Transcript Chapter 16 Cholinesterase Inhibitors

Chapter 37
Drug Abuse I:
Basic Considerations
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
Drug Abuse
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Knowledge of abuse needed by healthcare
members
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Diagnosis and treatment of acute toxicity
Diagnosis and treatment of secondary medical
complications of drug abuse
Facilitating drug withdrawal
Providing education and counseling to maintain
long-term abstinence
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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Definitions
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Drug abuse: using a drug in a fashion
inconsistent with medical or social norms
Drug addiction: disease process
characterized by continued use of a specific
psychoactive substance(s) despite physical,
psychologic, or social harm
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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Other Definitions
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Tolerance
Psychologic dependence
Physical dependence
Cross-dependence
Withdrawal syndrome
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Diagnostic Criteria for Substance
Abuse and Substance Dependence
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DSM-IV
See Table 37-1
DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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Factors That Contribute
to Drug Abuse
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Reinforcing properties of drugs
Physical dependence
Psychologic dependence
Social factors
Drug availability
Vulnerability of the individual
Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc.
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Neurobiology of Addiction
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Voluntary users can become compulsive
users as a result of molecular changes in the
brain
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Reward circuit (system that normally serves to
reinforce behaviors essential for survival) is
activated
Major transmitter is dopamine
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Principles of Addiction Treatment
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With therapy, 40%–60% can reduce drug use
Ideal goal of treatment is complete cessation
of drug use
Change from compulsive to moderate will be
beneficial
Sustained moderation is very difficult for
opioid, cigarette, and alcohol abuse
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The Controlled Substances Act
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Comprehensive Drug Abuse Prevention and
Control Act of 1970
Record keeping
DEA Schedules I through V
Prescriptions
Labeling
State laws
DEA = Drug Enforcement Agency.
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