Substance use disorders Flashcards
What type of disorder criteria is not to do with frequency/dose?
Substance Use Disorders
True or False?
Substance Use Disorders (SUD) criteria is not to do with frequency/dose
True
Substance Use Disorders (SUD) criteria is not to do with frequency/dose
What is the diagnosis based on?
It reflects the IMPACT of current substance use on functioning in everyday life
simply = the harm that is being done
What type of disorder has a diagnosis that reflects the IMPACT of current substance use on functioning in everyday life?
simply = the harm that is being done
Substance Use Disorders (SUD)
True or False?
Substance use can never be problematic/harmful without dependence criteria being met
False
Substance use can be problematic/harmful without dependence criteria being met
Substance use can be problematic/harmful without dependence criteria being met
What group of people is particularly affected by this?
People with mental health problems (who may have increased sensitivity to the effects of a substance)
What are the 3 direct consequences of substance use on physical health?
- Liver damage
- Heart and lung damage
- Increased risk of cancer
What are the 4 indirect consequences of substance use on physical health?
- Illness
- Injury
- Self-neglect
- Harm from risky behaviours (hepatitis, HIV, overdose)
What are the 4 consequences of substance use on social and interpersonal life?
- Conflict with others (e.g. disapproving family members)
- Exclusion / stigma
- Poor educational attainment
- Homelessness
What are the 3 consequences of substance use on mental health?
- Transient psychosis (e.g. cannabis induced psychosis)
- Depression & Anxiety (e.g. depressant effects of alcohol)
- Worsens conditions for people with established illness (e.g. psychosis)
Substance abuse worsens conditions for people with established illness (e.g. psychosis)
List 4 ways substance abuse does this
- More / worse symptoms
- Poorer functioning
- More relapses and hospitalisations
- Increased suicidality; Aggression
True or False?
There is not evidence for increased rates of mental health problems (e.g. psychosis) due to substance use
False
There is evidence for increased rates of mental health problems (e.g. psychosis) due to substance use
What is the evidence for increased rates of mental health problems (e.g. psychosis) due to substance use?
In 2019/20 there were 7,027 hospital admissions with a primary diagnosis of drug-related mental health and behavioural disorders (135 people per week)
This was 21% higher than 2009-10
In 2019/20 there were 7,027 hospital admissions with a primary diagnosis of drug-related mental health and behavioural disorders
How many people were diagnosed per week and how much higher is the number compared to 2009-2010?
135 people per week
This was 21% higher than 2009-10
What % of adults aged 16 to 59 had taken drugs at some point during their
lifetime in the UK?
35%
How many adults aged 16 to 59 had taken an illicit drug in the last year (3.2 million people) in the UK?
1 in 11 (9%)
How many young adults aged 16 to 24 had taken an illicit drug in the last year in the UK?
1 in 5 (21%)
What % of young adults aged 16 to 24 are classed as ‘frequent” drug users (at least monthly use) in the UK?
4.3%
Define “frequent” drug users
People who use drugs at least monthly
At what time frame did drug use fall in the UK?
1995-2013
True or False?
Drug use fell 1995-2013 but is now rising again
True
Drug use fell 1995-2013 but is now rising again
A large portion of the increase resulted from the increased use of…?
Class A drugs in 16–24-year-olds (largely MDMA/ecstasy and powdered cocaine)
What is the main contributor of drug use increase in the UK?
Increased use of class A drugs in 16–24-year-olds (largely MDMA/ecstasy and powdered cocaine)
There has been an increase in the use of class A drugs in 16–24-year-olds in the UK
What are the 2 types of drugs young adults consume?
- MDMA/ecstasy
- Powdered cocaine
What % of men had drunk alcohol in past week, according to NHS’s (2020) statistics on alcohol?
65%
What % of women had drunk alcohol in past week, according to NHS’s (2020) statistics on alcohol?
50%
According to NHS’s (2020) statistics on alcohol, alcohol prevalence increases with…?
Age (up to 75 years)
What % of men aged 55-64 drink ‘above safe limits’
(14 units +), according to NHS’s (2020) statistics on alcohol?
