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Questions and Answers
Which of the following symptoms could indicate someone is using drugs?
Which of the following symptoms could indicate someone is using drugs?
Which of these symptoms is most likely to be related to the physical effects of drug use?
Which of these symptoms is most likely to be related to the physical effects of drug use?
Which of these symptoms is NOT a direct indicator of drug use?
Which of these symptoms is NOT a direct indicator of drug use?
Which of the following can be a sign of a potential drug use problem?
Which of the following can be a sign of a potential drug use problem?
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Which of the following is MOST likely to be a direct physical effect of drug use?
Which of the following is MOST likely to be a direct physical effect of drug use?
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Which of the following is NOT a characteristic of addiction?
Which of the following is NOT a characteristic of addiction?
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What is NOT a factor that contributes to addiction, as stated in the text?
What is NOT a factor that contributes to addiction, as stated in the text?
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Which of the following brain reward pathways is involved in addiction as mentioned in the text?
Which of the following brain reward pathways is involved in addiction as mentioned in the text?
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What drug class is NOT mentioned in the text as a common substance of abuse?
What drug class is NOT mentioned in the text as a common substance of abuse?
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What criteria is NOT listed under DEPENDANCE?
What criteria is NOT listed under DEPENDANCE?
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Which of the following is a physical sign that may indicate a substance abuse problem?
Which of the following is a physical sign that may indicate a substance abuse problem?
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What is a likely behavioral sign of substance abuse?
What is a likely behavioral sign of substance abuse?
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Which of the following is NOT a factor that can influence the development of addiction?
Which of the following is NOT a factor that can influence the development of addiction?
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Which substance is classified as a stimulant?
Which substance is classified as a stimulant?
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What is the most important aspect to consider when dealing with substance abuse?
What is the most important aspect to consider when dealing with substance abuse?
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What is the primary purpose of the CAGE screening tool?
What is the primary purpose of the CAGE screening tool?
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Which of the following is NOT a physical exam finding that may indicate substance use disorder?
Which of the following is NOT a physical exam finding that may indicate substance use disorder?
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According to the provided text, which of the following is considered the most effective intervention for alcohol use disorder long term?
According to the provided text, which of the following is considered the most effective intervention for alcohol use disorder long term?
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Which of these laboratory tests is NOT commonly used in the diagnostics of substance use disorder?
Which of these laboratory tests is NOT commonly used in the diagnostics of substance use disorder?
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Which of the following medications is used to reduce alcohol cravings and enhance GABA activity?
Which of the following medications is used to reduce alcohol cravings and enhance GABA activity?
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Which of these is NOT a common symptom of opioid withdrawal syndrome?
Which of these is NOT a common symptom of opioid withdrawal syndrome?
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Which of the following is a common behavior associated with potential substance use disorder?
Which of the following is a common behavior associated with potential substance use disorder?
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What is the main purpose of using medications like Librium (chlordiazepoxide) during alcohol withdrawal?
What is the main purpose of using medications like Librium (chlordiazepoxide) during alcohol withdrawal?
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What is the most effective way to manage opioid use disorder, according to the text?
What is the most effective way to manage opioid use disorder, according to the text?
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Which of the following is NOT a common diagnostic test used to screen for substance use disorder?
Which of the following is NOT a common diagnostic test used to screen for substance use disorder?
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Which of the following medications can be used to treat opioid withdrawal?
Which of the following medications can be used to treat opioid withdrawal?
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Which of the following is TRUE regarding the opioid epidemic?
Which of the following is TRUE regarding the opioid epidemic?
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Which of the following statements is TRUE about Methadone?
Which of the following statements is TRUE about Methadone?
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Which of the following can lead to increased access to buprenorphine for treatment of opioid addiction?
Which of the following can lead to increased access to buprenorphine for treatment of opioid addiction?
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What was the major contributing factor to the opioid epidemic?
What was the major contributing factor to the opioid epidemic?
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Which of the following is a consequence of the widespread use of opioids?
Which of the following is a consequence of the widespread use of opioids?
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What is the role of Naloxone in opioid overdose?
What is the role of Naloxone in opioid overdose?
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Which statement best describes the trend regarding opioid prescribing?
