Substance Misuse And Pain Flashcards
Describe moderate alcohol dependence
Degree of dependence but have not reached the stage of ‘relief drinking’ to avoid withdrawal symptoms
May be suitable for detox in the community
Describe severe alcohol dependence
May have serious and long standing problems
Often seen as ‘chronic alcoholic’
Typically have experienced significant withdrawal symptoms and habitually drink to prevent symptoms
May require in-patient detox
Name some alcohol screening tests
CAGE
AUDIT
FAST
PAT
What does the CAGE alcohol screening test look at?
C = cutting down A = annoyed G = guilt E = eye opener
Describe some pharmacological interventions that help during withdrawal symptoms
Chlordiazepexide
Vitamin B complexes
Diazepam (valium)
Give some medications that promote abstinence
Acomprosate
Disulfiram
Nalmefene
How do you manage acute intoxication?
Monitor vitals, electrolytes (esp K+) and glucose
Administer thiamine (B1)
Management of withdrawal if necessary
What is the doctor role with regards to substance misuse?
Assessment Motivating patient Offering basic advice Knowing what the different treatments do Sign posting Supporting people
What are the cluster groups we use for drugs?
Depressants and dissociatives
Stimulants and empathogens
Hallucinogens and cannabis
Opiates and opioids
What is likely to have occurred if pain persists from more than 3 months?
Original physical damage may have healed but pain pathways have become over-sensitised or dysregulated
Does anxiety lead to increased or decreased pain tolerance?
Decreased pain tolerance
Does fear lead to increased or decreased pain tolerance?
Increased tolerance (released of endogenous opioids)
What is nocicepton?
The stimulation of peripheral pain receptors
What is pain sensation?
How the pain is interpreted
What is suffering?
Perceived pain, distress and disability that can arise from pain and other related factors
