Illicit substance misuse symposium Flashcards
(25 cards)
Classification: Hazardous use of drugs
Drug use that is likely to lead to harm
Classification: Harmful use
Drug use which causes damage to health (physical or mental)
Classification: dependence
Pattern of ongoing use that is hard to stop. "Wow Cant stop pretending I trampoline" Withdrawal Compulsion Salience Persistance despite evidence of harm Impaired control Tolerance A cluster of behavioural, cognitive and physiological phenomena that develop after repeated substance use and typically include:- 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”
Clinical presentation
A continuum between Withdrawal negative effects and intoxication negative effects.
“Sober”- Not in withdrawal and not intoxicated- will still need some level of drug to be at this point
Physical complications
Relate to specific drug effects, contaminants, method of use or lifestyle.
Contaminants: Baby powder, phentinyl (potent opioid) easy to overdose with
Method of use: Smoke it, Snort it, Inject it, tablets, rectal suppositries, s/c administration
(riskiest route is injecting. Can get abscesses, collapsed veins, overdose)
Lifestyle: Misuse- dietary intake reduced/not taking care of yourself. Some side effects eg for opiates = loss of appetite, functional reserve reduces and thus increased risk of health complications
Psychiatric complications
Drug misuse (intoxication/withdrawal) can mimic most psychiatric syndromes
Drug misusers increase rate psychiatric illness (anxiety, depression, PD, schizophrenia)
Suicide risk increases x15
Social complications
Social (Family, children, society)
Occupational (mostly unemployed)
Financial
Legal
Medical complications of cocaine use
Cardiovascular- BP increases, MI, arrythmias and sudden death
CNS- seizures
Infective- abscesses, cellulitis, hepatitis
Respiratory- chest pain, dyspnoea, lung damage, respiratory failure
General- weight loss
Obstetric- miscarriage, premature labour
Psychological complications of cocaine use
Crash (withdrawal- irritability, restlessness, fatigue, hypersomnia, hyperphagia) Anxiety especially panic Depression/mania antisocial behaviour Paranoid psychosis Tactile/visual hallucinations- bugs Repetitive behaviour
Signs of opiate intoxication
Euphoria/relaxation Feeling of wellbeing Constricted pupils Drowsiness Slurred speech Poor attention and concentration Respiratory depression is what kills people in opiate overdose
Opiate abstinence
Drug craving Anxiety Drug-seeking behaviour Yawning Sweating Running eyes and nose Restless sleep Dilated pupils Goose flesh Hot and cold flushes Shivering Aching bones and muscles Loss of appetite Irratbility Insomnia Low-grade fever Increased pulse rate Restlessness Abdominal cramps Nausea and vomiting Diarrhoea Weakness Weight loss
Opiate overdose
Accidental, Suicide attempt or Iatrogenic
Triad of symptoms pointint to OD: Unconciousness, respiratory depression, pin point pupils
Treat: Establish airways, ventilate, IV Naloxone, repeat 2-3 mins
When to refer to specialist services
If the person is:
- Unable to make changes following brief intervention and needing further help
- Dependent- with a history of withdrawal
Showing a high level or alcohol/drug related harm
- previously known to treatment services
- Pregnant/breastfeeding
- Experiencing mental health issues
- Mixing drugs, prescribed or illegal or legal
Why do people use drugs
- To numb pain
- Boredem
- Addiction
- Fun
- expected to
- Forced to
- To feel better
- To feel the same
- to feel worse (self harm)
Its easily available
its cheap
to gain confidence
to chill out
to sleep
to escape
habit
fashionable
stay awake
peer pressure
depressed
to rebel
Substance misuse
Drug free–> experimental–> recreational–> dependent–> chaotic
Harm reduction
Defined as: a term that defines policies, programmes, services and actions that work to reduce the health, social and economic harms to:
- individuals
- communities
- society
Harm reduction is:
- pragmatic
- prioritises goals
- has humanist values
- focuses on risks and harms
- does not focus on abstienence
- seeks to maximise the range of intervention options that are available
Drug categories
Depressants, stimulants, hallucinogens
Heroin
Opiate, dpressant
Looks like a brownish powder which comes in baggies, Class A
smoked, usually on foil, or dissolved in water, mixed with an acid, heated and injected
Immediate effects: intense sense of wellbeing, relaxed, drowsy and detached or physical pain. Slows the brain, heart rate and breathing. First time users may become sleepy, itchy and sick.
Risk and harms: can cause powerful physical and psychogolgical dependency. Legal and social risks. Overdose risk, especially if mixed with alcohol or benzos; also after period of abstinance eg in prison, hospital or recovery
Cocaine
stimulant. White powder, Class A.
Snorted, gummed, dissolved in water and injected
Immediate effects: increased energy, more alert, sociable, arrogant, aggressive
Risks and harms: when taken with alcohol potentially fatal results. Highly psychologcially addictive. Chronic use also causes severe damage to heart and circulation, brain damage and severe mental health problems
Crack
Smokable form of cocaine, water-insoluble cocaine base
Looks like small raisin sized pieces
Immediate effects: Same as cocaine excepted more intense and short acting
Risks: breathing problems
cannabis
Naturally occuring made from the cannabis plant. The main chemical in it is THC. Looks like solid dark lump or leaves stalks and seeds. Clas B.
Rolled in a joint
Immediate effects: giggles, munchies being talkative, more confident or more anxious and paranoid. Tiredness and lack of energy, memory loss, breathing disorders and cancers.
Risks and harms: may trigger or exacerbate mental health problems espcially where there is a family history
Synthetic Cannabinoids
dried plant matter that has been sprayed with a chemical designed to mimic THC, however effects are much stronger/intense
Looks like dried leafy material
Smoked with tobacco in a joint, or in a pipe. Cannabinoid oil can oil can be smoked in vaporizer. Class B.
Immediate effects: Some can make you feel happy and relaxed. Some people get the giggles, feel hunger pangs and become very talkative. Others get more drowsy. Mood perception can change and concentration and coordination may become difficult
Psychotic symptoms trigger
Mephedrone
Stimulant drug
Looks like white powder
snorted, injected, swallowed, up the bum
Immediate effects: euphoria, alertness and feeling effection towards the people around you
GHB/ GBL
Industrial solbent, central nervous system depressant
Looks like a transparent liquid with salty taste
Swallowed with water or juice
Euphpria, reduced inhibitions and drowsiness
Physically addictive, easy to overdose due to dose sensitiity.
date rape
