Illicit substance misuse symposium Flashcards
Describe hazardous use
Drug use likely to lead to harm
Describe harmful use
Drug use which causes damage to health
What is dependence?
Pattern of ongoing behaviour that is hard to stop
Cluster of behaviour, cognitive & physiological phenomena that develop after repeated substance use
What are some symptoms of dependence?
Withdrawal Compulsion Salience Persistence despite evidence of harm Impaired control - inability to stop Tolerance
What reasons cause people to be admitted to hospital for substance misuse?
Overdose Cellulitis Abscesses Thrombophlebitis Arterial occlusion Septicaemia Endocarditis TB Respiratory infections Hepatitis HIV
What methods are used to take drugs?
Inject Smoke Snort Pills Rectal suppository Skin popping
What are some negative side effects that injecting drugs can cause?
Abscesses Collapsed veins Blood-borne infections (HIV, hep C) Overdose Leg ulcers Oedema Bacterial endocarditis Sepsis Increased risk of DVT & PE
What psychiatric illnesses can drug misusers suffer with?
Anxiety Depression Personality disorders Schizophrenia Increased suicide risk
What are the signs of opiate intoxication?
Euphoria / relaxation Feeling of well being Constricted pupils Drowsiness Slurred speech Poor attention & concentration
What are the symptoms of opiate abstinence?
Drug craving / seeking behaviour Anxiety / irritability Yawning Sweating Running eyes & nose Restless sleep / insomnia Dilated pupils Goose flesh Hot & cold flushes - shivering Aching bones & muscles Loss of appetite / weight loss Increased pulse rate, BP & RR Restlessness Nausea, vomiting, diarrhoea, abdominal cramps Weakness
What is the triad of symptoms suggesting an overdose?
Unconsciousness
Respiratory depression
Pin point pupils
What is the treatment for overdose?
Establish airway
Ventilate
Naloxone - quick, short acting. Puts patient into withdrawal
Repeat every 2-3 minutes
When to refer to a specialist service?
Unable to make changes following brief interventions
Dependent with history of withdrawal
High level of alcohol / drug related harm
Previously known to treatment service
Pregnant / breastfeeding
Experiencing mental health issues
Mixing drugs
Why do people use drugs?
Numb pain / depressed Boredom / fun Addiction Expected / forced to Feel better / same / worse Easily available / cheap Social / cultural / peer pressure Gain confidence Chill out Sleep / stay awake Aid creativity Rebel
What are the points of harm reduction?
Pragmatic Priorities goals Humanist values Focuses on risks & harms Doesn't focus on abstinence Seeks to maximise range of interventional options available
What is some advice given for harm reduction?
Route of administration Test dosing & dosage Research Consider self & setting Have a sitter Thinking about safe sex Getting home safely Sleep & nutrition
Describe heroin
Brown, gear, smack, H Opiate Brownish powder, comes in baggies Smoked, injected Intense sense of wellbeing, relaxed, drowsy & detached, slows brain, HR & RR Physical & psychological dependence
Describe cocaine
Coke, Charlie, snow Stimulant White powder Snorted, gummed, injected Increased energy Psychologically addictive Chronic use lead to severe damage to heart & circulation, brain damage & severe mental health problems
What are some medical complications of cocaine?
Cardiovascular - BP increases, MI, arrhythmias, sudden death
CNS - CVA, seizure
Infective - abscesses, cellulitis, hepatitis, HIV
Respiratory - chest pain, dyspnoea, lung damage
General - weight loss
Obstetric - miscarriage, premature labour
Describe crack
White, rocks, snow
Smoke-able form of cocaine
Small pieces of off-white, waxy
Smoked or injected
Similar effect to cocaine but more intense
Breathing problems, harmful to veins as it doesn’t dissolve easily –> collapsed veins
Describe cannabis
Marijuana, Mary Jane, weed, grass
THC
Solid, dark lump or leaves, stalks, seeds
Rolled to smoke or eaten
Giggles, talkative, confident, tiredness, memory loss
Exacerbate mental health problems
Describe synthetic cannabinoids
Spice, herbal incense, pot Dried plant matter sprayed to mimic THC Dried leafy material Smoked with tobacco or smoked Happy & relaxed, giggles, talkative, drowsiness, mood changes Higher THC - panic, paranoia
Describe mephedrone
Meow, M-cat, drone, meph Stimulant White powder, shards, crystal Snorted, injected, swallowed, rectal Euphoria, alterness, suppressed appetite Overstimulate heart, circulation & nervous system
Describe GHB
Industrial solvent. GBL converted to GHB in body
Transparent liquid with salty taste
Swallowed with water or juice
Euphoria, reduced inhibitions & drowsiness
Physically addictive, easy to overdose
Date-rape drug
Describe new psychoactive substances
Synthetic chemicals manufactured to mimic effects of common drugs
Looks like GBL, ephedrine & legal highs
Snorted, injected, smoked, gummed, swallowed, rectal
Various effects
Little known about long term effects e.g. seizures, sudden death, coma, rashes, vomiting, mental health problems
