Substanc Abuse Flashcards
Harmful use definition
Continuation of substance use despite evidence of damage to users physical or mental health or to social, emotional or financial well being
Tolerance definition
A state where the individual needs more of a substance to achieve the same effects/same amount produces less of an effect
- tissue tolerance-> receptor down steaming
- metabolic-> enzyme induction
- psychological
Dependence syndrome ICD 10 criteria
> =3
1) a strong desire to take substance
2) impaired control of substance taking
3) physiological withdrawal state
4) signs of tollerance
5) neglect of other interests
6) persistence despite harmful effects
Units of alcohol calculation
Units=volume of alcohol (ml) x ABV (%) / 1000
Men 3-4 pd
Women 2-3 pd
Epidemiology alcohol abuse
Prevelance 7% m 2% female
25% of a and e admissions
10% of psych admissions
Aetiology of alcohol abuse
Genetics -> 1st degree relative-> x7 increased risk -personality traits -biochemical susceptibility -down regulation of GABA Psychological -operant conditioning -psych conditions Social -life events -occupation -availability -social attitudes -chronic pain/illness
Physical complications of alcohol abuse
Fatty liver/alcoholic liver disease Gastritis/ulcers/varices Cancer Malnutrition Delirium tremens/seizures Haemorrhagic stroke Neuropathy IHD/arrhythmia/hypertension Hypoglycaemia/hyperlipidemia Anaemia Resp depression/aspiration pneumonia
Wernicke-korsakoff syndrome
Thiamine deficiency Wernickes-> acute brain damage -delirium -opthalmoplegia -ataxia Korsakoff syndrome -> chronic damage -amnesia syndrome -frontal lobe dysfunction -psychiatric symptoms
Psychiatric complications of alcohol abuse
Pathological intoxication Suicide and self harm Alcoholic hallucinosis-> auditory Amnesia Cognitive impairment Pathological jealousy Exacerbation of existing disorders
Social consequences of alcohol abuse
Absence from/poor attendance at work Legal problems Interpersonal problems Financial difficulty Vagrancy Homelessness
Alcohol withdrawal syndrome- uncomplicated
40% 6-8hrs after last drink Trmulousness Sweating N+V Mood disturbances Sensitive to sound Sleep disturbances Psychomotor agitation *perceptual disturbances *withdrawal seizures
Alcoholic withdrawal syndrome delirium tremens
5% 1-7 days after Clouding of conciousness Visual hallucinations and paranoid delusions Autonomic arousal Agitation 5-15% mortality -> benzo's, fluid and electrolytes, thiamine
CAGE questionnaire
C have you ever felt like you should cut down on your drinking?
A have people ever annoyed you by criticising your drinking?
G have you ever felt guilty about your drinking?
E have you ever needed and eye opener in the morning to steady your nerves?
Sedatives
Drowsiness Disinhibition Confusion Poor concentration Miosis Hypotension Withdrawal seizures
Stimulants
Amphetamine, cocaine, MDMA Alertness, hyperactivity, confidence, euphoria Impulsivity Irritability and aggression Hallucinations Subsequent dysphoria Mydriasis, tremor, hypertension, tachycardia, arrhythmias Sweating and fever Convulsions
