Drug Addiction Overview

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Questions and Answers

What type of voices are most commonly reported by patients experiencing hallucinations?

Coherent and logical

Calm and reassuring

Maligning and reproachful (correct)

Cheerful and uplifting

What proportion of people with alcoholism report episodes of intense depression?

80% (correct)

100%

50%

20%

Which of the following symptoms is common in the context of alcohol withdrawal?

Memory preservation

Severe hallucinations

Anxiety symptoms (correct)

Enhanced cognitive abilities

What is a key characteristic of Alcohol-Induced Persisting Dementia?

Global decreases in cognitive abilities Signup and view all the answers

What is the typical age range for the occurrence of Alcohol-Induced Persisting Amnestic Disorder?

Rarely seen in individuals under 35 years Signup and view all the answers

What are some common withdrawal symptoms experienced after cessation of cannabis use?

Vivid dreaming Signup and view all the answers

Which of the following substances is commonly used to treat attention deficit hyperactivity disorder (ADHD)?

Amphetamines Signup and view all the answers

What effect does high doses of stimulants like cocaine usually have?

Euphoria and increased energy Signup and view all the answers

Which of the following hallucinogens is derived from a plant?

Psilocybin Signup and view all the answers

What is a typical method of ingestion for amphetamines commonly used as a street drug?

Intravenously Signup and view all the answers

Which of the following can be a severe consequence of high doses of cocaine?

Paranoid psychosis Signup and view all the answers

What effect does cannabis typically have on a user's perception of time?

Slows the appreciation of time Signup and view all the answers

What is one of the common withdrawal symptoms from amphetamines?

Nightmares Signup and view all the answers

What is the definition of drug abuse?

Maladaptive use leading to impairments Signup and view all the answers

Which drug is classified as a central nervous system depressant?

Alcohol Signup and view all the answers

Which of the following is a criteria for drug dependence?

Compulsive drug use despite harmful consequences Signup and view all the answers

Which of the following is commonly used as a stimulant drug?

Cocaine Signup and view all the answers

What percentage of alcoholic individuals may experience alcohol-induced psychotic disorder?

3% Signup and view all the answers

Which substance is classified as a volatile substance?

Inhalants Signup and view all the answers

What is a common form of alcohol?

Beer Signup and view all the answers

Which of the following drugs are classified as opioids?

Morphine Signup and view all the answers

Which of the following is NOT a common route of administration for opioids?

Sublingual Signup and view all the answers

What is the primary psychoactive compound found in cannabis?

Delta-9-tetrahydrocannabinol (THC) Signup and view all the answers

Which demographic has the highest reported prevalence of heroin dependence?

Males in their 30s to 40s Signup and view all the answers

What is a common withdrawal symptom associated with opioid dependence?

Intense craving for the drug Signup and view all the answers

Which of the following is NOT listed as an adverse effect of cannabis?

Mood stabilization Signup and view all the answers

What is the estimated risk of developing cannabis dependence for anyone who uses it?

1 in 10 Signup and view all the answers

Which symptom typically appears first during opioid withdrawal?

Restlessness and insomnia Signup and view all the answers

What is the expected duration of euphoric effects after cannabis is smoked?

2 to 4 hours Signup and view all the answers

Study Notes

Drug Addiction (Updated)

This presentation covers drug addiction, delivered by Professor Dr Hussain Habil, Head of School and Addiction Medicine Consultant and Psychiatrist.

Learning Outcomes

Students should be able to describe various types of stimulant drugs.
Students should be able to state criteria for drug dependence.

Definition of Drugs & Drug Abuse

Drugs are chemical substances used for treatment, cure, prevention, or diagnosis of disease, or to enhance physical/mental well-being.
Drug abuse is using any drug in a way that deviates from accepted social or medical norms, or using it in a maladaptive way resulting in biological, psychological, or social impairments.

Criteria for Drug Dependence (Based on ICD-10)

Dependence is diagnosed if three or more of the following have been experienced in the last year:
- Strong desire or compulsion to use the substance.
- Difficulty controlling substance use (onset, termination, or levels of use).
- Physiological withdrawal symptoms (characteristic withdrawal syndrome or reducing substance use to avoid withdrawal symptoms).
- Tolerance, needing increased doses for the same effect.
- Neglecting other interests or pleasures because of substance use, or spending excessive time obtaining/using/recovering from substance use.
- Continued substance use despite knowing it is causing harm.

Based on DSM-5 Classification

DSM-5 does not have a separate category for dependence, instead using the number of symptoms (2-3, 4-5, or 6 or more) to categorize severity.
Symptoms concern use in larger amounts, or longer periods than intended; problems with cutting down; craving; use taking over more of the person's life; use despite harm to health; and tolerance/withdrawal.

