| ID | 129 |
|---|---|
| Name | SUBSTANCE (DRUG) DEPENDENCE |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | |
| Management | |
| Introduction | The term ‘substance or drug dependence’ is used in a broad sense to include both addictions and habituations. It involves the triad of compulsive drug use referred to as drug addiction, which includes: 1. A psychologial craving or dependence and the behaviour included in the procurement of the drug (the life). 2. Physiologic dependence with withdrawl symptoms on discontinuance of the drug; and- 3. Tolerance, i.e. the need to increase the dose to obtain the desired effect. Dependency increases with increased amount and duration of drug usage. The most commonly used drugs that produce dpendence: A. Depressogenic substances : 1. Opiates- pethidine, morphine, heroin etc. 2. Barbiturates, 3. Others- alcohol, canabis indica (ganja) etc. B. B.Stimulants : Amphetamine. |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | Management of substance dependence: 1. Assessment: i. Observation of the patient ii. History taking iii. Physical examination iv. Psychiatric examination v. Sign / Symptoms of drug intake and withdrawal syndome vi. Social examination- whether any social etiological factor present 2. Medical detoxification: As per current substance use i. Drug withdrawal- in case of severe addiction, gradual withdrawal is preferred; Naloxan l-2mg i.v or Methadone substitution may be necessary for opiod users , ii. I.V fluid iii. Drugs: Sedatives and hypnotics may be required but should be used only for short-time, such as- Diazepam, Haloperidol, Antihistamines, Carbamazepine, Clonidine. 3. Rehabilitation & after care: i. Psychotherapy to maintain motivation. ii. Social help, financial help. iii. Social activities: Clubs, engagement with recreational activites. iv. Religious works. v. Vocational guidance. vi. Suitable employment. vii.Family support. |
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