EM Psych 9: Substance Use Disorders Flashcards

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1
Q

the majority of worldwide illicit drug-related deaths were attributed to

A

opioids

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2
Q

low-risk drinking is defined as

A

Men: no more than 14 drinks per week and no more than 4 drinks over a 2-hour occasoin

Women of all ages and men >65 y/o:
no more than 7 drinks per week and no more than 3 drinks over a 2- hour occasion

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3
Q

Binge drinking is defined as

A

alcohol consumption that results in a blood alcohol level over the U.S. legal limit of 0.08 grams/dL,
which for the average male is the result of more than 4 drinks in 2 hours and for the average female is more than 3 drinks in 2 hours

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4
Q

Those who begin drinking before ______ have a fourfold increased risk of developing dependence than those who begin drinking later

A

15 y/o

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5
Q

severity of substance use disorder (SUD)

A

mild: 2-3 criteria
mod: 4-5 criteria
sev: 6 or more

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6
Q

This treatment strategy has been associated with short-term benefits and reduction in cost and ED utilization

A

1) Screening
2) Brief intervention
3) Referral to treatment

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7
Q

Standard drink is

A

1.5 oz of spirits
6 oz of wine
12 oz of beer

1 oz is 30 mL

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8
Q

The first principle of promoting health behavior change is

A

that the argument for change needs to come from the patient, not the healthcare provider

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9
Q

Remarks on opioid agonist therapy

A

also known as medication-assisted treatment
done with buprenorphine or methadone
vital to reduce mortality among patients with opioid use disorder

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10
Q

medications for treatment of alcohol use disorder

A

Disulfiram
Acamprosate
Naltrexone

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11
Q

Remarks on Disulfiram

A

oral medication that irreversibly binds to and inhibits alcohol dehydrogenase
causes the unpleaseant disulfiram-ehtanol reaction (n/v, diaphoresis, flushing, tachycardia)

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12
Q

Remarks on Acamprosate

A

increases GABA transmission
but did not show efficacy in a large multicenter trialR

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13
Q

Remarks on Naltrexone

A

long-acting opioid mu receptor antagonist
indirectly affects the dopaminergic reward pathway through effects on the mu opioid receptor

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14
Q

remarks on benzodiazepine withdrawal

A

Symptoms of withdrawal may develop up to 7-10 days after stopping chronic benzodiazepine use, and patients may develop withdrawal seizures

Most evidence supports a prolonged benzodiazepine taper over 4-12 weeks

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15
Q

reccommendations of CDC on opioid use

A

“When opioids are used for acute pain, clinicians should prescribe the lowest effective dose of immediate-release opioids and should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids. 3 days or less will often be sufficient; more than 7 days will rarely be needed”

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16
Q

Patients who are increased risk of death from overdose

A

patients who used 4 or more prescribers or 4 or more pharmacies in 6 months

patients who take 50-100 morphine mg equivalents per day