Substance abuse

Question 1

Opioids - 2 main effects

Answer 1

Analgesic

euphoric

Question 2

Features of dependence (6) ICD-10

Answer 2

1) strong desire or sense of compulsion to take the substance.
2) Difficulty in controlling use.
3) A physiological withdrawal state.
4) Tolerance.
5) Neglect of alternative pleasures and interests.
6) Persistence of use despite harm to oneself and others

Question 3

Opioid withdrawal symptoms

Answer 3

Sweating.
Watering eyes.
Rhinorrhoea.
Yawning.
Feeling hot and cold.
Anorexia and abdominal cramps.
Nausea, vomiting and diarrhoea.
Tremor.
Insomnia, restlessness, anxiety and irritability.
Generalised aches and pains.
Tachycardia, hypertension.
Goose flesh (goosebumps).
Dilated pupils.
Increased bowel sounds.
Coughing.

Question 4

Health complications due to opioid dependence

Answer 4

Death (which may be due to overdose, suicide, accidents or health-related complications).
Skin infection at injection sites (can be severe; necrotising fasciitis can occur).
Sepsis.
Infective endocarditis.
HIV infection.
Hepatitis A, B and C infection.
Tuberculosis infection.
Venous and arterial thrombosis (due to poor injecting techniques).
Poor nutrition and dental disease.

Question 5

Social complications due to opioid dependence

Answer 5

Crime.
Relationship problems.
Child protection issues.
Homelessness and deprivation.
Working in the sex industry.

Question 6

Psychological complications due to opioid dependence

Answer 6

Craving.
Guilt.
Anxiety.
Loss of cognitive skills and memory.

Question 7

name an opioid antagonist used for reversing opioid intoxication

Answer 7

Naloxone (IM/IV/SC)

Question 8

Naloxone (IM/IV/SC) is used for what?

Answer 8

reversing opioid intoxication (an opioid antagonist )

Question 9

Methadone

Answer 9

for opioid withdrawal replacement

Question 10

Buprenorphine

Answer 10

for opioid withdrawal replacement

Question 11

Amfetamines (speed)

What does it do

Answer 11

Stimulant, makes you excitable, upbeat and energetic
usually a snorted powder
psychosis risk

Question 12

Cannabis (weed)

What does it do

Answer 12

Makes you happy and relaxed

Risks - bad anxiety, paranoia, poor cognitive function (concentration, memory)

Question 13

Cocaine

Answer 13

Powder, can be smoked or injected
Makes people feel super confident and alert, followed by a come down
#increases HR = BP can precipitate MI
risk of depression, anxiety, panic disorder and dependency

Question 14

Ecstasy

Answer 14

Usually a pill
Makes you feel high, happy, full of energy, makes you more affectionate, sounds and colours become more intense
Very low come down, often not a pure drug mixed with other stuff
Risks - depression, anxiety, memory problems, immune system, heart, kidney, liver problems

Question 15

Heroin

Answer 15

Usually injected 
Makes you calm, happy and relaxed
Extremely addictive 
Can stop breathing and die
Needles infection risk

Question 16

Ketamine

Answer 16

Swallow, snort, inject
Makes you very relaxed, feel as if you are out of your body, cause hallucinations (a trip) affecting how you see time and space (can be good or bad)
Risks - feel confused and frightened, nauseous, ketamine bladder syndrome (frequency + urgency)

Question 17

LSD (acid)

LySergic acid Diethylamide

Answer 17

Tablet or liquid
Causes ‘trips’ hallucinations which can be good (relaxed, happy) or bad (frightened, panic)
risk - flashbacks

Question 18

Magic mushrooms

liberty caps and fly agaric

Answer 18

Give you good or bad trips. may make you more creative

risks - GI diarrhoea, frightened, flashbacks etc

Question 19

Methamfetamines (meth, crystal meth)

Answer 19

Crystal form is strongest and most addictive
Strong high (energetic, awake, aroused) followed by severe come down
risk - increase HR - BP - MI risk, take risks

Question 20

Drugs used to help come off stimulants (cocaine, amphetamines etc)

Answer 20

benzodiazepams (diazepam)

Question 21

Kleptomania

Answer 21

• Repeated theft of objects that are unnecessary for either personal use or monetary value.
• Increasing tension immediately before the theft.
• Pleasure or relief upon committing the theft.
• The theft is not motivated by anger or vengeance, and is not caused by a delusion or hallucination.
• The behaviour is not better accounted for by a conduct disorder , manic episode , or antisocial personality disorder.