PH1122 - random unit areas Flashcards
what is the definition of substance misuse
Substance misuse is defined as intoxication by, or regular excessive consumption of and/or dependence on substances that have an effect on the brain, which leads to social, psychological, physical or legal problems
What are the responsibilities of the ACMD
Responsibilities of the ACMD
make recommendations to government on the control of dangerous or otherwise harmful drugs, including classification and scheduling under the Misuse of Drugs Act 1971 and its regulations
consider any substances which are being or appears to be misused and of which is having or appears to be capable of having harmful effects sufficient to cause a social problem
carry out in-depth inquiries into aspects of drug use that are causing particular concern in the UK, with the aim of producing considered reports that will be helpful to policy makers and practitioners
What is the role of the ACMD ?
Recommendations to the government on the control of dangerous or harmful drugs
Classification (A,B,C)
Scheduling under the Misuse of Drugs Act 1971
Substances which are/appear to be misused or having harmful effects sufficient to cause a social problem
In-depth enquiries in aspects of drugs use that are causing concern in UK -> reports that are helpful to policy makers
What were the main aims of the psychoactive substances act ?
The Psychoactive Substances Act 20161 (PSA) came into force on 26 May 2016 and
created a blanket ban on the production, distribution, sale and supply of psychoactive
substances in the United Kingdom for human consumption. It gives police and other
enforcement agencies a range of powers including: powers to seize and destroy
psychoactive substances as defined by the PSA; search persons, premises and vehicles;
and enter premises by warrant. It also includes a number of civil sanctions to enable a
proportionate enforcement response.
The main aims of the Act were as follows:
1. To put an end to the open sale of psychoactive substances in the United Kingdom,
both in stores and online, in order to protect citizens from the risks posed by untested,
unknown and potentially harmful drugs2.
2. To put an end to the game of ‘cat and mouse’3, where new drugs, with slight
differences in chemical make-up, appear on the market in response to legislation
when particular substances were controlled.
3. To reduce the number of people using psychoactive substances, including in subpopulations
where prevalence is particularly high, such as young people, the
homeless and those in prisons.
4. To reduce the various health and social harms associated with psychoactive
substances4, such as hospital admissions, deaths and violence.
Why and when should I get my eyes tested ?
No matter how old you are or how healthy you feel, it is always important to receive regular eye examinations from a qualified eyecare professional. While an eye test is certainly a good way to find out if your vision could be improved, a thorough eye examination will also check the health of your eyes. In fact, opticians can spot certain illnesses not directly related to the eyes, or help detect serious problems such as diabetes or high blood pressure.
This can vary from person to person but most optometrists recommended taking a thorough eye test every two years. However, it is recommended that patients over 70 are tested more frequently (probably every 12 months) to catch any health problems early.
It’s also recommended that younger children are tested annually, as children’s vision can change very rapidly at this stage of their lives.
What is CAM ?
Complementary and alternative medicine
Over 700 treatments / diagnostic methods
Implies can be used with or in place of orthodox medicine
Medicine / therapy
All – stimulating body to heal itself
Holistic – treats whole person rather than a condition or symptom in isolation
What are the 3 different groups of CAM ?
Group 1: Individual diagnostic approach, well-developed self-regulation, effectiveness established through research
Group 2: Don’t include diagnostic skills, not well regulated
Group 3: Long-established but indifferent to conventional scientific principles (3A), lack any credible evidence base (3B)
What would be some examples of group 1 CAM ?
Acupuncture* Chiropractic Herbal medicine* Homoeopathy* Osteopathy
What would be some examples of group 2 CAM ?
Alexander technique Aromatherapy Flower remedies Hypnotherapy Massage Meditation Nutritional medicine Reflexology Shiatsu Spiritual healing Yoga
What would be some examples of group 3 CAM ?
Group 3A Anthroposophical medicine Ayurvedic medicine Chinese herbal medicine Eastern medicine Naturopathy Traditional Chinese medicine (TCM)
Group 3B Crystal therapy Dowsing Iridology Kinesiology Radionics
What are some reasons people use CAMs
Holistic approach Disillusioned with orthodox medicine (OM) / OM consultation Perceived effectiveness / safety ‘Green’ / ‘natural’ Increased awareness (media, role models) Cultural reasons
What is homeopathy ?
They are extracts from various natural sources. eg. extracts from plants, animals
why is potentiation in homeopathy so controversial
Because the dose is so diluted or the concentration is so low that it is most likely to have no effect
30 c is the most common type
this means one drop of the substance is diluted in 99 drops which is then diluted with another 99 drops and so on
is there any supporting evidence for homeopathy ?
Its mainly anecdotal evidence
National Health and Medical Research Council (Australia) 2015: “There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health conditions considered: no good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment.”
Its not recommended
is there any supporting evidence for homeopathy ?
Its mainly anecdotal evidence
National Health and Medical Research Council (Australia) 2015: “There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health conditions considered: no good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment.”
Its not recommended
DO herbal medicines work and what would be an example ?
It depends on the plant
St John’s Wort (hypericum perforatum)
Aerial parts used for wound healing, diuretic, depression, pain relief etc.
Treatment of mild-moderate depression - as effective as conventional antidepressants?
Side-effects (GI) and quality issues
Interactions – (cytochrome P450 inducer). See BNF Appendix 1 (St John’s Wort). E.g. reduced effect of antidepressants, anti-epileptics, oral contraceptives
NICE – do not recommend despite evidence of efficacy
What are the regulations with herbal medicines ?
Registered traditional herbal medicines
Products required to meet specific standards of safety and quality and be accompanied by agreed indications, based on traditional usage, and information for the patients on the safe use of the product. See logo above.
Licensed herbal medicines
Herbal medicines which hold a product licence or marketing authorisation are required to demonstrate safety, quality and be accompanied by the necessary information for safe usage. Have PL number.
Unlicensed herbal medicines
Practitioners are allowed to make up and supply unlicensed medicines to meet the needs of an individual patient following a consultation. Medicines made up by practitioners are not subject to specific safety or quality requirements and do not offer adequate public health protection.
NB herbal medicines also on list of items which should not be routinely prescribed on NHS
What is acupuncture ?
Insertion of fine needles at various points (acupoints in TCM, trigger points in Western acupuncture)
is there evidence supporting acupuncture ?
NICE recommends
prophylaxis of migraine and tension headache
Also new re primary chronic pain: https://www.nice.org.uk/guidance/GID-NG10069/documents/evidence-review-7
NICE does not recommend for osteoarthritis, IBS, eating disorders
Evidence inconclusive for most conditions
back / neck pain, drug dependency, smoking, weight loss
Trials problematic due to difficulty in “blinding”
Safety – local reactions / sterility of needles?
what service would you use to translate labels into different languages ?
translabel
What are some big advances in medicine that the NHS contributed towards.
Delivered huge advances in medicine and public health
Eradicated polio and diptheria
Pioneered liver, heart and lung transplant; first hand transplant
What is the purpose of the NHS ?
“The establishment of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness” (1946 NHS Act).
what is the purpose of the clinical commissioning group ?
Responsible for planning AND commissioning health care services for their area
