = solid
= ONLY tablets now
Describe cannabis
Natural product
SCH 1
Active ingredient has medicinal use
Describe magic mushrooms
Similar hallucinogenic-type effects to LSD
No known therapeutic use
Describe legal highs
Modify different stimulant drugs
What is harm reduction?
Reduce adverse effects of drug misuse until user has decided to stop
What are the 3 principles of harm reduction?
Misuse of drugs accepted BUT not approved of]
User treated as human being
Harm reduction don’t necessarily lead to riding of drug misuse
Controversaries of harm reduction
Doesn’t focus on abstinence
Cost
Money better funded somewhere else?
What are we doing?
Needle exchange schemes
Instalment dispensing = smaller supply of drugs
Methadone
NRT