Which statement best describes the trend regarding opioid prescribing?
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When did the government first impose taxes on opium derivatives?
When did the government first impose taxes on opium derivatives?
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Which of the following are considered widely abused substances in the United States?
Which of the following are considered widely abused substances in the United States?
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What term is used to describe the physical changes that occur due to drug dependence?
What term is used to describe the physical changes that occur due to drug dependence?
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What was Bayer's marketing strategy for heroin in 1890?
What was Bayer's marketing strategy for heroin in 1890?
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Which of these is NOT a sign of Substance Use Disorder (SUD)?
Which of these is NOT a sign of Substance Use Disorder (SUD)?
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Flashcards
Substance Use Disorder (SUD)
Substance Use Disorder (SUD)
A maladaptive pattern of substance use leading to impairment or distress.
Harrison Tax Acts of 1914
Harrison Tax Acts of 1914
The first federal attempt to regulate drug use, imposing taxes on opium derivatives.
Opiates
Opiates
Substances derived from opium, used historically for pain relief.
Addiction stigma
Addiction stigma
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Synthetic opioids
Synthetic opioids
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Sleep disturbances
Sleep disturbances
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Appetite changes
Appetite changes
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Lack of motivation
Lack of motivation
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Addictive Disorders
Addictive Disorders
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Pathophysiology
Pathophysiology
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Brain Reward
Brain Reward
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Common Substances of Abuse
Common Substances of Abuse
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Diagnostic Criteria for Abuse
Diagnostic Criteria for Abuse
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Diagnostic Criteria for Dependence
Diagnostic Criteria for Dependence
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Tolerance
Tolerance
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Withdrawal
Withdrawal
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Physical Signs of Addiction
Physical Signs of Addiction
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Behavioral Signs of Addiction
Behavioral Signs of Addiction
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Overdose
Overdose
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Naloxone
Naloxone
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Methadone
Methadone
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Buprenorphine
Buprenorphine
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Clonidine
Clonidine
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Opioid Epidemic
Opioid Epidemic
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Pain as a Vital Sign
Pain as a Vital Sign
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Moodiness
Moodiness
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Physical coordination issues
Physical coordination issues
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Cold, sweaty palms
Cold, sweaty palms
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Excessive need for privacy
Excessive need for privacy
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Needle marks
Needle marks
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CAGE Screening
CAGE Screening
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DAST
DAST
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Red Flag Findings
Red Flag Findings
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Alcohol Withdrawal
Alcohol Withdrawal
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Naltrexone
Naltrexone
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12-Step Programs
12-Step Programs
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Antabuse
Antabuse
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Medication for Co-morbidities
Medication for Co-morbidities
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Individual Psychotherapy
Individual Psychotherapy
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Residential Treatment Programs
Residential Treatment Programs
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Study Notes
Substance Use/Abuse History
- Opiates derived from opium were used to treat ailments like cholera, smallpox, dental pain, and dysentery as far back as the Mayflower in 1620.
- As late as 1890, Bayer promoted both aspirin and heroin as remedies for coughs, colds, and pain, even for children.
Substance Use/Abuse Legislation and Stigma
- The Harrison Tax Acts of 1914 were the first government attempts at drug legislation, taxing opium derivatives.
- By 1920, medical professionals recognized the addictive nature of opiates.
- Addiction was then viewed as a moral, not medical, issue, leading to its stigmatization.
- The 1970s saw the rise of synthetic opiates like hydrocodone and oxycodone.
Substance Use Disorder (SUD) Definitions
- Substance Use Disorder (SUD) is a maladaptive pattern of substance use leading to impairment or distress in school, work, family, and physical/social difficulties.
- Key terms include dependence (psychological or physiological), withdrawal, detoxification, and tolerance.
Screening for Substance Abuse
- The question arises as to what type of primary care visit should include screening for substance abuse.
Substance Use Pathophysiology
- Addiction is thought to result from interactions among genetic, temperamental, psychosocial factors, resources, and substance accessibility.
- Changes in brain pathways and increased vulnerability to drug effects contribute to continued dependence.
- Both a "brain reward" system and avoidance of withdrawal contribute to substance use.
