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BearingPoint, Atos Healthcare, Ireland. Department of Social Protection. [Department of Social Protection] (2013) Substance and drug dependency. Dublin: Department of Social Protection. 49 p.

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Contents
1. Overview and Definition of Substance Abuse 5
1.1 Overview 5
1.2 Definition of the Condition 5
1.3 Diagnostic and Statistical Manual of Mental Disorders 4th Edition Text Revision (DSM-IV-TR) Classification 6
1.3.1 DSM-IV-TR Substance Abuse 6
1.3.2 DSM- IV-TR Substance Dependence 6
1.4 World Health Organisation: International Classification of Diseases 10th Edition (ICD-10) Classification 7
1.4.1 Acute intoxication 8
1.4.2 Harmful use 8
1.4.3 Dependence syndrome 8
1.4.4 Withdrawal State 9
1.4.5 Psychotic Disorder 10

2. Epidemiology 11

3. Aetiology 13
3.1 Aetiology 13
3.2 Neurobiology of misuse 13

4. Diagnosis 14
4.1 Clinical Features 14
4.2 The Mental State Examination 14
4.3 Physical Examination 15
4.4 Investigations 15
4.5 Clinical Features of Withdrawal 16

5. Differential Diagnosis and Comorbidity 17
5.1 Differential Diagnosis 17
5.2 Comorbidity 17

6. Treatment 19
6.1 Pharmacological Treatment Options for Opioid Dependence 19
6.1.1 Clinical Assessment and Assessment of Dependency 19
6.1.2 Opioid Maintenance Treatment 20
6.1.3 Withdrawal/Detoxification 21
6.1.4 Ultra- rapid withdrawal 21
6.1.5 Relapse Prevention 21
6.2 Psychological treatment for Substance Abuse 21
6.3 Rehabilitation 22
7. Prognosis (Main Prognostic Factors) 23

8. Information Gathering at the In Person Assessment 24
8.1 Assessing the Claimant 24
8.1.1 Informal Observation 24
8.1.2 Physical Assessment 25
8.1.3 Mental State Examination 25

9. Analysis of Effect on Functional Ability 27
9.1 Indicators of Ability/Disability 27
9.2 Ability/Disability Profile 29

10. Summary of Scheme Criteria 30
Appendix A - Opioids 31
Appendix B - Cannabinoids 32
Appendix C - Sedative Hypnotics 33
Appendix D - Cocaine 34
Appendix E - MDMA (Ecstasy) 35
Appendix F - Other Stimulant drugs 36
Appendix G - Hallucinogens 38
Appendix H - Volatile Solvents 39
Appendix I - Dissociative Substances 40
Appendix J - Other Substances 42
Appendix K - Neurobiology of drug misuse and dependence 43
Appendix L - Vernacular Names for Commonly Misused Substances 44
L.1 Opioids 44
L.2 Cocaine 44
L.3 Other Stimulant Drugs 44
L.4 Dissociative Substances 44
L.5 Gamma Hydroxy Butyrate (GHB) 45
11. References and Bibliography 46


Item Type:Evidence resource
Publication Type:Manual
Drug Type:New psychoactive substance, Cannabis, Alcohol or other drugs in general, Inhalents and solvents, CNS stimulants, Alcohol, Prescription/Over the counter, CNS depressants, Opioid, Cocaine
Intervention Type:Education and training, AOD disorder
Source:Department of Social Protection
Date:January 2013
Pages:49 p.
Publisher:Department of Social Protection
Corporate Creators:BearingPoint, Atos Healthcare, Ireland. Department of Social Protection
Place of Publication:Dublin
Edition:Medical Assessment Protocols
EndNote:View
Accession Number:HRB (Electronic Only)
Related URLs:
Subjects:HA Screening, identification, and diagnostic method > Medical screening and diagnostic method
G Health and disease > Drugs and alcohol disorder > Drug use > Drug intoxication
N Communication, information and education > Recommendations or guidelines > Practice / clinical guidelines
G Health and disease > Drugs and alcohol disorder > Alcohol use > Alcohol dependence
G Health and disease > Drugs and alcohol disorder > Drug use > Drug dependence
G Health and disease > Disorder classification
J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for drugs and alcohol use
G Health and disease > Drugs and alcohol disorder
A Drugs and alcohol use, abuse, and dependence > Drugs and alcohol effects and consequences

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