Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 26 Drug Abuse

Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Drug Abuse  Drug abuse is defined as the use of drugs for nonmedical purposes, usually with the intent of altering consciousness.  Both prescription and nonprescription drugs can be abused. 2

Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Drug Abuse  Psychological dependence is defined as a state of mind in which a person believes that he or she is unable to function without a specific drug.  Physical dependence is defined as the altered physiologic state that results from constantly increasing drug concentrations.  Physical dependence is determined to exist when the person experiences withdrawal symptoms during drug discontinuation. 3

Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Drug Abuse  Tolerance is defined as the need for dose increases in order to achieve the desired effect or if the same dose produces a diminished effect.  In persons that have addiction issues there is dependence and a desire to continue to use the drug.  Habituation is characterized by a desire to continue to use a drug for its effect. 4

Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Drug Abuse  Who Abuses Drugs?  Anyone can be a drug abuser.  Patients can be drug abusers.  Dental practitioners can be drug abusers.  Dental health care workers should become familiar with the different drugs that are abused as well as their patterns of abuse.  Many patients may present with abuse problems. 5

Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Drug Abuse  The most commonly abused drugs in the U.S. are alcohol, tobacco, and caffeine.  They are easily abused because they are readily accessible.  Most people do not consider them to be drugs.  Most people consider illegal drugs, opioid analgesics, benzodiazepines, and barbiturates as drugs of abuse. 6

Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Drug Abuse  Managing the Oral Health Care of Drug Abusers  Always check for oral lesions.  Many drug abusers have poor oral hygiene.  Avoid using other controlled substances in these people.  Aspirin and NSAID use may need to be avoided because of the increased risk of GI adverse effects.  Consider the patient’s liver status. 7

Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Drug Abuse  Managing the Oral Health Care of Drug Abusers  Oftentimes alcoholics have diminished liver capacity and lack vitamin K. They may be at higher risk for continued bleeding.  Dental hygienists are in an ideal position to help in promoting tobacco cessation.  Always check heart rate and blood pressure of known or suspected drug abusers.  Those abusing stimulants may not be able to receive epinephrine because of the increased risk of cardiac toxicity. 8