Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HSCI 214 > Lecture 14 > Flashcards

Lecture 14 Flashcards

1
Q

Which of the following is not an opioid?

A) Heroin
B) Oxycodone
C) Codeine
D) Mescaline

A

D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

define psychoactive substances

A
  • alter our consciousness perceptions and mood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the categories of psychoactive substances?

A
  1. Depressants
  2. Stimulants
  3. Hallucinogens
  4. Opioids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe depressants

A
  • Rx for anxiety, insomnia, seizures
  • Decreases CNS and heart rate
  • Decreases processing and coordination
  • inhibitions (a feeling that makes one self-conscious and unable to act in a relaxed and natural way)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe stimulants

A
  • energy
  • alert
  • jittery
  • increase heart rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe hallucinogens

A
  • a psychedelic
  • perceptual changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe opioids

A

Rx pain

  • decrease CNS
  • breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are examples of depressants?

A
  • barbiturates
  • benzodiazepines
  • alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are examples of stimulants

A
  • coffee/caffeine
  • cigarettes/nicotine
  • amphetamines/meth
  • ecstasy/MDMA/Molly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are examples of hallucinogens?

A
  • LSD
  • psilocybin (magic mushrooms)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are examples of opioids?

A
  • oxycodone
  • hydromorphone
  • morphine
  • methadone
  • heroin
  • fentanyl
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why do people use psychoactive substances (4 things and extras)?

A
  • Cultural reasons/traditional ceremonies
  • self-medicate to:
    — feel better; treat anxiety, stress, depression, isolation, numb emotional/Psychol pain or trauma
    — do better; improve performance, Rx ADHD
    — feel good; feelings of pleasure
    — survival - homeless, lack of $$
  • curiosity/to fit in:
    — experiment, build connections, peer pressure
  • avoid withdrawal
    — developed a physical dependency
    — physician over-prescribing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who introduced OxyContin? When was it introduced and what is it?

A
  • Purdue Pharma
  • in 2000
  • a long-acting opioid and promoted it
    — Pain was underrated
    — OxyContin was safe and non-addictive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happened to OxyContin?

A
  • Rx increased, diversion, crushed and snorted or injected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In 2012, OxyContin patent ended. What did Purdue introduced?

A
  • OxyNeo was introduced
  • tamper proof version
  • if crushed, became jelly-like, so can’t be snorted or injected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

explain the fall of OxyContin and emergence of fentanyl

A

2012: OxyContin was delisted in many jurisdictions

2014: fentanyl started appearing in unregulated street market
— powdered fentanyl mixed with or sold as heroin
— fake Oxy’s (green meanies) 2016

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Outcome is influenced by reasons for use, resiliency/support and social determinants of health like…?

A
  • poverty
  • unemployment
  • homelessness
  • adverse childhood experiences, physical/sexual abuse
  • indigeneity - colonization and racism, etc.
  • lack of belonging and connection - made worse by COVID
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 4 guidelines to using non-stigmatizing language?

A

treat all people with the same respect

  1. use people-first language
    — person who uses opioids // opioid user or addict
  2. Use language that reflects the medical nature of substance use disorders
    — person experiencing problems with substance use // abuser or junkie
  3. use language that promotes recovery
    — person experiencing barriers to accessing services // unmotivated or non-compliant
  4. avoid slang and idioms
    — positive test results or negative test results // dirty test results or clean test results
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the four pillars strategy?

A
  1. enforcement
  2. prevention
  3. treatment
  4. harm reduction
  • all 4 need to work together
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When do pillars not work?

A
  • pillars do not work in isolation. it’t not either one or another
  • enforcement encourage people to use more safely (ex. at supervised consumption sites)
  • enforcement may test substances and share information to enable accurate reduction/drug alert messages (Drug Overdose & Alert Partnership)
  • Engagement in harm reduction can build trusting relationships and lead to treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is enforcement?

A

criminalizing drug use/prohibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the aim of prohibition?

