drug_dependency
drug dependency
see also:
- drug dependent doctors
Drug Dependence & Addiction:
Drug abuse:
- use, usually by self-admin., of any drug in a manner that deviates from the approved medical or social patterns within a given culture;
Non-medical drug use:
- encompasses recreational & compulsive use excl. society factor;
Drug dependence:
- a behavioural syndrome where the use of a drug is given a much higher priority than other behaviours that once had a higher value → degrees of dependence.
- may not be a concern if drug low toxicity & inexpensive (eg. caffeine) → no medical or social problem;
- often but not necessarily associated with:
- tolerance:
- rpt doses → decr. potency → need to incr. dose for effect;
- physical dependence:
- altered physiol. state (neuroadaptation) produced by rpt admin. which requires continued admin. to prevent withdrawal or abstinence syndrome for that drug.
- defining criteria (Am.Psych.Ass.1987) :
- 1. taking drug more often or incr. dose than intended;
- 2. unsuccessful efforts to stop or decr. drug use;
- 3. large amt time spent acquiring/using/recovering from drug;
- 4. frequent intoxication or withdrawal symptoms
- 5. abandonment of social or occupation activities due to drug use;
- 6. continued use despite adverse psych. or physical effects;
- 7. marked tolerance;
- 8. frequent use of drug to relieve withdrawal symptoms;
Addiction:
- severe degree of drug dependence that is an extreme on a continuum of involvement in drug use;
Drugs as Reinforcers:
- The intrinsic tendency of a drug to induce re-self-administration of that drug;
- In decreasing order: opioids/cocaine; nicotine; caffeine; ethanol; phenoth. (nil);
- mechanism of primary reinforcement:
- ? involve dopaminergic neurons in ventral tegmental area → limbic/pallidum/frontal;
Cross-dependence:
- the ability of one drug to suppress the manifestations of physical dependance produced by another, & to maintain the physically dependent state.
- May be partial, complete, symmetric or assymetric;
- eg. most sedative-hypnotics (ethanol & benzodiazepines)
- ? all share some capacity to influence Cl channels regulated by GABA;
The Severe Substance Dependence Treatment Act 2010
- provides for up to 14 days of detention and treatment (currently St Vincent's Hospital) of people with severe substance dependence
- must be a matter of urgency to save life or prevent serious damage to health
- similar to Mental Health Act as there must be no less restrictive means available to treat the patient
- patient must lack capacity to make own decisions at time of detention
- seek expert Drug & Alcohol advice
- Magistrate's Court makes the treatment and detention orders
- Addiction Medicine Specialists, Psychiatrists & Custodial Medical Officers are currently allowed to make recommendations for detention
drug_dependency.txt · Last modified: 2015/12/31 02:31 by 127.0.0.1