PMH1011 Lecture Notes - Lecture 8: Insomnia, Pejorative, Atropine
4 Jul 2018
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1. WEEK 8 – DRUG, ALCOHOL USE AND ABUSE
Learning Objectives:
Understand the difference between drug use versus addiction.
Identify the biopsychosocial factors that influence addiction.
Recognise the services and agencies that are available within the community.
Appreciate the importance of prevention, early intervention, treatment and harm
minimisation.
Recognise the types of professionals who work within the drug & alcohol/addiction
sector.
Background
Substance: Material such as alcohol, caffeine, nicotine or other drugs that are used by
people to achieve certain effects.
Substance Use: The use of any substance that does not lead to detrimental health effects.
Substance Misuse: The use of any substance that does lead to detrimental health effects
for example physical ill health or mental health problems; usually occurs in the context of
physical and psychological dependence.
Common patterns of use may include:
oExperimental Use – E.g when teenagers tries a cigarette for the first time.
oRecreational Use – E.g when a person drinks a glass of wine each night after
work to help them to relax.
oSituation Use – E.g when a person smokes cannabis at a party when it is offered
to them.
oBingeing – E.g when a person drinks huge amounts of alcohol each weekend with
friends but does not drink any alcohol at all during the week. Patterns of drug use
by articulating a model that focuses on the problems that can arise from the use of
various substances.
oDependent Use – E.g When a person repeatedly priorities their substance use
over other activities in their life, possibly as a result of psychological or physical
yearning.
oIntoxication – Problems that arise from getting drunk/stoned as a result of the
short-term effects of the substance. These problems are seen most often and
include violence, accidents, risky sexual behaviour and high risk behaviour that
may lead to drowning or drinking driving.
oRegular excessive use – Problems that arise from using substances regularly and
excessive over a sustained period of time. The use does not allow for the body to
recover completely from the last time they used, consequences include the
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physical or medical consequences e.g. disease of the liver, brain damage, or
cancer.
Adverse effects of substance use
oIncrease of risk of psychosis, depression, accidental injuries, overdose, bloodborn
infections, physical illness and nutritional deficiencies.
oTabacco: Cardiovascular disease, chronic obstructive pulmonary disease,
including emphysema and chronic bronchitis and cancer.
oSmoking: Peripheral vascular disease and hypertension.
oAlcohol Consumption: Aggression and violence, accidents and injury, higher
levels of cancers, disbetes, overweight, and obesity, cardiovascular disease, liver
disease, pancreatic disease, diseases of the peripheral nerves and nutritional
deficiency.
o4 L’s: Live, Lover, Live
Liver: Problems related to the user’s physical or psychological health
such as cirrhosis; cancer; overdose; psychiatric, psychological or
emotional problems (amnesia, depression, paranoia, etc.); accidents or
other injuries while intoxicated; etc.
Love: Problems related to relationships, family, friends, intimate partners,
and children.
Livelihood: Problems related to the user’s professional live (e.g., lack of
concentration at work or school) and other non-professional activities such
as hobbies.
Law: Legal problems related to illegal drug use, drug acquisition, and/or
trafficking, including driving under the influence of drugs.
oAttitudes to substance use:
Illicit Substances: Substances that have been outlawed by governments
but continue to be used illegally by people to achieve certain effects.
oSubstance use and stigma:
The street policing of problems drugs users can be publicly humiliating
and add to feeling of injustice, alienation and stigmatization. For
recovering users, the continued labelling of them as drug users makes
change extremely difficult.
Attending a drug and alcohol program can increase stigmatization with
some people feeling that the very act of seeking treatment serves to
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cement an ‘addict’ or ‘junkie’ identity; leading to further rejection from
family and friends.
The supervised consumption of methadone in pharmacies provides a
context where a person’s problems are made public, with many feelings
stigmatised by the attitudes of pharmacy staff and other customers.
oAttitudes if health professionals
Essential that all health professionals view the person who has substance
use issues from a health perspective, rather than a moralistic or legalistic
perspective.
Develop a level of confidence in providing care to people with substance
use issues.
Most certainly encounter a person who uses substances in the course of
their work.
Health professionals who are not confident in what they do are less likely
to inspire confidence in the person seeking assistance.
oLanguage Use
Use of labels and pejorative language works so reinforce the shame, guilt
and embarrassment that challenge people with substance use issues who
seek treatment.
Pejorative language is more likely to be used to less pejorative language is
to speak as though the person you are speaking about is present in the
room.
oComorbidities:
Comorbidity: The simultaneous presence of two or more health
conditions, illnesses or disorders.
Health professionals need to be aware that there are ranges of terms used
within health services that for the most part mean the same thing.
Integrated Treatment: The synthesis of mental health and substance use
treatment interventions for the consumer.
Health Promotion and Disease Prevention:
Strategies Include 3 Pillars:
Demand Reduction – To prevent the uptake and/or delay the onset of use of alcohol, tobacco and
other drugs; reduce the misuse of alcohol and the use of Tabacco and other drugs in the
community; and support people to recover from dependence and reintegrate with the community.
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Document Summary
Week 8 drug, alcohol use and abuse. Understand the difference between drug use versus addiction. Recognise the services and agencies that are available within the community. Appreciate the importance of prevention, early intervention, treatment and harm minimisation. Recognise the types of professionals who work within the drug & alcohol/addiction sector. Substance: material such as alcohol, caffeine, nicotine or other drugs that are used by people to achieve certain effects. Substance use: the use of any substance that does not lead to detrimental health effects. Substance misuse: the use of any substance that does lead to detrimental health effects for example physical ill health or mental health problems; usually occurs in the context of physical and psychological dependence. The use does not allow for the body to recover completely from the last time they used, consequences include the physical or medical consequences e. g. disease of the liver, brain damage, or cancer.
