[Exam 2] Chapter 19: Addiction Flashcards
Substance Abuse: Detrimental Effects of this?
Costs to business, industry - 223 billion annually
Motor vehicle accidents, fatalities
Prenatal drug exposure
Increse in violence
Substance Abuse: Whois more likely to develop problems of alcohol?
Children of alcoholics 4x more likely
Substance Abuse: Percentage of traffic fatalities that involve alcohol?
30%
Substance Abuse: Percentage of suicide victims that are alcoholics?
15%
Substance Abuse: How many people die each year from alcohol-related causes?
88,000
Substance Abuse: What is binge drinking?
Pattern of drinking that brings a person BAC to 0.08 or above. Happens when men have had 5 or more drinks or women had 4 or more in 2 hours.
What are the diagnostic classes of substance abuse?
Intoxication
Withdrawal Syndrome
Detoxification
Substance Abuse
Substance Dependence
What is polysubstance abuse?
Abuse of more than one substance
Categories of drugs?
Alcohol
Sedatives, Hypnotics, Anxiolytics
Stimulants
Cannabis
Opioids
Hallucinogens
Inhalants
Types of Substance Abuse: What is intoxication?
Use of a substance that results in maladaptive behavior
Types of Substance Abuse: What is withdrawal syndrome?
refers to negative psychological and physical reactions that occur when substance use ceases or decreases
Types of Substance Abuse: What is detoxification?
Process of safely withdrawing from a substance, usually with medical oversight
Types of Substance Abuse: What is substance abuse?
Defined abusing a drug in a way that is inconsistent with medical or social norms and despite negative consequences
Types of Substance Abuse: What is substance dependence?
This is also chemical dependence. Problems associated with addiction such as tolerance, withdrawal, and unsuccessful attempts to stop using substance
Clinical course of Alcoholism?
First episode of ‘sipping’
First episode of intoxication
Blackout
Development of tolerance
Tolerance break
Clinical course of Alcoholism: Sipping may occur as early as when?
8 years
Clinical course of Alcoholism: When does more severe difficulities begin to merge?
mid 20s to mid 302. Include alcohol-relatd breakup, arrest for public intoxication
Clinical course of Alcoholism: What happens after continued heavy drinking?
Tolerance break. Which mean very small amount intoxicates the person
Clinical course of Alcoholism: Age for first intoxication?
Between 12-14 years
Clinical course of Alcoholism: What happens in a blackout?
Person continues to function but has no memory of their behavior. Brain not able to form memories
Clinical course of Alcoholism: What is moderate drinking?
2 drinks per day, no more than 2 per hour
Alcholism & Etiology: Biologic factors?
Genetic vulnerability: Doesn’t automaticlaly make you have alcholism but there is a higher probability
Neurochemical influences
Alcholism & Etiology: Psychological Factors?
Family dynamics
Coping Styles
Alcholism & Etiology: Social , Environmental factors?
Culture, social attiudes, peer behaviors
Law, cost, availability
Alcoholism and Cultural Considerations: What is this for muslims?
No alcohol
Alcoholism and Cultural Considerations: Jews?
Wine an integral part of religious rites
Alcoholism and Cultural Considerations: Some native american tribes?
Peyote (hallucinogen)
Alcoholism and Cultural Considerations: Japanese?
Alcohol not a drug
Alcoholism and Cultural Considerations: there are variations in enzymatic activites among who?
Asians, African Americans, and Whites
Alcoholism and Cultural Considerations: Alcohol abuse affects how many native americans?
1 in five
Alcohol: What does it do to CNS?
Depresses it. Causes relation/loss of inhibitions
Alcohol: Signs of alcohol use?
Slurred speech, unstedy gait, lack of coordination, impaired attention, memory, concentration, and judgement
Alcohol: What behaviors may someone display with alcohol use?
Aggressive behavior or display inappropriate sexual behavior
Alcohol: Treatment of alcohol overdose?
Gastric lavage or dialysis to remove the drug and support of respiratory and cardiovascular functioning in ICU
Alcohol withdrawal timeline: Onset begins when?
