Illicit substance misuse symposium Flashcards
Classification: Hazardous use of drugs
Drug use that is likely to lead to harm
Classification: Harmful use
Drug use which causes damage to health (physical or mental)
Classification: dependence
Pattern of ongoing use that is hard to stop. "Wow Cant stop pretending I trampoline" Withdrawal Compulsion Salience Persistance despite evidence of harm Impaired control Tolerance A cluster of behavioural, cognitive and physiological phenomena that develop after repeated substance use and typically include:- strong desire to take the drug difficulties controlling it’s use use despite harmful consequences, a higher priority given to drug use over other activities increased tolerance sometimes withdrawal”
Clinical presentation
A continuum between Withdrawal negative effects and intoxication negative effects.
“Sober”- Not in withdrawal and not intoxicated- will still need some level of drug to be at this point
Physical complications
Relate to specific drug effects, contaminants, method of use or lifestyle.
Contaminants: Baby powder, phentinyl (potent opioid) easy to overdose with
Method of use: Smoke it, Snort it, Inject it, tablets, rectal suppositries, s/c administration
(riskiest route is injecting. Can get abscesses, collapsed veins, overdose)
Lifestyle: Misuse- dietary intake reduced/not taking care of yourself. Some side effects eg for opiates = loss of appetite, functional reserve reduces and thus increased risk of health complications
Psychiatric complications
Drug misuse (intoxication/withdrawal) can mimic most psychiatric syndromes
Drug misusers increase rate psychiatric illness (anxiety, depression, PD, schizophrenia)
Suicide risk increases x15
Social complications
Social (Family, children, society)
Occupational (mostly unemployed)
Financial
Legal
Medical complications of cocaine use
Cardiovascular- BP increases, MI, arrythmias and sudden death
CNS- seizures
Infective- abscesses, cellulitis, hepatitis
Respiratory- chest pain, dyspnoea, lung damage, respiratory failure
General- weight loss
Obstetric- miscarriage, premature labour
Psychological complications of cocaine use
Crash (withdrawal- irritability, restlessness, fatigue, hypersomnia, hyperphagia) Anxiety especially panic Depression/mania antisocial behaviour Paranoid psychosis Tactile/visual hallucinations- bugs Repetitive behaviour
Signs of opiate intoxication
Euphoria/relaxation Feeling of wellbeing Constricted pupils Drowsiness Slurred speech Poor attention and concentration Respiratory depression is what kills people in opiate overdose
Opiate abstinence
Drug craving Anxiety Drug-seeking behaviour Yawning Sweating Running eyes and nose Restless sleep Dilated pupils Goose flesh Hot and cold flushes Shivering Aching bones and muscles Loss of appetite Irratbility Insomnia Low-grade fever Increased pulse rate Restlessness Abdominal cramps Nausea and vomiting Diarrhoea Weakness Weight loss
Opiate overdose
Accidental, Suicide attempt or Iatrogenic
Triad of symptoms pointint to OD: Unconciousness, respiratory depression, pin point pupils
Treat: Establish airways, ventilate, IV Naloxone, repeat 2-3 mins
When to refer to specialist services
If the person is:
- Unable to make changes following brief intervention and needing further help
- Dependent- with a history of withdrawal
Showing a high level or alcohol/drug related harm
- previously known to treatment services
- Pregnant/breastfeeding
- Experiencing mental health issues
- Mixing drugs, prescribed or illegal or legal
Why do people use drugs
- To numb pain
- Boredem
- Addiction
- Fun
- expected to
- Forced to
- To feel better
- To feel the same
- to feel worse (self harm)
Its easily available
its cheap
to gain confidence
to chill out
to sleep
to escape
habit
fashionable
stay awake
peer pressure
depressed
to rebel
Substance misuse
Drug free–> experimental–> recreational–> dependent–> chaotic
