Substance Dependence Flashcards
What are the different levels of alcohol dependence
Mild: usually doesn’t need assisted alcohol withdrawal
Moderate: treated in a community setting unless they are at a high risk of developing alcohol withdrawal seizures and delirium
Severe: undergo withdrawal in an inpatient setting
How do you treat alcohol dependence
Treated with cognitive behavioural therapy or with acamprosate or naltrexone (alternative is disulfram)
Fun fact: Metronidazole is an antibiotic similar to disulfram and shouldn’t be taken with alcohol
How do you treat withdrawal symptoms of alcohol dependence
Benzodiazepine such as chlordiazepoxide or diazepam (alternative is carbamazepine or clomethiazole)
What drug is used if delirium is experienced in alcohol dependence
Lorazepam
What is a common occurrence with people with alcohol dependence and how do you treat it
Wernickes encephalopathy and treated with thiamine (vitamin B1)
What are the three treatments pathways for nicotine dependence
1) Varenicline
- avoid in epilepsy, CVD, and psychiatric illness
2) Bupropion
- avoid in psychiatric illnesses, seizures and eating disorders
-can cause serotonin syndrome
3) Nicotine replacement therapy
Use a patch (16hr patch if pregnant or experience nightmares) AND
-use a short term reliever: lozenges, gum, sublingual tablets, inhalator, nasal spray and oral spray
What is Opioid dependence treatment pathway
Treatment for opioid dependence should be initiated under the supervision of a qualified prescriber
Prescribed on a FP10MDA (blue scripts) - maximum supply is 14 days
Three or more missed doses- refer back to specialist
Treatment should be continued throughout pregnancy
Naloxone can be prescribed as well if the patient is at high risk of overdose
What is buprenophine
Less sedating than methadone
Milder withdrawal symptoms
Lower risk of overdose
Suboxone (buprenophine with nbaloxone) when there is a risk of injecting)
What is methadone
Causes QT prolongation
Carefully titrated according to the patients needs
