HHS 350 Quiz #6 wk 7

What is PTSD? Symptoms include...

(Post Traumatic Stress Disorder) -Severe anxiety disorder that develops after any event resulting in psychological trauma -Symptoms include re-living event (flashbacks), avoidance (detachment, numbing), and arousal (hyper-vigilance, exaggerated responses)

What is the WHO Mental Health Gap Action Program (mhGAP)? What is its aim?

*Aim: Scaling up of services for mental, neurological and substance use disorders for countries especially with low- and middle-income. *Intervention guide has been developed to facilitate mhGAP-related delivery of evidence-based interventions in non-specialized health-care settings

How is Drug use measured?

*Difficult because drug use is: -Usually illegal -A hidden and stigmatized behavior *Standard measures of use to compare: Past month Past year Lifetime

Anxiety Disorder Hint: they are the _____ most common mental health disorder; it can impose...

*Globally, anxiety disorders are the second most common mental health disorder -14.6% are affected (measured as DALYs) *In the U.S., ~16 million people are afflicted each year *This disorder can impose high individual and social burden, tend to be chronic, and can be as disabling as somatic disorders -physical symptoms involving >1 body part, but no physical cause

What is Assessment Method?

*No blood test *Symptom based assessment by trained clinician -General appearance -Speech -Emotional expression -Thinking and perception -Cognitive functioning -Alertness, attentiveness, memory, judgment *Classification -Diagnostic and Statistical Manual of Mental Disorders (DSM) -International Classification of Diseases (ICD)

Goals of Harm Reduction

*Prevent disease -Sterile syringe access to prevent HIV and hepatitis *Reduce mortality -Overdose prevention with training and naloxone distribution; link to medical care and social services *Treatment for drug dependence -Buprenorphine or Methadone Maintenance *Empower communities and reduce stigma -Community organizing and engagement

Assessment Methods for Drug abuse (3)

*Surveys School (e.g., Monitoring the Future) Household (e.g., National Survey on Drug Use & Health) With drug users or high risk populations (e.g., homeless) *Health indicators Hospital admissions Treatment demand HIV and Hepatitis C infection Drug related deaths (mortality) *Crime indicators Drug seizures Drug related arrests and drug testing of arrestees

Key Barriers to Treatment

*the absence of mental health from the public health agenda and the implications for funding *the current organization of mental health services *lack of integration within primary care * inadequate human resources for mental health *lack of public mental health leadership

Suicide is among the top _____ leading causes of death globally for all ages. Every year, nearly ____ million people die from suicide.

20; one

What is Harm Reduction? A set of practical, public health strategies designed to reduce the negative consequences of drug use and promote healthy individuals and communities.

A set of practical, public health strategies designed to reduce the negative consequences of drug use and promote healthy individuals and communities.

What are examples of Substance abuse disorder

Alcohol and drug abuse

What are examples of Cognitive disorders?

Alzheimer's and other dementias

What is Drug Dependence?

An adaptive state associated with a withdrawal syndrome upon cessation of repeated drug intake Physical and psychological components (depending on drug) Used in clinical diagnosis and epidemiologic surveillance

What are examples of impulse-control disorders?

Anorexia nervosa Pathological gambling

What is the most commonly used illicit drug in the world?

Cannabis

What is Addiction?

Compulsive drug use despite harmful consequences Characterized by an inability to stop using a drug, failure to meet obligations, and sometimes tolerance and withdrawal Chronic, often relapsing brain disease

What are examples of Disorders usually diagnosed in infancy, childhood, or adolescence?

Developmental disorders Learning, motor skills, and communication disorders (Autism) Epilepsy

What is treatment gap?

Difference between treatment needed and treatment received Estimated at: Low/middle income countries: 76%-85% (not getting treated) High income countries: 35%-50%

DALY

Disability Adjusted Life Year

Schizophrenia Hint: what is it?; it affects ____ people worldwide; it is a _____ disorder

Disorder results in difficulty telling what is real and what is not real, thinking clearly, having normal emotional responses Schizophrenia affects about 24 million people worldwide. Schizophrenia is a manageable disorder, treatment being more effective in its initial stages. More than 50% of persons with schizophrenia are not receiving appropriate care. 90% of people with unmanaged schizophrenia are in developing countries. **Care of persons with schizophrenia can be provided at community level, with active family and community involvement.

