substance misuse - background Flashcards
What is a drug?
A medicine or other substance which has a physiological effect when introduced to the body
Who is most likely to use drugs?
Young adults between 16-24
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?
A chronic, primary, neurobiological condition influenced by genetic, psychosocial and environmental factors
What factors affect drug misuse and addiction?
Genetic factors
Socioeconomic factors
Environmental factors
Describe opioid addiction
Intense initial intoxication
Development of profound tolerance
Escalation in intake
Profound dysphoria, physical discomfort with withdrawal and somatic withdrawal signs during abstinence
Describe the pattern of addiction of alcohol
Initial in otic action is less than opioids
Pattern is characterised by binges
Severe emotional and somatic withdrawal syndrome
Intense craving for the drug that is often driven by both negative and positive emotional states
How does the reward pathway in the brain work?
Included a number of areas of the brain including the ventral regimental area (VTA), the nucleus accumbens and the prefrontal cortex
When activated by a rewarding stimulus, info travels from the VTA to the nucleus accumbens and then up to the prefrontal cortex
Dopamine mediated transmission allows us to feel pleasure
How do the use of drugs affect neurotransmitters?
Increased levels of dopamine leads to euphoria
Decreased levels of serotonin leads to decreased levels of contentment
What is the psychiatric view of addiction?
- Preoccupation/anticipation
- Binge/intoxication
- Withdrawal/negative affect
These are loops that keep going around
What is the psychodynamic theory of substance misuse?
Suggests that substance misuse stems from unconscious psychological conflicts and unresolved issues from early childhood experiences
How does prolonged exposure lead to addiction?
It reduces the sensitivity of the brain to the rewards system
What is psychological dependence?
An overriding compulsion to take the drug event in the certain knowledge that it is harmful
What is physical dependence?
Use followed by a withdrawal syndrome, characteristic of the psychoactive substance taken
What is withdrawal syndrome?
A specific array of symptoms and signs that follow sudden withdrawal of a drug that causes physical dependence
What is tolerance?
Following repeated administration, users may become less sensitive to the effects
In what 3 ways can drugs be classed?
Behavioural classification
Pharmacodynamic classification
Legal classification
What is the legal class of drugs and give an example for each
A eg - heroin
B eg - cannibis
C eg - anabolic steroids
What are the risks of illicit drug use?
Increased risk of infections
Sexually shared infections
Transmission of BBV
Health and social issues related to alcohol and smoking
What are the 5 methods of taking drugs and give an example for each?
Oral - alcohol
Transmucosal - cocaine
Inhalation/smoking - cannibis
Intramuscular - ketamine
Intravenous - heroin
Name 4 injection related complications
Cellulitis
Abscess
Embolism
DVT
What are the effects of cannibis?
Euphoria
Slowed thinking and reaction time
Anxiety
Confusion
What may cause a student to get a fitness to practice?
Behaviours involving or associated with potential criminality
Violent behaviour
Abusive behaviour
Sexual harassment
What advice should be given to pts for alcohol use?
14 units per week
2 alcohol free days
What is alcohol misuse?
The daily intake in excess of 5 units
Give 4 risk factors for alcoholism?
Armed forces
Bachelors over 40
Doctors
Entertainers
Name 4 signs of addiction?
Loss of reliability
Mood changes
Impaired driving
Bad record keeping
Name 4 signs of physical stress
Increased HR
Increased BP
Palpitations
Muscle tensions leading to headaches, dizziness, jaw ache and insomnia
Give 5 signs of emotional stress?
Irritability
Impatience
Fear
Anxiety
Panic
What should you do if you have an addiction?
Put pt interests first
Consult a senior colleague for advice and support
If you are the colleague then document the encounter
Support groups - British Doctors and Dentists Group
What is the government legislation for substance misuse?
Misuse of drugs at 1971
