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Year 2 - Theme 3 > Illicit substance misuse > Flashcards

Illicit substance misuse Flashcards

1
Q

Classification of drug use

A
  • Hazardous use
  • Harmful use
  • Dependence
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2
Q

Definition of hazardous use of drugs

A
  • Drug use that is likely to lead to harm
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3
Q

Definition of harmful use of drugs

A
  • Drug use which causes damage to health(physical or mental)
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4
Q

Definition of drug dependence

A
  • Pattern of ongoing use that is hard to stop
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5
Q

Signs of drug dependence

A
  • Withdrawal
  • Compulsion
  • Salience
  • Persistence despite evidence of harm
  • Impaired control
  • Tolerance
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6
Q

Give examples of behavioural, cognitive and physiological phenomena that develop after repeated substance use

A
  • strong desire to take the drug
  • difficulties controlling it’s use
  • use despite harmful consequences,
  • a higher priority given to drug use over other activities
  • increased tolerance
  • sometimes withdrawal”
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7
Q

What is the clinical presentation continuum

A
  • Withdrawal(negative effects) - sober - intoxication(negative effects)
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8
Q

Physical complications of drug addiction

A
  • Specific drug effects
    • Contaminants
    • Method of use
    • Lifestyle
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9
Q

Mortality of drug addiction

A
  • 1-2%/year

- 1500 deaths per year

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10
Q

Reasons for mortality from drug addiction

A 
• Overdose
	• cellulitis
	• abscesses, thrombophlebitis
	• arterial occlusion
	• septicaemia
	• endocarditis
	• TB
	• respiratory infections
	• Hepatitis
HIV
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11
Q

Psychiatric complications of drug addiction

A
  • Drug misuse (intoxication / withdrawal) can mimic most psychiatric syndromes.
  • Drug misusers increase rate psychiatric illness
    • anxiety (28%)
    • depression (26%)
    • PD (18%)
    • schizophrenia (7%)
  • Suicide risk x 15
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12
Q

Cardiovascular complications of cocaine use

A
  • BP increases
  • MI
  • Arrhythmias and sudden death
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13
Q

CNS complications of cocaine use

A
  • CVA’s

- Seizures(lowers threshold)

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14
Q

Infective complications of cocaine use

A
  • Abscesses
  • Cellulitis
  • Hepatitis
  • SABE
  • Septicaemia
  • HIV
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15
Q

Respiratory complications of cocaine use

A
  • Chest pain
  • Dyspnoea
  • Lung damage “crack lung”
  • Respiratory failure
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16
Q

A general complication of cocaine use

A
  • Weight loss
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17
Q

Obstetric complications of cocaine use

A
  • Miscarriage

- Premature labour

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18
Q

Psychological complications of cocaine use

A 
• Crash (Withdrawal)    
	• Irritability, restlessness, fatigue, hypersomnia, hyperphagia
• Anxiety especially panic
• Depression / Mania
• Anti-social behaviour
• Paranoid Psychosis
• Tactile / visual hallucinations. “Cocaine bug ”
Repetitive behaviour
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19
Q

Signs of opiate intoxication

A
  • Euphoria / relaxation
  • Feeling of well being
  • Constricted pupils
  • Drowsiness
  • Slurred speech
  • Poor attention and concentration
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20
Q

Short-term effects of heroin

A

Central - euphoria, alternately alert and drowsy state

Mouth - Dryness

Skin - warm flushing

Respiratory - slowed breathing

Muscular - weakness

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21
Q

Opiate abstinence syndrome

A
  • Drug Craving
  • Anxiety
  • Drug-seeking behaviour
  • Yawning
  • Sweating
  • Running eyes and nose
  • Restless sleep
  • Dilated pupils
  • Goose flesh (“cold turkey”)
  • Hot and cold flushes:
  • shivering
  • Aching bones and muscles
  • Loss of appetite
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22
Q

What are the majority of deaths from illicit opiate consumption due to

A
  • Overdose
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23
Q

Why is an opiate overdose the most common reason for death

A
  • Accidental
  • Suicide attempt
  • Latrogegenic
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24
Q

Triad of symptoms pointing to an opiate overdose

A
  • Unconsciousness
  • Respiratory depression
  • Pin point pupils
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25
Q

