Armando Hasudungan

Biology and Medicine Tutorials

auto-complete
more

Field of Study

Field of Study

Post Type

Post Type

Substance Dependence (Addiction), Withdrawal and Overdose

Notes »
disease »
Psychiatry
»
Substance Dependence (Addiction), Withdrawal and Overdose

Overview of addition medicine. This section is a brief introduction to substance abuse, followed by section that look at specific drugs of addiction.

Definition
Substance Misuse: Consumption above designated low risk levels
Substance Abuse: repetitive substance use resulting in social complications (financial, occupational and legal)
Substance Tolerance: Defined by either of the following: a need for markedly increased amounts of the substance to achieve intoxication or desired effect or markedly diminshed effect with continued use of the same amount of the substance.
Substance Dependence: Cluster of psychological, behavioural and cognitive syndromes that comprise an inner drive to repetitive substance use. Dependence is a clinical syndrome in which there is a prominent physiological drive to consume a substance
Withdrawal: Neurons adapt to the chronic presence of a substance. Cessation of substance results in abnormal neuronal function and therefore symptoms.
Hazardous substance use: Repetitive use at levels that place a person at risk of psychological or medical harm
Harmful substance use: Repetitive pattern of use that causes actual physical (e.g. liver disease) or psychological harm (e.g. depression, anxiety)

Risk Factors

  • Age
  • Gender
  • Personality
  • Family background
  • Recent or past stressors
  • Mental illness
  • External factors
    • surrounding culture
    • price
    • availability
    • advertising

Investigation

  • FBC - Infection, dehydration?
  • LFTs - Heavy alcohol use, hepatitis
  • EUC - Hydration status, electrolyte balance, renal function, blood alcohol level
  • CRP- Infection and Inflammation
  • Serology - Hep B, Hep C, HIV
  • Urine toxicology screen
  • Echocardiogram - If signs of endocarditis or murmurs on auscultation
  • Chest X-ray - If signs of respiratory infection
  • MRI - To rule out abscess’s formation under the skin at the site of cellulitis
URINE TOXICOLOGY SCREENING
Drug and duration of detectability in urine
Amphetamine 2-3 days
Cocaine 2-3 days
Weed 1-7 days (light test) 1 month for chronic users
Opiates 1-3 days
Alcohol

Clinical Presentation

  • Acute intoxication: Follows administration of alcohol or other psychoactive substances resulting in disturbances of level of consciousness, cognition, perception, affect, or behaviour.
  • Harmful use: A pattern of psychoactive substance use that is causing actual damage to the mental or physical health of the user.
  • Dependence syndrome: 3 or more of the following:
    • Strong desire or sense of compulsion to take the substance(craving).
    • Diffculty in controlling substance use (onset, termination, level of use).
    • A physiological withdrawal state when reducing or ceasing substance use.
    • Tolerance: increased doses are required to produce the original e ect.
    • Progressive neglect of alternative pleasures or interests.
    • Persisting use despite clear evidence of harmful consequences.
Contents
cross