Addictions Flashcards
Booze, liquor, drinks, cocktails, juice, beer, wine, sauce
Symptoms of intoxication;
Aggressiveness, euphoria, impaired judgement, emotional instability, slurred speech, depression
Symptoms of Overdose:
nausea, vomiting, shallow respirations, cold clammy skin, coma or death
Symptoms of Withdrawal:
tremors, vomiting, anxiety, headache, seizures, tachycardia, high blood pressure.
Alcohol
Marijuana, Pot, grass, MJ, gaunja, Hashish
Symptoms of intoxication:
Relaxation, talkativeness, lowered inhibitions, euphoria, mood swings,
Symptoms of Overdose;
Fatigue, paranoia, delusions/hallucinations, poss. psychosis
Symptoms of Withdrawal;
restlessness, irritability, insomnia, loss of appetite, depression, tremors, headache
Cannabis
Acid, LSD, PCP, Special K, Ecstasy, X
Symptoms of Intoxication;
visual hallucinations, disorientation, confusion, paranoid delusions, anxiety
Symptoms of Overdose;
agitation, extreme hyperactivity, violence, hallucinations, psychosis, death, panic attacks
Symptoms of Withdrawal;
Psychological withdrawal, anxiety, cravings, fatigue, flashbacks
Hallucinogens
Paint thinners, fuels/gas, varnish remover, rubber cement, “huffing”
Symptoms of Intoxication;
Belligerence, blurred vision, dizziness, slurred speech, stupor/coma, euphoria
Symptoms of Overdose;
ataxia, ototoxicity, encephalopathy, Parkinsonism, damage to PNS and brain
Symptoms of Withdrawal;
Mild, not significant
Inhalants
heroin, morphine, codeine, dilaudid, Demerol, Opium
Symptoms of Intoxication;
Euphoria, lethargy, drowsiness, lack of motivation, constricted pupils
Symptoms of Overdose;
Shallow breathing, slowed pulse, clammy skin, pulmonary edema, respiratory arrest, coma, death
Symptoms of Withdrawal;
Craving drugs, nausea/vomiting, muscle aches, lacrimation/rhinorrhea, pupillary dilation, insomnia
Opioids
Barbiturates; phenobarbital, Ambien/Lunesta
Xanax, Date Rape drug, roofies,
Symptoms of Intoxication;
disinhibition of sexual or aggressive impulses, impaired judgement, slurred speech, unsteady gait, confusion
Symptoms of Overdose;
effects on organs, coma/death, CNS depression
Symptoms of Withdrawal;
nausea/vomiting, malaise, weakness, tachycardia, orthostatic hypotension, seizures, delirium
Sedatives/Hypnotics/Anxiolytics
Java, coffee, mud, cancer sticks, cigarettes, coke, blow, cocaine, baking soda
Symptoms of Intoxication;
Euphoria, hyperactivity, restlessness, impaired judgement, nervousness
symptoms of overdose;
convulsions/death
Symptoms of Withdrawal;
headache, depression, anxiety, social withdrawal
Stimulants (include caffeine & tabacco)
physical and psychological dependence
substance use disorder
need for increasing amounts to produce the desired effects
Syndrome of withdrawal upon cessation.
physical dependence
Overwhelming desire to repeat the use of a particular drug to produce pleasure or avoid discomfort
Psychological dependence
Use of the substance interferes with ability to fulfill role obligations
Attempts to cut down or control use fail
Intense craving for the substance
Extensive amount of time spent trying to procure the substance or recover from its use
Use of the substance causes the person difficulty with interpersonal relationships or to become socially isolated
Engages in hazardous activities when impaired by the substance.
Tolerance develops and the amount required to achieve the desired effect increases.
Substance specific symptoms occur upon discontinuation of use
Substance Addiction
Development of a reversible syndrome of symptoms following excessive use of a substance.
Direct effect on the CNS.
Disruption in physical and psychological functioning.
Judgement is disturbed and social and occupational functioning is impaired
Substance Intoxication
Development of symptoms that occurs upon abrupt reduction or discontinuation of a substance that has been used regularly over a prolonged period of time.
Symptoms are specific to the substance that has been used.
Disruption is physical and psychological functioning, with disturbances in thinking, feeling, and behavior.
Substance Withdrawal
Alcohol, Caffeine Cannabis Hallucinogens Inhalants Opioids Sedatives/hypnotics Stimulants Tobacco
Classes of Psychoactive Substances
Genetics; apparent hereditary factor, particularly with alcoholism.
