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Chapter 26
Drug Abuse
Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Abuse
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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.
Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
2
Drug Abuse
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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.
Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
3
Drug Abuse
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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.
Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
4
Drug Abuse

Who Abuses Drugs?
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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.
Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
5
Drug Abuse
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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.
Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
6
Drug Abuse
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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.
Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
7
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.
Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
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