SUD Flashcards
What brain structure is damaged due to the chronic administration of drug
Prefrontal Cortex (gray matter volume decrease)
What is the “high” produced by a drug the result of
Large amounts of dopamine “the dopamine flood”
What are the categories of substance use disorder outlined by the DSM V?
Mild (2-3 symptoms)
Moderate (4-5 symptoms)
Severe (> 6 symptoms)
Where does the genetic predisposition of SUD come from?
Heritable family traits
Environmental effects on gene development that govern the response to drugs and stress
What are the goals of treatment for SUD?
Mitigate withdrawal sx
Dampen or eliminate craving - decrease reward for dysfunctional behavior, increase reward for healthy behavior, and decrease and eliminate cues and triggers for using
What is the role of alpha adrenergic blockade agents in mitigating withdrawal during detox?
Blunt of block the result of the “norepinephrine storm”
Is detoxification considered treatment?
No
What is a key part of treatment for support?
Peer support or a recovery coach
Why is diet and exercise important in the treatment of SUD?
Diet’s are full of sugar and salt in drug users, they can’t get healthy if their diet is unhealthy or not optimized. Exercise can also act on the brain and important for restoration and protection.
How is ETOH metabolized and by what enzyme?
Hepatic, alcohol dehydrogenase
What are early symptoms of alcohol withdrawal (6-24 hours)
Anxiety
Sleep disturbance
Vivid dreams
Anorexia, nausea
Headache
How long after their last drink does alcohol withdrawal delirium onset in alcoholics?
72-96 hours
When do seizures usually occur after a last drink?
8-24 hours after last drink
What is the treatment for seizures in alcohol withdrawal?
Benzos - GABA agonist
What antipsychotic can be added to the treatment of seizures?
Haloperidol - works but decreases seizure threshold
What is the triad of Wernicke-Korsakoff syndrome?
Mental disturbance
Ocular Paralysis (CN VI)
Ataxia
What are the medical uses of opioids?
Analgesia (pain control)
Sedation
Anesthesia
What are the symptoms of acute overdose?
Miosis
Altered mental status
Respiratory depression
Why does respiratory distress occur in overdose?
Decreased sensitivity in the pons and medulla to rising CO2 levels
Decreased gag reflux -risk of aspiration
Bronchospasm
Histamine release - vasodilation, orthostatic hypotension
What are the complications of IV drug use?
Viral transmission
Bacterial infection (osteomylitis, endocarditis)
Non-septic emboli
Rhabdomyolysis
Nephropathy
What is the gold standard for treating opioid use?
Methadone
What is the active chemical in cannabis?
D-9 tetrahydrocannabinol
There is substantial evidence between cannabis and the development of what psychologic disorder among frequent cannabis users?
Schizophrenia
What is the treatment of stimulant use disorder?
No medication treatment has been shown effective, best treatment is contingency management (boiling down the stimulant to small dose)