What is Cannabis? Hint: it is taken for....; can result in....; increasingly recognized for...

Dried Cannabis sativa or indica plant Includes marijuana and hashish Taken for relaxation, increased appetite, perception and mood changes Can also result in memory and coordination impairment Increasingly recognized for medicinal use

What is Drug Physical Harm?

Immediate effects (respiratory depression, cardiac arrest, poisoning) Chronic effects (psychosis, lung disease) Intravenous use (transmission of HIV, HCV)

Types of Mental Illness (7)

Impulse-control disorders Anxiety disorders Mood disorders Schizophrenia and other psychotic disorder Substance abuse disorder Cognitive disorders Disorders usually diagnosed in infancy, childhood, or adolescence

What is Drug Dependence Harm?

Intensity of pleasure (initial rush, extended high, depends on drug and method of use) Psychological dependence (repeated use without physical symptoms related to drug withdrawal, emotional and motivational symptoms following cessation) Physical dependence (increasing tolerance, intense craving, intense withdrawal reactions)

What is Drug Social Harm?

Intoxication (accidents, interpersonal violence, increased sex risk behavior) Other social harms (to family and community structures) Health care costs (drug related disease and deaths)

What are examples of Mood disorders?

Major depressive disorder Bipolar disorder

Risk factors of Suicide

Mental illness, primarily depression and alcohol use disorders, abuse, violence, loss, cultural and social background Prevention Restriction of access to means of suicide, such as toxic substances and firearms Identification and management of persons suffering from mental and substance use disorders improved access to health and social services responsible reporting of suicide by the media

What are examples of Anxiety disorders?

Panic disorder Obsessive-compulsive disorder

What are Opioids and Opiates? Hint: Preparation of ________, is one of the _____ known drugs; it includes....;taken for ....; consequences...; production regions....

Preparation of opium poppy, one of oldest known drugs Opiates mainly refer to natural products, opioids may be synthetic Includes heroin, morphine, codeine, opium, oxycodone, hydrocodone Taken for analgesic and euphoric properties High potential for abuse and severe physical withdrawal symptoms, respiratory related overdose Production regions in Southeast Asia, Afghanistan, Mexico, Columbia

What is cocaine? Hint: produced from...; taken for ...; Consequences...; Production regions...

Produced from coca leaf into white powder Crack is a smoked concentrated form Taken for stimulant properties High addictive potential and risk for cardiac related overdose Production regions in Argentina, Columbia, Peru, Bolivia

What are examples of Schizophrenia and other psychotic disorder?

Schizophrenia Delusional disorder

What is Amphetamines? Hint: taken for...; High ____ potential; side effects...

Synthetic Taken for stimulant properties including appetite suppression and as a performance enhancer High addictive potential Many negative side effects including paranoia, increased heart rate, weight loss, dental problems, skin sores

T or F: Arguments for criminalization *Drug use causes harm and should be prevented and punished -Drug users should be punished in order to protect the health and well being of citizens. -Punishing drug users protects children. -Some argue that punishing drug use prevents crime. -Drug use ought to be punished because using drugs is immoral.

T

What are the three categories of Drug Related Harms

Three categories: Physical, Dependence, Social

What drug causes the most deaths in the world?

Tobacco

T or F : Prevention and Treatment for Drug and Alcohol *Dependence Prevention Universal: reach entire population Selective: target subgroups at risk Indicated: target individuals showing early signs of substance abuse *Treatment 12 step programs Methadone & buprenorphine maintenance Group and Individual Therapy Social and economic support and stability

True

T or F: Arguments against criminalization? *Responsible drug use has positive benefits and does not cause harm *Criminalization is counter-productive -criminalization is aimed and selectively enforced against minorities -public health risks increase because drugs are dealt on the street -civil liberties are eroded by drug enforcement -some government corruption stems from drug payoffs and criminalization costs tens of billions of dollars per year.

