Drug use: Flashcards
List some behaviours seen in addiction:
- Craving
- Tolerance
- Compulsive drug-seeking behaviour
- Physiological withdrawal state
List 3 areas which in which drug dependence can impact:
Physical - acute/chronic
Social
Psychological
List 3 effects of heroin and 3 adverse effects:
Effects: - Euphoria - Intense relaxation - Miosis (pupillary constriction) - Drowsiness Adverse effects: - Dependence - Nausea - Constipation
How would you manage someone with heroin addiction?
1) Harm reduction - education
2) Detoxification:
- 1st line: Buprenorphine
3) Maintenance:
- Methadone OR
- Buprenorphine
4) Psychological interventions
What is the difference between methadone and buprenorphine?
Methadone = full agonist
Buprenorphine = partial agonist/antagonist
What is maintenance treatment in heroin addiction useful?
(use if long time addicted)
- Reduces mortality
- Reduced drug-related morbidity
- Reduces crime
What is used in heroin addiction to prevent relapses?
Naltrexone
What should be offered to a newly presenting drug user?
(think HIV/ HepB/C)
- Health check
- Screening
- Contraception
- Sexual health advice
- Immunisation status
- Sign post for help
- Information on local drug services
What is the mode of action of cocaine?
Block reuptake of serotonin and dopamine at synapse = intense pleasurable sensation
What are the acute effects of cocaine?
- Confidence
- Well being
- Euphoria
- Impulsivity
- Increased energy
What are the chronic effects of cocaine?
- Depression
- Panic
- Paranoia
- Psychosis
- Damaged nasal septum
What are the principles of treatment in drug dependence?
- harm reduction
- Brief intervention - advice on use, effects, risks
- Team working - sexual health/infectious diseases, specialist advice
List the 3 main classes or recreation drugs:
- Stimulants
- Sedatives
- Hallucinogens
Give 3 examples of stimulants:
- Nicotine
- Cocaine
- Crystal meth
Give 3 examples of sedatives:
- Alcohol
- BZD (Valium)
- Barbiturates
Give an example of a hallucinogen:
LSD
Give 3 acute and 3 chronic symptoms of stimulants:
Acute: - Energy - Excitement - Euphoria Chronic: - Anxious - restlessness - Irritable
Give 3 acute and 3 chronic symptoms of sedatives:
Acute: - Euphoria - Relaxation - Reduced anxiety Chronic: - Depression - Impaired coordination - Lethargy
Give 3 acute and 3 chronic symptoms of hallucinogens:
Acute: - Euphoria - Changed perceptions - Hallucinations Chronic: - Nausea - Paranoia - Panic
List 5 features of opiate withdrawal:
(picture of guy on sofa)
- Sweating
- Vomiting
- Mydriasis (dilated pupils)
- Tachycardia
- Abdo cramps
- Muscle cramps
Why is buprenorophine safer than methadone?
It is a partial agonist. If someone is to OD on it then a point is reached with buprenorphine where excess has no further effect (ceiling effect).
What services are there for drug users?
(SEX-C SHIT)
S - Sexual health screening
EX - needle EXchange
- C - Contraception
S - Signposting (councelling/stop-services)
H - Health Check
I - Immunisations (Hep B, C, A etc.)
T - Treatment (detoxification etc.)
What is the classification for dependence syndrome?
3 + of the following features:
- Strong desire
- Difficult controlling
- Tolerance
- Physiological withdrawal
- Neglect
- Persistent taking
