Drugs and AlcoholSubstance and drug dependency.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 46Medical screening and diagnostic methodDrug intoxicationPractice / clinical guidelinesAlcohol dependenceDrug dependenceDisorder classificationIdentification and screening for drugs and alcohol useDrugs and alcohol disorderDrugs and alcohol effects and consequences2013-01Department of Social ProtectionEvidence resource

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