Substance Abuse Flashcards
Substances most commonly misused by
College students
“Use”
drink, swallow, smoke, sniffs, ihales mind alt substance
“Abuse”
use of alc/drug for intoxication
“Addiction”
irresistible need to continue substance use/behavior despite the harm
Physical Dependence
physiological requirement for substance by the brain
Craving
urgent desire for substance/behavior, in response to triggers
Detoxification
safely withdraw a person from substance
Chemical hook theory
substance itself reinforces use
Alexander experiment
rats alone chose drug
rat park chose water
Impaired Response Inhibition and Salience Attribution
increased exposure to rewarding activity/substances, brain narrows its focus to just that
Alcohol
CNS depressant and euphoriant
0.1 0.01%
2 drinks per hour
Alcohol Abuse (3)
recurrent use in hazardous situations
legal problems,
failure to meet obligations,
despite social problems
Alcohol Dependence (5)
tolerance
withdrawal
increase time in alc activities in replace of important
drinking more/longer than desired
unsuccessful efforts
Korsakoff’s syndrome
Gradual onset; retrograde/anterograde amnesia
apathy/increase talking
confabulation/cackling laugh
Alcohol Withdrawal
Onset
as soon as 2 hours after last drink
Alcohol withdrawal
Early symptoms
Tremors, diaphoresis, rapid pulse, elevated BP
Alcohol Withdrawal Syndrome
Hallucination, grand mal seizure, changes in cognition
Delirium Tremens
Severe alc withdrawal
ANS instability
mental changes
3-5 days after last drink
Delirium Tremens Treatment
replace thiamine, niacin,folate, magnesium
Electrolytes
Benzos
Baclofen
Antipsych
Cocaine
CNS stimulant
produces euphoric rush of mental alertness and energy, confidence, 10-20 min CRASH HARD
Can produce paranoia/psychosis
Biological effects of Cocaine
Increase norepi(TACHY/HTTN)
dopamine (hallucination)
seratonin (paranoia)
Cocaine withdrawal
sleep 12-18hr
sleep disturbances (rebound REM) lethargy, depression, suicidality,
Amphetamines
block norepi/dopamine
affect PNS
Methamphetamine
release dopamine
easy to make at ghome
MDMA (Ecstasy)
causes hallucinations, confusion, depression, sleep problems, drug cravings
Nicotine
CNS/PNS/ANS stimulant
toxic in high doses
Nicotine Withdrawl
mood and physiologic changes
Cannabis
binds with opioid receptor in brain to block dopamine, euphoric sense of calm, impairs ability to form memories, recall events, blunts responsiveness
Hallucinogens
mushroom
LSD
mescaline
euphoria, altered body image, distorted/ sharpened visual perception
Benzodiazepines
CNS depressants
decrease REM
withdrawal begin as long as 7 days
Dissociative Anesthetics
Ketamine, PCP
reduce signals from conscious mind to other parts of brain
“Club Drugs”
Molly
cause severe dehydration and hyperthermia
GHB
CNS depressant
DATE RAPE DRUG
Used for narcolepsy
Opiate withdrawal
rebound hyperexitability
N/V/D, hypotension
sleepiness, restlessness, agitation, dysphoria
bone pain, cramping
Codependency
coping pattern result of living with someone of addiction
sacrificing self for relationship
s/sx abuse
Assessment r/t addiction
ready for sobriety?
support sx
nonjudgemental approach
do not rescue
denial, rationalization
Nursing intervention/treatment modiatility
SAFETY, harm reduction, prevent relapse
assure self awareness
meds
address deficits (cogition)
observe for withdrawal
SAMI
treat both addiction and mental illness
Motivational interviewing
acceptance facilitates change
express empathy, develop discrepancy, avoid argument, roll with resistance
Relapse prevention
Keep it simple, review instruction, journaling, identify situations/triggers
REPEAT AS NEEDED
Wernicke’s Encephalopathy
alc causes gastric irritation, reduce B vitamins
Sx: Acute palsy, ataxia
Treat: IV Thiam