Biochemical; alcohol may produce morphine-like substances in the brain that are responsible for alcohol addiction
Predisposing Factors
Developmental influences
Punitive superego
Fixation in the oral stage of psychosexual development
Psychological factors
certain personality traits are thought to increase a tendency toward addictive behavior
Low self-esteem
Frequent depression
Passivity
Inability to relax or defer gratification
Inability to communicate effectively
Personality factors
Social learning; children and adolescents more likely to use substance with parents who provide model for sub. use
Use of substances may also be promoted within peer group
Conditioning: pleasurable effects from substance use act as a positive reinforcement for continued use of substance
Cultural and ethnic influences: some cultures are more prone to substance abuse than others
Sociocultural factors
Prealcoholic phase: characterized by use of alcohol to relieve everyday stress and tensions of life.
Alcohol Use Disorder Phase I
Early alcoholic phase: beings with blackouts-brief periods of amnesia that occur during or immediately following a period of drinking; alcohol is now required by the person.
Alcohol Use Disorder Phase II
The crucial phase: person has lost control; physiological dependence is clearly evident.
Alcohol Use Disorder Phase III
The chronic phase: characterized by emotional and physical disintegration. The person is usually intoxicated more often than sober.
Alcohol Use Disorder Phase IV
occurs at blood alcohol levels between 100 and 200 mg/dL
Alcohol Intoxication
occurs within 4 to 12 hours of cessation of or reduction in heavy and prolonged alcohol use
Alcohol Withdrawal
A profile of the substance Barbiturates Non-barbiturate hypnotics Anti-anxiety agents Club agents
Sedative/Hypnotic Use Disorder
Effects on sleep and dreaming Respiratory depression Cardiovascular effects Renal function Hepatic effects Body temp Sexual functioning
Sedative/hypnotic effects on the body
Pattern of use
With these CNS deppressants, effects can range from disinhibition and aggressiveness to coma and death (with increasing dosages of the drug).
Intoxication; from sedatives/hypnotics
Onset of symptoms depends on the half-life of the drug from which the person is withdrawing.
Severe withdrawal from CNS depressants can be life threatening.
Withdrawal from a sedative/hypnotic
Amphetamines Synthetic stimulants Non-amphetamine stimulants Cocaine Caffeine Nicotine
A profile of the substance
Stimulants
CNS effects Cardiovascular effects Pulmonary effects Gastrointestinal and renal effects Sexual functioning
Stimulants effect on the body
Amphetamine and cocaine intoxication produce euphoria, impaired judgement, confusion, changes in vital signs (even coma or death, depending on amount consumed).
Caffeine intoxication usually occurs following consumption in excess of 250 mg. Restlessness and insomnia are the most common symptoms
Intoxication of Stimulants
Amphetamine and cocaine withdrawal may result in dysphoria, fatigue, sleep disturbances, and increased appetite.
Withdrawal from caffeine may include headache, fatigue, drowsiness, irritability, muscle pain, and stiffness, and nausea and vomiting.
Withdrawal from nicotine may include dysphoria, anxiety, difficulty concentrating, irritability, restlessness, and increased appetite.
Withdrawal from Stimulants
Aliphatic and aromatic hydrocarbons found in substances such as fuel, solvents, adhesives, aerosol propellants, and paint thinners
Inhalant Profile
CNS effects
Respiratory effects
Gastrointestinal effects
Renal system effects
Inhalant patterns of use/abuse
Develops during or shortly after use of or exposure to volatile inhalants
Dizziness, ataxia, muscle weakness,
euphoria, excitation, disinhibition, slurred speech
nystagmus, blurred or double vision
psychomotor retardation, hypoactive reflexes
stupor or coma
Inhalant intoxication
Opioids of natural origin
Opioid derivatives
Synthetic opiate-like drugs
Profile of Opioids
CNS effects
Gastrointestinal effects
Cardiovascular effects
Sexual functioning
Opioid patterns of use/abuse
Symptoms are consistent with the half-life of most opioid drugs and ususally last for several hours.
Symptoms include initial euphoria followed by apathy, dysphoria, psychomotor agitation or retardation, and impaired judgement.
Severe opioid intoxication can lead to respiratory depression, coma, and death.
