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What are some good alcohol screening tools?

1. CAGE questionnaire- simple screening test for alcohol abuse.
2. Michigan Alcohol Screening TEst (MAST)- oldest and most accurate
3. the alcohol use disorders identification test (AUDIt)- developped internationally.


What are the 4 questions asked on the CAGE questionnaire?

1. have you ever felt the need to cut down your drikning?
2. have poeple annoyed you by cirticizing your drinking?
3. have you ever felt guilty about drinking
4. have you ever felt you needed a drink first thing in the morning to steady your nerves or to get rid of a hangover?


What are the mortality implications of increased/chronic alcohol consumption?

1. cirrhosis
2. CV disorders
3. cancers
4. unintentional deaths via MVA, and high risk behaviours.


What is the most commony used illicit drug with current users?



How does MArijuana affect the system

1. enters the brain and lasts 1-3 hours.
2. heavy use impaires ability to form memories, recal events, and shift attention
3. disrupts coordination, and balance.
4. high dose can create acute toxic psychosis
5. long-term use increses risk of chronic lung diease and cancers of the head, neck and lungs.


What are the short-term physiological effects of cocaine? And what are the most frequent complications of cocaine?

constricted blood evssels, dilated pupils, increased temperatures, heart rate, blood pressure.
1. cardiovascular effects including arrhythmias and MI,
2. respiratory effects, including respiratory failure.,
3. neurological effects, including strokes, seizures, headaches.
4. GI effect, including abdo pain and nausea.


Define the mechanism of heroin?

absorbed quickly thorugh the blood-brain barrier where it is converted to morphine and rapidly binds to opioid receptors.
> can cause resp depression


Define the mechanism of methamphetamine

man-made substance structurally similar to amphetamine and dopamine.
- increases alertness, decreases appetitie and creases sensation of pleasure.
- longer duration in the body compared to coccaine.
- long term use creases sxs of anxiety, confussion, insomnia, mood disturbances, and violent behavirous. Also brain structure changes, in areas of motion and memory.


Define the mechanism of MDMA

semi-synthetic stimulant and hallucigen that is used to improve mood and maintain energy.
- reduces mental abilities, memory and information-processing capabilities. These sxs can last up to a week and perhaps longer in regular uses.


Define the mechanism of PCP (phencyclidime)

1. dissociative anaesthetic.
2. out-of body experience and sens of detachment from reality.
3. effects are unpredictable
4. can cause rapid, shallow breathing, HTN, tachycardia and elevated body temperatures.


Define the mechanism of LSD (lysergic acid diethylamide)

semi-synthetic hallucinogenic drug derived from rye fungus and is the most potent mood and preception altering drug.
- HTN, tachycardia, dizziness, dry mouthn, sweating, numbness and tremors.
- emotion inbalanace
-. hallucinations
- develop high tolerance which also dissipates quickly after cessation of use.
- Flash back concequence ( HPPD)


How are substance use disorders treated?

successful tx is challanging d/t the changes that occured in the brain from chronic use.
1. drug-rehabilitation.
2. 12-step recovery programs such as NA and CA.


Is there a relation between substance abuse and mental illness?

yes 6/10 people with substance use disorder have another form of mental illness, most commonly associated with:
1. antisocial personality disorder
2. schizophrenia
3. bipolar disorder,
4. major depressive disorder
6. generalized anxiety disorer


What is the mortality and morbidity among drug addits?

high d/t rates of suicide attempts, consequences of high-risk behavors, and unintentional deaths from OD. and injuries.


What are factors that affect the treatment success for drug abusers?

1. duration of use
2. drugs used
3. presence of polyp substance use
4. co-morbid mental health disorder
5. history of relapse
6. number of years drug-free


What are some u/w considerations when reviewing a history of drug use?

1. drugs used
2. hx of poly-substance abuse incl ETOH
3. use of px Rx at risk of being abused
4. hx of depression/other mood disorders
5. suicidal ideations/ attempts.
6. duration of abuse
7. duration of abstinence
8. hx and number of relapses
9. type of tx and compliance
10. presence of ongoing support
11. hx of high risk behavior, accdients/falls or violent behavior
12. Adverse MVR findings
13. unstable employement records
14. +ve findings on drug screens


What are the most commonly used paid relieves?

opioid compoused, which include:
1. hydrocodone
2. oxycodone
3. morphine
4. fentanyl
5. codeine
benzodiazepines which includes
1. dizepam
2. alprazolam
Px stimulants:
1. Dextroamphetamine
2. methylphenidate


What was caused of the increase incidence of px drug abuse?

1. rising number of medicines being px for a variety of health problems
2. ease of obtaining this rx online
3. access by children and family members to the px medicines of others in the hosuehold.


What is the most cmoon cause of mortality associated with teh nonmedical use of px drugs?

1. unintentional injury
2. suicide
3. death from injury of undetermined intent.
4. increases in poisoning mortality.


What are the underwriting consideridarations in u/w px use?

its difficult to detect.
1. records from px databases are useful for determining patterns.
2. medical records- if all physicians are disclosed.