Public health Flashcards
What diagnoses can have social labels with potentially negative consequences?
Psychiatric
Sick notes
Legal claims
What results in stigma?
Negative response to a label
Presence of some deviation from normality and social reaction to the subsequent diagnosis
What are the political consequences of stigma?
Political phenomenon related to citizenship and the lack of entitlement
Applied more broadly to any condition, attribute, trait, or behaviour that marks the bearer as culturally unacceptable or inferior
Where can stigma reside?
In the person
In the audience/observer
What are the 3 distinct types of stigma?
Abominations of the body such as blemishes/deformities
Character defects such as mentally ill/criminal
Tribal stigma -> distinction between virtual social identity (normative expectations) and actual social identity (attributes individual possesses)
What is the difference between discreditable and discredited tribal stigma
Discreditable -> something that can be hidden eg mastectomy/ileostomy
Discredited -> something that is obvious eg amputation/wheelchair user
What is felt/enacted stigma? What is the impact of both?
Enacted = discrimination
Fear of stigmatisation is more disruptive than enacted discrimination
What is the effect of weight stigma on children?
Bullying and impacts socialising and academic performance
What is the effect of weight stigma on adults?
Affects employment and health
Negatively impact likelihood of engaging in pro-health behaviours
Name some drugs that can cause addiction
Benzodiazepines
Opiates
Name some drugs that can cause follow-on abuse
Alcohol
Illicit drugs
Name some drugs that can cause electrolyte imbalances
Laxatives
Name some drugs that can cause withdrawal symptoms
SSRI
Name some drugs that can cause convulsions/acidosis
Chlorphenamine
Antihistamines
What are the main s/e of ibuprofen?
GI - indigestion, bleeding, death
Hypokalaemia
Acidosis
What are the main s/e of paracetamol?
Hepatotoxicity
Death
Rebound headache
What is the difference between misuse and abuse?
Misuse = wrong dose or indication, unintentional
Abuse = deliberately exploiting side effects, experimentation
What support is there for those abusing drugs?
Formal addiction services
Self-help
Involvement of GP
On-line support
Narcotic anonymous
Private clinics
Name 3 prescription drugs that are associated with abuse and dependency
Opioids
Benzodiazepines
Z-drugs (zopiclone, zolpidem)
SSRIs
GABAergics (pregabalin, gabapentin)
Name 3 OTC drugs that are associated with abuse and dependency
Analgesic codeine with paracetamol/ibuprofen
Opiate cough medicines
Sedative antihistamines
Laxatives
Nicotine replacement therapy
Decongestant stimulants
Who is most likely to abuse OTC medicines?
Older women
Name 3 risk factors for opiate abuse
Genetic predisposition
Personal psychosocial profile
Personal/family history of addiction
Psychiatric disorders
Younger
High opioid doses
Use of short-acting opioids
High pain level
Multiple pain complaints
Self-reported craving
Concurrent use of tobacco, alcohol, benzodiazepines
How can we deal with addiction in healthcare?
Pharmacy -> hide product, refuse sale, record sales
Harm reduction intervention pilot
Pack warnings
Training for HCPs
Increased awareness of issue
Information for patients about risk
Prevention
Treatment
Internet support groups
What treatment is available for addiction?
Depends on the medicine
Opiates -> substitution treatment (methadone)
Benzos -> tapering dose