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Behavioral Med > Substance Use > Flashcards

Substance Use Flashcards

1
Q

What is the difference between how the DSM IV and how the DSM V describes SUD

A

Dependence, abuse, addiction are not separated, rather under an umbrella. Addictive behavior has been added under this umbrella

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2
Q

What is the current diagnostic criteria for substance use disorders?

A

11 equally weighted symptoms, generally related to ”loss of behavioral control” which is the cardinal feature of addiction

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3
Q

What 3 basic neurotransmitters are related to SUD and what is the main function of each.

A

Dopamine (reward), GABA (chief inhibitory), Serotonin (feelings and emotion)

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4
Q

Describe the reward pathway

A

At the nucleus accumbens, dopamine triggers a surge of pleasurable feelings. At another location, dopamine is released into the amygdala and relieves anxiety and stress.

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5
Q

What causes the enhancement of dopamine?

A

Opiates inhibit GABA —> no inhibitory stimulus —> larger dopamine release

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6
Q

What happens when the opiates are taken away?

A

Unpleasurable effects and seeking begins due to the loss of GABA (causes withdrawals)

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7
Q

SUDs fall into what 4 main types

A
  1. Impaired control
  2. Social impairment
  3. Risky use
  4. Pharmacological indicators (tolerance and withdrawal).
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8
Q

Diagnostic criterial for SUD

A

Must be present for 12 months
2-3 criteria met- mild
4-5 criteria met- moderate
6 or more criteria met- severe

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9
Q

What 9 types of substance related disorders are established in the DSM-5?

A

Alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics or anxiolytics, stimulants, tobacco, NOT CAFFEINE

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10
Q

T or F: incarceration is a diagnostic criteria for SUD

A

False

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11
Q

What level of treatment is prevention and early intervention according to AMSA?

A

0.5

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12
Q

What level of treatment is outpatient services according to AMSA? What does this entail?

A

Level 1. Treatment facilities providing counseling, meds, and referral services
Commonly referred to as Medication Assisted Treatment

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13
Q

Most hospitalization and inpatient treatment revolves around the need for ___________

A

Detox and withdrawal

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14
Q

What is the first step of treatment for SUD?

A

Screening (CAGE)

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15
Q

What are the approaches to treatment?

A

Abstinence programs, needle exchange programs, medication assisted programs, holistic herbal and non-certified programs

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16
Q

What is medication assisted treatment?

A

The use of FDA-approved medications in combination with counseling and behavioral therapies to provide a “whole patient” approach to the treatment of SUD

17
Q

What is a common misconception that providers, family members and patients need to understand?

A

MAT does not just substituting one drug for another. They provide a safe and controlled level of medication to relieve withdrawal symptoms and physiological cravings that cause chemical imbalances in the body. No adverse effects

18
Q

MAT contributes to lowering a person’s risk of contracting __________

A

HIV or Hep C

19
Q

MAT increases ________ in treatment and helps prevent __________

A

Retention
Relapse

20
Q

The ultimate goal of MAT is _________

A

Patient recovery

21
Q

What medications are used in MAT

A
  1. Methadone
  2. Buprenorphine
  3. Disulfiram
  4. Acamprostate (GABA analogue)
  5. Naltrexone
    Also barbiturates, antihistamines, clonidine, lofexidine for withdrawal symptoms
22
Q

What medication is a pure Mu agonist, processed in the liver, long half life, and has extensive historical data

A

Methadone

23
Q

What medication is a partial Mu and Delta Agonist, kappa antagonist, short half life, and has data 2000 restrictions

A

Buprenorphine

24
Q

What is the difference between naltrexone and naloxone

A

Naltrexone is for treatment, naloxone is for overdose

25
Q

Neonatal abstinence syndrome

A

Caused by long term opiate/opioid use regardless if it’s illicit or from treatment- can happen to mothers on methadone and Buprenorphine.

26
Q

T or F: outcomes are better for neonates born to mothers treated with Buprenorphine than those treated with methadone

A

True

27
Q

One must accept that treatment is/is not drug use

A

Is not

Behavioral Med (2 decks)

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