Substance Misuse Flashcards
What is a drug?
a medicine or substance which has a physiological effect when ingested or otherwise introduced into the body
What are substance use disorders?
a cluster of cognitive, behavioural and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems
What is an addiction?
chronic, primary, neurobiological condition influenced by genetic, psychosocial and environmental factors
What are the risk factors for drug misuse?
- gender
- men
- genetics
- socioeconomic factors
- environmental factors
- family and friends using drugs
- time of drug use
- earlier use increases risk
- availability of drugs
- personality
- low-self esteem
- stress
- method of administration
- co-existing mental problems
- peer pressure
- physical and sexual abuse
- early exposure to drugs
- stress
- trauma
- increased risk of future trauma
What factors are associated with initiation of drug abuse and addiction?
- initiation of drug abuse
- social factors
- environmental factors
- addiction
- neurobiological factor
What are the patterns of addiction for opioids?
- intense initial intoxication
- development of profound tolerance
- escalation in intake
- profound dysphoria, physical discomfort and somatic withdrawal signs during abstinence
What are the pattern of alcohol addiction?
- initial intoxication
- less than opioids
- pattern in characterised by binges
- severe emotional and somatic withdrawal syndrome
- intense craving for drug that is often driven by negative emotional states but also by positive emotional states
What is the reward pathway and how is it related to addiction?
- reward pathway includes a number of areas of the brain including the ventral tegmental area (VTA), the nucleus accumbens and the prefrontal cortex
- when activated by a rewarding stimulus, information travels from the VTA to the nucleus accumbens and then up to the prefrontal cortex
- dopamine mediated transmission allows the feeling of pleasure
How can drugs impact neurotransmitters?
- dopamine
- increased level
- euphoria
- serotonin
- decreased level
- contentment
What is the psychiatric view on addiction?
- pre-occupation/anticipation
- binge/intoxication
- withdrawal/negative effect
What is the result of prolonged exposure to drugs?
- addiction through the rewards pathway
- chronic exposure reduces the sensitivity of the brain to the rewards system
- greater role of habituation and compulsion as a result of conditioning and environmental stimuli
What is psychological dependence?
an overriding compulsion to take the drug even in the certain knowledge that it is harmful and whatever the consequences of the method of obtaining it
What is physical dependence?
sudden drug is followed by a withdrawal syndrome for some drugs, characteristic of the psychoactive substance taken, varies from person to person and depends of regular administration in sufficient dosages over a period of time
What is withdrawal syndrome?
specific array of symptoms and signs that follow sudden withdrawal of a drug that causes physical dependence
What is tolerance to a drug?
following the repeated administration of some drugs, users may become less sensitive to the effects of the drug over time and require larger doses to achieve the same effects
What are the 3 different ways in which drugs can be classified?
- behavioural
- pharmacodynamic
- legal classification
What are the different behavioural drugs and explain their effect?
- stimulants
- stimulate or produce arousal and behavioural activation
- cocaine, amphetamines, nicotine, caffeine
- opioids
- natural semisynthetic or synthetic
- bind to opioid receptors to produce analgesia
- sedative hypnotics
- sedate or decrease arousal
- anti-anxiety, hypnosis or sleep
- antipsychotics
- used to treat psychosis
- haloperidol
- antidepressants
- used to treat major depressive episodes
- SSRIs
- psychedelics
- produces psychedelic experiences
- mind-altering
What are the different pharmacodynamic classifications of drugs?
- dopamine agonists
- stimulants
- opioid receptos agonists
- opioids
- y-aminobutyric acid neurotransmission (indirect facilitation)
- sedative hypnotics
- dopamine D2/serotonin 5-HT2 receptor antagonists
- antipsychotics
- serotonin/norepinephrine reuptake inhibitors
- antidepressants
- serotonergic activity facilitators
- psychedelics
What determines the class of illegal drugs?
- based on the level of harm
- Under the Misuse of Drugs Act it is an offence to:
- unlawfully possess a controlled drug
- possess a controlled drug with intent to supply it
- unlawfully supply a controlled drug
- allow premises you occupy or manage to be used for the smoking or use of drugs
What are the different legal classifications of drugs?
- Class A
- crack cocaine
- cocaine
- ecstasy (MDMA)
- heroin
- LSD
- Class B
- amphetamines
- cannabis
- codeine
- ketamine
- Class C
- anabolic steroids
- benzodiazepines (diazepam)
What are the risks of illicit drug use in healthcare professionals?
- between 10-15% misuse alcohol or drugs
- risk decreases with age
- patter of alcohol use is a significant factor for the risk of subsequent illicit drug use
- not socialising with substance abusers
What are the risks of illicit drug use?
- increased risk of infections
- TB
- STIs
- BBVs
- transmission through IVDU
- HIV, Hep B, Hep C
- contaminated blood and blood products
- sharing injecting equipment
- needle-stick injuries
- injection related complications
- cellulitis
- abscess
- thrombophlebitis
- bacteraemia
- embolisation in organ
- meningitis
- endocarditis
- osteomyelitis
- septic arthritis
- gangrene
- thrombosis
- embolism
- deep vein thrombosis
- sexually transmitted infections
- higher rates seen in drug users
- sex as trade for drugs
- more likely to indulge in unprotected sex
