DSM5 Substance Use Flashcards
How many hours after using an opioid can they be detected with urine drug tests?
12-36 hours
What liver disease occur commonly in those who inject opioids?
Hep C
What diseases are of concern for IV drug users?
HIV
Hepatitis
TB
Bacterial Endocarditis
Physical Exam Sign seen in Opiate Withdrawal, Hallucinogen Intoxication, and Stimulant Intoxication
Pupillary Dilation
What challenge test can you use to diagnose opioid intoxication?
Naloxone (Narcan) Opioid Antagonist Challenge
What symptoms are indicative of more severe Opiate Withdrawal?
Piloerection
Fever
What is Suboxone?
Combination of Naloxone (Narcan) and Buprenorphine
Symptoms of Opiate Withdrawal
Dysphoria N/V Muslce Aches Lacrimation/Rhinorrhea Pupil Dilation Piloerection Fever Sweating
Signs of Opioid Intoxication
Pupillary Constriction
Drowsiness/Coma
Impaired Attention/Memory
Slurred Speech
What test do you order to differentiate PCP intoxication and stimulant intoxication
Urine Drug Test
What do cocaine users often use to reduce insomnia, nervouseness and other SE?
Sedatives: ALCOHOL
What do amphetamine users often use to reduce SE?
Marijuana
What is a sign of stimulant withdrawal?
Bradycardia
What psych disorders are risk factors for stimulant use disorder?
Antisocial Personality Disorder
Bipolar Disorder
Schizophrenia
Other Substnce Use
What can be used to detect a stimulant 90 days after use?
Hair Sample
Which forms of administration leads to most rapid onset of action with cocaine?
Inhalation
Injection
What is Speedball
Cocaine + Heroin
What neurotransmitters are affected with Cocaine?
Dopamine, Glutamate
Both increased
Most substance induced disorders resolve within this amount of time after the cessation of acute withdrawal, the cessation of severe intoxication, or the use of the substance.
1 month
Which sex has higher prevalence of alcohol use disorder?
Males
2x as much as females
For an individual who has a close relative (parent) with an alcohol use disorder, their risk is this many times higher than normal
3-4x
Elevations in these two lab test results are sensitive indicators of ongoing heavy drinking and can be used to monitor abstinence
GGT and CDT (Carbohydrate Deficient Transferrin)
What can GGT and CDT be useful in detecting?
History of Heavy Drinking
Detect relapse to heavy drinking
Monitor abstinence
Can MCV ube used to detect history of heavy drinking or relapse?
No. Not useful for monitoring due to long half life of RBCs
Which psych disorders predispose patients with markedly high rate of co-morbid alcohol use disorder?
Bipolar Disorder
Schizophrenia
Antisocial Personality Disorder
Impaired control
Social impairment,
Risky use
Pharmacological criteria
Continued use despite persistent or recurring interpersonal problems
Social Impairment
Impaired control, Social impairment,
Risky use, or Pharmacological criteria
A desire to cut down or unsuccessful attempts decrease or stop use refers to this Criterion A
Impaired Control
Impaired control, Social impairment,
Risky use, or Pharmacological criteria
Pharmacological criteria refers to “putting up” with these two phenomenon
Tolerance and Withdrawal
Impaired control, Social impairment,
Risky use, or Pharmacological criteria
Taking the substance in larger amounts or over a longer time period than intended refers to this Criterion A
Impaired Control
Impaired control, Social impairment,
Risky use, or Pharmacological criteria
Use in physically hazardous situations or continued use despite knowledge the substance is causing or worsening a medical problem is called this
Risky Use
Impaired control, Social impairment,
Risky use, or Pharmacological criteria
Spending a great deal of time obtaining, using, or recovering from the substance use refers to this Criterion A
Impaired Control
Impaired control, Social impairment,
Risky use, or Pharmacological criteria
Failure to fulfill major obligations at work, home, or school refers to this Criterion A
Social Impairment
Impaired control, Social impairment,
Risky use, or Pharmacological criteria
Craving refers to this Criterion A
Impaired Control
What is phencyclidine and what substance induced disorders can it cause?
Hallucinogen
May induce psychotic disorders, anxiety disorders, delirium, and mood disordesr (both bipolar and depressive)
What disorders can opioid intoxication cause?
Sleep Disorders
Sexual Dysfunction
Delirium
Depressive Disorder
Opioid intoxication will not, but opioid withdrawal may induce this type of substance disorder
Anxiety
Alcohol & sedative/hypnotic intoxication may both induce the same type of substance disorders except sedative/hypnotic
intoxication will NOT
induce this
Anxiety
What can intoxication, but not withdrawal of stimulants like cocaine cause?
Sexual Dysfunction
Delirium
Substance induced Psychotic Disorders
What can intoxication AND withdrawal of stimulants cause?
Anxiety, OCD, Sleep and Mood Disorders
What substanes do not cause a withdrawal?
Inhalants
Hallucinogens
