Substance Use Disorder and Harm Reduction

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Questions and Answers

What is substance use disorder characterized by?

A cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite substance-related problems.

Which mnemonic is often used to remember the criteria for substance use disorder?

WILD ADDICTD

What does the AIHW report reveal about drug-induced deaths over the past decade?

There has been a 264% increase in drug-induced deaths over the past decade.

Men are more likely to have a higher hospitalization rate due to drug use than women.

<p>True</p> Signup and view all the answers

Match the drug with its common effects:

<p>Cannabis = Mild euphoria, relaxation, perceptual alterations Meth/amphetamine = Euphoric sense, increased attention, talkativeness, nervousness, anxiety, paranoia, aggression</p> Signup and view all the answers

Study Notes

Substance Use Disorder

  • A cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite substance-related problems.
  • Marked with underlying change in brain circuits that may persist beyond detoxification.
  • Useful mnemonic for criteria: WILD ADDICTD
    • W: Work, school, home obligations failure
    • I: Interpersonal or social consequences
    • L: Dangerous use
    • A: Activities given up or reduced
    • D: Dependence → tolerance, withdrawal
    • D: Dependence → duration or amount of use greater than intended

Assessment of Substance Use

  • Pattern of recent drug use: when was it last used, alone or with other drugs, why, and how?
  • Dependence: evidence of psychological and/or withdrawal symptoms
  • Addiction: behaviors associated with self-regulation loss, drug-seeking behaviors

Prevalence of Recreational Drug Use in Australia

  • 47% of the population (10.2 million) have used an illicit drug at some point in their life
  • 1 in 6 Australians have used an illicit drug in the past 12 months
  • Rise of 264% in drug-induced deaths over the past decade
  • 3% of the total burden of disease and injury in 2018

Vulnerable Groups

  • Men are most likely to try and have a higher hospitalization rate
  • Young adults, aged 20-29 years, are most vulnerable
  • 20% of drug treatment service clients in WA identified as Indigenous
  • Highest rate of drug-induced deaths among 45-64-year-olds living in disadvantaged areas

Harms of Drug Use

  • Health impacts: drug-induced deaths, cardiovascular disease, respiratory problems, addiction
  • Social impacts: increase in risky, criminal activities, domestic violence, child maltreatment
  • Economic impacts: $80.3 billion in addiction costs, $4.5 billion in cannabis-related costs, $5 billion in methamphetamine-related costs

Most Commonly Used Drugs

  • Cannabis: most used illicit drug in Australia, accounts for 52% of national illicit drug seizures, and 47% of arrests
  • Methamphetamine: reported increased consumption, 3 in 5 users were male, 1 in 5 were Indigenous, and 58% were aged 20-39

Effects of Drug Use

  • Cannabis: short-term effects include mild euphoria, relaxation, and perceptual alterations, long-term effects include long-term dependence, mental health conditions, anxiety, and appetite disturbances
  • Methamphetamine: short-term effects include euphoric sense, increased attention, and aggression, long-term effects include mood and anxiety disorders, psychotic symptoms, and poor concentration and memory

Prognosis and Recovery

  • Addiction is a treatable disorder
  • Individuals with chronic substance dependence achieve 58% sustained recovery
  • Amphetamine users may remit from drug dependence in a given year
  • Cannabis users may remit from drug dependence in a given year
  • Typical time it takes between first substance use to stable recovery is 27 years

Harm Minimization Strategies

  • Demand reduction: prevention approach, delaying first use, and integrated care and accessible treatment and support services
  • Supply reduction: restricting availability and access, dismantling manufacturing facilities, and regulating sale, age restrictions, and border control
  • Harm reduction: identifying specific risks, encouraging safer behaviors, and effective public policy and safer settings

Fuelling Recovery

  • Requirements for recovery: safe place, freedom from physical and psychiatric distress, empowerment, and longitudinal support
  • Strongest predictor of higher life quality: engaging in activities like volunteering, education, work, family, and social support
  • Recovery is mediated by social and cultural support

Community Resources

  • Community-based counseling and case management: patients can require self-referrals
  • Needle and syringe programs: provide sterile needles and syringes to prevent transmission of blood-borne viruses
  • Better Access initiatives: give Medicare rebates to help people access mental health professionals and care
  • Drug Aware: 24-hour alcohol and drug support line
  • Family Drug Support: for help dealing with drug and alcohol use in the family

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