Substance Abuse Flashcards
List the ICD-10 criteria for substance misuse
Acute intoxication
Harmful use
Dependence syndrome
Withdrawl state
Psychotic disorder
Amnesic syndrome
Residual disorder
What is dependence syndrome?
Prolongued, compulsive substance use leading to addiction, tolerance, and the potential for withdrawal syndromes
What is withdrawl state?
Physical and/or psychological effects from complete (or partial) cessation of a substance after prolonged, repeated, or high level of use
What is psychotic disorder?
Onset of psychotic symptoms within 2 weeks of substance use
Must persist for more than 48 hours
What is amnesic syndrome?
Memory impairment in recent memory (learning of new information) and ability to recall past experiences
Also defect in recall, clouding of consciousness and global intellectual decline
What is residual disorder?
Specific features (flashbacks, PD, addictive disorder, dementia, persisting cognitive impairment) subsequent to substance misuse
Which gender is substance abuse more common in?
Male
3:1 M:F
What are the complications of substance abuse?
Physical: death, infection (HIV, TB, hep A/B/C, Staph A, group A Strep, Clostridium), endocarditis, superficial thrombosis, DVT, PE
Psychological: craving, anxiety, cognitive disturbance, drug-induced psychosis
Social: crime, imprisonment, homelessness, prostitution, relationship problems
How can substance abuse be classified
D rug P roblems W ill C ontinue T o H arm
≥3 of the following manifestations must have occurred over 1 month: (1) Strong Desire (compulsion) to consume substance; (2) Preoccupation with substance use;
(3) Withdrawal state when substance ingestion is reduced or stopped; (4) Impaired ability to Control substance-taking behaviour (e.g. onset, termination or level of use); (5) Tolerance to substance, requiring more consumption for desired effect; (6) Persisting with use, despite clear evidence to the Harmful effects.
What is the management for substance abuse?
A keyworker with a therapeutic alliance (psychosocial support)
Hep B immunisation
Motivational interviewing + CBT (Co-morbid)
Contingency management
Supportive help (financial, housing, employment etc.)
Self-help groups (NA, CA)
Refer to DVLA guidelines
Biological therapies
IV naloxone (antidote to overdose)
What biological therapies are available for substance misuse?
Methadone (first-line) / buprenorphine = detoxification and maintenance
Naltrexone = formerly opioid dependent, motivated to continue abstinence
IV naloxone = antidote for opioid overdose
