Tutorial #29: Substance Use Disorder Flashcards
Can you use Urine Drug tests to diagnose substance use disorder?
No! A substance use disorder is a clinical diagnosis
What is the precontemplation stage of change?
Patient is not concerned about substance use and is not considering change.
What is the contemplation stage of change?
Patient has considered change/possibility that their use may not be best for them.
What is the determination stage of change?
Patient has decided to reduce or stop their use.
What is the action stage of change?
The patient is actively reducing or stopping their use.
What is the maintenance stage of change?
The patient has reduced or stopped use and is continuing on that course.
What is the relapse stage of change?
The patient has returned to previous, unhealth levels of substance use.
If a patient is in the precontemplation stage of change, what should be your goal as the clinician?
To increase the patient’s perception that there is a concern.
If a patient is in the contemplation stage of change, what should be your goal as the clinician?
Tip the balance between pros and cons of the behaviour towards greater concern and behaviour change.
If a patient is in the determination stage of change, what should be your goal as the clinician?
To help determine the best course of action. You should help the patient decide on achievable goals.
If a patient is in the relapse stage of change, what should be your goal as the clinician?
Help them go back to the process of contemplation
If a patient is in the maintenance stage of change, what should be your goal as the clinician?
Help them prevent relapse or return to drug use.
If a patient is in the action stage of change, what should be your goal as the clinician?
Help them take steps to continue that change
You suspect a patient is going through substance use withdrawal. The patient has pilorection, is yawning, has diarrhea and dilated pupils. What is the most likely class of drug they are withdrawing from?
Opioids
What is the most efficacious treatment for opiate use disorder?
Buprenorphine-naloxone (Suboxone)
You suspect a patient is going through substance use withdrawal. The patient seems depressed, has extreme lethargy, and has sleep disturbances. What is the most likely category of drug they are withdrawing from?
Stimulants
Examples include: cocaine, amphetamines, methylphenidate
You suspect a patient is going through drug withdrawal. The patient is tachycardic, diaphoretic, has nausea/vomitting, developed a tremor, and is starting to have hallucinations.
Alcohol (ie. sedatives)
What is the treatment for alcohol use disorder? (x2)
Naltrexone (opioid antagonist) and acamprosate (glutamate antagonist)
There are other agents include disulfiram, topiramate, and gapabentin, but these 2 have been proven to improve outcomes and are underutilized.
What are the features of alcohol withdrawal seizures?
Generalized onset tonic-clonic seizures that occur typically 12-48 hours after last EtOH
Left untreated, can lead to delirium tremens.
What is the management of alcohol withdrawal seizures?
Benzodiazepines
