Pharmacotherapies Flashcards
Recovery without treatment
Most people with dependencies stop unaided. With alcohol 75% smoking 66-75% but stopping without support is the least effective. Can be dangerous for some addictions.
Detoxification (phase one)
Achieve abstinence sustained and safe to decrease physical symptoms. Often needs pharmacological interventions. Can use a similar substance, makes withdrawal less acute but longer and more gradual.
Initial recovery (phase two)
Sustain motivation to avoid relapse. Develop new patterns of behaviour. Learn strategies for tolerating cue induced craving accompanied by long term meds to decrease drug reward and craving.
Relapse prevention (phase three)
Aim to develop long term strategies to replace drug behaviour. Addresses decreased motivation and deal with cues. continued support system and pharmacotherapies.
Varenicline
Most effective meds for smoking cessation. 24% success with individual behaviour support. 32% success with group behaviour support.
Uptake very low only 0.5%. binds to aloha 4 beta 2 nicotine receptors triggering dopamine release stops nicotine from binding and decreased dopamine.
Naloxone
Emergency antidote for opiate overdose. Overdose slows and stops breathing, Naloxone reverses.has stringer affinity for opioid receptors than opioids so knocks them off, receptors for a while.
Disulfiram (Antabuse)
Causes negative effects when drink, must be very very motivated to continue. Blocks action of acetaldehyde dehydrogenase essentially causing extreme hangovers very quickly.
Opioid substitution therapy
Maintenance treatment. Long acting synthetic opioid agonist, blocks effect of illicit opioids. Longer half life than heroin so don’t need to take as often. Longer duration of action. Don’t experience high and lows of short acting opioids. Prevents withdrawal.
Nicotine replacement therapy
Cochrane review. 133 RCTs compare RCT to placebo. Effects largely independent of of intensity of additional support or setting of NRT. Very effective.
E cigarettes
Smoking is the leading cause of preventable deaths in UK 2/3 smokers die 10 years early. Deliever nicotine with less associated harms. 95% less harmful. No evidenx they lead to smoking. NICE recommended. Uptake was very high but has platoued.
Harm perceptions
Lots of misinformation, vaping related lung disease in US 33 deaths, 1500 cases. From black market THC not regulated and is lipid soluble. Drawn into lungs and causes lipid pneumonia. Misperceptions are increasing.
