Substance Abuse Disorder Flashcards

1
Q

What is the triad for substance abuse?

A

(1) Psychological dependence or craving
(2) Physiologic dependence
(3) Tolerance

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2
Q

What is the 3rd leading preventable cause of death in the United States?

A

Alcohol Use Disorder

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3
Q

“Risky” alcohol use refers to…..

A

consumption of alcohol that puts patient at risk for health consequences

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4
Q

Nation Institute of Alcohol Abuse and Alcoholism (NIAAA) has estimated consumption amounts of alcohol that increase health risks:
1) Men under age of 65
–a) More than ___standard drinks per week on average
–b) More than ___ drinks on any day
—-(1 Standard drink: 5 oz of wine, 12 oz beer
–b) More than 4 drinks on any day
2) Women and adults 65 years and older
–a) More than __ standard drinks per week on average
–b) More than __ drinks on any day

A

1) a) 14
1) b) 4
2) b) 7
2) a) 3

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5
Q

Alcohol Use Disorder is diagnosed as mild, moderate, or severe on the basis of the number of the following present. How many is required for mild?
1) Recurrent drinking resulting in failure to fulfill role obligations
2) Recurrent drinking in hazardous situations
3) Continued drinking despite alcohol-related social or interpersonal problems
4) Evidence of tolerance
5) Evidence of alcohol withdrawal or use of alcohol for relief or avoidance of
withdrawal
6) Drinking in larger amounts for longer periods than intended
7) Persistent desire or unsuccessful attempts to stop or reduce drinking
8) Great deal of time spent obtaining, using, or recovering from alcohol
9) Important activities given up or reduced because of drinking
10) Continued drinking despite knowledge of problems caused
11) Alcohol craving

A

2-3

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6
Q

Medical Complications of alcohol use

A

1) HTN
2) Cardiovascular disease
3) Liver disease
4) Pancreatitis
5) Gastritis
6) Esophagitis
7) Neuropathy

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7
Q

there is strong association between alcoholism and psychiatric disorders such as:

A

1) Depression
2) Anxiety
3) PTSD
4) Eating disorders
5) Other substance use disorders
6) Sleep disturbances
7) Suicidal ideation and attempt

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8
Q

What are the “CAGE questions”?
What are they used for?

A

a) Have you ever felt you should Cut down on your drinking?
b) Have people Annoyed you by criticizing your drinking?
c) Have you ever felt bad or Guilty about your drinking?
d) Have you ever taken a drink first thing in the morning (Eye opener) to steady your nerves or get rid of a hangover?

Alcohol use disorder

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9
Q

True/False
The “Cage” questionnaire is a valid screening tool intended to detect full spectrum of unhealthy alcohol use

A

False

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10
Q

How many affirmative “CAGE” questions are:
a) 77% sensitive, 79% specific for alcohol abuse and dependence
b) 53% sensitive, 70% specific for unhealthy alcohol use

A

2 Affirmative questions

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11
Q

One complication of Alcohol use disorder is _________.
This is due to deficiency of Thiamine (Vitamin B1)

A

Wernicke Korsakoff syndrome

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12
Q

What issue?
acute syndrome
(1 Direct damage to the brain caused by thiamine deficiency
-a Demyelination, atrophy, hemorrhages, vascular congestion
(2 Triad
–(a Encephalopathy
–(b Disorientation, inattentiveness
–(c Oculomotor dysfunction
–(d Nystagmus most common finding
(3 Gait ataxia
(4 Wide based gait
(5 Slow, short spaced steps
(6 Most will not have triad
(7 Most common symptom: ConfusionW

A

Wernicke encephalopathy (WE)

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13
Q

What issue?
Chronic neuro condition
(1 Usually a consequence of WE
(2 It is a late neurophsychiatric manifestation of Wernickes
(3 Causes anterograde and retrograde amnesia
-(a Long term memory and cognitive skill impairment is less common

A

Korsakoff syndrome

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14
Q

True/False
Alcohol withdrawal is a potentially life-threatening problem

A

True

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15
Q

What issue?
Leading preventable cause of mortality worldwide
(a) Estimated cause of 6 million deaths worldwide
(b) 400,000 deaths in US annually

A

Tobacco use disorder

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16
Q

_____ has mortality benefit for both men and women of all ages for tobacco use disorder

A

Smoking cessation

17
Q

What are the major causes of mortality from Tobacco use disorder?

A

Cardiovascular disease
Pulmonary disease (COPD)
Cancer

18
Q

Tobacco cessation: What is the role of the clinician?

A

(a) Ask about tobacco use
(b) Advise quitting
(c) Do not have to spend long time on this
(d) Clear evidence that less than 5 minutes of advice at each encounter can increase rates of quitting
(e) Assess readiness to quit
(f) Assist those who are ready to quit
(g) Follow up

19
Q

Clear evidence that less than ___ minutes of advice at each encounter can increase rates of quitting smoking

A

5

20
Q

There are multiple stages that someone who is considering quitting may be in
(a) ______: Not ready to quit
(b) ______: Considering a quit attempt
(c) ______ : Actively planning a quit attempt
(d) ______: Actively involved in a quit attempt
(e) ______: Achieved smoking cessation

A

a) Pre-contemplation
b) Contemplation
c) Preparation
d) Action
e) Maintenance

21
Q

What is the greatest barrier in quitting smoking?

A

Nicotine withdrawl

22
Q

Nicotine withdrawal peaks in the first ____ days and slowly subsides over the course of _______

A

3 days
one month

23
Q

A patient attempting to quit smoking is presenting with these issues what issue would you suspect?
-increased appetite,
-weight gain,
-depression,
-insomnia,
-irritability,
-anxiety,
-restlessness

A

nicotine withdrawal

24
Q

What are some treatment options for nicotine withdrawal?

A

1) Nicotine replacement therapy is a popular option. Includes both long and short
acting nicotine replacement
-a) Long acting: Nicotine patch
-b) Short acting: Gum or lozenges available
2) Buproprion (Wellbutrin)
3) Varenicline (Chantix)

25
Q

With moderate dosage, marijuana produces what two phases?

A

Mild euphoria followed by
sleepiness

26
Q

What is the most widely used approach to psychotherapy in treating patients with substance use disorders, especially for cannabis dependence?

A

Cognitive behavioral therapy

27
Q

What is the treatment of choice for acute opioid intoxication?

A

Naloxone

28
Q

What issue is easily confused with opioid intoxication?

A

Hypoglycemia

29
Q

Pt presents with these issues what would you suspect
Hx of stimulant use
1) Sweating
2) Tachycardia
3) Elevated blood pressure
4) Mydriasis
5) Hyperactivity
6) Acute brain syndrome with confusion and disorientation.

A

acute stimulant intoxication