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BM: Unit 4 > Substance Abuse Disorders > Flashcards

Substance Abuse Disorders Flashcards

1
Q

Define substance abuse w/ DSM V criteria

A
  1. a pattern of maladaptive substance use that is associated with recurrent and significant adverse consequences characterized by at least 3 of the 7 symptoms:
    A. Tolerance (a state in which a person no longer responds to a drug; a higher dose is required to achieve the same effect)
    B. Withdrawal
    C. Increased consumption
    D. A lack of desire or ability to stop
    E. Large amounts of time devoted to procuring substance
    F. Abandonment of typical activities because of need to use substance
    G. Continued use despite knowledge of damaging effects
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2
Q

Define substance dependence

A
  1. Compulsive pattern of use characterized by a loss of control over substance use and continued use despite the significant substance related problems
  2. A state in which a person functions normally only in the presence of a drug
  3. Dependence develops when the neurons adapt to the repeated drug exposure and only function normally in the presence of the drug
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3
Q

What common sxs of CNS depressant (ETOH) abuse?

A
  1. Brain: HA, blackouts, delusions, paranoia, forgetfulness, imparied judgement, bleeding, etc
  2. Liver: fatty cells, tissue scarring, jaundice, hepatitis, irreversible cirrhosis
  3. Pancreas: poor digestion, malnutrition, early diabetes
  4. Male Sex organs: depressed testicular production, impotence, breast growth
  5. Female Sex organs: failure to ovulate, spontaneous abortion
  6. Bones: degeneration and risk of fracture
  7. Nervous system: malfunctions, shakiness, tremors
  8. Intestines: inflammation
  9. Extremities: Pins and Needles
  10. Stomach: gastritis, peptic ulcer disease
  11. Heart: weak and fatty heart, weakening of heart muscles, HTN, anemia
  12. Muscles: degenration, weakness, pain
  13. Esophagus: corrosive effect and increased risk of cancer
  14. Throat: Increased risk of esophageal varices
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4
Q

What can a BAC of upto 0.05 cause?

A
  1. feeling of wellbeing

2. talkative, relaxed, confident, happy, cheerful

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5
Q

What can a BAC of 0.05 to 0.08 cause?

A
  1. Getting risky

2. Impaired judgement, lack of attention, reduced inhibition

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6
Q

What can a BAC of 0.08 to 0.15 cause?

A
  1. Dangerous

2. Speech slurred, visual impairment, N/V, slowed reflexes, tolerance affected

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7
Q

What can a BAC of 0.15 to 0.40 cause?

A
  1. Stupor
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8
Q

What can a BAC of over 0.40 cause?

A

Death, coma, shock

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9
Q

What are the equivalent of ETOH content among types?

A
  1. Beer = 12 oz 5%
  2. Wine= 6oz 10%
  3. Liquor=1.5 oz, 80 proff
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10
Q

What does MUST HELP stand for?

A
  1. Mental confusion
  2. Unresponsiveness
  3. Snoring/gasping for air
  4. Throwing up
  5. Hypothermia
  6. Erratic Breathing
  7. LOC
  8. Paleness/blueness of skin
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11
Q

What are the sxs of mild ETOH withdrawal

A
  1. anxiety
  2. agitation
  3. tremor
  4. Nausea
  5. tachycardia
  6. HTN
  7. Raised temperature
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12
Q

What are the sxs of severe ETOH withdrawal

A
  1. Vomiting
  2. Extreme agitation
  3. disorientation
  4. COnfusion
  5. Paranoia
  6. Hypervention
  7. Delerium tremens
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13
Q

What are the sxs of benzo abuse?

A

fatigue/tiredness, irritability, drowsiness, loss of coordination, emotional numbing, mania, hostility, rage, aggressiveness and impulsivity, hallucinations.

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14
Q

What are the sxs of benzo withdrawal?

A

Withdrawal: drowsiness, impaired judgment, impaired motor skills, CNS respiratory depression, paradoxical excitement, restlessness, delirium and cardiovascular collapse.

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15
Q

Define Huffing (inhalants)

A

which can take the form of sniffing or snorting fumes from a container, spraying aerosols directly into nose or mouth, placing an inhalant soaked rag in the mouth, inhale fumes from a balloon or plastic bag that contains the inhalant.

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16
Q

What are sxs of inhalant abuse?

A
  1. chemical odors on breath or clothing
  2. paint or other stains on face, hair, clothes
  3. Hidden empty spray paint cans
  4. drunk or disoriented appearance
  5. slurred speech
  6. N/V, loss pf appetite
  7. Inattentiveness, lack of coordination, irritability, depression
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17
Q

What are the effects of inhalant abuse?

A
  1. Brain damage
  2. Kidney damage
  3. muscle weakness and cramping
  4. Involuntary voiding and defecation
  5. Irregular heartbeat
18
Q

How do cocaine user present?

A
  1. dialted pupils
  2. nosebleeds
  3. nasal congestion
  4. snifing
  5. tachycardia
  6. impaired movement
  7. seizures
  8. elevated BP, respirations, temperature
  9. hallucinations
  10. Anorexia
  11. weight loss
19
Q

What are the types of stimulants?

A
  1. ecstacy
  2. crystal meth
  3. Amphetamines
20
Q

What are common effects of stimulants?

A
  1. euphoria
  2. increased energy
  3. mental alertnes
  4. rapid speech
  5. psychosis
21
Q

What are the sxs of caffeine overdose?

