Addictions/Substance Use Disorders Flashcards
What is ‘addiction’
a condition where a person becomes dependent on a substance (like drugs or alcohol) or a behavior (like gambling) and feels a strong urge to use it or do it, even when it causes harm to themselves or others.
Repeated use of these substances or frequent substance intoxication can develop into a long-term problem known as
substance abuse
Abuse typically occurs when an individual consumes the substance for an extended period and develops a__ to the ingested substance
tolerance
A substance use disorder (SUD) occurs when
an individual continues using substances despite cognitive, behavioral, and physiologic symptoms
Define:
Abuse of more than one substance
Polysubstance abuse
4 major groups where symptoms of Substance Use Disorder (SUD) fall into:
- Impaired control: Struggling to limit how much or how often you use a substance
- Social impairment: Neglecting responsibilities at work, school, or home due to substance use.
- Risky use: Continuing substance use in dangerous situations (e.g., driving)
- Physical effects: intoxication, tolerance, and withdrawal
What is the purpose of the DSM-5 in relation to Substance Use Disorders?
Outlines specific criteria for diagnosing Substance Use Disorders (SUDs).
A nurse is reviewing the DSM-5 criteria for diagnosing substance use disorders. How many criteria must an individual meet within a 12-month period to be diagnosed with a substance use disorder?
A) One
B) Two
C) Three
D) Four
B) Two
2 or more from the DSM-5 List
(if meet 2-3 criteria = mild)
DSM-5 Criteria:
Moderate diagnoses is considered
if meet 4-5 criteria
DSM-5 Criteria:
SEVERE diagnoses is considered
if meet 6 or more criteria
Substance withdrawal symptoms are specific to
the substance used
Biological factors:
What role does genetics play in substance use disorders?
Some people have a genetic tendency to become addicted to alcohol.
( certain individuals may inherit genes from their parents that make them more vulnerable to addiction)
Withdrawal symptoms develop upon __
ABRUPT reduction or discontinue of substance that has been used.
One of the leading causes of irreversible mental retardation
Fetal Alcohol Syndrome (FAS)
What impact do parents who model substance use have on their children?
children (adolescents) are more likely to use substances if they have parents who provide a model for substance use.
What is the primary goal for individuals who have experienced substance abuse?
Recover from the abuse
Treatment and Recovery of Substanace Use:
Recovery involves a partnership between
List 3 individuals
- health care provider
- the individual and
- family
A nurse is educating a group of nursing students about the withdrawal process from substance use. Which statement accurately describes the process?
A) Withdrawal symptoms are always life-threatening and require immediate intervention.
B) Detoxification is the first step, followed by the beginning of the recovery process.
C) Recovery can begin without detoxification if the individual is motivated.
D) The withdrawal process does not require medical supervision in all cases.
B) Detoxification is the first step, followed by the beginning of the recovery process.
A nurse is providing education to a patient in recovery from substance use disorder. Which of the following statements regarding relapse should the nurse emphasize?
A) Relapse is uncommon and indicates that treatment has failed.
B) Relapse is an expected part of the chronic disease of addiction and may occur multiple times throughout recovery.
C) Once a patient achieves sobriety, they will not experience cravings or relapse.
D) Relapse only happens if the individual does not follow the treatment plan strictly.
B) Relapse is an expected part of the chronic disease of addiction and may occur multiple times throughout recovery.
(relapse is the PRIMARY concern)
A nurse is admitting a patient with a history of alcohol use disorder to the hospital. What is the nurse’s first priority during the initial assessment?
A) Assess the patient’s vital signs and mental status.
B) Determine whether the patient will be withdrawing.
C) Evaluate the patient’s nutritional status and hydration levels.
D) Initiate a referral to a substance use counselor for treatment options.
B) Determine whether the pt will be withdrawing
- after pt is NO LONGER in danger of withdrawal symptoms, then the nurse can discuss the use of substance and encourage individual to seek help for the addiction.
What is the nurse’s next step after a patient is no longer in danger of withdrawal symptoms?
The nurse can discuss the use of substance and encourage the individual to seek help for the addiction
- After ensuring the patient is stable, nurses play a crucial role in facilitating discussions about substance use, helping the individual understand their situation, and encouraging them to seek help. This holistic approach is essential for effective recovery and long-term well-being.
Substance Use:
Can a patient be in denial?
Yes. It is common and often a priority
The 7 categories of addicting Drugs
- alcohol
- sedatives/hypnotics
- stimulants
- opioids
- hallucinogens
- inhalants
- cannabis
Alcohol contributes to what 3 chronic diseases?
