3. 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
4. Acute
Intoxication
Small doses of substance
produce disproportionately
severe intoxication effect
Causes behavioural
disinhibition
►Recovery is usually
complete ..Funny Anti Smoking Commercial - EPIC
SPOOF.flv
6. 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 of
consequences
7. Tolerance
Increased
doses
required
- Alcohol and
opiate-
dependent
individuals
take daily
doses
sufficient to
incapacitate
or kill non-
tolerant
users
8. Withdrawal State
Indicator of Dependence
Syndrome
Repeated prolonged high dose
Onset and Course is time
limited
Physical symptoms
Psychological disturbances:
Anxiety, Depression & Sleep
disorders
9. 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
10. 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
11. Amnesic Syndrome
Chronic impairment in memory
Remote memory lost, immediate memory
preserved
Disorientation
Confabulation
Personality changes
Korsakov’s syndrome ..Requiem for a Dream.flv
12. Residual and Late onset Psychotic
Disorder
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
16. Articles
SUBSTANCE ABUSE IN INDIA, Ahmad Nadeem, Bano
Rubeena, Agarwal V.K., Kalakoti Piyush
Tobacco use in India: prevalence and predictors of
smoking
and chewing in a national cross sectional household survey
M Rani, S Bonu, P Jha, S N Nguyen, L Jamjoum