Treatment for an opiate overdose

A
  • Establish airway
  • Ventilate(100% O2)
  • Naloxone IV/IM
  • Repeat 2-3mins
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26
Q

Signs and symptoms of an opiate overdose

A
  • Decreased level of consciousness
  • Cyanosis
  • Skin cold and clammy
  • Pupils pin point(later dilated)
  • Muscles flaccid(can cause rhabdomyolysis)
  • Respiratory arrest
  • Cardiac arrest
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27
Q

When to refer to specialist services

A
  • Unable to make changes following brief intervention & needing further help?
  • Dependent – with a history of withdrawal?
  • Showing a high level of alcohol / drug related harm?
  • Previously known to treatment services?
  • Pregnant / breast feeding?
  • Experiencing mental health issues?
  • Mixing drugs, prescribed or illegal or legal?
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28
Q

What is substance misuse

A

A person with a substance misuse problem is any person who experiences physical, psychological, social or legal problems as a consequence of their own repeated use of a substance, or the repeated use of a substance/s by other persons

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29
Q

What is harm reduction

A 
A term that defines policies, programmes, services & actions that work to reduce the:
Health, social and economic harms to:
	• individuals
	• communities
	• society              that are associated with the use of drugs (Newcombe 1992)1.
Harm reduction is:
• Pragmatic
• Prioritises goals
• Has humanist values
• Focuses on risks and harms
• Does not focus on abstinence
• Seeks to maximise the range of intervention options that are available
30
Q

General harm reduction methods

A
  • Advice around route of administration
  • Test dosing and dosage information
  • Advice on poly-drug use
  • Research
  • Consider ‘self’ and ‘setting’
  • Have a ‘sitter’
  • Thinking about safe sex
  • Getting home safely
  • Consider sleep and nutrition
31
Q

Examples of depressants

A
  • Alcohol
  • Heroin
  • Methadone
  • Diazepam
  • GHB/GBL
32
Q

Examples of stimulants

A
  • Caffeine
  • Mephedrone
  • Cocaine
  • Ephedrine
  • Amphetamine
33
Q

Examples of hallucinogens

A
  • Salvia
  • LSD
  • Ketamine
  • Methoxetamine
  • Mescaline
  • Psilocybin mushrooms
34
Q

What is heroin? (brown, gear, smack, H)

A
  • Opiate; depressant derived from the opium poppy
35
Q

What does heroin look like

A
  • Brownish powder which comes in ‘baggies’. Class ‘A’
36
Q

How is heroin used

A
  • Smoked, usually on foil; ‘chasing the dragon’, or dissolved in water, mixed with an acid, heated & injected
37
Q

Immediate effects of heroin

A
  • intense sense of wellbeing, relaxed, drowsy and detached from emotional or physical pain. Slows the brain, heart rate and breathing. First time users may become sleepy, itchy and sick.
38
Q

Risks and harms of heroin

A
  • Can cause powerful physical & psychological dependency. Legal and social risks. Overdose risk, especially if mixed with alcohol or benzo’s; also after period of abstinence e.g. in prison, hospital or recovery
39
Q

What is crack(white rocks, snow)?

A
  • Smoke-able form of cocaine, water-insoluble cocaine base(or freebase)
40
Q

What does crack look like

A
  • Small ‘raisin-sized’ pieces, off- white, waxy. Class A
41
Q

How is crack used

A
  • Smoked, usually in a pipe, dissolved in water and injected
42
Q

Immediate effects of crack

A
  • Similar to cocaine but much more intense and short-acting

- Crack use is harder to control than cocaine as the high is so intense

43
Q

Risks and harms of crack

A
  • Breathing problems ‘crack lung, crack cough’

- If injected, it is really harmful to veins as it doesn’t dissolve easily

44
Q

What is cannabis

A
  • Naturally occurring, made from the cannabis plant. The main active chemical in it is tetrahydrocannabinol (THC for short).
45
Q

What does cannabis look like(marijuana, mary jane, weed, grass)

A
  • solid, dark lump (resin); or leaves, stalks & seeds (marijuana, grass).
    Class ‘B’.
46
Q

