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drug use and misuse Flashcards

1
Q

why do people use pcychoactive substances?

A

peer pressure
depression - to ease mental distress
dependence
experimenting

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2
Q

why is it difficult to know hoe many people use opiates?

A

not all of them access treatment services

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3
Q

give examples of reasons for the high cost of drug use

A 
death 
crime 
health problems 
benefit system
the cost is over £16 bln/year
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4
Q

what are the most common illegal drugs used?

A

cannabis
ecstasy
new psychoactive substances = legal highs

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5
Q

which national system do drug and alcohol agencies have to report to?

A

national drug treatment monitoring system

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6
Q

why are such a high number of people in treatment struggling with opiate use?

A

as they are prescribes methadone as a substitute and this can be an incentive to come for treatment as they are given an alternative - for non-opiates there is no alternative given so less people seek treatment

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7
Q

how does methadone work?

A

μ-opioid receptor agonist with a lower affinity than morphine

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8
Q

what are the commonest types of drug addiction that people seek treatment for?

A

opiates - most common

alcohol

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9
Q

how can we define the substances used for non-therapeutic use?

A

ingestion of a substance affecting the CNS which leads to behavioural and psychological changes

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10
Q

give examples of categories of substances that can be misused in terms of their effect on the CNS

A

opiates
depressants
stimulants
hallucinogens

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11
Q

give examples of opiates

A

heroin

morphine

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12
Q

what effect do opiates have on users?

A

euphoria

pain relief

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13
Q

what effect do depressants have on users?

A

sedation
relaxation
slow down thinking and acting

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14
Q

give examples of depressants

A

alcohol

benzodiazepines eg valium

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15
Q

what effect do stimulants have on their users?

A

increase alertness and activity

elevate mood

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16
Q

give examples of stimulants

A

caffeine
nicotine
cocaine
khat

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17
Q

give examples of hallucinogens

A

ecstasy
ketamine
magic mushrooms

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18
Q

how do hallucinogens affect their users?

A

alter sensory perception
alter thinking patterns
loss of sense of reality

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19
Q

name some new psychoactive substances

A

spice and black mamba
Benzo fury
Eizolam
Bromo-dragonfly

20
Q

when did new psychoactive substances become illegal?

A

2016

21
Q

how do new psychoactive substances work?

A

mimic the effects of other substances but less predictably

22
Q

what are the different types of new psychoactive substances?

A

synthetic cannabinoids
stimulant type drugs which mimic amphetamines, cocaine and ecstasy
tranquliser-type drugs - mimic the anxiolytics eg benzodiazepine
hallucinogens that mimic substances like LSD

23
Q

what harm can new psychoactive substances?

A

addiction within a few weeks
people lose touch with reality even with small amounts, which are panic inducing and scary and have physiological and psychological effects
people were being sold them and they could be mixed with other substances, so may not be pure
overdose
temporary psychotic states
unpreditcable behaviour
A+E and hosp admissions
sudden increase in body temperature and heart rate
coma and risk to internal organs
hallucinations
vomiting
confusion leading to aggression and violence
intense comedown which can cause users to feel suicidal
may cause mental health problems eg paranoia, psychosis, anxiety

24
Q

what factors will have an impact on the level of risk associated with drugs?

A
  1. the type of substance
  2. the route of administration - eg IV is more dangerous because of blood bourne infections
  3. quantity and frequency of use - daily or occasional
    knowledge of what they are using - strength, purity, knowledge of how to use them
  4. what else are they using - alcohol, opiates, ITC drugs or meds
  5. propensity for risky behaviour
  6. co-existing problems eg mental or physical health, support, friends
25
Q

what are the different theories about how we should treat drug addicts? disease models are written in capitals

A
  1. addiction is a disease so we should treat it with medication DISEASE
  2. addiction is influenced by genes - genetic therapies DISEASE
  3. addiction is a bad habit - increase punishments to make the behaviour less attractive BEHAVIOURAL
  4. a failure of will - increase people’s self efficacy and education on the consequences VOLITIONAL
  5. social problem - target poverty, social exclusion, housing and mental health SOCIO-CULTURAL
26
Q

what are the different treatment models called?

A

disease model
behaviour model
volitional model
socio-cultural model

27
Q

how do we prevent substance misuse?

