Social Pharmacy

  1. Name the stages of drug abuse
    Stage I: experimentation

    Stage II: recreational use

    Stage III: problematic use

    Stage IV: addiction
  2. What are the two forms of cocaine?
    Hydrochloride: soluble, injected

    Freebase: lower bp, less soluble, vaporised and inhaled
  3. What are the different types of cannibis and how much active compound do they contain?
    Marijuana: up to 10% THC

    Hashish: up to 15% THC

    Oil: up to 30% THC
  4. What drugs are contained in class A?
    • Ecstacy
    • LSD
    • Heroin
    • Cocaine
    • Crack
    • Magic mushrooms
    • Amphetamines (if prepped for injection)
  5. What drugs are contained in class B?
    • Amphetamines
    • Methamphetamine
    • Pholcodine
    • Cannabis
  6. What drugs are contained in class C?
    • Buprenorphine
    • Tranquilisers
    • Some painkillers
    • GHB
    • Ketamine
  7. What are the risks of using heroin?
    • OD
    • HIV/other infections
    • Damage to veins
    • Physical dependence leading to crime
  8. How can we reduce the harm associated with injecting?
    • Needle exchanges
    • Education
    • Provide clean, sterile paraphenalia
    • Accept return of used equipment for safe disposal
  9. How would you go about preparing freebase heroin into an acid salt to inject?
    • Mix the freebase with ascorbic or citric acid (vinegar too strong and lemon juice has a risk of fungal infection) with water (ideally wfi but if not possible then clean e.g. bottled)
    • Heat in a "cooker" (spoon held over a lighter)
    • Draw through a filter into a syringe to remove particles (ensure the filter will not shed particles into syringe)
    • Locate the vein (get to know arm to avoid valves), use a tourniquet, insert needle into vein and draw up some blood
    • Inject the drug
    • Withdraw the needle
  10. What paraphenalia can and can't be supplied as part of the needle exchange program?
    • Can:
    • Sterile "cookers"
    • Citric acid (100mg sachets)
    • Ascorbic acid (100mg sachets)
    • Filters
    • Alcohol swabs
    • Water for injections

    • Can't:
    • Tourniquets
    • Lighters
    • Matches
    • Night lights
  11. Do's and Don't's of preparation of drugs for injection
    • Do:
    • Wash your hands
    • Use sterile equipment
    • Prepare on a clean disposible surface
    • Use your own cooker and filter
    • Use the smallest amount of acid
    • Reduce the amount of drug after a period of abstinence

    • Don't:
    • Use more than one drug
    • Use lemon juice or vinegar
    • Crush tablets
  12. Advice on injecting sites
    • Peripheral veins are safer than deep veins
    • It's better to have several injection sites and rotate them

    Avoid femoral vein and veins in the breast, neck or penis
  13. Advice on injecting practice
    • Use the smallest needle
    • Use a tourniquet to identify vein and release prior to injecting
    • Inject on the line of the vein towards the heart
    • Use a shallow angle
    • Inject slowly
    • Apply pressure to site

    Do not share equipment or inject alone
  14. Steps of the cycle of change
    • Pre-contemplation
    • Contemplation
    • Determination to stop
    • Action
    • Maintenance
    • Relapse
  15. Symptoms of opioid withdrawal
    • Short term:
    • Flu like - sweating, chills, piloerection
    • Muscle twitching
    • Diarrhoea
    • Agitation
    • Insomnia

    • Long term:
    • Anorexia
    • Insomnia
    • Lethargy
    • Craving
  16. Stages of drug addiction treatment
    Stage I: Maintenance - replace drug with legal alternative on Rx

    Stage II: Withdrawal - aim to become drug free
Card Set
Social Pharmacy
Pharmacy social pharmacy module