Broadway doesn't go for BOOze and DOPE! Flashcards
Substance Abuse – or chemical dependency
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use of a substance(s) in an
UC-PHM
use of a substance(s) in an uncontrolled, compulsive, and potentially harmful manner
Criteria for diagnosis of substance abuse includes a
maladaptive pattern of substance use during a 12 month period that results in impairment of at least one of the following:
LOLR
- Lack of fulfillment of role obligations
- Ongoing interpersonal problems as a result of or exacerbated by use
- Legal problems
- Risk of physical danger because of use
Physical dependency
refers to?
is accompanied by?
Refers to development of a withdrawal syndrome
following abrupt cessation
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Accompanied by tolerance to a substance – increasing dosage is req to sustain same effects
Addiction is characterized by (3)
psychological dependence and preoccupation
with obtaining or using a substance
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loss of control over the use of a substance
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continued use despite adverse consequences.
How people with substance abuse problems have
other mental health problems.
6 out of 10
Patients with mood disorders and anxiety disorders
are how much more likely to have substance abuse problems and vise versa.
Twice as likely
Screening Tools for Identification of
Substance Abuse in the Older Adult
REMEMBER!!!
– A complete comprehensive assessment is important.
Patient history and medical record contribute to the picture – often overlooked….
Screening Tools for Identification of
Substance Abuse in the Older Adult
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CAGE Questionnaire
- 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 an Eye opener (drink) first thing in the morning to steady your nerves?
Screening Tools for Identification of
Substance Abuse in the Older Adult
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Second test mentioned + how does it work?
Michigan Alcoholism Screening Test – Geriatric – 24 questions - 5 or more yes answers are positive –
Shortened MAST protocol?
Shortened MAST – 10 questions – 2 or more yes answers are positive, focus is alcohol,
not drug abuses.
When should screening be considered?
If the older adult is going through life transitions, such as retirement, taking on caregiver role, or death of a spouse.
What should prompt screening?
Physical signs should prompt screening –
Examples of physical signs that should prompt screening.
SAD BUG FIN
Look for how many of these cues?
Sleep complaints
Anxiety
Depression
Bruising
Unexplained physical complaints
Gait disturbance
Frequent falls
Irritability persistent
Neglect of hygiene
All have been identified as clues to substance abuse. Look for several, not just one….
Just a bunch of Frannyisms Be... Engage from... Seek... Do...
Be respectful and non-judgmental
Engage from concern
Seek to understand the individual.
As often as we miss the cues, we…
hypothesize incorrectly!
When does late onset alcohol abuse occur?
After 60
Late Onset Alcohol Abuse occurs as a result of
the stress of aging and related situations
Late Onset Alcohol Abuse occurs as a result of the stress of aging and related situations, such as?
L L–3 RR
Loneliness and isolation Loss – social/emotional support – sensory capabilities – full mobility Reactive depression Reduced ability of aging body to handle alcohol
Elderly recovery rate from alcohol abuse
75%
System changes (aging plus alcohol): (5) NG RIM
Neurological – memory loss GI – gastritis, cirrhosis Renal and pharmacokinetics Immune – increased infx Musculoskeletal – muscle atrophy
Pharmacological agents used in conjunction with an
overall program of couselling support, self-help groups, and medical monitoring.
Benzodiazepines – shorter acting used for alcohol
withdrawal (lorazipam, oxazipam) 1/2 to 1/3 dosage
Antismoking Medications
Antibuse
Alcohol detoxification and older adults?
riskier
Alcohol detoxification minor withdrawal?
6-12 hours
Alcohol detoxification major withdrawal?
10-72 hours