A
  1. Irritable, anxious, restlessness, confusion, delerium, HA, insomnia
  2. sezuires, twitching, rapid breathing, rapid heartrate, irregular rhythm
22
Q

What are “psychoactive bath salts’? (PABS)

A

CNS stimulant with hallucinogenic properties that inhibit the norepinephrine-dopamine reuptake system

23
Q

What is the most common ingredient in PABS?

A
  1. MDPV (methylenedioxypyrovalerone), mephedrone and pyrovalerone.
  2. Structurally similar to cathinone, an alkaloid found in the khat plant and methamphetamine.
24
Q

How is PABS taken?

A

Snorted, smoked, ingested, used rectally and injected

25
Q

What are the effects of PABS? How long do they last?

A
  1. Produces a “high” similar to methamphetamine
  2. Effects occur with doses as small as 3 – 5 mg/ average dose is 5 – 20 mg.
  3. High risk for overdose because most packages contain up to 500mg.
  4. Oral ingestion produces peak “rush” at 1.5 hours, effect lasting 3-4 hours and then a hard “crash”.
  5. Total effects up to 8 hrs
26
Q

What are the sxs of PABS?

A
  1. anxious/jitery
  2. Violence
  3. self mutilation
  4. hyperthermia
  5. delerium
  6. insomnia
  7. lack of appetite
  8. severe paranoia
27
Q

What are the sxs of opioid intoxication?

A
  1. Euphoria or dysphoria
  2. feelings of warmth, facial flushing, itching
  3. Imparied judgement, attention, memory
  4. Analgesia
  5. constipation
  6. pupillary constriction
  7. Drowsiness
  8. respiratory depression, areflexia, hypotension
  9. Tachycardia
28
Q

What are the sxs of opioid withdrawal?

A
  1. Depressed mood and anxiety
  2. Cravings
  3. Piloerection, lacrimatino, rhinorrhea
  4. high attention
  5. joint and muscle pain
  6. Diarrhea and GI cramping, N?V
    7/ insomnia
  7. yawning
  8. Autonomic hyperactivity
29
Q

What are the screening tools for abuse?

A
  1. AUDIT – alcohol screening questionnaire with 10 questions
  2. DAST - drug abuse screening test with 10 questions
  3. ASSIST - alcohol, smoking and substance involvement screening test with 8 questions; also has feedback card for patients
  4. CRAFFT – targets alcohol and drug use in adolescents; has 6 questions
  5. TWEAK – (Tolerance, Worried, Eye-opener, Amnesia and K/Cut down) 5 item scale to screen for risk of drinking during pregnancy
  6. 5 P’s - (parents, peers, partner, past, present) 8 questions for pregnant women and those of child bearing age.
30
Q

What are antidipsotropics? What are they used for?

A
  1. Best known medication in this category is disulfiram (anatabuse)
  2. When taken with alcohol, negative physical reactions can range from nausea and headaches to unconsciusness or death
  3. Not a cure for alcohol dependency, but can be used on a long-term basis as part of a complete treatment program
  4. Examples: anabuse, naltrexone, acamprosate
31
Q

What is naltrexone and what is it used for?

A

opioid receptor antagonist but also useful to help with cravings (available p.o. and IM)

32
Q

What is Acamprosate (Campral)? What is it used for?

A

calcium-acetyl homotaurine/ works on GABA and glutamate. Helps with cravings and post-acute withdrawal syndrome

33
Q

What are the 3 types of substance abuse medications?

A
  1. ANTIDIPSOTROPICS
  2. OPIATE REPLACEMENT THERAPY
  3. Nicotine Addiction medications
34
Q

What is opiate replacement therapy? What are examples?

A
  1. used to help stop use of heroin, morphine, OxyContin, Dilaudid, Vicodin through substitution; prevents withdrawal symptoms but doesn’t provide a strong euphoria; usually a long-term treatment that lasts for years
  2. Ex, methadone, Suboxone (Buprenorphine
35
Q

What is methadone used for?

A

synthetic opioid; acyclic analog of heroin and morphine; acts on same receptor sites.

36
Q

What is Suboxone (Buprenorphine) used for?

A

semi-synthetic opioid used to treat opioid addiction in higher doses; can only be prescribed by DEA qualified physicians; less tightly controlled than methadone (patients can have their medications at home)

37
Q

What are the nicotine addiction medications?

A
  1. NICOTROL: delivers nicotine without smoking; includes inhalants, lozenges and patches
  2. BUPROPION(Zyban, Wellbutrin): an anti-depressant that can be used to stop smoking…usually prescribed for up to 6 months
  3. VARENICLINE (Chantix): blocks nicotine receptors and is generally prescribed for 12 – 24 weeks
38
Q

What is motivational interviewing?

A

A clinical approach that helps people with mental health, substance use disorders and other chronic conditions such as diabetes, cardiovascular conditions and asthma make positive behavioral changes to support better health.

39
Q

What are the 4 principles of MI?

A

The approach uphold 4 principles: expressing empathy and avoid arguing, developing discrepancy, rolling with resistance and supporting self-efficacy.

40
Q

What are the best practices for substance abuse?

A
  1. SCREENING: a healthcare professional assesses a patient for risky substance use behaviors using standardized screening tools. Screening can occur in any healthcare setting.
  2. BRIEF INTERVENTION: a healthcare professional engages a patient showing risky substance use behaviors in a short conversation, providing feedback and advice.
  3. REFERRAL TO TREATMENT: a healthcare professional provides referral to brief therapy or additional treatment to patients who screen in need of additional services.

BM: Unit 4 (5 decks)

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