- Brain reward involves dopamine, norepinephrine, endogenous opioids (endorphins), GABA, serotonin, acetylcholine, and adrenergic systems.
Common Substances of Abuse
- The presented table lists various substances categorized by their effects on the central nervous system (CNS), such as opioids, stimulants, psychotomimetics (hallucinogens), inhalants, and anabolic steroids.
- Examples of substances include alcohol, benzodiazepines, heroin, morphine, cocaine, amphetamines, LSD, PCP, cannabinoids, solvents, nitrous oxide, volatile nitrites, synthetic methadone, and fentanyl..
Diagnostic Criteria for Abuse/Dependence
- Abuse (1 or more in a 12-month period): failure to fulfill roles, hazardous situations, legal problems, and social/interpersonal issues.
- Dependence (3 or more in a 12-month period): tolerance, withdrawal, increased use, efforts to cut down, excessive time on activities to get the drug, important social, occupational, or recreational activities, and continued use despite knowledge of negative consequences.
Clinical Presentation: Signs and Symptoms
- Physical and behavioral signs of substance abuse are highlighted in the notes.
- Physical signs include: sleeplessness, unusual activity levels, appetite changes, physical symptoms, and hygiene deterioration.
- Behavioral signs encompass attitude changes, academic/work performance decline, dishonesty, sudden mood shifts, and motivation loss.
Screening Tools: CAGE and DAST
- CAGE (Concern, Anger, Guilt, Eye-Opener) and DAST (Drug Abuse Screening Test) are presented as screening tools.
Physical Exam: Red Flag Findings
- Frequent absences from school/work and a history of trauma or accidents
- Depression, anxiety, labile hypertension
- Gastrintestinal issues, sexual dysfunction, and sleep disorders are also listed.
- Physical signs like tremors, breath odor, enlarged/tender liver, and nasal/conjunctival irritation are significant symptoms.
Diagnostic Tests
- A range of diagnostic tests, some needing individualization, are suggested, including a complete blood count (CBC) with differential, comprehensive metabolic panel (CMP), drug screening, hepatitis panel, HIV, syphilis (RPR), thyroid stimulating hormone (TSH), and B-hCG, as needed.
Management Strategies
- Risk reduction strategies include inpatient detox, residential and outpatient treatment programs, Alcoholics Anonymous (AA), and Narcotics Anonymous (NA).
- Medical management of comorbidities, psychotherapy, and pharmacological agents to reduce cravings and control dependence are also crucial components of comprehensive treatment.
Pharmacological Management: Alcohol
- 12-step programs are considered the most effective long-term management method for alcohol use disorders.
- Pharmacologic interventions including Librium (chlordiazepoxide) or other benzodiazepines are frequently employed to treat alcohol withdrawal.
- Naltrexone, Campral, and Antabuse are discussed as potentially helpful medications for cravings, GABA enhancement, and aversion therapy.
Pharmacological Management: Opioids
- Medications are the first-line treatment for opioid use disorder, supplemented by 12-step programs.
- Naloxone is a first-line overdose reversal agent.
- Methadone and buprenorphine, with or without naloxone, are used for withdrawal and maintenance phases.
- Clonidine is an anti-hypertensive medication utilized for withdrawal management.
NJ Stats (2016): Opioid Overdose Data and Rates
- Data displays the significant increase in opioid-related overdose deaths in New Jersey from 1999 to 2016, contrasted with national figures.
Opioid Epidemic: Background and Implications
- The opioid crisis emerged from well-intentioned healthcare policies focusing on pain management as a vital sign, leading to over-prescription of opioids.
- The risk-benefit ratio tilted heavily towards opioids, overlooking potential consequences.
- Increased awareness of risks and restricted opioid use followed.
Overprescription and the Epidemic's Path
- Over-prescription of opioids occurred due to the mistaken notion of treating pain as a vital sign and the absence of complete awareness of the long-term risks.
- Consequently, an opioid crisis emerged and caused addiction and death.
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Description
Test your knowledge on the symptoms and signs of substance abuse and addiction. This quiz will cover physical effects, behavioral indicators, and criteria involved in addiction. Knowing these aspects can help in identifying potential drug use problems in individuals.