Substance Abuse Flashcards

1
Q

What is substance use disorder?

A

cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance related problems

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2
Q

What is an important characteristic of substance use disorders

A

the underlying change in brain circuits that may persist beyond detoxification

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3
Q

What may be experienced when individuals are exposed to drug related stimuli?

A

brain changes may be exhibited in repeated relapses and intense drug craving

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4
Q

How many substances contribute to substance use disorder?

A

11

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5
Q

Mild

A

2-3

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6
Q

Moderate

A

4-5

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7
Q

Severe

A

> 6

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8
Q

What is impaired control?

A

substance taken in larger amounts, persistent desire, time spent obtaining the substance, craving

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9
Q

What is social impairment?

A

recurrent substance use that results in failure to fulfill major roles, and also causes the person to give up or reduce activites

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10
Q

What is risky use?

A

recurrent substance use in situations in which it is physically hazardous and continued use despite knowing its risk

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11
Q

What is tolerance?

A

requiring markedly increased dose of the substance to achieve the desired effect

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12
Q

What is withdrawal?

A

a syndrome occurring when blood or tissue concentrations of a substance decline

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13
Q

Screening for adolescent alcohol use?

A

annually at age 11 yo

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14
Q

What is the screening tool for adolescent alcohol use?

A

CRAFT screen

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15
Q

What makes a adolescent screening positive?

A

> 2 positive answers

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16
Q

Who recommends questions normalizing use?

A

US National Institute on Alcohol Abuse and Alcoholism (NIAAA)

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17
Q

C

A

Have you ever ridden in a CAR driven by someone who was high, drunk, or had been using drugs?

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18
Q

R

A

Have you ever used drugs or alcohol to RELAX?

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19
Q

A

A

Do you ever use ALONE?

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20
Q

F

A

Do you ever FORGET things that you did while using?

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21
Q

F

A

Do FAMILY or FRIENDS tel you to cut down?

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22
Q

T

A

Have you ever gotten into TROUBLE when using?

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23
Q

What does CRAFFT stand for?

A

CAR, RELAX, ALONE, FORGET, FAMILY & FRIENDS, TROUBLE

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24
Q

When is substance abuse often found?

A

Incidentally or when investigating worsening health

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25
Q

What two screenings are used for alcohol screening in adults?

A

AUDIT-C or CAGE

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26
Q

What screening is used for detecting opioid?

A

Rapid Opioid Dependence Screen

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27
Q

What are the 3 questions in the Audit-C questionnaire?

A

1) How often did you have a drink containing alcohol in the past year?
2) How many drinks containing alcohol did you have on a typical day when you were drinking in the past year?
3) How often did you have six or more drinks on one occasion in the past year?

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28
Q

What 4 questions are apart of CAGE?

A

1) Have you ever felt you should CUT down on your drinking?
2) Have people ANNOYED you by criticizing your drinking?
3) Have you ever felt bad or GUILTY about your drinking?
4) Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (EYE-OPENER)

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29
Q

Medical detoxification for substance use disorder?

A

Alcohol and Benzodiazpines

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30
Q

Often used long acting benzo?

A

Librium & clonazepam

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31
Q

What is required during a medical detoxification for alcohol and benzo’s?

A

tapering w/ benzodiazepine

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32
Q

Why must benzodiazepine be used for tapering?

A

to avoid dangerous withdrawals

33
Q

What can be used to treat all substances for detox?

A

Fluid rehydration

Vitamins and nutrition

34
Q

What is substance induced disorder?

A

overall category of intoxication, withdrawal, and other substance/medication-induced mental disorders

35
Q

Psychosis or anxiety is an example of?

A

Substance induced disorder

36
Q

a 6 pack of beer equal to ?? wine and ?? liquor

A

1 wine and 6 “shots” liquor

37
Q

a 12 pack of beer equal to ?? wine and ?? liquor

A

2 wine and pint of liquor

38
Q

a 18 pack of beer equal to ?? wine and ?? liquor

A

3 wine and a 1/5 (750 cc) liquor

39
Q

a case of 24 pack of beer equal ?? wine and ?? liquor

A

4 wine and liter liquor

40
Q

Having a “buzz” and experiencing euphoria and mild deficits in coordination, attention, and cognition

A

BAC 0.01- 0.10

41
Q

decreased attention, ataxia, impaired judgment, slurred speech, and mood variability

A

BAC 0.10 and 0.20

42
Q

severe alcohol intoxication: lack of coordination, incoherent thoughts, confusion, and nausea and vomiting

A

BAC 0.20- 0.30

43
Q

stupor and loss of consciousness, coma, respiratory depression, and death is possible

A

BAC > 0.30

44
Q

At what rate is alcohol cleared?

