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Substance use disorders

Substance use disorders






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    Substance use disorders Substance use disorders Presentation Transcript

    • SUBSTANCE USEDISORDERSNiharika ThakkarChild Guidance Centre andDepartment of Behavioural Sciences and MentalHealth,Sahyadri Hospitals ltd, Pune
    • What are Substances??•Alcohol•Opioids•Cannabinoids•Sedatives/Hypnotics•Cocaine•Caffeine•Hallucinogens http://learn.genetics.utah.edu/content/addiction/drugs/ab•Tobacco•Volatile solvents
    • How to identify? Self report data Analysis of blood, urine etc Presence of drug samples Clinical signs and symptoms (Disturbances in levels of consciousness, perception, affect, behavior, psycho-physiological functions and responses) Informant history Comorbidity with other psychotic disorders
    • AcuteIntoxication Small doses of substance produce disproportionately severe intoxication effect Causes behavioural disinhibition ►Recovery is usually complete ..Funny Anti Smoking Commercial - EPIC SPOOF.flv
    • Harmful Use Pattern of Use Abusing the Substance Binging
    • Dependence Syndrome Strong desire or compulsion Difficulty in controlling in terms of onset, termination or levels of use Withdrawal state Evidence of tolerance Neglect of alternative pleasures Persistent use inspite ofconsequences
    • Tolerance Increased doses required- Alcohol and opiate- dependent individuals take daily doses sufficient to incapacitate or kill non- tolerant users
    • Withdrawal State Indicator of Dependence Syndrome Repeated prolonged high dose Onset and Course is time limited Physical symptoms Psychological disturbances: Anxiety, Depression & Sleep disorders
    • Withdrawal State with Delirium Delirium tremens: Short lived Occasionally life threatening Toxic-confusional state with accompanying somatic disturbances: Insomnia, tremulousness and fear Clouding of consciousness, vivid hallucinations and illusions affecting any sensory modality, delusions, agitation, automatic over activity.http://learn.genetics.utah.edu/content/addiction/drugs/abuse.html
    • Psychotic Disorder During or immediately after psychoactive substance use Vivid hallucinations Misidentifications Delusions or ideas of reference Psychomotor disturbances Abnormal affect : Fear to ecstasy Immediately or in 48 hours (or late onset) Resolves within a month and fully within 6 months
    • Amnesic Syndrome Chronic impairment in memory Remote memory lost, immediate memory preserved Disorientation Confabulation Personality changesKorsakov’s syndrome ..Requiem for a Dream.flv
    • Residual and Late onset PsychoticDisorder Beyond the period during which psychoactive substance related effect might reasonably be assumed to be operating Not always reversible: Dementia Not to be confused with Withdrawal state Negative history: Rule out acute and transient psychotic disorders Flashbacks
    • Guess the Celebrity??
    • Articles SUBSTANCE ABUSE IN INDIA, Ahmad Nadeem, Bano Rubeena, Agarwal V.K., Kalakoti Piyush Tobacco use in India: prevalence and predictors of smokingand chewing in a national cross sectional household surveyM Rani, S Bonu, P Jha, S N Nguyen, L Jamjoum