Substance Misuse

Question 1

Examples of opiates of abuse?

Answer 1

• heroin
• morphine
• methadone

Question 2

Examples of stimulant drugs of abuse?

Answer 2

• cocaine

- amphetamines

Question 3

Examples of hallucinogenic drugs of abuse?

Answer 3

• ecstasy (MDMA)
• gammahydroxybutrate (GHB)
• gamma-butyrolactone (GBL)
• LSD
• magic mushrooms

Question 4

What is the active compound in cannabis?

Answer 4

• tetrahydrocannabinol (THC)

Question 5

What are the intended effects of opiates?

Answer 5

• intensely pleasurable buzz/rush, then
• feeling of peace/detachment
• avoid withdrawal symptoms (if physically dependent)

Question 6

What are the negative effects of opiates?

Answer 6

CNS depression:
- miosis
- tremor
- malaise
- constipation
- weakness
- impotence
- respiratory depression (can be fatal in overdose)
IV administration side complications: e.g. BBV
Social: e.g. personal neglect

Question 7

Can you be physically dependent on opiates?

Answer 7

• yes
• 10% users are physically dependent
• tolerance and withdrawal develop quickly

Question 8

Describe the management of opioid dependency

Answer 8

• can be residential or community based
• pharmacology used for detox or maintenance: methadone of buprenorphine
• contingency management
• harm reduction: needle exchange, education about overdose, emergency Narcan/naloxone rescue packs

Question 9

What is contingency management in terms of addiction therapy?

Answer 9

• an applied form of operant conditioning which incentivises abstinence from drugs of abuse and engagement with therapy
• proved by meta-analyses to be an effective and cost-efficient addition to drug addiction programs
• shown to effectively bring about smoking cessation in the short term but has no long term effect
• can take the form of token-based reward systems, chances to win prizes, and less commonly: punishments for undesirable behaviours

Question 10

What are the intended effects of stimulant drugs of abuse?

Answer 10

• brief high with euphoria
• increased energy
• increased concentration

Question 11

What are the negative effects of stimulant drugs of abuse?

Answer 11

Immediately: depression and tiredness follow use
Long term: increased risk of psychosis
IV administration complications: e.g. BBV
Social: personal neglect, out of character behaviours

Question 12

How is stimulant drug misuse managed?

Answer 12

• community psychological therapy