Within 4-12 hours afer cessations
Alcohol withdrawal timeline: When does this end?
In about a week
Alcohol withdrawal timeline: How many stages are there for withdrawal?
3
Alcohol withdrawal timeline: Stage 1 of withdrawal?
8 Hours. Includes anxiety, insomnia, nausea, and abdominal pain
Alcohol withdrawal timeline: Stafe 2 of withdrawal?
1-3 days. High blood pressure, increased body temp
Alcohol withdrawal timeline: Stage 3 of withdrawal?
1 week. Hallucinations, fever, seizures, and agitation
Alcohol withdrawal timeline: Severe or untreated withdrawal may progress to what?
Transitent hallucinations, seizures, or delirium
Alcohol withdrawal timeline: What medicine is used for safe withdrawal?
Benzodiazepines
Alcohol withdrawal timeline: Peak of withdrawal symptoms?
Day 2 if we are able to get them into treatment
Sedatives. Hyponotics, and Anxiolytics: What are these all classified as?
CNS depressants
Sedatives. Hyponotics, and Anxiolytics: Benzodiazepines risk?
Alone , with oral overdose rarely faatal; lethargy confusion
Sedatives. Hyponotics, and Anxiolytics: Barbituraes risk?
Overdose probably lethal. Can lead to coma, respiratory arrest, cardiac failure, deah
Sedatives. Hyponotics, and Anxiolytics: Problem this causes on person?
Withdrawal dependent on drug
Sedatives. Hyponotics, and Anxiolytics: How to detoxify?
Via drug tapering
Sedatives. Hyponotics, and Anxiolytics: Benzodiazepines overdose will be he opposite of what?
The intended treatment
Sedatives. Hyponotics, and Anxiolytics: What must we be sure of with drug tapering?
Slowly slowly taper off the drug.
Stimulants: This includes what?
Amphetamines, Cocaine
Stimulants: Whaat does this do to body?
CNS stimulant
Stimulants: Signs when using this?
High or euphoric feeling, hyperactivity, hyperviglance, physiologic signs
Stimulants: Benefits of cocaine?
Absolutely none
Stimulants: What can these eventually lead to after prolonged use?
Onset of withdrawal within hours to several days
Stimulants: Withdrawal syndrome of this?
Dysphoria, fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor retardation, depressive syndrome.
Stimulants: Tx for withdrawal?
None
Stimulants: Onset of withdrawal?
Days to hours.
Cannabis: What is this used for?
Psyschoactive effects
Cannabis: Excessive use possibl leads to what?
Delirium or cannabis-induced psychotic disorder
Cannabis: Can you overdose?
No
Cannabis: Withdrawal syndrone?
Nothing to significant. POssible symptons of insomnia, muscle aches, sweating, anxiety, tremors
Cannabis: How to treat this??
Symptomatic treatment, just treating symptoms they are experiencing
Opioids: What is this classified as?
CNS depressant
Opioids: Intended affects of this?
Desensitization, euphoria, well-being
Opioids: Intoxication signs of this includes what?
Apathy, lethargy, listlessness, impaired judgement, psychomotor retardation or agitation, constricted pupils , drowsiness, slurred speech, impaired attention
Opioids: Overdose signs?
Coma, respiratory depression, ,pupil constriction, unconsciousness, death
Opioids: Treatment for this?
Naloxone
Opioid Withdrawal: What does this look like?
N/V, Dysphoria, Lacrimation, Rhinorrhea, Sweating , diarrhea, yawning ,fever, insomnia
Opioid Withdrawal: What is lacrimation?
flow of tears
Opioid Withdrawal: Heroin onset?
6-24 hours
Opioid Withdrawal: Heroin peak?
2-3 days
Opioid Withdrawal: Heroin subsiding?
5-7 days
Opioid Withdrawal: Longer acting drugs like methadone onset?
2-4 days
Opioid Withdrawal: Longer acting drugs like methadone subsiding in how long?
2 weeks
Opioid Withdrawal: Symptoms of peak?
