Session 5: Substance misuse

Question 1

Provide a definition of substance misuse

Provide a definition of substance misuse and outline associated epidemiology

Answer 1

the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs
can lead to dependence syndrome

Question 2

Identify the different types of substances that are commonly misused

Provide a definition of substance misuse and outline associated epidemiology

Answer 2

• stimulants: feel alert (tobacco, cocaine, speed-amphetamine, mephedrone)
• hallucinogens: mind altering (LSD, magic mushrooms, MDMA)
• depressants: feel relaxed (alcohol, heroin, transquillisers, MDMA)

Question 3

Describe the key risk factors for drug use

Provide a definition of substance misuse and outline associated epidemiology

Answer 3

• family life issues - neglect/abuse
• mental health - depression/anxiety
• unemployment and poor education attainment
• social group
• adverse childhiid experiences (ACE)
• biology - previous positive experience using drugs

Question 4

Outline the effects of drug misuse (physical, social, psychological and mental health)

Provide a definition of substance misuse and outline associated epidemiology

Answer 4

Physical:
* dependence (DVT, abcesses)
* complications of injecting
* blood-borne virus transmission
* effects of poverty (malnutrition)
* poor pregnancy outcomes
* side effects of opioids and cocaine

Question 5

Outline the effects of drug misuse (physical, social, psychological and mental health)

Provide a definition of substance misuse and outline associated epidemiology

Answer 5

Social:
* effects on families and children
* drive to criminality
* imprisonment
* social exclusion

Question 6

Outline the effects of drug misuse (physical, social, psychological and mental health)

Provide a definition of substance misuse and outline associated epidemiology

Answer 6

psychological:
* fear of withdrawal
* cravings
* guilt

Question 7

Outline the effects of drug misuse (physical, social, psychological and mental health)

Provide a definition of substance misuse and outline associated epidemiology

Answer 7

mental health:
* self medication
* depression

Question 8

Explain the different types of dependence

Describe mechanisms of dependence (both physical and psychological), tolerance, withdrawal and addictive behaviour and models of addiction

Answer 8

physical - experiencing symptoms associated with withdrawal from substances
psychological - dependence relating to having impaired control; described (by ICD-10) as a cluster of psychological, behavioural and cognitive phenomena, such as increased tolerance and withdrawal

Question 9

Describe an example of a tool to assess alcohol dependence

Describe mechanisms of dependence (both physical and psychological), tolerance, withdrawal and addictive behaviour and models of addiction

Question 10

Explain theories of dependence (learning theories, imitation, rational choice)

Describe mechanisms of dependence (both physical and psychological), tolerance, withdrawal and addictive behaviour and models of addiction

Answer 10

• drug dependence arises from environmental effects paired with drug effect
• falling blood alcohol levels lead to craving and withdrawal (unconditional responses)
• cue is paired with unconditional response (i.e. seeing fav drink and falling blood alcohol levels)

Question 11

Explain theories of dependence (learning theories, imitation, rational choice)

Describe mechanisms of dependence (both physical and psychological), tolerance, withdrawal and addictive behaviour and models of addiction

Answer 11

• social learning theory - learning through observation and listening to others
• modelling - seeing others around you use drugs/alcohol increases the likelihood of you doing it
• expectation - positive ‘reward’ makes drug use more likely
• self-efficacy - ability to abstain or deal with situations

Question 12

Explain theories of dependence (learning theories, imitation, rational choice)

Describe mechanisms of dependence (both physical and psychological), tolerance, withdrawal and addictive behaviour and models of addiction

Answer 12

• dependency involves making rational choices that favours the benefits of dependence over costs
• individuals are motivated by goals and wants
• if they discount the future they’re more likely to become addict and dependent

Question 13

Describe the application of the stages of change model to substance misuse

Describe mechanisms of dependence (both physical and psychological), tolerance, withdrawal and addictive behaviour and models of addiction

Question 14

Describe the key elements of treatment and care for substance misuse

Describe the common treatment regimens for various types of substance misuse problems and withdrawal states

Question 15

Describe the variety of UK treatment agencies to which patients with substance misuse problems can be referred

Question 16

Outline lessons for medical professionals in working more effectively with people experiencing substance misuse

Recognise and understand the role of medical professionals in the treatment and support of patients with substance misuse problems.