S6) Substance Misuse and Treatment Options Flashcards Preview

(LUSUMA) Applied Social & Behavioural Healthcare Delivery Science I > S6) Substance Misuse and Treatment Options > Flashcards

Flashcards in S6) Substance Misuse and Treatment Options Deck (20)
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1
Q

What is substance abuse?

A

Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs

2
Q

Psychoactive substance use can lead to dependence syndrome.

What is dependence syndrome?

A

Dependence syndrome is a cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug

3
Q

Identify 5 consequences of dependence syndrome

A
  • Difficulties in controlling drug use
  • Persisting drug use despite harmful consequences
  • Higher priority given to drug use than to other activities
  • Increased tolerance for drug
  • Withdrawal symptoms
4
Q

What are the three main types of substances?

A
  • Stimulants
  • Hallucinogens
  • Depressants
5
Q

What are depressants?

Provide some examples

A

Depressants are substances that make you feel relaxed e.g. alcohol, tranquilisers, cannabis

6
Q

What are stimulants?

Provide some examples

A

Stimulants are substances that make you feel more alert and give you more energy and confidence e.g. tobacco, cocaine, amphetamine (speed)

7
Q

What are hallucinogens?

Provide some examples

A

Hallucinogens are mind-altering substances that can change/impact your perceptions, mood and senses e.g. LSD, magic mushrooms and ecstasy

8
Q

Describe the treatment regime outlined in the Medical Model

A
  • Detoxification regimes
  • Substitute prescribing
  • Focus on the physical condition i.e. tolerance, physical withdrawal symptoms, vitamin deficiency, pancreatitis
9
Q

Describe the treatment regime as outlined in the Disease Model

A
  • Addiction is an illness, with loss of control the primary symptom
  • Addiction is genetic & therefore predetermined
  • Abstinence/avoidance is the only viable treatment e.g. Alcoholics Anonymous / Narcotics Anonymous
10
Q

Describe the treatment regime outlined in the Behavioural Model

A
  • Addiction doesn’t exist, excessive use is merely a ‘mis-learnt coping-mechanism’ for anxiety/low self-esteem
  • Excessive use/misuse is a result of social, economic & familial learned experiences
  • Alternative coping mechanisms can be taught, & past experiences addressed
11
Q

What treatment is offered when addicts don’t want to change?

A

Harm Reduction:

  • Alcohol: Vitamin B
  • Opiates: Naloxone
  • Injecting: Needle exchange, BBV screening, sexual health
12
Q

What treatment is offered when addicts don’t want to stop?

A

Substitute prescribing:

- Opiates: Methadone, Buprenorphine

  • Amphetamine: Dexamphetamine
13
Q

What treatment is offered when addicts do want to change?

A

Detoxification:

  • Alcohol Benzodiazepines: Chlordiazepoxide
  • Opiate Substitutes: Methadone, Buprenorphine
14
Q

What treatment can be given when addicts want to stay changed?

A

Relapsed Prevention:

  • Disulfiram (Antabuse): Alcohol Deterrent
  • Acamprosate (Campral): Anti-craving
  • Naltrexone: Opioid-receptor antagonist
15
Q

What is erratic/unintentional non-adherence?

A

Erratic non-adherence occurs when the patient wants to follow the agree treatment but is prevented from doing so by barriers beyond their control

16
Q

What is intelligent / intentional non-adherence?

A

Intelligent non-adherence occurs when the patient decides not to follow the treatment recommendations

17
Q

How can one understand intelligent non-adherence?

A

This is best understood in terms of the beliefs and preferences that influence the person’s perceptions of the treatment and their motivation to start and continue with it

18
Q

Identify and describe the 5 factors in the multidimensional model of adherence

A
  • Disease factors: no, few or mild symptoms
  • Healthcare factors: poor availability of services, long waiting times
  • Treatment factors: complex regimens, unpleasant side effects
  • Psychosocial factors: depression, poor support
  • Patient factors: negative attitudes to treatment
19
Q

What is concordance?

A

Concordance involves negotiation between patient & doctor over treatment regimes, in which patients beliefs and priorities are respected

20
Q

State the 8 steps outlined in the concordance approach

A

⇒ Define problem

⇒ Describe treatment options & consequences of no treatment (convey equipoise)

⇒ Provide info in preferred format

⇒ Check patient understanding of options

⇒ Elicit patient’s concerns and expectations

⇒ Ascertain patient’s preferred role in decision making

Defer if necessary

Review decisions