A
  • put people in prision
    — who import, produce, sell (traffic), possess (use) drugs
  • reduce number of people who use drugs
    — make drugs harder to get, increase cost of drugs, make people afraid to use drugs (scare tactic)
  • make communities safer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is drug laws based on racism?

A
  • people of colour are overrepresented in US prisons, 2016
24
Q

Is Canada any better about racism?

A
  • federal prison (2+ years) Indigenous people are 5-6% population, in 2019 - 30% overall corrections population
  • BC Corrections Indigenous peoples 35% of those in custody

2022 Indigenous women in both federal and provincial corrections > 50%

25
Q

In 1920-1933, Alcohol was…?

A
  • widely available (speakeasies)
  • stronger - spirits more available than beer or wine (easier to transport smaller volumes
  • illicitly produced - contains toxins, no quality control/consistency of content and strength
  • controlled by gangs and violent criminals
26
Q

does prohibition work?

A
  • the price of heroin and cocaine came down despite increased incarceration
  • drugs are available in jail
  • teens may find it easier to buy illegal drugs than regulated alcohol and tobacco. Don’t need to show ID to buy drugs!
  • It’s easy and fast to have illegal drugs delivered to your home - Dial-a-dope
27
Q

What is the goal of harm reduction?

A
  • aims to keep people safe and minimize death, disease, and injury from high-risk behaviour by promoting safer practices
28
Q

What are some examples of broader harm reduction?

A
  • accepts risky behaviour will occur but resources/supports to make it safer
  • if your drink, don’t drive (safe ride home)
  • teen sexual behaviour (birth control pills, condoms)
  • driving (car seats, seat belts, airbags)
  • working (hard hats, boots)
  • sports (protective gear like padding or helmets or goggles, etc.)
29
Q

What harms are due to illegal drug use?

A
  • infections: (use in unsterile way)
    — HIV and HCV
    — bacterial from injecting: septicemia, abscess, endocarditis
  • criminal activities
    — organized crime/violence
    — individual crimes to fund drug use, B&E, sex work
    — drug possession trafficking
    — incarceration
  • overdose events and death
    — unregulated supply with unknown potency and constituents
30
Q

Explain the substance use journey

A
  • addiction is a chronic relapsing issue
  • even with treatment it’s not a straight line from dependency to abstinence
  • abstinence is not the ultimate goal for many
  • everyone has the right to the best possible health
31
Q

A person who uses drugs …?

A
  • is a human being and deserves to be treated with respect
  • is someone’s sister, father, daughter, uncle
  • has complex needs
  • does not want to have a dependency on substances
  • is aware how dangerous drug use is - they have seen their friends and family members die
32
Q

What does harm reduction do?

A
  • is a philosophy and human rights approach
  • treats people with respect
  • does not insist on abstinence
  • works with prevention, treatment and enforcement - 4 pillars approach
  • connects people to services
  • meets people where they are
  • engages with people who use drugs - nothing about us without us
33
Q

What does harm reduction do?

A
  • is a philosophy and human rights approach
  • treats people with respect
  • does not insist on abstinence
  • works with prevention, treatment and enforcement - 4 pillars approach
  • connects people to services
  • meets people where they are
  • engages with people who use drugs - nothing about us without us
34
Q

define abstinence

A

the practice of restraining oneself from indulging in something, typically alcohol or sex:

35
Q

What does harm reduction not do?

A
  • mean legalizing drugs
  • only provide services (ex. needles or supervised consumption sites)
  • prevent people from entering treatment or stopping use
36
Q

What does harm reduction not do?

A
  • mean legalizing drugs
  • only provide services (ex. needles or supervised consumption sites)
  • prevent people from entering treatment or stopping use
37
Q

Someone says “Giving out needles to those addicts promotes drug use and is a waste of tax payers dollars. We need to invest in police not harm reduction to stop the junkies from using it?

How would you respond?

