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mental health > class 10 (addictions) > Flashcards

class 10 (addictions) Flashcards

1
Q

stress and addicton

A

-stress is a leading risk factor & also a risk factor for reoccuring substance use

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2
Q

mental illness and addition

A

increases suicide risk

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3
Q

medical complications from addiction

A

increased risk of infection secondary to IV drug use, lifestyle (poor nutritition & high risk behaviours)

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4
Q

most common addictive substance

A

alcohol

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5
Q

DSM5 and substance use

A

recognizes SUD from 10 different classes of drugs: alcohol, caffeine, hallucinations, inhalants, opioids, sedatives/hypnotics/anxiolytics, stimulants, tobacco, other unknown sub
-increase in coke and meth
-ER visits double d/t prescription Rx

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6
Q

experimentation - holistic view of addiction

A

tries it once/for the first time

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7
Q

integral use - holistic view of addiction

A

wine at dinner every day

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8
Q

excessive use - holistic view of addiction

A

substance use affects family and friends

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9
Q

addiction - holistic view of addiction

A

physiological or psychological dependence
social, biological components

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10
Q

physiological dependence

A

CNS/PNS dependence
-need substance to function/avoid pain

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11
Q

psychological dependence

A

all the person thinks about
believes they cannot live without it

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12
Q

how does halflife affect withdrawl?

A

long halflife= less intense withdrawl
short halflife= intense withdrawl

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13
Q

what is concurrent disorder

A

coexisting dx to SUD

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14
Q

what is withdrawl

A

physiological/pyschological S&S after decrease in drug levels

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15
Q

what is tolerance

A

increasing need for drug to achieve affect d/t continued use

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16
Q

what is flashbacks

A

when someone reexperiences the effects of a drug days/months/years after use

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17
Q

what is synergistic effect

A

2+ drugs at the same time to prolong/intensify effect
-can be fatal

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18
Q

what is antagonistic effects

A

drugs taken will weaken/stop effect
i.e. opioids and naloxone

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19
Q

what is detoxification

A

using a process to safely & effectively to remove substance from their system (usually under HCP supervision)

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20
Q

what is relapse

A

returning back to drug use after a remission period

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21
Q

what is harm reduction

A

decreasing risk/harm to individuals using substances
i.e. clean needles, safe injections sites

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22
Q

how do you qualify for substance DEPENDENCE?

A

must have 3 or more of the following in a 12 month period:
-tolerance
-withdrawl
-taking more of the substance/over a longer period of time then intended
-persistence desire/unsuccessful efforts to cut down or control substance use
-spending a great deal of time in efforts to obtain,use,or recover from substance
-not managing to do what individual should at home, school, work
-deciding to use it again depsite knowing of/or experiencing problems associated with its use

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23
Q

how do you qualify for substance MISUSE?

A

1 or more of the following in a 12 month period:
-recurrent use results in failure to fulfill major role obligations
-recurrent use in hazardous situations
-recurrrent use legal problems i.e. DUIs
-recurrent use despite having persistence/recurrent social or interpersonal problems that arise as a result of the substance

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24
Q

how to opioids affect the body

A

CNS depression, decrease pain with a “high”
-decrease RR and cognitive function
-endocarditis, bowel infection, clogging of blood vessels in liver, lungs, brain

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25
Q

heroin, fentanyl, and carfentanyl in SUD

A

all opioids
heroin is processed from morphine
fentanyl is 3x potent than heroin
you can see, smell, or taste fentanyl (increased risk of OD)
carfentanyl is 100x potent than fentanyl (very easy to OD)

26
Q

what is the opioid crisis

A

increasing # of people experiencing OD/death d/t opioids
~12 deaths per day
er visits 2x due to it
increasing common in women
growing more common d/t drug contamination (fentanyl)

27
Q

canada’s focus for the opioid crisis

A

-emergency treatment fund
-opioid pubic awareness
-opioids data, surviellance, and research
-federal action on opioids
-Canada’s response to the opioid crisis
-supervised consumption sites
-canadian drugs and substances strategy
-substance use and addictions program
-the good samaritan drug overdose act

28
Q

Acid descripiton/onset - club drugs

A

“mellow yellow” white odourless bitter powder
psychological dependence->physiological is less of a concern
~60min to kick in, peak is 2-4h, lasts 10-12h
flashbacks can happen after 1 use and be lifelong

29
Q

what are the affects of acid - club drugs

A

depersonalization, distorted sensory perception
pseudohallucinations: visual (aware its a hallucination)
dilated pupils, sweating, heart palpitations, decreased coordination, increased RR, HR,Temp, anxiety, paranoia

30
Q

ecstasy description/onset - club drugs

A

“E, X, molly, love drug”
tablet, capsule
~30min to kick in lasts 3-4h

31
Q

what are the affects of ecstasy - club drugs

A

distorts time & perception
causes confusion & anxiety
risk for dehydration: increased HR, Temp=organ failure=death
insomnia, acute renal failure, hepatotoxicity, psychosis, panic attacks, depression, rhabdomyolysis(w/ ongoing use)

