Addiction Flashcards
desire to continue/repeat using the drug
psychological dependence
need to increase amount of drug taken to produce desired effect, experience withdrawal upon cessation
physical dependence
intense craving for drug, use interferes with normal role obligations, can’t quit, becoming socially isolated from non-substance users, tolerance develops, withdrawal upon cessation
substance addiction
direct effect on the CNS, disruption in physical and psychological functioning, judgement is disturbed and social/occupational functioning is impaired
substance intoxication
development of substance specific symptoms, disruption in physical and psychological functioning, disturbances in thinking, feeling, and behavior
substance withdrawal
biological (genetic/biochemical), psychological (developmental influences - punitive superego/oral fixations), personality (low self-esteem, frequent depression, passivity, inability to relax, inability to communicate effectively, sociocultural (social learning, conditioning, cultural/ethnic influences)
Factors effecting Substance Use & Addiction
Patterns of Alcohol Use
Phase 1: prealcoholic phase - use of alcohol to relieve stress of everyday life
Phase 2: early alcoholic phase - begins with blackouts; alcohol is required by the person
Phase 3: crucial phase - person lost control; physiological dependence is evident
Phase 4: chronic phase - emotional and physical disintegration; person intoxicated more than sober
Occurs at BAL of 100-200mg/dL
Alcohol intoxication
Occurs within 4 - 12 hours of cessation or reduction of heavy and prolonged use of alcohol
Alcohol withdrawal
Barbiturates, non-barbiturate hypnotics , antianxiety agents, club drugs
Sedative/Hypnotic drugs
Effects sleep and dreaming, respiratory depression, CV effects, renal function, hepatic effects, body temp, sexual functioning
Patterns of Sedative/Hypnotic Use
Sedative/Hypnotic intoxication
Ranges from disinhibition and aggressiveness to coma and death (increasing dosages)
Onset depends on 1/2 life of drug, severe withdrawal from these can be life threatening
Sedative/Hypnotic Use withdrawal
Amphetamines, synthetic stimulants, non-amphetamines, cocaine, caffeine, nicotine
Stimulant drugs
Amphetamine and cocaine - euphoria, impaired judgement, confusion, changes in VS
Caffeine - restlessness and insomnia (following consumption in excess of 250mg)
Stimulant intoxication
Amphetamine and cocaine - dysphoria, fatigue, sleep disturbances, increased appetite
Caffeine - headache, fatigue, drowsiness, irritability, muscle pain and stiffness, N/V
Nicotine - dysphoria, anxiety, difficultly concentrating, irritability, restlessness, increased appetite
Stimulant withdrawal
Aliphatic and aromatic hydrocarbons (fuel, solvents, adhesives, paint thinners)
Inhalant drugs
CNS effects, respiratory effects, GI effects, renal system effects
Patterns of Inhalant use
Symptoms occur during or shortly after use: dizziness, ataxia, muscle weakness, euphoria, disinhibition, slurred speech, blurred/double vision, psychomotor retardation, hypoactive reflexes, stupor
Intoxication of stimulants
Opioids of natural origin, opioid derivatives, synthetic opiate-like drugs
Opioid drugs
CNS effects, GI effects, CV effects, sexual functioning
Patterns of use
Symptoms consistent with 1/2 life and usually last for several hours: initial euphoria, then apathy, dysphoria, psychomotor agitation or retardation, impaired judgement
*if severe, can lead to respiratory depression, coma or death
Opioid intoxication
Dysphoria. Muscle aches, N/V, pupillary dilation, piloerection, sweating, abd cramping, diarrhea, yawning, fever, insomnia
Symptoms of Opioid withdrawal
Naturally occurring hallucinogens, synthetic compounds
Hallucinogen drugs
Occurs during or shortly after use
Symptoms: perceptual alteration, depersonalization, derealization, tachycardia, palpitations
PCP: belligerence, assaultiveness (may lead to seizure or coma)
Hallucinogen intoxication
Physiological: N/V, chills, pupil dilation, increase BP and pulse, loss of appetite, insomnia, high blood glucose, decrease resps
Psychological: heightened response to color/sounds, distorted vision, sense of slowed time, magnified feelings, paranoia/panic, euphoria/peace, depersonalization, derealization, increased libido
Effects on the body from hallucinogen drugs
Marijuana/hashish
Cannabis
CV, Resp, Repro, CNS, sexual functioning
Effects on the body from cannabis
Impaired motor coordination, euphoria, anxiety, sensation of slowed time, impaired judgement
Cannabis intoxication
Irritability, anger, aggression, anxiety, sleep disturbances, decreased appetite, depressed mood, stomach pain, tremors, sweating, fever, chills, headache
Cannabis withdrawal
What is the CAGE questionnaire?
Cut down: Have you ever felt you should cut down on your drinking?
Annoyed: Have people annoyed you by criticizing your drinking?
Guilty: Have you ever felt bad or guilty about your drinking?
Eye-opener: Have you ever had a drink first thing in the morning to steady your nerves?
Clients with a coexisting substance disorder and mental disorder
Dual diagnosis
Ineffective denial Ineffective coping Imbalanced nutrition Risk of infection (no AEB) Chronic low self-esteem Deficient knowledge
NANDA diagnoses for addiction
Risk for injury r/t CNS agitation
Withdrawing from CNS depressants
Risk for suicide r/t intense feelings of depression, “crashing” suicidal ideation
Withdrawing from CNS stimulants
Planning for addiction clients
Rehab/detox
Treatment
AA/NA
Treatment for alcohol abuse
Disulfiram (Antabuse) naltrexone (ReVia) Nalmefene (Revex) SSRIs Acamprosate (Campral)
Alcohol intoxication/withdrawal drugs
Benzodiazepines
Anticonvulsant
Multivitamin therapy
Thiamine
Opioid intoxication/withdrawal drugs
Narcotic antagonists: Naloxone (Narcan) Naltrexone (ReVia) Nalmefene (Revex) Methadone Buprenorphine Clonidine
Depressants intoxication/withdrawal drugs
Phenobarbital (Luminal)
Long acting benzodiazepines
Stimulant intoxication/withdrawal drugs
Minor tranquilizers
Major tranquilizers
Anticonvulsants
Antidepressants
Hallucinogens and cannabis intoxication/withdrawal drugs
Benzodiazepines
Antipsychotics
predisposing factors
genetics/biochemical
psychological: developmental influences
sociocultural: social leanring, conditioning, culture and ethnic influence
NANDA for substance use disorder
ineffective denial
ineffective coping
imbalanced nutrition: < body requirements
risk for infection
chronic low self-esteem
deficient knowledge
withdrawal from depressants: risk for injury
withdrawal from stimulants: risk for suicide
family/pt education
nature of illness: effects on body, ways it affects life
management of illness: activities to substitute use in stressful times, relaxation techniques, problem solving skills, good nutrition
support services: financial assistance, legal assistance, AA, 1-to-1 support
