Substance Misuse Flashcards
What is acute intoxication?
Transient disturbances of consciousness, cognition, behaviour, perception, affect or behaviour following the administration of a psychoactive substance
How is harmful use defined by ICD?
Damage to the individual’s health and adverse effects on family and society
What is dependence?
Signs of dependence = CAN’T STOP. Usu associated with neglect of personal/ social / occupational activities.
- Compulsion to take substance
- Aware of harm but persists
- Neglect of other activities
- Tolerance
- Stopping leads to withdrawal
- Time preoccupied with substance
- Out of control use
- Persistent, futile wish to cut down
What effect do drugs of abuse have on the brain?
All drugs of abuse activate the dopamine system in the mesolimbic reward pathway
Management of substance misuse?
- residential rehab, community or hospital
- CBT, motivational interviewing
- contingency mx programs
- medication
- injection harm reduction strategies
Early withdrawal symptoms of opiates?
Within 24-48h
- craving
- flu like Sx
- sweating
- yawning
What are the later opiate withdrawal symptoms?
7-10d:
- Mydriasis (pupil dilation)
- abdo cramps / diarrhoea
- agitation, restlessness
- piloerection
- tachycardia
Drugs used in opiate detoxification programs?
Methadone (opioid agonist) or buprenorphine (opioid partial agonist).
Less euphoriant and relatively long half life cf opioids of abuse.
What is naltrexone?
Opioid antagonist. Blocks euphoric effects and sometimes used to prevent relapse.
Signs of overdose opioids?
Miosis and respiratory depression.
Drug mx opioid overdose?
Naloxone
Effects of cocaine?
Restlessness, increased energy, abolition of fatigue, hunger. Resemble hypomania.
Duration of cocaine effect?
~20mins
What is post cocaine dysphoria?
Sleeplessness and intense depression; precedes withdrawal (depression, insomnia, craving).
Effects of amphetamines?
-Euphoria
-Increased concentration and energy
-Mydriasis
-Tachycardia
-Hyperreflexia
Followed by: depression, fatigue, headache
