Substance Use Disorders & Withdrawal Flashcards
cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems
substance use disorder
a syndrome occurring when blood or tissue concentrations of a substance decline in an individual who maintained prolonged heavy use of the substance for a period
withdrawal
at what age does AAP recommend screening adolescents for substance use?
11 yo
what is the mnemonic used for screening kids for substance use disorder?
C
R
A
F
T
what is the mnemonic used for screening adults for substance use disorder?
C
A
G
E
what substance must go under medical detoxification? (2)
alcohol
benzodiazepines
why must alcohol and benzodiazepines be tapered during medical detoxification?
to avoid dangerous withdrawals like seizures and death
what 2 medications can be used during medical detoxification of alcohol and benzodiazepines?
chlordiazepoxide (librium)
clonazepam
what assessment determines the intended withdrawal syndrome?
CIWA
how much diazepam should be given if a patient’s CIWA is 8 or more?
5-10 mg
alcohol withdrawal is related to induced _____ insensitivity and _____ receptor upregulation
GABA
glutamate
when does minor alcohol withdrawal occur after cessation?
less than 6 hours
when does moderate to severe alcohol withdrawal occur after cessation?
96 hours (4 days)
a patient presents with insomnia, tremulousness, mild anxiety, GI upset, anorexia, headache, diaphoresis, and palpitations. what are they likely experiencing?
minor alcohol withdrawal
a patient presents with hallucinations, seizures, and delirium tremens. what are they likely experiencing?
moderate to severe alcohol withdrawal
what are the 2 main treatments for alcohol withdrawal?
thiamine IV
benzodiazepines
what are 3 benzodiazepines used for alcohol withdrawal?
lorazepam
diazepam
chlordiazepoxide
what are 2 non-traditional medications used for acute alcohol withdrawal?
haloperidol
propofol
a patient presents with hyperthermia, perspiration, mydriasis, tachycardia/arrhythmias, elevated BP, n/v, agitation, confusion, seizures, dyskinesias and dystonia. what are they likely experiencing?
stimulant intoxication
a patient presents with fatigue, dysphoric mood, vivid/unpleasant dreams, hypersomnia, increased appetite, and psychomotor retardation or agitation. what are they likely experiencing?
stimulant withdrawal
what is the treatment for stimulant withdrawal? (3)
IV fluids
nutrition
time
what is the most inappropriately used opioid?
heroin
a patient presents with miosis, sleepiness/unresponsiveness, shallow/infrequent respirations, snoring breathing sounds, bradycardia, and cyanosis. what are they likely experiencing?
opiate intoxication
what is the treatment for opiate intoxication?
0.2-2mg naloxone IV or IM
IV drip or continue dosing q 30 mins
a patient presents with dysphoric mood, n/v, muscle aches, lacrimation/rhinorrhea, mydriasis, piloerection, sweating, diarrhea, yawning, fever, and insomnia. what are they likely experiencing?
opiate withdrawal
what is the short term treatment for opiate withdrawal?
clonidine
what is the long term treatment for opiate withdrawal?
buprenorphine 3x/week
what is the treatment used for opiate withdrawal that must be given once a day?
methadone
a patient presents with abdominal pain, vomiting, and/or nausea that is relieved by hot showers. what are they likely experiencing?
cannabis hyperemesis syndrome
what are the 3 treatments for cannabis hyperemesis syndrome?
IV fluids
antiemetics
benzodiazepines
what are the 2 alternative treatments for cannabis hyperemesis syndrome?
haloperidol
capsaicin cream on stomach