How is cannabis used

A
  • rolled (usually with tobacco) in a joint / spliff; smoked in a pipe; eaten in food.
47
Q

Immediate effects of cannabis

A
  • Giggles, ‘munchies’, being talkative, more confident, or more anxious or paranoid. Tiredness and lack of energy, memory loss, breathing disorders and cancers (especially if used with tobacco).
48
Q

Risks and harms of cannabis

A
  • May trigger or exacerbate mental health problems

especially where there is a family history

49
Q

What is spice

A
  • Chemical mixture that is up to 100x more potent than THC
50
Q

What does spice look like

A
  • Raw form is crystalline white power
51
Q

Effect of spice

A
  • Cn cause strong hallucinogenic effects
52
Q

Withdrawal symptoms of spice

A
  • Physical withdrawal i.e palpitations, tremors, psychotic episodes
53
Q

What are synthetic cannabinoids(spice, herbal incense, pot pourri, room oduriser)

A
  • dried plant matter which has been sprayed with a chemical designed to mimic THC, however effects are much stronger / intense.
54
Q

What do synthetic cannabinoids look like

A
  • dried leafy material, similar to Cannabis but smells more chemically
55
Q

How are synthetic cannabinoids used

A
  • Smoked with tobacco in a joint, or in a pipe, bong.

Cannabinoid oil can be smoked in a vaporizer. Class B.

56
Q

Immediate effects of synthetic cannabinoids

A
  • Some can make youfeel happy & relaxed. Some peoplemay get the giggles, feel hunger pangs & become very talkative. Others get more drowsy. Mood / perception can change & concentration / co-ordination may become difficult.
57
Q

Risks and harms of synthetic cannabinoids

A
  • Higher THC (panic, paranoia, M.H issues) & Lower CBD (anxiety-reducing, relaxing). Associated with triggering psychotic symptoms even in those who have never experienced MH issues before.
58
Q

What is mephedrone(meow, m-cat, drone, meph)

A

stimulant drug belonging to the chemical family of the ‘cathinones’. (A group of drugs related to amphetamine, compounds likespeedand ecstasy)

59
Q

What does mephedrone look like

A
  • White powder, shards / crystals. Class B.
60
Q

How is mephedrone used

A
  • Snorted, injected, Swallowed, up the bum
61
Q

Immediate effects of mephedrone

A
  • Euphoria, alertness and feelings of affection towards the people around you. Supressed appetite. Feelings of anxiety and paranoia.
62
Q

Risks and harms of mephedrone

A
  • Can overstimulate heart, circulation & nervous system, with risk of fits. Strong desire to re-dose. Causes nasal damage if snorted. Risk of BBV’s, STI’s, injecting wounds if new to injecting.
63
Q

What is GHB/GBL(geebs, G, gina)

A
  • Industrial solvent, used in mechanics, central nervous system depressant. GBL is converted to GHB shortly after entering the body.
64
Q

What does GHB look like

A
  • transparent liquid with a salty taste. Class B.
65
Q

How is GHB used

A
  • swallowed with water or juice
66
Q

Immediate effects of GHB

A
  • feelings of euphoria, reduced inhibitions & drowsiness. Effects start after about 10 minutes to an hour and can last for up to seven hours or so.
67
Q

Risks and harms of GHB

A
  • physically addictive, easy to overdose due to dose sensitivity (0.5 – 2ml). Linked to sexual assaults (date rape). Extremely dangerous when mixed with alcohol or other depressants.
68
Q

What are NPS

A
  • synthetic chemicals manufactured to mimic effects of common illegal drugs or prescribed drugs, now classified under the Psychoactive Substances Act
69
Q

What do NPS look like

A
  • includes GBL, Mephedrone & what were ‘Legal Highs’
70
Q

How are NPS used

A
  • Snorted, injected, smoked, gummed, swallowed,

up the bum – depends on what type!

71
Q

Immediate effects of NPS

A
  • VARIOUS – 100’s of different combinations, all with different chemical mixtures and strengths.
72
Q

Risks and harms of NPS

A
  • little long term effects known. Highly variable effects ranging from seizures, sudden death, coma, rashes, vomiting, mental health problems, addiction…

Year 2 - Theme 3 (9 decks)

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