D&K Exam 3
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To treatments reach everyone?
No! less then 10% of adolescents and 94% of people ages 12 or older with substance disorder
Which age range doesnt get the treatment?
18-25
Barriers to treatment
The stigma, lack of problem of recognition, mental disorders
Public opinion on treatments
Most people dont want a heavy drinker as a neighbor
External barriers to treatments
Cost, time conflicts, lack of availability
Do treatments work?
No evidence but its better than nothing
Consideration for treatments
Their age (brain development), their life goals, limited life experience, labeling
Public health approach
Minimize the problems associated with use
Safe injection sites
Opened in 2003, allowed people to use drugs on sights with no prosecutions
Safe injection sites stats
Visited by 7k people; heroin, methadone, and cocaine were used; Budget of 500k; Trusted burse and staff was present (95% rated good); 76% of residents showed support
Safe injection sites results
Decreased needle sharing and reuse of needles; fewer people injecting in public, and less syringes in public areas; No increase in police reports and new imitate of drug use; Number of years saved 1,175
E-cigs pros
Better than tobacco (harm reduction); helps with smoking cessation; Less chemicals (only 5 vs 9k); no significant risk to bystanders; Lower risk for cancer; lower nicotine delivery
E-cigs cons
High carcinogens level; low quality control; false ads on no nicotine; unknown level of nicotine level; other harmful chem; 42% people age 20+ complained of vomiting…
E-cigs in teens
Aggressively marked towards teens (58% of 12-17 were reached); Celebrity endorsement; Renormalization of smoking; Teens are more likly to smoke when they use, they are an addition to cigs (76% use both)
Medically Supervised Withdrawal (detoxification)
Carried out in a hospital setting, allows medical people to monitor and treat withdrawal symptoms; 80% of them use medications
Agonist
You know
Antagonist
Binds and blocks the physiological effecs You know
Methadone
Opioid agonist, schedule 2, normal dose = no high, only one time a day; used to prevent withdrawal symptoms
Naltrexone
Opioid Antagonist, you must be clean for 7 day to use, prevents releases after withdrawal; Can lead to a reduced tolerance = increase risk of overdose; daily (oral) or monthly (injectable)
Naloxone
Brand name of Narcan; Opioid antagonist; used to treat opioid overdose; not addictive, side effects are rare; withdrawal symptoms can onset after use; all 50 states allow + DC
Buprenorphine
Opioid partial agonist; Used to help people withdraw from heroin and methadone and treat severe pain; Schedule 3 drug, requires waver; Has many methods of administering
Stander drinking amount
12 oz beer = 8-9oz malt = 5 oz wine = 1.5 shot
Disulfiram
When combined with alcohol produces vomiting and headaches (etc…) or even worse shock and/or death; Brand name Antabuse; Given daily; Ideal for people who are committed to abstinence and willing to take
Acamprosate
Decreases the cravings and urges to use alcohol; Restore naturally occurring neurotransmitters; Doesnt help with withdrawal symptoms (for people who already detoxed/abstinent); 3x a day