Addictive Psychiatry

Question 1

Stimulant drugs

Answer 1

Cocaine

Amphetamine

Question 2

Which drug is the most potent natural stimulant?

Answer 2

Cocaine

Question 3

How is cocaine taken?

Answer 3

Coca leaves = chewed or brewed
Cocaine hydrochloride = snorted or injected
Cocaine freebase or crack cocaine = smoked

Question 4

What does cocaine hydrochloride have an association with?

Answer 4

Wealth

Question 5

What does crack cocaine have an association with?

Answer 5

Violence and bad backgrounds

Question 6

Effects of cocaine depend on what?

Answer 6

Dose

Rate of entry

Question 7

How long does smoking cocaine take to have its effects?

Answer 7

Almost immediately

Effects of crack smoking very intense but over really quickly (15 mins)

Question 8

How long does injecting cocaine take to have its effect?

Answer 8

15 to 30 secs

Question 9

How long does snorting cocaine take to have its effect?

Answer 9

3 to 5 mins

Question 10

Effects of cocaine

Answer 10

Stimulant 
Euphoriant 
increased alertness and energy 
increased confidence and impaired judgement 
lessens appetite 
lessens desire for sleep

Question 11

Side effect of cocaine

Answer 11

Financial impact 
damage to nose and airways
convulsions with respiratory failure
cardiac arrthymias and MI
hypertension and CVA 
Toxic confusion 
paranoid psychosis

Question 12

Withdrawal effects of cocaine

Answer 12

depression 
irritability 
agitation 
craving
hyperphagia (excessive eating)
hypersomnia

Question 13

What is the chemical compound of amphetamine?

Answer 13

Amphetamine sulphate

Question 14

How is amphetamine taken?

Answer 14

Sniffed
Swallowed
Injected

Question 15

How long does amphetamine effects last for?

Answer 15

2-3 hours (longer than cocaine)

Question 16

side effects of amphetamines

Answer 16

amphetamine psychosis in heavy chronic use
toxic confusion
convulsions
death

Question 17

types of opiates

Answer 17

opium 
morphine 
Heroin (diamorphine)
methadone
codeine and dihydrocodeine

Question 18

Effects of opiates

Answer 18

Intense but transient feeling of pleasure

• a rush
• almost orgasmic
• physical and emotional anaesthetic

Question 19

Side effects of opiates

Answer 19

first time = nausea/vomiting and headache
second time
- phlebitis 
- anorexia 
- constipation 
Longer term 
- tolerance
- withdrawal 
- social and health problems

Question 20

Symptoms of opiate withdrawal syndrome

Answer 20

craving
insomnia
yawning
muscle pain and cramps
increased salivary, nasal and lacrimal secretions
dilated pupils
piloerection

Question 21

What is heroin available as chemically?

Answer 21

Diamorphine

Diamorphine hydrocodiene

Question 22

How Is heroin presented?

Answer 22

Powder

tar like substance

Question 23

How is heroin taken?

Answer 23

Snorting
Smoking (chasing the dragon)
Injection (dangerous)

Question 24

Street names for heroin

Answer 24

H
Gear
Smack
Brown

Question 25

What is used for heroin withdrawal?

Answer 25

Methadone

Question 26

What does methadone in the treatment of heroin addiction allow for?

Answer 26

Decriminalises drug use allowes normalisation of lifestyle reduces IV misuse

Question 27

effects of heroin

Answer 27

analgesia drowsiness and sleep mood change (euphoria, intense pleasure)

Question 28

Side effects of heroin

Answer 28

Respiratory depression - if taking too much - can lead to respiratory arrest with a pulse cough reflex depression sensitisation of the labyrinth with nausea and vomiting decreased sympathetic outflow (bradycardia and hypotension) lowering of body temperature pupillary constriction constipation pinpoint pupils unreactive to light snoring giving way to shallow respiration (<8 breaths per min) varying degree of consciousness/coma

Question 29

How is ecstasy used?

Answer 29

Orally

Question 30

How long does ecstasy take to work and how long does it last for?

Answer 30

after 20 mins | lasting 2-4 hours

Question 31

Effects of ecstasy

Answer 31

relaxed euphoric state without hallucinations followed by a feeling of calm increased sociability inability to distinguish between what is desireable and what isn't

Question 32

What is another name for ecstasy?

Answer 32

MDMA

Question 33

Side effects of ecstasy

Answer 33

``` nausea dry mouth increased BP increased temp in clubs users risk dehydration large doses can cause anxiety and panic drug induced psychosis liver and brain cell damage ```

Question 34

What is the most commonly used illicit drug?

Answer 34

Cannabis

Question 35

What is the psychoactive agent in cannabis?

Answer 35

Tetrahydrocannabinol

Question 36

What can cannabis be presented as?

Answer 36

Loads of different forms including - marijuana - hashish (cannabis resin) - hash oil

Question 37

How is cannabis taken?

Answer 37

Eaten | Smoked (spliffs or blunts)

Question 38

What has a high THC content in cannabis and therefore has higher risk?

Answer 38

Skunk (sensimilla)

Question 39

Effects of cannabis

Answer 39

``` relaxing or stimulating euphoriant increased sociability and hilarity increases appetite changes in time perception synaesthesia ```

Question 40

Effects of cannabis in higher doses

Answer 40

severe anxiety panic persecutory ideation hallucinatory activity

Question 41

Ill effects of cannabis

Answer 41

respiratory problems as with tobacco toxic confusion exacerbation of mental illness cannabis psychosis

Question 42

What are some novel psychoactive substances?

Answer 42

NPS | Legal highs

Question 43

What do anabolic (androgenic) steroids contain?

Answer 43

Testosterone and many synthetic analogues

Question 44

When are anabolic steroids used illegally?

Answer 44

In sports requiring muscle mass and strength | To enhance appearance - increase muscle mass and reduce body fat

Question 45

Anabolic steroids are legitimately prescribed in....

Answer 45

hypogonadism muscular dystrophy various anaemias wasting in AIDs

Question 46

What do anabolic steroids cause?

Answer 46

Muscle hypertrophy | - especially in upper body such as pectoralis, deltoid, trapezius and biceps

Question 47

Side effects of anabolic steriods

Answer 47

Acne Stretch marks baldness irritability and anger - 'roid rage' hypomania and mania in males - feminisation = hypogonadism and gynaecomastia (occasioning use of anti-oestrogens) in women - virilisation = hirsutism, deep voice, clitoral enlargement, menstrual irregularities, hair thinning - CVS = increased cholesterol and HTN - growth deficits = due to premature closure of epiphysis - liver disease = cholestatic jaundice, liver tumours depression and suicidality on withdrawal

Question 48

What are the 3 most common drugs abused?

Answer 48

Cocaine Heroin Diazepam

Question 49

Substitutes for coming off heroin

Answer 49

Methadone | Suboxone

Question 50

When is suboxone used?

Answer 50

Once have come off methadone

Question 51

What form is methadone?

Answer 51

Liquid

Question 52

What form is suboxone?

Answer 52

Tablet

Question 53

Comorbidities often involved with drug abuse

Answer 53

Viral hepatitis BBVs Infection