substance use disorders

Question 1

define substance use disorder

Answer 1

a pathological use of a substance that leads to a disorder of use

Question 2

risk factors

Answer 2

genetic, neurobiological, environmental
stigma (only one in two people get treatment

Question 3

substances used in a disordered manner

Answer 3

caffeine
cannibals (marijuana)
hallucinogens
inhalants
opioids (heroin and prescription drugs)

Question 4

caffeine

Answer 4

most widely used psychoactive substance in the world
can result in intoxication, overdose and withdrawl

Question 5

cannabis (marijuana)

Answer 5

third most commonly used psychoactive drug
becoming more potent

Question 6

hallucinogens

Answer 6

cause a disturbance in reality

Question 7

inhalants

Answer 7

solvents for glue and paint

Question 8

Opioid use disorder

Answer 8

heroin and prescription drugs
cravings result in larger amounts, longer periods of use, increasing tolerance to its effects

results in significant impairment in life roles, interpersonal conflict, and puts a person in particularly hazardous situations

overdose: death usually d/t respiratory arrest, pinpoint pupils cardinal sx/sx
tx: airway and narcan

Question 9

Opioid withdrawal
**can be a medically supervised withdrawal

Answer 9

methadone, clonidine, buprenorphine, naloxone
COWS assessment

Question 10

sedative and hypnotic drug use disorders

stimulant use disorder

Answer 10

sedatives: benzos and barbiturates

stimulants: amphetamine-type=cocaine

Question 11

tobacco

Answer 11

withdrawal is distressing
tx: behavioral therapy, hypnosis, nicotine replacement therapy, bupropion, or varenicline

Question 12

gambling disorder

Answer 12

gamblers anonymous
tx: SSRIs, therapy, etc.

Question 13

Alcohol Use Disorder

Answer 13

sedative with initial euphoria
CIWA (treat above 8) legal BAC: 0.8-0.10
American Indians and Alaska Natives have the highest risk
genetic, neurobiological and sociocultural risk factors

withdrawal is dangerous

Question 14

Alcohol Use Disorder
withdrawal, treatment, cognitive disturbances

Answer 14

withdrawal is dangerous
delirium tremors=happen in 3-5% of people, but 37% of people will die without effective treatment
hallucinations and illusions, increased: BP, temperature, sweating

tx: benzos by IV (Ativan, valium, Librium) for severe withdrawal symptoms

Benzos by mouth for medically supervised withdrawal

Question 15

Cognitive Disturbances

Answer 15

Wernicke-Korsakoff syndrome
deficiency of thiamine (vitamin B1) is responsible for the symptom complex manifested
**sx/sx: impaired memory that progressively gets worse, ophthalmoplegia, gait ataxia, nystagmus, mental status changes (apathy, indifference, paucity of speech, hallucinations, agitation)

Question 16

treatment for Wernicke-Korsakoff

Answer 16

naltrexone and acamprosate (1st line, naltrexone blocks the MU receptors and can cause constipation)
disulfram (second line) **contraindications=HF and CAD)