Intoxication of Opioids
From short-acting drugs (heroin)
Symptoms occur within 6 to 8 hours, peak within 1 to 3 days, and gradually subside in 5 to 10 days.
Withdrawal from Opioids
short acting
From long-acting drugs (methadone)
Symptoms occur within 1 to 3 days, peak between days 4 and 6, and subside in 14 to 21 days.
Withdrawal from opioids
long acting
From ultra-short-acting meperidine
Symptoms begin quickly, peak in 8 to 12 hours, and subside in 4 to 5 days
Withdrawal from opioids
ultra-short acting
Dysphoria, muscle aches, nausea/vomiting, lacrimation or rhinorrhea, pupillary dilation, piloerection, sweating, abdominal cramping, diarrhea, yawning, fever, and insomnia
Symptoms of opioid withdrawal
Naturally occuring hallucinogens
Synthetic compounds
Profile of Hallucinogens
Use is usually episodic
Hallucinogens pattern of use
Occurs during or shortly after using the drug
Symptoms include perceptual alteration, depersonalization, derealization, tachycardia, palpitations,
Symptoms of PCP intoxication include belligerence and assaultiveness and may proceed to seizures or coma
Intoxication of a hallucinogen
Nausea/vomiting Chills Pupil dilation increased BP; pulse loss of appetite insomnia elevated blood sugar decreased respirations
Physiological effects on the body from Hallucinogens
Heightened response to color, sounds distorted vision sense of slowed time magnified feelings paranoia, panic euphoria, peace depersonalization derealization increased libido
Psychological effects on the body from hallucinogens
Marijuana
Hashish
Profile of Cannabis
Cardiovascular Respiratory Reproductive Central nervous system sexual functioning
effects on the body from cannabis
symptoms include impaired motor coordination, euphoria,, anxiety, sensation of slowed time, impaired judgement,
Physical symptoms include conjunctival injection, increased appetite, dry mouth, and tachycardia
Impairment of motor skills lasts for 8 to 12 hours
Intoxication of Cannabis
Occurs upon cessation of cannabis use that has been heavy and prolonged
Symptoms occur within a week following cessation of use
Symptoms include irritability, anger, aggression, anxiety, sleep disturbances, decreased appetite, depressed mood, stomach pain, tremors, sweating, fever, chills, or headache
Withdrawal from Cannabis
Nurses must begin relationship development with a substance abuser by examining own attitudes and personal experiences with substances.
Application of the Nursing Process
Various assessment tools are available for determining the extent of the problem a client has with substances.
Drug Hx & Assessment
Cinical institute withdrawal assessment of alcohol scale
Michigan Alcoholism Screening Test (MAST)
CAGE Questionaire
Nursing Process: Assessment
Have you ever felt you should Cut down on your drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt bad or Guilty about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves (Eye-opener)
CAGE Questionaire
Clients with a coexisting substance disorder and mental disorder may be assigned to a special program that targets the dual diagnosis
Program combines special therapies that target both problems
Dual Diagnosis
Ineffective Denial related to weak, underdeveloped ego
Outcome: Client will demonstrate acceptance of responsibility for own behavior and acknowledge association between personal problems and use of substance(s).
Nursing Diagnosis
Ineffective Coping related to inadequate coping skills and weak ego
Outcome: Client will be able to demonstrate more adaptive coping mechanisms that can be used in stressful situations (instead of taking substances)
Nursing Diagnosis
Imbalanced Nutrition less than body requirements/Fluid volume deficit related to drinking or taking drugs instead of eating
Outcome: Client will be free from signs and symptoms of malnutrition/dehydration
Nursing Diagnosis
Risk for Infection related to malnutrition and altered immune condition
Outcome: Shows no sign or symptoms of infection
Nursing Diagnosis
Chronic Low Self-Esteem related to weak ego, lack of positive feedback
Outcomes: Exhibits evidence of increased self-worth by attempting new projects without fear of failure and by demonstrating less defensive behavior toward others
Nursing Diagnosis
Deficient Knowledge (effects of substance abuse on the body) related to denial of problems with substances evidenced by abuse of substances Outcomes: Verbalizes importance of abstaining from use to maintain optimal wellness.