A

reduce risk factors

increase protective factors

28
Q

what influences risk and protective factors?

A 
individual
family 
school
environmental 
community
29
Q

what are the family risk factors for substance misuse?

A

family history of substance misuse
poor parenting - lack of boundaries
family conflict including domestic abuse
being in care

30
Q

what are the school and community risk factors for drug misuse?

A
  1. low academic attainment and committment
  2. not in education, employment or training
  3. availability of drugs -eg if friends are using them
  4. community norms are favourable to drug use
  5. community disorganisation
  6. transitions
  7. low neighbourhood attachment - no sense of belonging
  8. gang culture
31
Q

what are the individual and peer risk factors?

A
  1. sensation seeking/risk taking
  2. rebelliousness
  3. peer pressure
  4. favourable attitudes to anti-social behaviour - ie seen as ‘cool’
  5. experience of trauma eg abuse, loss, poor parenting
32
Q

what are the protective factors?

A

family attachment
academic achievement or extra-curricular
have opportunities to feel that they can make a difference
reward for positive involvement
opportunities to develop self-confidence, self worth and resilience

33
Q

what is physical dependence?

A

the body adapts to the presence of the substance and over time needs more for the same effect (tolerance)
stopping the drug leads to withdrawal symptoms - runny nose, stomach cramps, muscle aches

34
Q

what is psychological dependence?

A

feeling that life is impossible/challenges cannot be faced without the drug - emotional effect eg feelings of fear, pain, shame, guilt if not on drug

35
Q

how is dependence syndrome defined in the ICD 10?

A

3 or more in the past 12 months:
1. Strong desire or compulsion to use
2. Difficulties in controlling substance-taking behaviour
(onset, termination, or level)
3. Physiological withdrawal state when reduce use (or
substitution to avoid withdrawal )
4. Tolerance (more for same effect)
5. Progressive neglect of pleasures/interests, increased
time spent using
6. Persistent use despite evidence of harmful
consequences (physical health, mood, cognition)

36
Q

give examples of withdrawal symptoms?

A 
anxiety 
irritability 
fatigue 
nausea
hand tremor 
seizure
37
Q

what is the National Drug Strategy for dealing with drugs?

A

reducing demand
restricting supply
building recovery in communities
involving the family for support

38
Q

what does the support given depend on?

A
  1. the drugs they are using
  2. the level and pattern of use - are they dependent or not
  3. the pt’s preferences for support
  4. what support they have tried before
  5. mental and physical health
  6. other issues eg housing, employment , support from family and friends
39
Q

what drug use services are available locally?

A
  1. GPs
  2. harm reduction services eg needle exchange
  3. open access services
  4. talking treatments eg CBT
  5. prescribing services eg for people using opiates
  6. detox - community or in patient
  7. mutual aid - eg alcoholics anonymous, cocaine anonymous etc
  8. residential rehabilitation
40
Q

how can talking treatments help patients?

A
  1. motivational interventions - for people who cannot imagine giving up illegal drug use
  2. psychological support during substitution treatment or detoxification
  3. relapse prevention - planning strategies to deal with any lapse and support abstinence
41
Q

how can community prescribing ie by GPs or specialist services help?

A
  1. substitution treatment - help the pt come off drugs gradually or long tern replacement for heroin ie methadone
  2. opioid antagonists eg Naltrexone which help to reduce desire for opioids
    other help:
  3. counselling and advise
  4. community detoxification
  5. referral to housing
  6. help with criminal justice issues
  7. blood borne virus testing and vaccination
42
Q

what is detoxification

A

can be inpatient or outpatient - a pt gradually reduces the amount of drug they are using and they are given medication to ease withdrawal symptoms
use of Naltrexone or Naloxone which are opioid antagonists are given AFTER DETOX

43
Q

what are the features of residential rehabilitation?

A

treatment for those who wish to attain/maintain abstinence
done for 3-12 months
works on solving underlying issues and they each use different philosophies

44
Q

what other problems may a drug abuser have?

A 
mental health 
medical problems 
education status 
legal issues - crime 
financial issues 
family 
child care 
housing 
BBVs
45
Q

how is recovery defined?

A

voluntary sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society

46
Q

how might recovered drug addicts spend their time?

A

peer support groups
hobbies
volunteering
job

GI (15 decks)

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