38%
What % of women aged 55-64 drink ‘above safe limits’
(14 units +), according to NHS’s (2020) statistics on alcohol?
19%
What are the safe limits of alcohol consumption?
14 units and below
According to NHS’s (2020) statistics on alcohol, what statistics did they find on never drinking and binge drinking in young adults?
Increase in people ‘never’ drinking and decrease in binge drinking, particularly among young adults
True or False?
Decrease in people ‘never’ drinking and increase in binge drinking, particularly among young adults
False
Increase in people ‘never’ drinking and decrease in binge drinking, particularly among young adults
True or False?
Some groups are more likely to drink problematically/ use illicit substances than other
True
Some groups are more likely to drink problematically/ use illicit substances than other
Who are these groups of people? List 2 points
- Young people, especially students
- People with mental health problems
Drug-related hospital admissions are five times more likely in the most deprived areas
What is this evidence for?
Evidence that some groups are more likely to drink problematically/ use illicit substances than other
Drug-related hospital admissions are ___ times more likely in the most deprived areas
a. five
b. three
c. ten
d. seven
a. five
Substance use and mental health problems are highly comorbid
What does this mean?
Substance use and mental health problems frequently occur together
True or False?
Substance use and mental health problems are not significantly comorbid
False
Substance use and mental health problems are highly comorbid
Define Comorbidity
When two disorders or illnesses occur simultaneously in the same person
When two disorders or illnesses occur simultaneously in the same person
This is known as…?
Comorbidity
Sometimes people with mental illness and comorbid substance use are referred to as being …?
“Dually diagnosed”
True or False?
There is lifetime prevalence of Substance Use Disorder (SUD) for people with mental health disorders
True
There is lifetime prevalence of Substance Use Disorder (SUD) for people with mental health disorders
This is especially true for people with…?
- Schizophrenia
- Bipolar Disorder
True or False?
There are multiple positive consequences (physical, psychological) of not intervening substance abuse, particularly for people with comorbid mental illness
False
There are multiple negative consequences (physical, psychological) of not intervening substance abuse, particularly for people with comorbid mental illness
Which group of people experience poorer outcomes of not intervening substance abuse?
People with comorbid mental illness
Interventions in substance use leads to less engagement with ___ and decreased ___ adherence
- Services
- Medication and treatment
What did NICE guidelines recommend for interventions in substance use?
Psychotherapeutic interventions should aim to stop /reduce substance use in people with mental health problems
Give 3 reasons why we should intervene in substance use
- Multiple negative consequences (physical, psychological) particularly for people with comorbid mental illness for whom outcomes are poorer
- Less engagement with services; decreased medication and treatment adherence
- NICE guidance: psychotherapeutic interventions should aim to stop /reduce use in people with mental health problems
What should the goal of substance use treatment be?
List 3 goals
- Remission
- Abstinence
- Harm reduction
Define early remission of substance use, according to the DSM-5
Early remission is defined as at least 3 but less than 12 months without substance use disorder criteria (except craving)
Defined as at least 3 but less than 12 months without substance use disorder criteria (except craving)
This is known as…?
Early remission of substance us
Define sustained remission of substance use, according to the DSM-5
At least 12 months without substance use disorder criteria (except craving)
At least 12 months without substance use disorder criteria (except craving)
This is known as…?
Sustained remission of substance use
Define abstinence of substance use
Based on the idea that there is no “safe” amount of use.
Aim = complete cessation of use
Based on the idea that there is no “safe” amount of use.
Aim = complete cessation of use
This is known as…?
Abstinence of substance use
Give 2 examples of how we can achieve abstinence of substance use
- Detoxification programmes (opioid treatment programmes)
- Pharmacological interventions
- Detoxification programmes (opioid treatment programmes)
- Pharmacological interventions
These can be used to achieve:
a. Harm reduction
b. Depression relief
c. Abstinence
d. Remission
c. Abstinence
Give 2 types of pharmacological interventions/medications used to achieve abstinence of substance abuse
- Naltrexone – reduces craving for alcohol / blocks effects of opiods in the brain (reducing pleasure)
- Methadone – reduces withdrawal symptoms