Substance misuse: Illegal drugs Flashcards
(58 cards)
What percentage of adults have tried illegal drugs in their lifetime, and how many were in the previous year?
33% lifetime
10% in previous year
What percentage of Under 25s have tried illegal drugs in their lifetime, and how many were in the previous year?
50% lifetime
33% in previous year
Name 3 risk factors for illegal drug use
Male (3-4:1)
Younger age (Under 25: 50%)
Lower socioeconomic class
Psychiatric illness
What are the 5 patterns of drug use?
Experimental use - typically softer drugs
Situation use - mainly stimulants and hallucinogenics
Recreational use - regular but not dependent
Dependent use
Dual diagnosis - drug users with major mental illness
What is the diagnostic criteria for dependence syndrome?
At least 3 symptoms over a 12 month period:
- Compulsion to take substance
- Impaired control over use
- Salience (prioritisation above all else)
- Tolerance
- Withdrawal or relief use
- Persistent use despite clear evidence of harm
- Rapid reinstatement after abstinence
What are the categories of drugs of abuse?
Opiates Depressants Stimulants Hallucinogenics Others
Name 3 opiates commonly abused
Heroin Methadone Codeine Pethidine Buprenorphine
Name 3 depressants commonly abused
Alcohol
Benzodiazepines e.g. Diazepam
GHB
Name 3 stimulants commonly abused
Cocaine “Coke”
Amphetamines “Speed”
MDMA “Ecstasy”
Name 3 hallucinogenics commonly abused
LSD “Acid”
Mushrooms
Ketamine “Vitamin K”
PCP “Angel dust”
Name 3 other commonly abused drugs
Cannabis “Weed/Dope”
Volatile chemicals (Glues, gases and aerosols)
Anabolic steroids
What is the difference between opiates and opioids?
Opiates - naturally occurring
Opioids - synthetically produced
What are the desirable properties of opiates/opioids?
Euphoriant
Anxiolytic
Potent analgesic (medical use)
How can heroin be taken?
Smoking “Chasing”
Oral
Snorted
Parental IV, IM, or SC
What acute medical problems are associated with heroin?
Constipation NaV Respiratory depression Aspiration and loss of consciousness Death
Name 3 complications that may occur as a result of IVDU?
Local abscess Cellulitis Bacterial endocarditis - tends to occur in right heart Osteomyelitis Sepsis Hep B and C, and HIV
What sign and symptoms present in heroin toxicity?
Coma
Respiratory depression
Mitosis - Pinpoint pupils
Track marks
Fresh puncture wounds
What are the early signs and symptoms of opiate withdrawal?
Lacrimation and sweating Muscle ache Agitation Tachycardia Hypertension Sleep disturbance Anxiety
What are the late signs and symptoms of opiate withdrawal?
Diarrhoea NaV Goosebumps Stomach cramps Cravings and depression
Outline the general management of substance misuse
Therapeutic alliance Harm reduction Substitution Detox Maintaining abstinence Preventing relapse Social recovery
What harm reduction steps can be taken in drug misuse?
Do not use while alone Do not use with other drugs Avoid IV route If injecting, use safe injective advice -Sterile needles/syringes/water -Don't share needles -Rotate injection site
What social problems are associated with illegal drug dependence?
Crime
Homelessness
Name the 2 types of drug substitution therapy, and state their indications
Maintenance therapy - harm reduction and stabilisation, better for longterm addicts.
Detoxification - aim to come off a drug, suitable for highly motivated individuals looking to detox from all drugs within that class. Circumstance must be stable to maintain abstinence.
What investigations should be done when assessing suitability for substitution therapy?
FBC
LFTs
ECG - QTc
