Controlled Drug, Opioid Misuse + Opioid Substitution Therapy

Question 1

Can drugs be not deliberately misused?

Answer 1

YES
= didn’t know medicine was addictive

Question 2

What drugs are misused?

Answer 2

OTC
Prescription
Plant material
Caffeine
Tobacco

Question 3

What are some OTCs?

Answer 3

Valoid tablets - cyclizine
Sudafed
Senna
Co-codamol

Question 4

Cyclizine

Answer 4

Anti-sickness
Antihistamine
Grounded up + IV = euphoric effect

Question 5

Sudafed
Pseudoephedrine

Answer 5

Precursor for meth

Question 6

Senna

Answer 6

Stimulant laxative
Eating disorders

Question 7

Co-codamol

Answer 7

Analgesic
Paracetamol + codeine
= opioid = addictive

Question 8

Methylated spirit

Answer 8

Methanol = alcoholic effect
BUT can make you blind

Question 9

How do they treat methanol poisoning?

Answer 9

Treat by giving ethanol
= metabolism of ethanol will compete with metabolism of ethanol

Question 10

Solvents
eg. glue

Answer 10

Sniff = high BUT sensitise body to adrenaline

Question 11

Describe opioids

Answer 11

Ver addictive
Derived from opium poppy

Question 12

What are the alkaloids of opium?

Answer 12

Morphine
Codeine
Papaverine = erectile disfunction
Noscapine = cough suppressant

Question 13

Describe heroin

Answer 13

Diamorphine
Semi-synthetic derivative
Sch 2

Question 14

What is heroin structure?

Answer 14

Same as morphine BUT OH groups replaced by CH3
= more lipophilic
= get to brain quicker
= 2x more potent

Question 15

Why can you overdose quite easily with heroin?

Answer 15

Don’t know how much active ingredient is present
= drug cut with citric acid/baking powder
= make more soluble

Question 16

How can heroin cause loss of limbs?

Answer 16

Contain small insoluble particles (drug cut with)
= block blood vessels
= tissue necrosis

Question 17

Describe cocaine

Answer 17

Local anaesthetic

Question 18

Hydrochloride cocaine

Answer 18

Coke
= snorted

Question 19

Alkaloid base cocaine

Answer 19

Crack
= vapour inhaled

Question 20

How does cocaine work?

Answer 20

Massive release of catecholamine transmitters

Question 21

What damage can cocaine cause?

Answer 21

To nasal mucosa

Question 22

What are amphetamines used to treat?

Answer 22

Narcolepsy or ADHD

Question 23

What are the different amphetamines?

Answer 23

Atomoxetine
Dexamfetamine
Methylphenidate
ALL STIMULANTS

Question 24

How is crystal meth taken?

Answer 24

Smoked
Snorted
Taken orally
Injected

Question 25

What is 3,4-methlenedioxymethamphetamine?

Answer 25

MDMA

Question 26

How can meth be made?

Answer 26

Pseudoephedrine

Question 27

What is the RPS advice for pseudoephedrine?

Answer 27

Limit max pack size to 720mg = 12 tablets

Question 28

Describe benzodiazepines

Answer 28

Medication on prescription All contain benzene Relive anxiety

Question 29

What are some examples of benzodiazepines?

Answer 29

Lorazepam = short acting = reduces anxiety Temazepam = long acting = promote sleep

Question 30

What is the guidance on prescription of benzodiazepines?

Answer 30

Treat insomnia or short-term relief anxiety ONLY if severe, disabling or unacceptable stress

Question 31

Benzodiazepines at high dose

Answer 31

High

Question 32

Which benzodiazepines is particularly abused?

Answer 32

Temazepam = used to be liquid-filled capsule = injected = changed to gel-filled BUT gel extracted + heated BUT when gel cools = solid = ONLY tablets now

Question 33

Describe cannabis

Answer 33

Natural product SCH 1 Active ingredient has medicinal use

Question 34

Describe magic mushrooms

Answer 34

Similar hallucinogenic-type effects to LSD No known therapeutic use

Question 35

Describe legal highs

Answer 35

Modify different stimulant drugs

Question 36

What is harm reduction?

Answer 36

Reduce adverse effects of drug misuse until user has decided to stop

Question 37

What are the 3 principles of harm reduction?

Answer 37

Misuse of drugs accepted BUT not approved of] User treated as human being Harm reduction don't necessarily lead to riding of drug misuse

Question 38

Controversaries of harm reduction

Answer 38

Doesn't focus on abstinence Cost Money better funded somewhere else?

Question 39

What are we doing?

Answer 39

Needle exchange schemes Instalment dispensing = smaller supply of drugs Methadone NRT