PSYC SUD Therapeutics ; Epidemiology

Epidemiology:

1) 1 in __ Canadians meet criteria for SUD in their lifetime

2) What are the 2 largest contributors to having the most consequences  + highest cost to healthcare systems 

3) What are the most common substances for SUD in Canada (2)

1) 1 in 5

2) Tobacco, alcohol

3) Cannabis, alcohol 

DSM-5 Criteria for SUD

1) ≥ __ criteria within __ months; grouped into 4 clusters

2) What are the 4 clusters

3) Score for mild

4) Score for moderate

5) Score for severe 

1) ≥ 2 criteria within 12 months

2) 4 clusters:

• Impaired control (Using more/longer, craving, unsuccessful cut down)

• Social impairment (Failure at work/school/home)

• Risky use (Hazardous use, continued use despite harm)

• Pharmacological (tolerance/withdrawal)

3) 2-3

4) 4-5

5) 6+

Substance Induced Disorder causes what 3 category of things

1. Intoxication

2. Withdrawal

3. Others (Secondary diseases)

   1. Psychosis

   2. Depression

1) What is considered early remission (+ one outlier)

2) What is considered sustained remission

3) Approximately what percentage range of people achieve remission from SUD

4) Average time to achieve remission (for all substances combined)

1) None of the criteria has been met for 3-12 months (except craving which can last 12+ months)

2) No criteria met for over 12 months

3) 35-55% (1/3-1/2)

4) 14 years

Death rate from 1.___ has gone down while death rate from 2.___ has gone up

1) Fentanyl

2) Benzos

Examples of Harm Reduction (3)

• Remember: DO NOT require people to stop using substances

• Used to decrease complications from substances used

1. Overdose prevention + supervised consumption sites

2. Naloxone kits

3. Supplies for safer drug use

Examples of HARM-REDUCTION PRESCRIBED ALTERNATIVES for

1) Opioids (2)

2) Stimulants (2)

3) Alcohol (1)

A) Are they mostly short or long acting? What’s the exception 

B) Which category of harm reduction prescribed alternatives leads to NO DIFFERENCE in acute care visits (hospitalizations?)

C) Which category of harm reduction prescribed alternatives leads to DECREASED acute care visits (hospitalizations?)

1. Hydromorphone Tablets; Fentanyl Powder

2. Methylphenidate; Dextroamphetamine

3. Managed alcohol program 

   1. Small doses of alcohol to replace non-beverage alcohol use (rubbing alcohol)

A) Mostly short-acting. Exception = fentanyl patch 

b) Opioid

C) Stimulant

• Due to decreased exacerbation of psychosos + mental health conditions

What’s the difference between

1. Supervised Consumption Sites

2. Overdose Prevention Sites

A) Permanent or temporary?

B) Who runs it

C) What kind of consumption / route of administration

Supervised Consumption Sites:

• Official PERMANENT sites

• Health Canada

• Trained staff, often healthcare professionals

• MAINLY INJECTION FOCUSED

Overdose Prevention Sites:

• Temporary sites running under order from BC Ministry

• Peer run

• Allows for other forms of drug consumption (ex: inhaled)

Which SUD withdrawal can be life threatening (death)

Alcohol, benzodiazepines