Substance Misuse- 14

Question 1

What are substances that can be abused.

Answer 1

Opioids/opiates
Heroin
Alcohol
Tobacco
Cannabis

Hallucinogens
LSD, MDMA
Magic mushrooms

Stimulants
Cocaine, Crack,
Caffeine

New Psychoactive Substances (NPS)
Ivory wave
Black Mamba

Question 2

How and Why does addiction happen?

Answer 2

Brain chemistry and sensitivity changes
release of neurotransmitters and hormones including adrenaline, noradrenaline, GABA, dopamine, serotonin, endorphins

All give an enhanced sensation of enjoyment / pleasure
Reward pathways and positive reinforcement – it feels good!!

Not all (substance) use is dependent or problematic use
Consider recreational use of ‘soft drugs’ for weekend use only

Question 3

What are reasons for initial use and relapse of substances

Answer 3

Peer pressure
Reduced inhibitions
Post trauma / Coping mechanisms (physical / mental / sexual abuse or assault)
Seen as the “norm”: Nature vs nurture – links with deprivation

Question 4

What is the criteria for smoking cessation service and how is it carried out?

Answer 4

12 years or over
Pharmacy staff proactively seek out clients: cardiac, respiratory disease, pregnant
women, young people

Record client details, motivation to quit, set provisional quit date & offer return appoint
Pharmacist assessment & initial supply of NRT (written & verbal advice)
Subsequent (maintenance) supplies over 12 week period – (trained support staff)
Client smoking status determined at each visit
4 weeks post quit date follow up : 12 week & 12 month (paid by HB)

Question 5

What are substnce misuse policies

Answer 5

Prohibition / Abstinence

Substitution using a Harm Reduction approach – continued usage with a substitute substance to avoid the harm associated with the original product / substance.

Rehabilitation / Active Treatment (mainly psychological) – Cognitive Behaviour Therapies (e.g. coping strategies / programme the brain to think differently)