Overview of addiction

Question 1

Can you detain someone under the MHA for addiction treatment?

Answer 1

NOPE

Question 2

Definition of addiction (DSM)

Answer 2

Maladaptive pattern of substance abuse, leading to clinically significant impairment or distress (three or more of the following in 12-month):
-Tolerance: Need for markedly increased amount, Markedly diminished effect

-Withdrawal:
Characteristic syndrome, Substance taken to relieve/avoid

• Taken in larger amounts or over a longer period than intended
• Unsuccessful efforts to control5. Time spent in activities to obtain, use, or recover
• Important activities given up
• Continued use despite knowledge of harm

Question 3

describe the dopamine pathway in the brain’s effect

Answer 3

reward
pleasure
euphoria
motor function 
compulsion 
perseveration

Question 4

describe the effect of the serotonin pathway in the brain

Answer 4

mood
memory processing
sleep
cognition

Question 5

MOA of cocaine on the dopaminergic pathway

Answer 5

↓↓D2 Rec.

• ↓↓ social status
• ↑↑ drugs use
• Vicious circle!
• Partial recovery upon cessation

Question 6

symptoms of heroin withdrawal

Answer 6

Sweating, Malaise and Anxiety
Yawning and Sneezing
Tears, Rhinorrhea, Diarrhoea 
Cold sweats 
Insomnia
Nausea and Vomiting 
Severe muscle/joint cramps and aches 
Fever, Hypertension, hyperventilation

Question 7

Substitutes for opioids during withdrawal

Answer 7

Methadone - opioid agonist

Buprenorphine (Subutex) sublingual - partial opioid agonist (combined with naloxone = Suboxone)

Question 8

5 techniques for relapse prevention

Answer 8

Skill Power (vs. will power)
Identify high risk situations 
Cue exposure (desensitisation)
Coping with social pressures and craving 
Refusal: practice as ‘pusher’ and ‘user’
Emergency plan in case lapsed

Question 9

4 social interventions during addiciton recovery

Answer 9

Housing
Employment advice
Education/training
Government policy