W5) 12) Addiction psychiatry Flashcards
What is the problem with this?
Alcohol is too cheap and too readily available.
Overuse of caffieine in young people = underlying conditions.
Green plant, chewed on too much by the Somalian society = psychosis.
Magic mushrooms = hallucinogens - these are mostly safe.
Duel diagnosis = primary psychiatric condition treated with drugs… Can lead to secondary mental health condition.
What are behavioural addiction?
Eg. Gambling
What makes a substance addictive?
Half-life is important - how quickly the drug gets to the brain. Liver breaks it down, the blood concentration increases slowly.
Tobacco - short half-life. Inhale = short.
Gabanergic, serotonin and dopeminergic system.
Pregabalin = addictive.
What is addiction?
Brain changes due to drug use - most irreversible.
What is the definition of tolerance and withdrawl?
They might lose insight with psychosis, schizophrenia etc…
Addiction people know they need help.
What are the alcohol withdrawl system = need alcohol in their system all the time. Activated GABAnergic system… Causes drowsiness. Due to tolerance, the Glutamate system increases to equilibrium. If you take alcohol away, you get too much glutamate and they could have a seizure. The risk of death is higher.
They need to come into an addiction centre and have a detox. The doses are gradually decreased. Detox involves diazephams.
What are the reward systems?
What do D2 receptors do?
Too many D2 receptors, you are more likely to use drugs. Take a family history.
What does this show?
The nucleus accumbens.
Addictive substances give artificial pleasures.
Why is the social factor important?
What do these D2 receptors show? DAT scan?
Top row = normal
Middle = cocaine abuser not used it in 10 days
Bottom = cocaine not used in 100 days
Brain never goes back.
This shows the half-life of alcohol.
Nicotine is a safe drug. Don’t smoke,.
Heroine causes extreme euphoria. Main cause of death is depression due to an overdose.
What are treatments?
The lady with the neck injections use it once a week - religous heroine practices. No longer an addict.
Self-harm right man - alcohol makes him aggitated though hes nice.
What is substitution treatment?
Give them clean needles.
Substitute Heroine with methadone…
Cannabis maybe legalised soon…
THC is psychogenic… Doctors can prescribe it in the UK now.
It has anxiolytic properties.
Most of these people are malnaurished. Diazepam detox.
Meetings are free and important. Social interactions.
Interventions.
Non-judgemental clinicans.
What are relapse preventions?
3 months of rehab in a different environement, comes back and you get a relapse.
Social environment and government funding is important.
What did the prevalence data show?
Alcohol poses the biggest problem.
Need to increase prices and reduce availability.
France drinks a lot more, but they drink it differently. It is spread across the week.