- Heart disease
- cancer
- Cerebralvascular Accident (CVA): brain attack
What is the nutritional impact of ethanol (ETOH) in food
ETOH contains calories but has no nutritional value.
At what blood alcohol level are individuals considered legally intoxicated in most states?
0.08 - 0.10
What type of effect does alcohol exert on the central nervous system (CNS)?
depressant effect on the CNS
Which 2 tools are commonly used to screen for: alcohol use disorders, drinking patterns & behaviors
- CAGE Questionnaire
- Alcohol Use Disorders Identification Test (AUDIT)
What is the INITIAL effect of ethanol (ETOH), and how does it act on the body?
ETOH is a sedative but initially creates a feeling of euphoria.
Is alcohol digested?
No.
Where does alcohol enter FIRST?
BLOODSTREAM, then travels to every part of the body.
What organ does alcohol affect FIRST?
BRAIN
(then kidneys, lungs, and liver)
What are some physical and mental health risks for older adults who drink excessive amounts of alcohol?
- Stroke
- Heart disease
- Cancer
- Depression
- Confusion
- Dementia
What does alcohol do to your blood vessels?
Widens (vasodilates)-
* causing blushing, heat loss, decrease in body temp and drop in BP
What does receiving 2 “yes” responses on the CAGE screening indicate?
the possibility of alcoholism should be investigated further.
What are the potential consequences of alcohol overdose?
Can cause permanent brain damage or death.
What cardiovascular effects can ACUTE alcohol intoxication cause?
- Hypotension
- tachycardia
(due to peripheral vasodilation or fluid loss)
What S/S are commonly associated with a blood alcohol level of 0.08 - 0.1?
- Impaired driving
- Slurred speech
- Ataxia: lack of muscle coordination
- Reduced sensory function
S/S of alcohol blood level of 0.2-0.3
All sensory motor function impaired
S/S of alcohol blood level of 0.3 and up
- Increase potential cardiovascular and respiratory COLLAPSE
- coma
- death
Q: When do symptoms of alcohol withdrawal usually begin?
A: Symptoms usually start 4-12 hours AFTER stopping or cutting back on drinking.
S/S of alcohol withdrawal
- tremors
- sweating
- anxiety
- hyper alertness
- elevated pulse and B/P
- insomnia
- anxiety
- restlessness
- N/V
Q: What is required for safe alcohol withdrawal?
A: Alcohol withdrawal needs to be accomplished under medical supervision.
During alcohol withdrawal, VS should be monitored every
Q 4 hrs.
Medications to suppress withdrawal symptoms include:
benzodiazepines: Valium, Ativan, Librium
- REMEMBER: Benzo and VAL
What assessment tool is used to assess & manage alcohol WITHDRAWAL symptoms. Used in hospitals to evaluate severity of withdrawal & guide treatment decisions.
Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar).
What can complicated alcohol withdrawal syndrome PROGRESS to?
May progress to alcohol withdrawal delirium.
- Usually happens 48 to 72 hours after the last drink and can cause confusion, hallucinations, severe agitation, tremors, and changes in heart rate and blood pressure. This condition requires immediate medical attention
What is CIWA?
Clinical Institute Withdrawal Assessment for Alcohol
* It is a tool used to assess the severity of alcohol withdrawal symptoms in patients.
* It evaluates symptoms such as nausea, tremors, sweating, anxiety, agitation, hallucinations, and orientation.
* Each symptom is rated, and the total score helps guide treatment decisions.
* A higher score indicates more severe withdrawal symptoms.
CIWA:
Mild withdrawal symptoms can be treated with
(score of 7 or below)
Supportive care such as: IV fluids and close monitoring
CIWA:
Moderate withdrawal symptoms can be treated with
(score of 8-15)
more intensive interventions such as: IV meds or sedation
CIWA:
SEVERE withdrawal symptoms may require
(score of 16 or more)
intensive tx such as an ICU care
What nutritional deficiencies can occur with alcohol abuse?
List 3
- Vit. B12
- folic acid
- Thiamine (Vit. B1)
What is the purpose of administering a “banana bag” to a patient during alcohol withdrawal?
- To treat electrolyte imbalances and nutritional deficiencies in alcohol withdrawal.
- It typically contains thiamine (B1), folic acid, magnesium, and a multivitamin
Which medications are commonly prescribed to suppress ALCOHOL withdrawal symptoms?
Benzodiazepines:
* Diazepam (Valium)
* Chlordiazepoxide (Librium)
* Lorazepam (Ativan)