Substance Misuse and Alcohol Abuse Flashcards
Define “substance misuse”
Maladaptive and recurrent use of a substance, leading to significant functional impairment
Define “acute intoxication”
Transient disturbance of consciousness/cognition/behaviour as a direct effect of a substance
Define “harmful use”
Recurrent misuse resulting in bio/psycho/social consequences, but not dependence
Define “dependence”
Prolonged, compulsive substance misuse leading to addiction, tolerance and withdrawal symptoms
What are the key features of dependence?
“CANT STOP”:
- Compulsion
- Aware of risks but persists anyway
- Neglect of other activities
- Tolerance
- Stopping causes withdrawal
- Time preoccupied with substance
- Out of control use
- Persistent, futile wish to stop
Define “withdrawal state”
Physical and/or psychological effects from complete/partial cessation of a substance, after prolonged/repeated use
Define “substance-induced psychosis”
Psychosis occurs within 2 weeks of substance use and persists for at least 48 hours
Define “residual disorder”
Symptoms which persist long-term despite abstinence e.g. PD, affective disorder, dementia
List some aetiological factors in substance misuse
- Genetics
- Life stressors
- Parental drug use
- Cultural acceptability
- Psych hx
- Availability of drug
What are the 2 major perpetuating factors in drug misuse?
- Biological reward - activation of mesolimbic pathway
- Social - peer pressure
List some important questions to ask during a drug abuse hx
- Type, Route, Administration, Pattern
- Impact on life?
- Tried to stop?
- Drug always on mind?
List 3 important investigations for someone with substance misuse
- Blood borne viruses
- LFTs and clotting
- ECG
Outline the general management of substance misuse
- Hep B jab
- Movitational interviewing/CBT
- Support with housing/employment etc
- Narcotics Anonymous
- Allocate keyworker
What pharmacological options are there for someone addicted to opiates?
- Methadone - detox and maintenance
- Buprenorphine (2nd line) - detox and maintenance
- Naltrexone - continued abstinence
Define “alcohol abuse”
Consumption of alcohol at a level sufficient to cause physical, psychiatric and/or social harm