Nursing Diagnosis
Disulfiram (Antabuse) other medications Naltrexone (ReVia) Nalmefene (Revex) SSRIs Acamprosate (Campral)
Pharmacotherapy for alcoholism
Benzodiazepines
Anticonvulsants
Multivitamin therapy
Thiamine
Psychopharmacology for substance intoxication and substance withdrawal from Alcohol
Narcotic antagonists Naloxone (Narcan) Naltrexone (ReVia) Nalmefene (Revex) Methadone Buprenorphine Clonidine
Psychopharmacology for substance intoxication and substance withdrawal from Opioids
Phenobarbital (Luminal)
Long-acting benzodiazepines
Psychopharmacology for substance intoxication and substance withdrawal from Depressants
Minor tranquilizers
Major tranquilizers
Anticonvulsants
Antidepressants
Psychopharmacology for substance intoxication and substance withdrawal from Stimulants
Benzodiazepines
Antipsychotics
Psychopharmacology for substance intoxication and substance withdrawal from Hallucinogens and cannabinols
a powerful desire for something
craving
to use wrongfully or in a harmful way. Improper treatment or conduct that may result in injury.
abuse
the state of relying on or being controlled by someone or something else.
Dependence
the ability or willingness to tolerate something in particular to the existence of opinions or behavior that one does not necessarily
Tolerance
the action of withdrawing something, removal, elimination
withdrawal
a physical and mental state of exhilaration and emotional frenzy or lethargy and stupor.
Intoxication
Blood alcohol levels, 0.02% relaxed, 0.04% relax cont. buzz develops, 0.06% cognitive judgement impaired, 0.08% legally intoxicated, nausea can appear/motor coordination impaired, 0.10% clear deterioration in cognition and motor judgement, 0.15%- .25% blackouts, .25%-.35% pass out/risk of death, .40%-.45% lethal dose
BAL (difference in levels)
questionaire Cut down on your drinking Annoyed @ people for criticizing Guilty about drinking Want to drink 1st thing in the morning. Eye opener
CAGE Questionaire
Clinical Opiate Withdrawal Scale
Flow sheet of measuring s/s over a period of time during buprenorphine induction.
Evaluates 11 common opiate withdrawal s/s
COWS
Clinical Institute Withdrawal Assessment of Alcohol Scale
10 item scale, used in assessment and management of withdraw of alcohol
CIWA
Michigan Alcoholism Screening Test
alcohol screening test identifying dependent drinkers 98% accuracy
MAST
The use of various medications to decrease the intensity of symptoms in an individual who is withdrawing from, or experiencing the effects of excessive use of, substances.
Substitution Therapy
A client has a dual diagnosis when it is determined that he or she has a co-existing substance disorder and mental illness. Treatment is designed to target both problems.
Dual Diagnosis
A physical and mental state of exhilaration and emotional frenzy and lethargy and stupor.
Intoxication
The physiological and mental readjustment that accompanies the discontinuation of an addictive substance.
Withdrawal
C2H5OH or ETOH
whiskey means “water of life”
around since 6400BC
alcohol
peripheral nerve damage;
pain, burning, tingling etc
Common in chronic alcoholics
Process reversible, if abstinence of alcohol and restoration of nutritional defeciences
Peripheral Neuropathy
acute or chronic pain/swelling, poss. blood in urine
Vit B deficiency
Abstinence from alcohol
Alcoholic Myopathy
Most serious form of thiamine deficiency
death can occur
Wernicke’s Encephalopathy
confusion, loss of memory and confabulation
Koraskoff’s Pychosis
effects of alcohol on the heart is an accumulation of lipids in the myocardial cells, resulting in an enlargement and a weaken condition.
Alcoholic Cardiomyopathy
inflammation and pain in the esophagus-toxic effects of alcohol on the esophageal mucousa
Esophgitis
effects of alcohol on the stomach include inflammation of the stomach include inflammation of the stomach lining.
-break down the stomach lining mucosal barrier-allowing acid to erode stomach wall.
Gastritis
acute or chronic 1 to 2 days after binge of excessive alcohol consumption.
Pancreatits
inflammation of the liver caused by long term heavy alcoholism use
Alcoholic Hepatits
"crocodile" 10x more potent 10x cheaper Russia now AZ extremely addictive; rots skin inside and out opiate like heroin
Desomorphine
methylenedioxpyrovalerone
bath salts; zombie drug
crystal meth and LSD
MDPV
reversal drug for opioids
Narcan
bupernorfen and nocloxin
28 days immediate through 3 weeks
blocks high withdrawing
antihypertensive for opioids withdrawal
Syboxin
