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Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Chapter 37 Drug Abuse I: Basic Considerations
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2Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Drug Abuse Knowledge of abuse needed by healthcare members 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
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3Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Definitions 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
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4Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Other Definitions Tolerance Psychologic dependence Physical dependence Cross-dependence Withdrawal syndrome
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5Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Diagnostic Criteria for Substance Abuse and Substance Dependence DSM-IV See Table 37-1 DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
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6Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Factors That Contribute to Drug Abuse Reinforcing properties of drugs Physical dependence Psychologic dependence Social factors Drug availability Vulnerability of the individual
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7Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Neurobiology of Addiction Voluntary users can become compulsive users as a result of molecular changes in the brain Reward circuit (system that normally serves to reinforce behaviors essential for survival) is activated Major transmitter is dopamine
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8Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. Principles of Addiction Treatment 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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9Copyright © 2013, 2010 by Saunders, an imprint of Elsevier Inc. The Controlled Substances Act 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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