Substance Related And Addictive Disorder

Question 1

Substances that cause dependence

Answer 1

Etohl 
Caffeine 
Cannabinol 
Hallucinations lsd 
Inhalants سلسيون
Opioids heroines 
Sedatives/hypnotic barbiturates benzodiazepines
Stimulant amphetamine exctasy 
Cocaine 
Tobacco صعود السيجار و السجاير

Question 2

What is their effects

Answer 2

Activate reward systems

Question 3

Substance related division

Answer 3

Use
Induced
Withdrawal
Mental disorder due

Question 4

Criteria for substance use disorder

Answer 4

Pr cost to rewire
Primacy: impairment of control 1- longer use and
2- persistent desire
3- great time to acquire ,to use and to recover
Social impairment SOD 4/5 continues in use despite the social and interpersonal issues
6- persistence of use despite knowledge that use going to
Risky use 7- in hazardous situation
Pharmacological physical dependency :8- Tolerance 9-withdrawal physical or psychological symptoms relived upon uses

Question 5

Substance induced disorder

Answer 5

Substance intoxication
Reversible syndrome due to recent use
Substance withdrawal physiology psychology history from collateral in emergency

Question 6

Assessment

Answer 6

1- drugs history first exposure at what age take each drug history separately where does he get it from where died he use it with whom how does he take it the dose increased or not frequency route when did he use it regularly period of heavy use
What is the height dose he took what is the drug effects why did he continue where he stoped if he stopped
Recent use the last 6 months dose frequency route withdrawal symptoms increased tolerance escalating dose source of supply and price paid
Reason for referrals

Question 7

Consequences

Answer 7

Physical illness predominantly alcohol liver fatty cirrhosis neurological peripheral neuropathy
Mental illness : especially with amphetamine cocaine
Social problems: divorce
Legal problem: illegal substance possession

Question 8

Life history of drug user

Answer 8

Family: if there is a family 
Early:
School: escape or 
Employment: stable or not 
Marital usually di
Social functioning 
Social network هل عندو

Question 9

Physical examination

Answer 9

General appearance
Gait
Eyes cannabis :red eyes ,dilated in heroine withdrawal ,pinpoint in intoxication
Nose inhalants increased vascularaization
Skin
Mouth smell of alc
Cvs
Respiratory sedative depression alcohol heroine
Abdomen liver alcoholism palpable rough cirrhosis

Question 10

Mental state examination

Answer 10

Not in diagnosing but help in
Coexisting
Psychology consequences
Withdrawal symptoms like irritability hallucination
Intoxication liabilities of mode and beleaguered

Question 11

Investigation

Answer 11

Hb
Urea 
L FT 
Hepatitis and HIV in needles users
Chest X-ray high incidence of pulmonary tb

Question 12

Screening for drugs

Answer 12

Blood urine in both use urine more convenient

Limitations of urine : cheating in collection ,

Question 13

Detoxification treatment management
Stages 1detoxification total abstaining is required 2weeks dangers alcohol sedatives hypnotics
2Relapse prevention
3Rehabilitation

Answer 13

Detoxification
In vs out patient could be out patient
The need for medication depends on the substance and the duration of withdrawal and severity of symptoms
Duration of treatment 10d-2weeks
Treatment or referral of associated medical disorder co operate with medicine doctor

Question 14

Relapse prevention psychologically important by counselor social worker

Answer 14

Prescription of medication aberration therapy!
Supervise psychosocial treatment
Detect and diagnose early signs of relapse
3month - 2 years

Question 15

Recovery stage

Answer 15

The pt stoped and maintenance of stopping” abstaining with change”
Once an addict always addict
Psychologist and social worker
Your job is to supervise the recovery stage