Substance Misuse

Question 1

What is the typical history associated with substance abuse?

Answer 1

Recurrent use of substances leading to significant impairment. Neglect of major responsibilities. Social or interpersonal problems. Legal issues related to substance use.

Question 2

What are the key physical examination findings in substance abuse?

Answer 2

Signs of intoxication or withdrawal. Physical signs specific to the substance used (e.g., track marks for IV drug use). General neglect of health and hygiene.

Question 3

What investigations are necessary for diagnosing substance abuse?

Answer 3

Clinical diagnosis based on history and symptoms. Urine drug screen. Blood tests for liver function, complete blood count, and infectious diseases.

Question 4

What are the non-pharmacological management strategies for substance abuse?

Answer 4

Behavioral therapy and counseling. Support groups (e.g., AA, NA). Psychoeducation and harm reduction strategies.

Question 5

What are the pharmacological management options for substance abuse?

Answer 5

Medications to manage withdrawal symptoms. Pharmacotherapy for maintenance (e.g., methadone, buprenorphine for opioid dependence). Medications to reduce cravings or block effects of substances (e.g., naltrexone).

Question 6

What are the red flags to look for in substance abuse patients?

Answer 6

Overdose symptoms: respiratory depression, unconsciousness. Severe withdrawal symptoms: seizures, delirium tremens. Co-occurring psychiatric disorders.

Question 7

When should a patient with substance abuse be referred to a specialist?

Answer 7

Severe or complex cases. Co-occurring psychiatric disorders. Need for detoxification or rehabilitation programs. Persistent substance use despite treatment.

Question 8

What is one key piece of pathophysiology related to substance abuse?

Answer 8

Altered brain chemistry and reward pathways. Chronic exposure leads to neuroadaptation. Genetic and environmental factors contribute to development.