Substance dependance and misuse Flashcards
What are the risk factors for susstance dependance?
Lower socioeconomic group
Genetic factors
Childhood experiences e.g. abandonment, abuse
Adolescent experiences e.g. family breakdown
Environmental experiences e.g. availability of substance
What is the pattern of developing substance misuse?
Casual use into regular use through to compulsion
What are some of the key features of dependance syndrome?
Salience (change in life priorities to drug seeking behaviour)
Tolerance
Impaired control of consumption
Returning to previous behaviour following absinence
Withdrawl syndrome (anticipate and avoiding withdrawls)
What biological changes occur in addiction
There is neuro adaptation in the pre frontal corte that overrides normal judgement
What are some of the common defence mechanisms in addiction?
Most commonly denial
Rationalisiation (I drink to sleep)
Passive aggression
Humour
What is the states of change model?
Allows you to understand motivation for addiction and tailor treatment
Are hallucinations present in alcoholism?
Yes they can commonly occur in alcoholics
What is wernicke korsakoff’s syndrome caused by?
This is caused by Thiamine deficiency which causes haemorrhages in the mammary bodies and floor of the third ventricle
What is korsakoff’s psychosis?
Following Wernickes if patients survive they can develop korsakoff’s psychosis which is anterograde loss of short term memory
What is delerium tremens and what is it a feature of?
This is a triad of symptoms: -Delerium -Hallucinations -tremor Typically occurs following severe alcohol withdrawl
What is typically used to treat alcohol withdrawl symptoms?
Treated with Chlordiazepoxide or diazepam
What nutrients should alcohol withdrawl patients be given?
Iv pabrinex to treat thiamine deficiency
What interventions should be used once alcoholics are off alcohol to stop them going back on it?
Psychosocial interventions:
- Brief interventions
- Cognitive behavioural therapies
What are some of the signs and symptoms of opiate overdose?
It causes resp depression Pinpoint unreactive pupils Decreased sympathetic activity (low BP) Bradycardia Severe drowsiness
How do you treat opiate overdose?
Naloxone
How long does withdrawl from opiates take? When is it worst?
It begins after 4-12 hours and peaks at 48-72 hours
Takes 7-10 days altogether
What are the symptoms of opiate withdrawl?
Muscle aches, vomiting, diarrhoea, agitation, sweating, insomnia
What medication is typically used for opiate withdrawl?
Methadone dose can be titirated according to the withdrawl symtpoms
Buscopam can be used abdominal cramps and benzodiazepine can be used for other symptoms
What is the antidote to benzodiazepine overdose and how does this work?
Flumazenil, it works by competitivly inhibits benzodiazepines at the GABA binding site
How do benzodiazepines work?
They bind to GABA and reduce the excitability of neurones in the brain. This is because they increase GABA activity and this is an inhibitory neurotransmitter
Broadly how do ectasy, cocaine and MDMA work?
Amphetamines that increase sympathetic activity in the brain
What can be used to help with amphetamine dependance?
Antidepressants
