Flashcards in Substance Abuse Deck (66):
Up to __% of patients seen in an ambulatory may have associated substance abuse
About __% of american will show clinical dependence on a non-tobacco substance at some point in their lifetime
Are substance abuse disorders more common in men or women?
Intoxication associated with __% of MVAs, DV cases, and murders.
T/F: Addiction is a diagnostic term according to DSM-5
It is not
How are substance abuse disorders defined in DSM-5?
Any inappropriate use of a substance versus previous definitions that separated this into abuse versus dependence
_________ is defined as a reversible syndrome due to the recent use of substance
_______ is defined by the following.....
1) Need to use an increased amount of a substance in order to achieve the desired effect
2) Markedly diminished effect with continued use of the same amount of the substance
________ is defined as normal function only becomes possible with active use of a substance, and cessation of this substance causes adverse physiological consequences.
_______ is defined as a cluster of symptoms with an onset closely following the cessation (or reduction in dose) that is specific to a drug (or drugs). Symptoms can be both physiological and cognitive
What is the name of the questionnaire used in assessing alcohol dependence?
Should you complete a mental status examination when working up substance abuse?
What co-morbid conditions are likely to accompany a patient with a substance abuse disorder?
Why are the following ordered (to rule in/out) when working up Alcohol Abuse....
CBC - Anemia, Bone Marrow Depression
CMP - Liver Function
Thiamina - Wernicke's Encephalopathy
Which of the following would NOT be considered a direct diagnostic test for alcohol abuse
A) A blood alcohol level in excess of 300 mg/dL
B) A blood alcohol level of greater than 150 mg/dL without gross evidence of intoxication
C) A blood alcohol level of 100 with evidence of clinical intoxication
D) A blood alcohol level of greater than 100 mg/dL upon routine examination indicates alcoholism with a high degree of reliability
C) A blood alcohol level of 100 with evidence of clinical intoxication
What are EARLY manifestations of chronic alcoholism with underlying organ disease?
Palpable liver from fatty liver disease
What are LATE manifestations of chronic alcoholism with underlying organ disease?
To be diagnosed with an alcohol use disorder.....
A patient must exhibit signs/symptoms/behaviors over a ___ _______ period
12 Month Period
An uncomplicated withdrawal ("Shakes") typically onsets when?
Onset: 7-38 hours after cessation
Peak: 24-48 Hours
Subsides: 5-7 Days
What manifestation during a alcohol withdrawal period would be indicative of marked, chronic alcohol abuse?
A patient may develop alcoholic hallucinosis how long after cessation of alcohol?
What types of hallucinations may occur?
Can these be permanent?
Within 48 hours of cessation
Hallucinations can be auditory, visual, or tactile
These can sometimes become permanent
What is the most severe form of alcohol withdrawal?
What are clinical manifestations of delirium tremens?
T/F: Delirium Tremens is NOT a medical emergency
T/F: Delirium Tremens can progress to cardiovascular collapse
What medication class is commonly used in alcohol withdrawal?
T/F: Patients experiencing alcohol withdrawal and seizures, hallucinosis, or DTs should be hospitalized
What is the name of the 'score' used in alcohol withdrawal assessment?
Other than benzodiazepines.....
What are THREE medications used to treat alcohol abuse disorders?
1. Disulfiram (Antabuse)
2. Naltrexone (Avoid in liver disease)
3. Acamprosate (Compliance issues, need to take TID)
What is the number 1 goal of alcohol abuse rehabilitation?
What percent of patients with alcohol abuse disorder will relapse following treatment?
In what time interval is relapse most likely?
Relapse is most likely within the first 6 months following initial treatment
T/F: All alcohol abuse patients should be referred to AA in order to obtain further support from people going through the same issues
Abuse of the following would be considered a ______-abuse disorder
T/F: Opioid prescription users have a very LOW chance of becoming addicted to their medications
They have a very high chance
Opioid abuse in general is more common in _____ (men/women).
Prescription pain medication addiction is more common in ____ (men/women)
In a patient intoxicated by opioids would you expect to see.....
Mydriasis or Miosis?
Bradycardia or Tachycardia?
Tachypnea or Bradypnea?
Hypertension or Hypotension?
Excitation or Sedation?
Is opioid withdrawal life threatening?
What are symptoms of opioid withdrawal?
How is this managed?
No (But very uncomfortable)
Symptomatic (Antiemetic, NSAIDs, Antidiarrheal, BZDs)
What is the name of the medication used in opioid withdrawal that is a long acting opioid itself?
This can only be prescribed with a federal license
Other than methadone....
What are two additional medications used in opioid withdrawal management?
T/F: Intoxication from sedative, hypnotic, or anxiolytic medications will appear similar to opioid intoxication
It will appear similar to alcohol intoxication with less cognitive/motor impairment
What are symptoms of sedative, hypnotic, or anxiolytic intoxication?
What is a common cause of sedative, hypnotic, or anxiolytic withidrawal?
Tapering dose too quickly
What are symptoms of sedative, hypnotic, or anxiolytic withdrawal?
Abuse of the following medications would be considered a _______-abuse related disorder
Stimulant-Abuse Related Disorder
What are common symptoms of stimulant intoxication?
T/F: Cocaine intoxication can induce tactile hallucinations
What are TWO concerning potential manifestations of cocaine intoxication/abuse?
Rhabdomyolysis with compartment syndrome
What are symptoms of stimulant withdrawal?
When would you expect these symptoms to peak?
Peak in 2-4 days from cessation and are self limiting
Although stimulant withdrawal is typically self-limiting.....
What medications can be used to treat agitation in stimulant withdrawal?
What are you concerned for 2 WEEKS after stimulant abuse cessation?
What are examples of common hallucinogens that are abused?
How may a hallucinogen intoxication present?
Is it possible for patients to have 'bad trips' or flashbacks while intoxicated on hallucinogens?
Are there often concerning symptoms when a patient is withdrawing from hallucinogens?
What medication class can be used if the patient does develop agitation?
T/F: Hallucinogen OD can result in life threatening symptoms such as arrhythmias or stroke
T/F: Hallucinogen withdrawal is treated with supportive care
The following are all symptoms of _______ intoxication.
What are Sx of cannibis withdrawal?
T/F: Cannibis withdrawal is primarily pharmacologically manged
Supportive Care (Hydration, Supervision)
__% of US death have tobacco involvement
What percent of smoker die from a tobacco induce disorder?
__-__% of schizophrenic patients smoke tobacco
Is there a tobacco intoxication diagnosis in DSM-5?
The following are all symptoms of _____ withdrawal