True

T or F: Depression Facts Depression is the most common mental disorder. Globally, more than 350 million people of all ages suffer from depression. Depression is the leading cause of disability worldwide and in the U.S., and is a major contributor to the global burden of disease. Depression affects about 6.7% of American adults every year. More women are affected by depression than men. There are effective therapeutic treatments

True

T or F: Lack of skilled workforce *Shortages of psychiatrists, psychiatric nurses, psychologists and social workers are among the main barriers to providing treatment and care in low- and middle-income countries. *Low-income countries have 0.05 psychiatrists and 0.42 nurses per 100 000 people. *The rate of psychiatrists in high income countries is 170 times greater and for nurses is 70 times greater. *Possible solution?: Task shifting -Allowing health or social service professional with different level of education or training to provide services (e.g. promotores/community health workers)

True

T or F: Mental Health 400-500 million people are affected by mental illness worldwide. Mental illness is leading cause of disability worldwide All mental health conditions combined represent ~15% of total global disease burden of disease **Depression is the 3rd leading cause of disease burden Equivalent to diarrhea and pneumonia in children *1 in 4 people will suffer from a mental health disorder in their lifetime

True

T or F: Mental Health and War *War and other major disasters have a large impact on the mental health and psychosocial well-being. *Rates of mental disorder tend to double after emergencies. *PTSD (Post Traumatic Stress Disorder) -Severe anxiety disorder that develops after any event resulting in psychological trauma -Symptoms include re-living event (flashbacks), avoidance (detachment, numbing), and arousal (hyper-vigilance, exaggerated responses)

True

T or F: Other Drugs Hallucinogens (mushrooms, LSD, mescaline, PCP) Benzodiazepines Ecstasy/MDMA/Molly Solvents and Inhalants Designer Drugs Tranquilizers and Sedatives Prescription Drugs

True

T or F: Policy related harms? Costs for enforcing drug laws, imprisonment Disproportionate targeting of minorities Excessive sentencing Drug market violence *Much political and moral controversy exists about whether these harms are due to the drugs themselves or due to their criminalization

True

T or F: Recent Changes in Drug Policy 1970s - present United States: decriminalization and medical marijuana in certain states 2001 Portugal: decriminalization of drug use 2009 Mexico: decriminalization of small amounts of drugs for "personal use" 2013 Uruguay: legalization and commercialization of recreational cannabis 2015 Jamaica: decriminalization of cannabis possession, legal to have plants for personal use 2012 - present United States: legalization in 4 states (Washington, Colorado, Alaska, Oregon, + DC?)

True

T or F: Risk Factors for Drug and Alcohol Dependence Genetic propensity Risk taking, sensation seeking personality Family and peers who use drugs Early trauma or abuse Young first use Male gender High stress, low control psychosocial situations

True

T or F: U.S. Scheduling (1970) I: High potential for abuse and/or no medical use (heroin, LSD, marijuana) II: Highest potential for abuse (morphine, cocaine, amphetamines, barbituates) III-V: the higher the schedule the greater the medical use and lower abuse potential Does this make sense? How a drug is scheduled influences the culture surrounding it and attitudes towards it and the individuals who use it.

True

T or F: Unique Challenges of mental health *Lack of definitive diagnostic tests -Cultural variation in presentation -Somatic symptoms in Asia more common *Stigma about mental disorders and discrimination against patients and families prevents people from seeking mental health care. *Human rights violations of psychiatric patients are routinely reported in most countries. -Physical restraint -Seclusion -Denial of basic needs and privacy

True

What country has the highest rate of incarcerated people?

United States *The United States has the highest incarceration rate in the world. 2,424,279 Americans or 1 in every 99.1 adults were incarcerated in 2009, most for non-violent drug related crimes. *Two-thirds of those incarcerated are black or Hispanic, although these groups use and sell drugs at similar rates as whites. *Over 200,000 students have lost financial aid eligibility because of a drug conviction

What is Polydrug Use?

Use of more than one substance at a time Increases effects and risks of drugs