32
Q

Rohypnol - club drugs

A

“roofie, date rape drug”
amnesia
anxiolytic
severe insomnia

33
Q

ketamine - club drugs

A

“k”
can be problematic
dissociative->”k-hole”
lasts ~24h

34
Q

methamphetamine - CNS stimulants

A

“crystal, ice, speed, meth”
acts like adrenaline
causes euphoria, aggression, anxiety, depression after
suicidal ideation
brain damage

35
Q

Cocaine - CNS stimulants

A

“blow, snow, coke”
very addictive and hard to quit
vasoconstriction->MI
dilated pupils, excessive muscle movement

36
Q

s&s of cocaine withdrawl

A

lethargic, N&V, depression, paranoia, anxiety, inc appetite, heart failure, MI, respiratory failure

37
Q

alcohol use in canada

A

most common
overconsumption: health & social consequence
-follow canada’s guide on alcohol & health
-20% canadians consume above rec guidelines
-prevelent in ages 18-24
long term memory issues, mental health issues, cancer, cirrhosis

38
Q

clinical opioid withdrawl scale (COWS)
clinical institue withdrawl assessment for alcohol (CIWA-Ar)

A

-used to assess for SUD/withdrawls
also must obtain FHx, blood work, psychosocial, hx of SUD (amount, when,where,how)
help create tx plan for someone in withdrawl

39
Q

screening for pediatric & adolescent population

A

-should be performed at every well child visit, as well as episodic sick visits
-screenign does not yield formal Dx but guides decision making
-screening is designed to determine if the adolescent has used alcohol or drugs in prev 12m & determines level of risk
also screen for concurrent MHDx

40
Q

what is the CRAFFT questionnaire for

A

assesses adolescents drug use

41
Q

CRAFFT questionnaire meaning

A

C-> driven a Car on drugs
R->take them to Relax
A->take them Alone
F->do Friends use them
F->does Family use them
T->have you gotten in Trouble because of drugs

42
Q

what is the CAGE questionnaire

A

-alcohol use questionnaire
-4 questions
-2 positives=suggestive, 3-4=diagnostic

43
Q

computer & gambling addiction in Canada

A

increase in recent years
guidelines to follow BUT they use blanket statement=not individualized

44
Q

gaming disorder

A

not offically in the DSM yet
d/t fortnite
uses same reward system as drugs

45
Q

substance misuse in nursing

A

-job stress is leading contributing factor
-accessible d/t drug diversion

46
Q

what is the transtheoretical model of change

A

allows pt to acknowledge behaviours
phases: precontemplation->contemplation->preparation->action->maintence and then the person exits the cycle into stable lifestyle ot reenters via relapse

47
Q

nursing interventions for SUD

A

-self awarness of the nurse
-comprehensive assessment
-psychological interventions (motivational interviewing, CBT)
screen using COWs

48
Q

how to have a difficult conversation about SUD with a pt

A

-pt may be in denial
-create relapse prevention plan(coping, pt involvement, support, identify triggers)
-teenager education about drugs 7 alcohol
-family education d/t recovery and thei role
-non-judgemental & encouraging

49
Q

alcohol withdrawl treatment - pharmacological

A

Acamprosate (campral) (dec intake of ETOH thru restoring GABA system, cannot be taken w/impaired renal function)
naltrexone (revia) (non-selective opioid antagonist, interferes w reinforcement & dec cravings of ETOH)
tropiramate (topamax) (similar to campral)

50
Q

opioid addiction treatment - pharmacological

A

methadone (Metadol): 1st line, no euphoria, blocks cravings, but can become dependent
Naltrexone (reVia,vivitrol);dec cravings, a single dose=72h opioid
clonidine (catapres);withdrawl, nonopioid suppressor, no dependence, must be taken regularly
buprenorphine (analgesic) blocks s&s of opioid wihdrawl->”matchstick” inserted under the skin for 6m

51
Q

nicotine addiction treatment - pharmacological

A

bupropion (wellbutrin, zyban)
nicotine patch
e-cigarettes/vaping(may do more harm than good)

52
Q

what is a harm reduction approach?

A

-dec risk/injury to individual
=/=abstinence
non-judgmental approach

53
Q

key principles of harm reduction

A

pragmatism
human rights
priority of immediate goals
focus on harms

54
Q

pragmatism - key principles of harm reduction

A

views both sides of illicit drug abuses
risk vs benefits to dec harm

55
Q

human rights - key principles of harm reduction

A

self-determination
dignity
right to care

56
Q

focus on harms - key principles of harm reduction

A

drug use secondary to effects of drug use (dec of negative effects vs dec drug)

57
Q

priority of immediate goals - key principles of harm reduction

A

meeting person where they are
small wins
continue to show up for them
wellness is key

58
Q

what are harm reduction strategies

A

peer support programs
supervised consumption sites
street nursing

59
Q

how does a harm reduction approach help

A

dec OD’s & drug use associated dx (hep C, HIV)
dec stigma=inc therapeutic relationships
dec incarceration

60
Q

tertiary prevention in SUD

A

dec complications & dysfunction in regards to addiction
if indigenous: healing lodges

61
Q

opioid-dependent newborns

A

NAS: moving towards using rooming-in rather than morphine for withdrawl s&s

62
Q

substance use in older adults

A

-there are resources available i.e. improving quality of life: substance-use and againg

mental health (10 decks)

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