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
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
A particular slide catching your eye?
Clipping is a handy way to collect important slides you want to go back to later.