Substance Dependance Flashcards
What is the typical history associated with substance dependence?
Tolerance (need for increased amounts to achieve desired effect). Withdrawal symptoms when not using. Unsuccessful attempts to cut down or control use. Continued use despite harmful consequences.
What are the key physical examination findings in substance dependence?
Signs of intoxication or withdrawal. Physical signs specific to the substance used (e.g., jaundice for chronic alcohol use). General neglect of health and hygiene.
What investigations are necessary for diagnosing substance dependence?
Clinical diagnosis based on history and symptoms. Urine drug screen. Blood tests for liver function, complete blood count, and infectious diseases.
What are the non-pharmacological management strategies for substance dependence?
Behavioral therapy and counseling. Support groups (e.g., AA, NA). Psychoeducation and harm reduction strategies.
What are the pharmacological management options for substance dependence?
Medications to manage withdrawal symptoms. Pharmacotherapy for maintenance (e.g., methadone, buprenorphine for opioid dependence). Medications to reduce cravings or block effects of substances (e.g., naltrexone).
What are the red flags to look for in substance dependence patients?
Overdose symptoms: respiratory depression, unconsciousness. Severe withdrawal symptoms: seizures, delirium tremens. Co-occurring psychiatric disorders.
When should a patient with substance dependence be referred to a specialist?
Severe or complex cases. Co-occurring psychiatric disorders. Need for detoxification or rehabilitation programs. Persistent substance use despite treatment.
What is one key piece of pathophysiology related to substance dependence?
Altered brain chemistry and reward pathways. Chronic exposure leads to neuroadaptation and physical dependence. Genetic and environmental factors contribute to development.
