Introduction to Substance Abuse Flashcards
(31 cards)
What is a drug?
A medicine or other substance which as a physiological effect when ingested or otherwise introduced into the body
What age group are at higher risk of drug misuse?
16-24 y/o
Define substance use disorders:
“a cluster of cognitive, behavioural and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems”
What is an addiction?
chronic, primary, neurobiological condition influence by genetic, psychosocial and environmental factors
Give some examples of risk factors for drug misuse & addiction:
- men twice as likely to have drug problems
- home and family, friends and acquaintances who use drugs
- stress
- availability of drugs
- method of drug administration
- coexisting mental problems
- peer pressure
- early exposure to drugs
Discuss the pattern of addiction associated with opioids:
- intense initial intoxication
- development of profound tolerance
- escalation in intake
- profound dysphoria, physical discomfort, and somatic withdrawal signs during abstinence
How can drugs affect neurotransmitters?
The use of drugs can produce:
- increased levels of dopamine (euphoria)
- decreased levels of serotonin (decreased levels of contentment)
How does prolonged exposure of drugs alter the brain?
Results in addiction through the rewards pathway
- chronic exposure reduces the sensitivity of the brain to reward systems
Discuss the different behaviour classifications of drugs:
- stimulants
- opioids
- sedative hypnotics
- antipsychotics
- antidepressants
- psychedelic
What % of healthcare professionals misuse drugs or alcohol?
10-15%
What risks are associated with illicit IV drug use?
- increased risk of infections
- sexually shared infections
- cellulitis
- abscess
- thrombophlebitis
- DVT
- embolism
What term do we use nowadays instead of IV drug users?
People who inject drugs (PWID)
How do STIs relate to drug users?
- high rates of STIs seen among DUs
- more prone to indulge in frequent high-risk sexual activity
What is the most common BBV transmitted by IV drug users/people who inject drugs?
Hepatitis C
What are some side effects of cannabis?
- euphoria
- slowed thinking & reaction time
- confusion
- impaired balance & coordination
- cough
- increased HR
- anxiety
- panic
- tolerance
Give some examples of signs of addictions:
- loss of reliability
- mood changes
- impaired driving
- worsening personal & professional isolation
- excessive amounts of time spent near a drug supply
How does stress present physically?
- increased heart rate & blood pressure
- palpitations
- increased muscle tensions
- headaches
- jaw ache
- insomnia
How might you recognise substance misuse in your patients?
- loss of reliability
- mood & behaviour changes
- impaired ability to drive
- requesting specific drugs
- tremors
- constricted or dilated pupils
- bruising, puncture marks, scare or pigmentation over veins
Give examples of barriers to accessing dental services:
- professionals negative perception of these people
- low priority of oral health compared with drug use
- fear of dentists
- self medication
- chaotic lifestyles
- fear judgement
- poor attendance & compliance
Why can drugs pose an issue to proper consent?
- capacity considerations
- treatment may need to be postponed if pt is under influence of drugs/alcohol
What issues around LA are associated with opioid users?
LA resistance
An alcoholic patient present to your clinic & requires treatment with LA. Why must you be careful in your LA selection?
Avoid using LA that is metabolised in the liver / keep doses to a minimum
- even 2 cartridges can trigger CNS toxicity signs in severe liver disease
What are examples of general dental implications of substance misuse?
- rampant caries
- periodontal disease including necrotising conditions
- NCTSL
- masseteric hypertrophy
- hyposalivation (opiates & cannabis)
- poor OH
- poor denture hygiene
- opportunistic infections
- trauma
- oral cancer & mucosal lesions
What are some risk factors for development of necrotising periodontal diseases?
- HIV
- malnourishment
- extreme living conditions
- smokers
- psychosocially stressed
