Management of Opiate Misuse Flashcards
what makes heroin so addictive
Rapidity of onset of action
Short half life
Availability
what ways can you take heroin
Intravenous Smoking Suppository Insufflation Ingestion
what is problem drug use
problematic use of opiates and or/ benzodiazepines and implies routine and prolonged use as apposed to recreational and occasional use
what does heroin do to you
Euphoria Analgesia Respiratory depression Constipation Reduced conscious level Hypotension and bradycardia Pupillary constriction Tolerance develops with repeated use
what are withdrawal effects from heroin
Occur within 6-8 hours
Dyspgoria and craving Agitation Tachycardia and hypertension Piloerection (goose bumps) Diarrhoea, nausea, vomiting Dilated pupils Joint pains Yawning Runny nose and watery eyes
what are some complications of IV drug use
Infections
- local - abbess, cellulitis, thrombophlebitis, necrotising fasciitis
- distant - infective endocarditis
- systemic - hep B, HIV, hep C
Thrombotic/embolic
-DVT, PTE, ischaemic limb
what are social consequences of heroin use
unemployment neglect of family/children loss of alternative interests criminality risk of violence prostitution
what are some psychiatric consequences of heroin
depression
anxiety
(does not cause psychosis or delerium)
what is opiate substitution therapy
the replacement of a short acting opiate with a long acting opiate
buprenorphine or methadone
once daily dosing - taken under supervision
what are some pros of opiate substitution therapy
reduced mortality rate
reduces HIV risk by 50%
what are some cons of OST
Daily visits to the chemist
Stigma
Side effects
Ongoing cost
what is methadone
A long acting full agonist
tablet or liquid - liquid used
what is buprenorphine
long acting partial agonist
tablet
aims of pharmacological treatment
reduce harm
promote recovery
maintain abstinence
what is opiate detoxification
Complete abstinence from ALL opiates
can be done via reducing methadone, buprenorphine etc
