Drugs of misuse

Question 1

What are legal highs?

Answer 1

Essentially drugs which are illegal, which have been slightly modified and therefore aren’t illegal but still potentially harmful, designed not to be picked up by drug tests!

Question 2

Name three novel psychoactive drugs

Answer 2

Mephedrone - miaw miaw
GHB/GBL solvent
Methoxetamine

Question 3

Name three depressants

Answer 3

Opiod
Benzo
Alcohol

Question 4

Name two NPS depressants

Answer 4

GBL

Phenibut

Question 5

Name three stimulant drugs

Answer 5

Cocaine
Amphentamines
MDMA
Caffeine

Question 6

Name three NPS stimulants

Answer 6

m-cat
NRG-1
BZP
MDAI
Synthacaine

Question 7

What is the ICD-10 criteria of ‘dependence syndrome’?

Answer 7

3 or more in the last year:
Strong desire or compulsion to use substance
Difficulty controlling use/amount/recidivism (failed to quit)
Tolerance to drug effects
Neglect of other activities
Persistent use despite adverse consequences
Withdrawal symptoms
Use of substance in a particular way - narrowing repertoire

Question 8

What is recidivism?

Answer 8

Failure to quit, therefore return to substance

Question 9

What does alcohol do to the brain?

Answer 9

increases inhibitory GABA-receptor activity

antagonises excitatory NMDA-receptor

Question 10

Substance misuse history

Answer 10

What substances?
Quantity
Route
When is it used
Why is it used (triggers)
First use
When did you start to use it regularly?
Heaviest use/cumulative use
Any features of dependence?
Withdrawal effects

Question 11

1 bottle of whisky

Answer 11

30 units

Question 12

1 pint of beer

Answer 12

2.5 units

Question 13

1 large glass of wine

Answer 13

3.25 units

Question 14

1 bottle of wine

Answer 14

10 units

Question 15

1 can of beer

Answer 15

4 units

Question 16

How do you work out the units?

Answer 16

percentage ABV x volume / 1000

Question 17

Signs of injecting drug use

Answer 17

Punctures
Track marks
Cellulitis
DVTs
bacterial endocarditis

Question 18

Signs of acquired illnesses due to substance abuse

Answer 18

Hepatitis
HIV
Injuries

Question 19

What is insufflation?

Answer 19

Nasal septum damage due to insufflation

Question 20

What is formication?

Answer 20

Feeling that little bugs ar eon your skin

Question 21

Withdrawal symptoms + what is kindling

Answer 21

Delirium tremens 3 days after withdrawal - psychosis from alcohol withdrawal
Tremors
Kindling - more likely to get seizures/withdrawl symptoms second time round if you’ve already had it

Hallucination
Formication
Seizures
Generalised seizures over 6 hrs

Question 22

How does delirium tremens present?

Answer 22

Agitation
Paranoia
Intense fear

Question 23

What drug do you give for alcohol withdrawal?

Answer 23

Chlordiazepoxide (librium)

Also prophylaxis for wernicke’s

Question 24

Treatment for seizures

Answer 24

Diazepam IV or rectally

Question 25

Antimitochondrial antibodies and jaundice

Answer 25

Primary biliary cirrhosis

Question 26

Wernicke syndrome

Answer 26

Confusion
Ataxia
Nystagmus/Opthalmoplegia

Question 27

Korsakoff syndrome

Answer 27

Anterograde amnesia/dementia (not really psychosis)

Question 28

Why do you get wernicke-korsakoff syndrome

Answer 28

Thiamine deficiency - alcohol reduces duodenal transport of thiamine, and CLD reduces activaiton and storage of thiamine

Question 29

Signs

Answer 29

Diplopia
Broad based gait
Cognitive decline
Episodic memory loss

Question 30

Pin point pupils and reduced resp rate

Answer 30

Opiate overdose