Diarrhea, abdominal cramping, goose bumps, n/v, dilated pupils, rapid heartbeat, high blood pressure
Halucinogens: What do they do?
Reality distortion. Like psychosis (hallucinations, depersonalization)
Halucinogens: What can this cause on the body?
Increased pulse, bp, and temperature, dilated pupils and hyperreflexia
Halucinogens: Overdose risk?
None but can have toxic reaction
Halucinogens: PCP toxicity signs?
Seizures, hypertension, hyperhermia, respiratory depression
Halucinogens: Tx?
Supporitive tx for the symptoms
Halucinogens: Withdrawl syndrome fo rthis?
None
Halucinogens: How often can flashbacks happen?
For few months for up to 5 years
Inhalants: What does this do?
Intoxication: Neurologic and behavioral symptoms
Inhalants: Acute toxicity?
Anoxia, respiraotry depression, vagal stimulation, dysrhythmias
Death possible from bronchospasm, cardiac arrest, suffoicaiton
Inhalants: withdrawal?
No withdrawal or detoxifcation?
Inhalants: tx?
Supporitive tx
Inhalants: Inhalant intoxication produces what effects?
Dizziness, nystagmus (eyes make repetitive, uncoordinated movementS) , lack of coordincation, slurred speech, unsteady gait
Substance Abuse Treatment: Concept of this?
Medical illness, chronic, progressive, characterized by remissions and releapses
Substance Abuse Treatment: Treamtn models fo rhtis?
Hazelden Clinic Model
12 Step Program of AA
Substance Abuse Treatment: What was Hazelden Cliic Model?
This was founded in 1949 and was viewed as something that was a problem for the patient.
Substance Abuse Treatment: Most important point of AA?
That there are sponsors. There are people who have been in these siutations before and can help guide you
Substance Abuse Treatment: Types of counseling?
Individual or group
Substance Abuse Treatment: Pharmacologic Treatment example?
Safe withdrawal, prevent relapse.
Medications help to manage withdrawal or cravings, but is not a specific treatment for susbtance abuse
What is dual diagnosis here?
Substance abuse + another psychiatric illness
Dual diagnosis: What are some relapse prevention strategies?
Healthy, nuturing, supporitve living environment
HElp with fundamental life changes like finding job
Connections with other recovering people
TX of comorbid conditions
Substance abuse And Assessment: History?
Chaotic family life, crisis rthat caused this?
Substance abuse And Assessment: General appearnace?
Motor, behavior
Substance abuse And Assessment: Mood , affect?
Expressing guilt, remorse, angry, quiet
Substance abuse And Assessment: Thought process?
Content, denail, blaming others, rationalization
Substance abuse And Assessment: Sensorium ?
Intact
Substance abuse And Assessment: Judgement and insight?
Poor judgement, impulsivity is able to control substanace use
Substance abuse And Assessment: Self concept example?
low self esteem and probs with feelings
Substance abuse And Assessment: Roles and relationships?
Often strained
Substance abuse And Assessment: Physiologic considerations?
Poor nutriiton, sleep disturbance,s liver damage, HIB, lung damage
Substance abuse And Outcome goal?
Abstain from substance use
Accept responsibility for behavior
Establish aftercare plan
Substance abuse And Interventions?
Health teaching for patient, family
Addressing family issues
Coping SKills
Elder Considers: RF for this?
Chronic illness that causes pain, long term use of meds, life stress, loss, social isolation
Community-BAsed CAre Options?
Outpatient tx
Freestabdning abuse treating
Self-Help (AA)
Agency sponsored aftercare
Individual counseling
CLinic
Mental Health promotion?
Public awarenedd, educationa dvertising
Early identifcation of older adults with alcholism
College drinking prevention program
Substance abuse in health professionals: Ethical and legal responsibility to do what?
To report suspicious behavior to supervisor
Substance abuse in health professionals: General warning signs?
Poor work performance/frequent absenteeism
Unusual behavior
Isolated form peers
Substance abuse in health professionals: Related Disorders?
Gambling
Caffeine and Tobacco Addictions
Internet