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2. Drug Misuse and Dependency

2. Drug Misuse and Dependency. April 2016. What is substance misuse/dependency? Can one become dependent on legal highs?.

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2. Drug Misuse and Dependency

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  1. 2. Drug Misuse and Dependency April 2016

  2. What is substance misuse/dependency?Can one become dependent on legal highs?

  3. Substance Use Disorders -Classificationdiagnostic statistical manual DSM V (USA) or International Classification of Diseases and Health Problems (ICD-10) ICD10 (Europe): • Recurrent use resulting in a failure to fulfil major obligations at work, school, or home • Legal problems resulting from recurrent use • Continued use despite significant social or interpersonal problems caused by the substance use • Recurrent use in situations which are physically hazardous (e.g. driving while intoxicated) • http://www.dsm5.org/Documents/Substance%20Use%20Disorder%20Fact%20Sheet.pdf • http://www.who.int/substance_abuse/terminology/ICD10ClinicalDiagnosis.pdf

  4. DSM IV Substance Dependence: • Substance abuse • Increase in tolerance • Withdrawal symptoms • Compulsion to use

  5. Withdrawal Abrupt discontinuation or decrease in intake of medications or recreational drugs Common withdrawal problems with some antidepressants, psychostimulants, benzodiazepines and alcohol

  6. Withdrawal effects • Anxiety • Irritability • Drug craving • Cramps • Hypo-locomotion • Anhedonia • Depression?

  7. Cognitive deficits • While under the influence • Loss of concentration • Dissociation • Psychoses • After chronic use • Memory loss • Executive function

  8. Evidence for legal highs showing addictive and/or withdrawal effects?

  9. Literature Erik W. Gunderson, et al (2012)“Spice” and “K2” Herbal Highs: A Case Series and Systematic Review of the Clinical Effects and Biopsychosocial Implications of Synthetic Cannabinoid Use in Humans The American Journal on Addictions 21 (4) 320-326. DOI: 10.1111/j.1521-0391.2012.00240.x Lally J, Hallaghan B et al. Prevalence study of head shop drug usage in mental health. B J Psych. 2013. doi: 10.1192/pb.bp.111.038315. 7. The rise and rise of legal highs http://www.menshealth.co.uk/healthy/addictions/the-rise-and-rise-of-legal-highs Turnbull A ( 2015) Independent Nurse, The low profile of legal highs http://www.independentnurse.co.uk/news/the-low-profile-of-legal-highs/110920/

  10. Literature Psychiatria Danubina, 2011; Vol. 23, Suppl. 1, pp 32–34 Conference paper UNUSUAL PRESENTATION OF A PATIENT WITH GBL WITHDRAWL: A CASE REPORT Gursharan Lal Kashyap & Ashok G. Patel South Essex Partnership University Foundation Trust Calnwood Court Luton Bedfordshire, UK http://www.hdbp.org/psychiatria_danubina/pdf/dnb_vol23_sup/dnb_vol23_sup_32.pdf Royal College of Psychiatrists (2014)One new drug a week Why novel psychoactive substances and club drugs need a different response from UK treatment providers p8 table listing effects http://www.rcpsych.ac.uk/pdf/FR%20AP%2002_Sept2014.pdf Winder ,G.S. et al (2103)Are “Bath Salts” the next generation of stimulant abuse? Journal of Substance Abuse Treatment 44(1) p 42–45 doi:10.1016/j.jsat.2012.02.003

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