Preoperative assessment
Brian J Pollard, Gareth Kitchen in Handbook of Clinical Anaesthesia, 2017
Substance abuse is the self-administration of a substance that is not for normal medicinal purposes and which may lead to physical and/or psychological dependence. Physical dependence occurs when the presence of the substance is necessary for normal physiological wellbeing and when specific symptoms (‘withdrawal’) occur if it is not taken. Psychological dependence occurs when the substance produces a desire to repeat the experience again and again. Tolerance to a substance may develop such that increasing doses are required to produce the same effect. There is an association with hepatitis, AIDS, personality disorders, unwanted pregnancy and antisocial behaviour. Drug overdoses are common due to mistakes, the desire to try more, unexpected variation in strength and mixing with other drugs or substances. Table 25.27 summarises anaesthetic implications of common substances abused.
Generic role in response to alcohol and drug misuse
G. Hussein Rassool in Alcohol and Drug Misuse, 2017
Given this increasing prevalence of alcohol and drug misuse and the normalisation of psychoactive substances in society, only a minority of drug and alcohol misusers is likely to come into contact with specialist drug and alcohol agencies. Most of them will invariably have first contact with primary care services, medical and psychiatric services, social services and voluntary agencies and the criminal justice system. The need for a multi-disciplinary response to alcohol and drug problems from generic, specialist and non-specialist agencies cannot be overlooked. From a public health perspective, in the context of substance misuse, some of the particular areas identified as threats to the nation’s health are smoking, alcohol-related diseases, blood-borne infections and disease and drug-related death due to overdose and blood borne viruses. Many of the medical problems can be directly linked to drug abuse and they include: cancer (tobacco); heart disease (tobacco, cocaine, MDMA (Ecstasy), amphetamines and steroids); HIV and hepatitis C (injection drug use) and alcohol (aenemia, cancer, cardiovascular disease, cirrhosis, dementia, depression, seizures, gout, high blood pressure, infectious disease, nerve damage and pancreatitis). Alcohol and drug misuse often co-exist with depression, anxiety, marital difficulties and personality disorders.
Introducing Models of Care
Richard Bryant-Jefferies, Don Lavoie in Models of Care for Drug Service Provision, 2018
Assessors at Tier 2 will need to have received the appropriate level of training to ensure that they have an appreciation and understanding, and the necessary skills, to encourage clients to convey the information needed upon which their assessment will be based. How problematic is a client’s drug use? Is it generating dependence and risk of withdrawal? Does the client need assessment for substitute prescribing or full assessment for possible mental health problems? Does the client need a physical check-up from a clinical nurse specialist? Are there physical symptoms being described that could be linked to drug use? Does the client need to be seen by a doctor and, if so, how urgently? It will be vital that Tier 2 services are able to distinguish those clients suited to their package of interventions, and those that need a more comprehensive assessment of their needs.
Associations of deviant peer affiliation with youths’ substance use disorder abstention motivation: The mediating role of perceived social support and the moderating role of collective identity
Published in Journal of Ethnicity in Substance Abuse, 2022
Xiaoqing Zeng, Yuling Chen
By the end of 2018, there were 2.404 million people with substance use disorder in China, 52 percent of them between the ages of 18 and 35. Methamphetamine has replaced heroin as the most abused drug in China (China National Narcotic Control Committee, 2018). Drug abuse not only causes serious damage to the physical and mental health of persons with substance use disorder, it also takes a toll on their families and makes them threats to public safety (Krishnan et al., 2016). Drug addiction is a physiological, psychological, and social maladjustment phenomenon characterized by repeated drug use. In the past, although remarkable advances have been made in understanding persons with substance use disorder, and the influence of treatment, society and pharmacology, little is known about the psychosocial processes that lead to the cessation of addictive behavior (Fiorentine & Hillhouse, 2003). At present, the research on the theoretical basis of relapse is not mature, and the influencing factors and neural mechanisms that lead to addiction and relapse are still unclear (Miles et al., 2019). Clinicians have found that psychological dependence on drugs is one of the most important reasons for relapse, while motivation is a key factor and an effective index of behavioral change (Zeng et al., 2019).
Provider–patient communication about prescription drug abuse: A qualitative analysis of the perspective of prescribers
Published in Substance Abuse, 2020
Stephanie M. Mathis, Angela Hagaman, Nicholas Hagemeier, Katie Baker, Robert P. Pack
Prescription drug misuse and abuse are a pressing public health issue in the United States.1–4 In 2016, approximately 6.2 million persons 12 years or older misused prescription drugs in the past month, with approximately 3.3 million persons misusing prescription opioids in particular.5 Prescription opioid use disorder is among the most common types of substance use disorder related to illicit drug use.5,6 In 2016, approximately 1.8 million persons 12 years or older had a prescription opioid use disorder in the past year.5 Prescription opioids helped fuel the drug overdose epidemic,7 contributing to more than 200,000 drug overdose deaths from 1999 to 2017 according to the Centers for Disease Control and Prevention (CDC).8
Predictors of illicit drug use among a national sample of adolescents
Published in Journal of Substance Use, 2018
Rebecca A. Vidourek, Keith A. King, Ashley L. Merianos, Lauren A. Bartsch
The three dependent variables in the current study were ever have used illicit drugs, used illicit drugs in the past year, and used illicit drugs in the past month of taking the survey. Illicit drug use included the use of marijuana, cocaine/crack, heroin, hallucinogens, inhalants, or prescription-type psychotherapeutic drugs (pain relievers, tranquilizers, stimulants, and sedatives). Ever have used illicit drugs was measured by one item (0 = never used; 1 = ever used). Past year illicit drug use was measured by one item (0 = did not use in past year; 1 = used in past year). Past month illicit drug use was measured by one item (0 = did not use in past month; 1 = used in past month). Statistical imputation items were used to replace any missing or ambiguous data with definite values, such as if there was no definite period of last illicit drug use within the participants’ lifetime.
Related Knowledge Centers
- Cannabis
- Cocaine
- Ethanol
- Hallucinogen
- Methaqualone
- Benzodiazepine
- Barbiturate
- Substance-Related Disorder
- Anti-Social Behaviour
- Substituted Amphetamine