Ch. 16, 20 & 22 Flashcards
Which substance abuse is most common?
Alcohol. More common in men
What’s the difference between abuse, dependence, and addiction?
Abuse is using when not medically needed or socially acceptable, and it has adverse effects on the user. Dependence is when the need to use increases and addiction occurs when there is tolerance, so more and more is needed to prevent withdrawal.
What is a psychological reason for addiction?
Stress
Dependence is _____ or _____, while addiction is just _____.
Physiological or psychological. Physiological.
What are the 3 C’s of addiction?
Compulsion/Craving, continues use, control loss
What is a good prevention strategy for teens and young adults?
Anticipate pressures.
Can genetics cause alcoholism?
Yes. They have identified 1 gene that makes alcohol effects more pleasurable.
Besides biologic and psychologic, what other theories are there regarding substance abuse?
Familial and learned. Learned is based on reinforcement. College campus.
What part of the body is affected the most by alcohol? Why?
Brain. Alcohol is water soluble. Women more affected.
What recreational drugs act as depressants?
Benzo’s, alcohol, cannabis, opiates
What recreational drugs act stimulants?
Meth, coke
What recreational drugs act hallucinogens?
LSD, peyote, mushrooms, ecstacy
What are some prevention strategies for substance abuse?
Positive role models/behaviors, reinforce dangers, establish limits and structure (especially for kids), anticipate pressures (especially teens and young adults), reinforce positive coping, provide life skills training, monitor media use.
What are some common comorbidities to substance abuse?
A. B. S. Antisocial, Bipolar, Schizophrenia
Why do anabolic steroids work?
Work out longer because of reduced inflammation
Where is alcohol mostly absorbed?
Absorbed in GI, not digested. 20% in stomach
How is alcohol affected by carbonation?
Absorbs faster.
Where does the high of alcoholism come from if it is a depressant?
You push past sleepiness to reach a high, unless you are me, and then you give in and go to sleep.
What is a common problem for diabetics who have an occasional drink or two?
Hypoglycemia
What eventually happens with overuse of opiates? Remedy?
Forget to breathe. Narcan.
What do you have to be careful about when giving narcan?
Can cause withdrawal symptoms in addict
Does narcan have a long or short half life?
Short
What are cocaine’s s/s?
Increases HR, BP, vasoconstriction. Rips placenta away if pregnant. Causes heart attack/stroke. Holes in nasal membranes, sleeplessness.
What can happen with ecstacy use?
Lack of temperature regulation. Hyperthermia.
What can happen with anabolic steroids?
Increases aggression, lowers testosterone, cancer later in life by reducing immune response, rapid muscle and bone loss when stopped.
What are some s/s of alcohol withdrawal?
Autonomic system hyperactivity-increased HR, tremors, seizures, visual/tactile disturbances (pink elephants)
When does alcohol withdrawal start? Opiates?
6-12 hrs after quitting. Lasts up to 72 hrs. About 4-12 hrs. Lasts 3-4 days.
What are the s/s of opiate withdrawal?
Flu-like symptoms, depression, exhaustion, twitching, tremors.
What are the s/s of cocaine withdrawal?
Severe depression/suicidal, dehydration, more from exhaustion.
What are the important expected outcomes?
ABC’s (airway, breathing, cardio) safety
What are the most important expected outcomes for substance abuse?
Maintain biologic function, reduce hallucinations, maintain nutrition/hydration.
What are some psychotherapy treatments for substance abuse?
Group, family, and behavioral therapy.
What drug is used for alcohol addiction: Opioids?
Antabuse. Makes you sick if you drink it. Narcan (naltrexone), and methadone (eases withdrawal)
What are the 5 levels of suicidal behavior?
Think, threaten, gestures, attempts, completed suicide
What etiologic factors relate to suicide?
Biologic (neurotransmitters/genetics/altered brain), psychologic (self-directed, personal conflict, negative thinking, negative reinforcement), sociologic (isolation-adolescents). Usually combination of these.
What are some age related risk factors for suicide? Sex related?
15-24 and over 65. Men succeed more, women attempt more
What are some race/ethnicity risk factors for suicide?
Caucasian, young African Americans and Native Americans
What are some s/s of an impending suicide?
Depression, weight changes, disturbed sleep, fatigue, self-depreciation, anger, hopelessness, preoccupation with death/dying
What can increase the risk for suicide?
History of previous attempts, real or perceived lack of social support, recent losses, psycho disorders, medical problems, drugs (increase impulsivity/depression, decreased cognition/problem solving
A fleeting idea of suicide is considered a minimal risk for suicide. How would you describe someone who is a very low risk?
Mild thoughts of suicide, states he will not make an attempt, uses support, identifies reason for living.
How would you describe someone who is at low risk for suicide?
Thinks of suicide, wants to sleep and never awaken, wants to escape, doesn’t use support, no pain, deterred by religious beliefs
How would you describe someone who is a moderate to high risk for suicide?
Makes gestures, has intrusive thoughts of suicide, tells others, gives belongings away, puts legal affairs in order, does not use support, rationalizes religious beliefs
How would you describe someone who is a high risk for suicide?
Wants to die, sees no other solution, specific plans, increased energy and mood, questions God, highly intrusive thoughts of suicide. Needs hospitalization.
Do people who talk about suicide do it?
Yes
Do people that are going to commit suicide give clues?
Mostly yes
Does improved mood mean the crisis is over when dealing with the suicidal?
No
Do children commit suicide?
Yes, but it is rare.
Do most communicate thought about suicide?
Yes
Do most of them have a diagnosis of depression?
No
What do you say to someone considering suicide?
You are not alone.
What are some other interventions for suicide?
Safe haven, crisis is temporary, help is available
What are the top 3 outcomes for suicide?
Remain safe, verbalize absence of suicidal thoughts, verbalize desire to live and reasons why
What are the first 3 interventions for suicide?
Accounting of environmental objects, awareness of whereabouts, 1 on 1
What are some “helps for helpers” for suicide?
Group discussions, rotation of staff, leave “it” at work, support groups, we can’t save everybody (focus of control)
What are the number 1 and 2 causes of grief?
Loss of loved one, loss of self-esteem/self-worth
What are some physical manifestations of loss?
Weakness, anorexia, choking, SOB, tightness in chest, GI, sleep, increased vulnerability
What are some cognitive manifestations of loss?
Preoccupation with deceased, difficulty concentrating, longing, hallucinations (of deceased)
What are some behavioral manifestations of loss?
Disruptions in conduct (can’t do ADLs, disorganization, rumination), isolation, lack of meaning.
What are some affective manifestations of loss?
Sadness, guilt, loneliness, anger
Can you name Kubler-Ross’s stages of grief?
Shock, denial, anger, bargaining, depression, testing, acceptance
Are the stages of grief always in the same order?
No
How long does it take to work through grief?
At least 1 year
What are the 6 tasks of grief?
Telling story, expressing emotions, reviewing relationship, exploring possibilities, understanding, being understood
What are the complicating factors of grief?
Pain of great intensity (avoiding/not expressing/fear of loss of control), cultural values
What are some examples of end of life care for Latinos?
Respect, family, body cleansing
What is chronic sorrow?
Type of sorrow associated with long term diagnosis like schizo or chronic disease
What is dysfunctional grief?
Traumatic (rape/murder), absent (stoic, minimal expression, buried deep), conflicted (I was divorcing my wife and she dies), chronic (Cambodian, native americans)
What is the most important outcome criteria for grief?
Safety! Watch for depression/suicide. Watch for our safety if in the anger stage of grief.
