MedPrep

TextbookSubstance Misuse

Substance Misuse

Alcohol dependence, opioid substitution, withdrawal management, harm reduction, and dual diagnosis approaches.

16 topics201 questions

A

Alcohol Use Disorder

Alcohol use disorder (AUD) is a chronic relapsing condition characterised by impaired control over alcohol use, with physical and psychological dependence, affecting approximately 600,000 dependent drinkers in England.

MRCPsychPLAB 1UKMLA+1

Alcohol Withdrawal

Alcohol withdrawal syndrome is a potentially life-threatening condition occurring 6-24 hours after cessation or significant reduction of chronic heavy alcohol use, ranging from mild tremor to seizures and delirium tremens.

MRCPsychPLAB 1UKMLA+1

Alcoholic Liver Disease

Alcoholic liver disease (ALD) encompasses a spectrum from simple steatosis through alcoholic hepatitis to cirrhosis, representing the leading cause of liver-related death in the UK and the commonest indication for liver transplantation.

MRCPsychPLAB 1UKMLA+1

B

Benzodiazepine Dependence

Benzodiazepine dependence is a common iatrogenic and recreational substance use disorder characterised by tolerance, physical and psychological dependence, and a potentially life-threatening withdrawal syndrome requiring gradual dose reduction.

MRCPsychPLAB 1UKMLA+1

C

Cannabis Use Disorder

Cannabis use disorder involves problematic cannabis use leading to significant impairment, with increasing potency of modern cannabis strains associated with higher rates of dependence, psychosis, and cognitive impairment, particularly in young people.

MRCPsychPLAB 1UKMLA+1

Cocaine and Stimulant Misuse

Cocaine and stimulant misuse encompasses the harmful use of cocaine (powder and crack), amphetamines, and methamphetamine, presenting with significant cardiovascular, neurological, and psychiatric complications and increasing drug-related deaths in the UK.

MRCPsychPLAB 1UKMLA+1

D

Dual Diagnosis

Dual diagnosis refers to the co-occurrence of substance misuse and mental health disorders, affecting approximately 30-50% of mental health service users and 50-70% of substance misuse service users, requiring integrated treatment approaches for optimal outcomes.

MRCPsychPLAB 1UKMLA+1

H

Harm Reduction Strategies

Harm reduction is a pragmatic, evidence-based public health approach that aims to reduce the adverse health, social, and economic consequences of substance use without necessarily requiring abstinence, encompassing needle exchange, naloxone provision, opioid substitution, and supervised consumption.

MRCPsychPLAB 1UKMLA+1

K

Korsakoff Syndrome

Korsakoff syndrome is a chronic irreversible neuropsychiatric condition characterised by profound anterograde amnesia and confabulation, typically resulting from untreated or inadequately treated Wernicke encephalopathy due to thiamine deficiency.

MRCPsychPLAB 1UKMLA+1

M

Motivational Interviewing

Motivational interviewing (MI) is an evidence-based, patient-centred counselling approach designed to strengthen intrinsic motivation for behaviour change by exploring and resolving ambivalence, widely used in substance misuse, chronic disease management, and health promotion.

MRCPsychPLAB 1UKMLA+1

N

Novel Psychoactive Substances

Novel psychoactive substances (NPS, formerly 'legal highs') are synthetic compounds designed to mimic effects of established drugs, posing significant clinical challenges due to unpredictable potency, unknown pharmacology, and frequent non-detection on standard drug screens.

MRCPsychPLAB 1UKMLA+1

O

Opioid Overdose Management

Opioid overdose is a medical emergency characterised by respiratory depression, miosis, and reduced consciousness, requiring immediate naloxone administration and airway management, with approximately 2,300 opioid-related deaths annually in England and Wales.

MRCPsychPLAB 1UKMLA+1

Opioid Substitution Therapy

Opioid substitution therapy (OST) involves prescribing long-acting opioid agonists (methadone or buprenorphine) to reduce illicit opioid use, injecting behaviour, and associated harms, and is the most effective treatment for opioid dependence.

MRCPsychPLAB 1UKMLA+1

Opioid Use Disorder

Opioid use disorder is a chronic relapsing condition characterised by compulsive opioid use despite harmful consequences, with approximately 260,000 high-risk opioid users in England and significant associated mortality from overdose and blood-borne viruses.

MRCPsychPLAB 1UKMLA+1

S

Smoking and Nicotine Dependence

Smoking is the leading preventable cause of death in the UK, responsible for approximately 76,000 deaths annually, with nicotine replacement therapy, varenicline, and behavioural support forming the evidence-based approach to cessation.

MRCPsychPLAB 1UKMLA+1

W

Wernicke Encephalopathy

Wernicke encephalopathy is an acute neuropsychiatric emergency caused by thiamine (vitamin B1) deficiency, classically presenting with the triad of ophthalmoplegia, ataxia, and confusion, requiring immediate parenteral thiamine replacement.

MRCPsychPLAB 1UKMLA+1