A

20mg/dL per hour

45
Q

What happens to receptors during alcohol withdrawal?

A

induced GABA insensitivity and glutamate receptor upregulation

46
Q

Minor withdrawals occur when?

A

<6hrs of cessation or with relatively low blood alcohol

47
Q

What are 7 minor withdrawals?

A
insomnia
tremulousness
mild anxiety
gastrointestinal upset, anorexia
headache
diaphoresis
Palpitations
48
Q

When does moderate to severe withdrawals occur?

A

up to 96hrs of last drink

49
Q

What are 3 moderate to severe alcohol withdrawal symptoms?

A

hallucinations-usual visual
seizures
delirium tremens

50
Q

untreated severe alcohol withdrawals can lead to

A

DEATH

51
Q

What makes up delirium tremens?

A

hallucinations, disorientation, tachycardia, hypertension, hyperthermia, agitation, and diaphoresis

52
Q

What is the treatment for alcohol withdrawal?

A

Thiamine IV

Benzodiazepines

53
Q

What are some non-traditional meds for acute withdrawal

A
Haldol
Propofol (anesthetize)
54
Q

What is the mainstay and you need alot of it for alcohol treatment?

A

Benzodiazepines (Lorazepam, Diazepam, Chlordiazepoxide)

55
Q

Librium

A

Chlordiazepoxide

56
Q

Valium

A

Diazepam

57
Q

Ativan

A

Lorazepam

58
Q

What are considered stimulants?

A

Amphetamines
Cocaine
Synthetics (Bath Salts, Molly)

59
Q

What are 3 symptoms seen in stimulant intoxication?

A

pupillary dilation, tachycardia, weight loss w/ chronic use

60
Q

What are 6 symptoms seen in stimulant withdrawal?

A

Fatigue, Dysphoric mood, Vivid, unpleasant dreams, hypersomnia, increased appetite, psychomotor retardation or agitation

61
Q

What is the treatment for stimulant withdrawal?

A

IV fluids
Nutrition
Time

62
Q

What is considered opiates?

A

herion, morphine, oxycodone

63
Q

What is the most commonly abused opioid?

A

Heroin

64
Q

What are some nicknames for heroin?

A

Smack, H, sugar brown, junk, horse, dope, china white, and black tar

65
Q

What is the most potent route of administration for heroin?

A

intravenous use “shooting up/mainlining” (3-5x more potent)

66
Q

What are 6 symptoms of opiate intoxication?

A
pinpoint pupils
sleepiness- unresponsive
shallow- infrequent respirations
snoring breathing sounds
bradycardia
cyanosis
67
Q

What is the treatment for opiate intoxication?

A

Naloxone IV or IM

68
Q

How should opiate be administrated?

A

1st strap the pt down,30 min duration if given IV, keep dosing or start IV drip

69
Q

What are symptoms of opiate withdrawal?

A

piloerection, muscle aches, yawning, insomnia

70
Q

What is a short term txt for opiate withdrawal?

A

Clonidine

71
Q

What is a long term txt for opiate withdrawal?

A

Buprenorphine

72
Q

What removes the danger and safety of needles, can be used for once daily dosing in txt opiate withdrawal?

A

Methadone

73
Q

Dosing for Buprenorphine

A

3x week dosing

74
Q

How does Cannabis qualify as a substance use disorder?

A

based on # of criteria experienced by patient

75
Q

What is Cannabis hyperemesis syndrome?

A

abdominal pain, vomiting, or nausea that is typically relieved by hot showers

76
Q

How is cannabis hyperemesis treated?

A

IV fluid hydration, antiemetics (dilaudid) and benzo

77
Q

What are two alternatives txt for cannabis?

A

Haldol or capsaicin cream on stomach

78
Q

What is another name for Cannabis?

A

Marijuana Syndrome