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In 2009, ___million americans aged 12 or older were current illicit drug users. Of these users, ___% actually undergo treatment.
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Less than ___ of primary care physicians carefully screen for substance abuse.
1/3
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Define drug abuse, addiction, tolerance, physical dependence, psychological dependence, withdrawal, cross-dependence.
- Drug abuse: the use, usually by self-administration, of any drug in a manner that deviates from the approved medical or social patterns within a given culture.
- Addiction: behavior pattern of drug use, characterized by overwhelming involvement with the use of a drug (compulsive use), the securing of its supply, and a high tendency to relapse after withdrawal.
- Tolerance: when increased dosages are necessary to have the same effect.
- Physical dependence: a state in which a substance must be present to maintain "normal" physiologic functioning
- Psychological dependence: indicated by the frequency of using a drug or by the amount of time an individual spends in drug-seeking behavior.
- Withdrawal: a condition resulting from abstinence froma particular substance that may involve gastric upset, sleep disturbances, anxiety and a craving for the substance involved.
- Cross-dependence: when one substance can replace the actions of another.
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What does the ICD-10 test?
Diagnostic guidelines for substance dependence syndrome
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What does the DSM IV-TR test?
Criteria for substance dependence or criteria for substance abuse
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Alcohol prevalence:
Sex?
Ethnicity?
Age?
Military rank?
- Men > women
- White > all other races
- Younger adults (21-29) > older adults (60+)
- Enlisted > officers
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(T/F) Rate of heaving drinking among military service members is 3times greater than the rate for civlians of the same age.
True
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What is the CAGE questionnaire?
- Most widely used alcohol screening tool in primary care.
- C-Have you ever felt you should cut down your drinking?
- A-Have people annoyed yoou by criticising your drinking?
- G-Have you ever felt guilty about your drinking?
- E-Have you ever had an eyeopening?
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What is the AUDIT?
- Alcohol use disorders identification test.
- 10 questions scored on scale of 0-4
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How are steroids different from other drugs of abuse in terms of its effects in the brain?
Doesn't trigger rapid increases in dopamine (no euphoria)
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What is the most commonly used illicit drug in the US?
Marijuana
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What is "spice"
Dried, shredded plant material and chemical additives that produce psychoactive (mind-altering) effects
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How do nitrites differ from volatile silvents, aerosols and gases?
They dilate blood vessels and relax muscles (stimulate CNS). The other three directly affect (depress) the CNS. Used as a gateway drug.
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What is the most widely used treatment for substance abuse?
CBT - Cognitive Behavioral Therapy. One of the most cost-effective treatment options.
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Define/give examples of opioids.
Opium (contains morphine), morphine, heroine (morphine mixed with acetic acid), codeine. Synthetics: dolophine, demerol, oxycontin
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What is the addiction potential for opioids?
50%
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What is the addiction potential for cocaine?
>50% for smoked, low potential for chewed or snorted cocaine
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What are examples of sedative hypnotics?
Barbituates, benzodiazapines
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What is the addiction potential for sedative hypnotics?
When mixed with alcohol, raises addiction potential. Otherwise it is minimal. Requires in patient detox (death or seizures with sudden withdrawal)
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What are examples of hallucinogens and psychedelics?
LSD (lysergic acid diethlyamide); peyote, mescaline, psilocybin ("shrooms"); low addiction potential
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What are examples of dissociate drugs?
Phencyclidine (PCP), angel dust; ketamine, special K, cat tranquilizers; dextromethorphan, cough syrups and suppressants
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Which drug gives you "superhuman strenght"?
PCP (dissociative drugs)
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Which drugs have FDA approved medications for their treatment?
Alcohol, opiates (=narcotics)
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Calm, not psychotic, constricted pupils, sweaty, warm, not flushed
Sedative/tranquilizer intoxification
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Calm, not psychotic, dry, dilated pupils, dry, warm, not flushed skin
Opiate intoxification
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Calm, psychotic, constricted pupils, diaphoretic, warm, flushed skin
Stimulant withdrawal
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Calm, psychotic, dilated pupils, dry, warm, flushed skin
Stimulant intoxification
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Excited, not psychotic, constricted pupils, diaphoretic, warm/cool, flushed skin
Opiate withdrawal
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Excited, not psychotic, constricted pupils, dry, cool, not flushed skin
Sedative withdrawal
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Excited, not psychotic, dilated pupils, dry, cool, flushed skin
Chronic stimulant withdrawal
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Excited, psychotic, dilated pupils, diaphoretic, warm/not flushed skin
Tranquilizer withdrawal
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Excited, psychotic, dilated pupils, diaphoretic, warm/flushed skin
Dissociative intoxification
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Excited, psychotic, dilated pupils, diaphoretic, cold/not flushed skin
Psychedilic intoxification
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Excited, psychotic, dilated pupils, dry, warm/flushed skin
Acute stimulant intoxification
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