How is addiction defined?
A chronic, relapsing brain disorder involving compulsive substance use despite harm.
What brain pathway is activated in addiction?
The dopamine reward pathway: VTA → nucleus accumbens → prefrontal cortex.
What are major alcohol-related physical complications?
GI bleeding, liver disease (cirrhosis), pancreatitis, cardiomyopathy, hypertension, increased cancer risk.
What brain changes occur with repeated substance use?
Reduced natural dopamine production
Impaired impulse control
Strong cravings
Compulsive use
What cognitive complications can alcohol cause?
Cognitive impairment and Wernicke–Korsakoff syndrome.
What are common complications of injectable drug use?
Bloodborne infections (HIV, Hep B/C), endocarditis, abscesses, cellulitis, vein damage.
What diseases are linked to tobacco use?
COPD, lung cancer, cardiovascular disease, stroke, peripheral vascular disease.
What is substance abuse?
Harmful use causing social or occupational problems.
What is dependence?
Tolerance, withdrawal, and compulsive use.
What are key criteria for SUD?
Using more/longer, failed attempts to cut down, time spent using, cravings, role failure, social issues, risky use, tolerance, withdrawal.`
Why is relapse common in addiction?
Because addiction cycles between use → abstinence → relapse; stress, cues, environment, and withdrawal trigger relapse.
What harm-reduction steps can paramedics support?
Needle exchange info, safe-use advice, encouraging GP/MH/detox follow-up.
What communication style should paramedics use with people who use substances?
Trauma-informed, non-judgmental communication.
Why is rapport important?
Reduces shame and increases engagement in care.
What are symptoms of mild–moderate withdrawal?
Tremors, anxiety, sweating, tachycardia, hypertension, nausea.
When does alcohol withdrawal begin?
6–24 hours after the last drink.
When do alcohol withdrawal seizures occur?
6–48 hours after last drink.
What is delirium tremens (DTs) and when does it occur?
A life-threatening state of confusion, agitation, hallucinations, fever; occurs 48–96 hours after last drink.
How is alcohol withdrawal treated in hospital?
Benzodiazepines, thiamine, fluids, monitoring.
What are long-term medical effects of chronic alcohol use?
Liver disease (fatty → hepatitis → cirrhosis), pancreatitis, cardiomyopathy, malnutrition, neurocognitive impairment, mood disorders, ↑ cancer risk.
What are cannabis effects and risks?
Relaxation, altered perception; risks include anxiety, paranoia, cognitive impairment, cannabis hyperemesis syndrome; dependence possible.
What are amphetamine effects?
Euphoria and increased alertness.
What are amphetamine risks?
Aggression, psychosis, tachycardia, arrhythmias, stroke, “meth mouth,” long-term cognitive decline.
What are symptoms of opiate withdrawal?
Sweating, goosebumps, yawning, diarrhoea, vomiting, bone pain, agitation.
