Lecture 3: Substance Abuse Flashcards
Annual Cost of Substance abuse in US
500 Billion annually
- alcohol (highest cost)
- illicit drugs
- tobacco
Addiction
Overwhelming Compulsion / mental / craving / nothing matters
- Repetitive drug-taking behavior
- Serious health and social consequences
Substance Dependence
Physical and psychological desire to take a drug
Cannot stop taking drug w/out withdrawals
Physical Dependence Ex.
Opioids alcohol sedatives some stimulants nicotine
Psychological Dependence Ex.
Marijuana
Anti-anxiety drugs
Tolerance
Body adapts to repeated admin of a drug
-requires higher doses of drug to produce initial effect
Common in substances that affect nervous system
Cross-Tolerance
Requires dosage adjustment to obtain therapeutic benefit
Ex.
Anesthetic w/ sedatives
Stimulants (Uppers)
Ex. Cocaine / Amphetamines / Methamphetamines
Pts die of cardiac arrest w/ cocaine
-Fight or flight – Blood flow goes to vital organs
-vasoconstriction in the periphery
-Increased heart rate and respirations
-Increased BP
-dilated pupils
sweating
tremors
Downers (relaxers)
Ex. Benzodiazipines / Alcohol / Opioids / Marijuana / Barbiturates
Opioids attach to receptors in the brain stem:
- Heart rate, BP, and respiratory rate are all decreased
- Vasodilation
- unclear mental status
- reddening of the skin
Alcohol (CNS Depressant)
Alcohol withdrawal syndrome is severe and may be life threatening
benzodiazepines are the preferred drug class for treatment of alcohol withdrawal
help patients with alcoholism with ABSTINENCE
Antabuse (disulfiram)
Makes someone toxic almost immediately after consuming alcohol. Stays in system for 2 weeks.
Nicotine
Affects nervous, cardiovascular, and endocrine system
-Very quickly leads to physical and psychological dependence
Marijuana
MOST COMMONLY used illicit drug
- Causes disconnected thoughts, paranoia, euphoria
- Causes RED BLOOD SHOT EYES
Withdrawal Definition
Often withdrawal symptoms and signs are the opposite of what the drug originally causes.
Opioid withdrawal symptoms
Sympathetic response:
Excessive sweating Restlessness goose bumps Muscle spasms N/V
Barbiturates Withdrawal Symptoms
Insomnia
Anxiety weakness
seizures
delirium
Alcohol Withdrawal symptoms
Withdrawal can be life threatening
-Treat alcohol withdrawal w/ benzodiazepines or Librium
Stimulant withdrawal Vs. Downer withdrawal
Withdrawing from a downer is much more dangerous than withdrawing from a stimulant
With IV-drug users nurse must consider…
HIV infection
Hepatitis
TB
CNS Stimulants
- Sense of exhilaration / reduced appetite
- High psychological dependence
- Less severe physical signs
- Increases CNS and Cardiac activity
Sedatives Prescribed for Sleep disorders
- Physical dependence, psychological dependence, and tolerance to high doses
- Moderate-to-high psychological dependence
- Moderate-to-EXTREME physical signs of withdrawal
Opioids prescribed for severe Pain
- Addiction occurs rapidly
- Intense withdrawal symptoms
- High psychological dependence
Heroin
Nicotine Withdrawal Symptoms
Irritability, anxiety, and restlessness
INCREASED appetite, headache, insomnia
Decrease in HR and BP
Marijuana Withdrawal Symptoms
Irritability and restlessness
Insomnia and tremors
Chills and weight loss