Commonly Used Drugs in Malaysia

Methamphetamine (syabu)
Alcohol
Cannabis
Heroin

Classification for Drug Dependence

Drugs are classified into categories based on their effect on the central nervous system (CNS). These groups include CNS depressants, opioids, stimulants, and hallucinogens.

Alcohol

Alcohol is a CNS depressant and a common substance abuse issue globally. It comes in various forms like beer, wine, and liquor.

Alcohol Intoxication

DSM-5 diagnostic criteria for alcohol intoxication/simple drunkenness are based on recent ethanol ingestion, maladaptive behavior, and at least one symptom. Symptoms include slured speech, dizziness, incoordination, unsteady gait, nystagmus, and impaired attention/memory. Levels of intoxication correlate with different degrees of impairment.

Alcohol Withdrawal

Withdrawal symptoms vary in severity and timing, based on the length of use. Symptoms can range from minor issues like tachycardia and tremors to major issues like seizures or delirium tremens.

Alcohol-Induced Disorders

Alcohol can cause various disorders, including psychotic disorders, mood disorders, anxiety disorders, persisting dementia, and persisting amnestic disorders.

Opioids

Opioids (like heroin) have powerful pain-relieving and mood-altering effects.
Epidemiology shows heroin is widely abused, often by those with lower socioeconomic backgrounds to fund drug acquisition.
Examples include Morphine, Codeine, Heroin and synthetic analgesics like pethidine/methadone.
Routes of administration include intravenous use, subcutaneous, and inhaled routes.
Clinical effects include respiratory depression, constipation, reduced appetite, and lowered libido.
Withdrawal involves intense cravings, restlessness, insomnia, muscle/joint pain, and potentially severe symptoms like diarrhea and rapid heart rate.

Cannabis

Cannabis is derived from the Cannabis sativa plant, often used in various ways (smoked cigarettes, tea).
Delta-9-tetrahydrocannabinol (THC) is the primary psychoactive component.
Epidemiology shows cannabis is a widely used recreational drug, especially among younger age groups.
Clinical features after use include euphoria, reddening of eyes, dry mouth, tachycardia, irritation of the respiratory tract, and coughing.
Adverse effects can include chronic respiratory diseases, lung cancer, cerebral atrophy, seizure susceptibility, chromosomal damage, birth defects, impaired immune function, hormonal changes, and menstrual cycle irregularities.

Cannabis Use Disorder

Regular cannabis use over several weeks to months can lead to dependence, with a risk around 1 in 10 for users.
Earlier initiation of use, increased frequency, and longer use are associated with increased risk of dependence.

Cannabis Intoxication

Symptoms show within minutes of use, peaking in 30 minutes, and lasting 2-4 hours.
Effects include euphoria, heightened senses (colors seem brighter), slowing of time perception, and impaired motor skills.

Cannabis Withdrawal

Withdrawal in heavy users can manifest within one to two weeks of cessation.
Symptoms include irritability, cannabis cravings, weight loss, depressed mood, restlessness, headaches, chills, disturbed/vivid dreams, gastrointestinal upset, sweating, and tremors.

Stimulant Drugs

Drugs in this category include amphetamines and cocaine.

Amphetamines

Amphetamines have effects similar to increasing dopamine and norepinephrine, and are used pharmacologically to treat ADHD and narcolepsy.
They are often illegally used as "speed" or "whizz".
Routes of administration include oral, intravenous, and inhalation.

Amphetamine Withdrawal

Withdrawal symptoms include low mood, depression, anxiety, tremors, lethargy, fatigue, nightmares, drug cravings, and even suicidal thoughts.

Cocaine

Cocaine, derived from the coca plant, stimulates the central nervous system, producing effects similar to amphetamines.
Effects include excitement, increased energy, euphoria, grandiose thinking, impaired judgment, sexual disinhibition, visual/auditory hallucinations, and formication.
High doses can lead to paranoid psychosis and violent behavior.

Hallucinogens

Hallucinogens like LSD, PCP, psilocybin, and mescaline produce alterations in perception and consciousness, including hallucinations.
Synthetic hallucinogens are often easily made and distributed, with notable examples of LSD and PCP.
Hallucinogens frequently involve oral ingestion, although some are smoked or injected.
Psychedelic/psychotomimetic effects include a reduction in reality contact and heightened sensory awareness as well as hallucinations.
Hallucinogen use is most prevalent in young adults (15-35) and often White men, with lower morbidity/mortality compared to some other drugs.

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Description

This quiz focuses on drug addiction, exploring various types of stimulant drugs and the criteria for drug dependence. It is based on the presentation by Professor Dr Hussain Habil, providing essential definitions and insights into drug abuse. Test your knowledge of addiction medicine and the impact of substance use.