A
  • Language
  • can keep people alive
  • SUD/addiction not a choice, it’s a health not a criminal issue
  • HR does not promote drug use
  • treats PWUD as humans
  • helps develop relationships, ,by building trust connects people and may lead to treatment
38
Q

Review one size doesn’t fit all

A

How do we know what the issues are?

  • different needs in different regions, substances used, age groups
  • need a range of options
  • people with lived and living experience of substance use are the experts in their reality
39
Q

Review one size doesn’t fit all

A

How do we know what the issues are?

  • different needs in different regions, substances used, age groups
  • need a range of options
  • people with lived and living experience of substance use are the experts in their reality
40
Q
  • Explain the affect of the engagement of peers and peer workers
A
  • is recognized as best practice in harm reduction
  • can lead to nimble/effective OD response & prevention services
  • can create “safe spaces” for PWUD & improve program access
  • can build connections and trust with shared experiences
41
Q

What is the HR services in Canada?

A
  • opioid agonist treatment
  • Rx alternatives to toxic drug supply (safer supply)
  • drug checking services
  • HR supplies
  • observed consumption sites
  • take-home naloxone
42
Q

What are the drug checking services?

A
  • currently available at SCS & OPS or in person or mail in “Get Your Drugs Tested”
  • test strips
    — fentanyl fairly sensitive
    — Benzodiazepines/Etizolam not so good
  • various technologies but most point of care give qualitative results (ex. +/-)
43
Q

What are HR supplies for substance use used for?

A
  • safer injection and safer smoking supplies
44
Q

What is the observed consumption in BC?

A

In BC there are:

  • 3 supervised consumption sites
  • 44 overdose prevention services
    — episodic OPS
    — peer witnessing
45
Q

What additional challenges did COVID bring?

A
  • some sites closed, and restricted # visits to enable physical distancing
  • people who use drugs may avoid crowds and hence use alone
  • drugs initially became more expensive and are more toxic - high level fentanyl, added benzos, etc.
46
Q

Explain the take-home naloxone

A
  • PWUDs in BC asked why don’t we have naloxone?
  • program started August 31, 2012
  • initially naloxone was prescription only
  • naloxone now unscheduled, available at >2000 community sites at no charge and no identification needed
47
Q

How does naloxone work?

A
  1. Naloxone binds to opioid receptors in the brain
  2. opioids are forced off
  3. breathing is restored
48
Q
  • How long does it take for naloxone to work?
A
  • works in 2-5 minutes
49
Q

how long does naloxone last?

A
  • lasts 20 to 90 minutes
50
Q

Since August 31, 2012, how many THN kits were shipped?

A

1.8 million THN kits shipped

51
Q

Why do we need a range of options in treatment?

A

Detox and abstinence based treatment
- not suitable for many
- risks if relapse (loss tolerance)

52
Q

Treatment must be accessible to those who need it, therefore… (the 5 A’s)

A

Appropriate
- diverse options

Accommodating
- hours of opening

Available
- Equity - rural geography

Acceptable
- no stigma from staff

Affordable
- Low or no cost
- can continue to work

53
Q

list the prescribed opioid treatment

A

Methadone - oral

Buprenorphine/naloxone - oral (Suboxone)

Slow release - oral, morphine (Kadian)

Buprenorphine - oral

Hydromorphone (Dilaudid) tablets - oral

Hydromorphine - injection

Diacetylmorphine (heroin) - injection

54
Q

What is the aim of BC Risk Mitigation Guidance?

A
  • reduce COVID risks, enable people to isolate/quarantine
55
Q

What were the actions of the BC Risk Mitigation Guidance?

A
  • pharmacy home delivery
  • BC nurse prescribing of OAT
  • Expansion of treatment options
    — Hydromorph/Dilaudid - oral
    — Slow release oral morphine (Kadian)
    — Sustained release oral morphine (M-Eslon)
    — iOAT, TiOAT (Dilaudid)

HSCI 214 (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions