2025 Medical Review Officer Online Course with Live Discussion (Includes Digital Syllabus)-Syllabus

Syllabus

Pdf Summary

This comprehensive document addresses Substance Use Disorders (SUD) and substances of abuse, outlining diagnostic criteria, categories of drugs, effects, treatment, and rehabilitation.<br /><br />A positive toxicology screen alone does not diagnose SUD; diagnosis requires criteria per DSM-V, including craving, tolerance, withdrawal, continued use despite harm, and social/occupational impairment. SUD is classified as mild (2-3 criteria), moderate (4-5), or severe (6 or more).<br /><br />Substance use patterns include experimental, recreational, and circumstantial use. The Substance Abuse and Mental Health Services Administration (SAMHSA) targets five or six drug families: amphetamines/methamphetamines, cocaine, marijuana (THC), opiates/opioids, phencyclidine (PCP), and fentanyl.<br /><br />Psychoactive substances fall into five categories: opiates/opioids, stimulants, psychedelics/hallucinogens, sedatives, and inhalants. Opiates include heroin, morphine, and semi-synthetic opioids like oxycodone. Stimulants include cocaine, amphetamines, and synthetic cathinones ("bath salts"). Hallucinogens include LSD, MDMA (Ecstasy), PCP, and synthetic cannabinoids ("K2"). Sedatives involve alcohol, benzodiazepines, barbiturates. Inhalants include solvents and gases.<br /><br />Each class exhibits specific signs of intoxication, withdrawal, and overdose, with opioids causing respiratory depression and pinpoint pupils; stimulants causing agitation and cardiac symptoms; hallucinogens triggering psychosis; sedatives causing CNS depression; and inhalants causing anesthetic effects and cardiac toxicity.<br /><br />Treatment involves assessments by Medical Review Officers (MROs), use of pharmacotherapies like methadone, buprenorphine, and naltrexone for opioid use disorder, and FDA-approved medications for alcohol use disorder including disulfiram, naltrexone, and acamprosate. Rehabilitation integrates detoxification, outpatient/inpatient therapy, mutual-help groups (AA, NA), and abstinence monitoring.<br /><br />Data from studies (NTIES, NORC CALDATA) show treatment reduces substance use, criminal activity, homelessness, and HIV-risk behavior while improving employment and health outcomes. Medication-Assisted Treatment (MAT) with opioid agonists/antagonists improves recovery success.<br /><br />Historical context notes Alcoholics Anonymous founded in 1935; alcoholism recognized as disease by AMA in the 1950s. Treatment modalities vary in cost-effectiveness but all share a goal to restore function and prevent relapse.<br /><br />Overall, an integrated approach combining diagnosis, pharmacotherapy, behavioral treatment, and social support is essential for effective management of substance use disorders.

Keywords

Substance Use Disorders

DSM-V criteria

Drug categories

Psychoactive substances

Opioid use disorder

Pharmacotherapy

Detoxification

Medication-Assisted Treatment

Rehabilitation programs

Alcoholics Anonymous