Substance Abuse Flashcards
Addiction
A compulsive or chronic requirement. The need is so strong as to generate distress (physical or psychological) if left unfulfilled
Substance use disorder
When use of a substance interferes with one’s ability to fulfill role obligations, such as work, school or home
Substance intoxication
- the development of a reversible syndrome of symptoms following excessive use of a substance
- the symptoms are drug-specific and occur during or shortly after the ingestion of a substance
Substance intoxication manifestations
- judgement is disturbed
- there is inappropriate and maladaptive behavior
- social and occupational functioning are impaired
Substance withdrawal
Occurs upon abrupt reduction or discontinuation of a substance that has been used over a prolonged period of time
Substance withdrawal manifestations
- substance-specific clinically significant signs and symptoms
- psychological changes such as disturbances in thinking, feeling and behavior
Alcohol
- blocks messages between neurons
- works on GABA neurotransmitter to relax person
Alcohol symptoms of use
- CNS depression
- relaxation
- loss of inhibitions
- lack of concentration
- drowsiness
- slurred speech
- sleep
Alcohol therapeutic uses
- antidote for methanol consumption
- ingredient in many pharmacological concentrates
Sedative, hypnotic, anxiolytic drugs
- anxiolytic drugs that produce relaxation and drowsiness
- includes barbiturates and benzodiazepines
Sedative, hypnotic or anxiolytic symptoms of use
- CNS depression varying from tranquilizing relief of anxiety to anesthesia, coma, death
- same as alcohol
- generally categorized as 1) barbiturates 2) nonbarbiturate hypnotics 3) antianxiety agents
Sedative, hypnotic or anxiolytic therapeutic uses
- relief from anxiety/insomnia
- as anticonvulsants and anesthetics
Stimulants
- increase the CNS activity, blood pressure, heart rate, alertness
- caffeine, nicotine, cocaine, amphetamines
Amphetamines and related drugs
- similar effects as cocaine
- produce rush
- increase energy and alertness
Amphetamines and related drugs symptoms of use
- CNS stimulation
- hyperactivity
- agitation
- euphoria
- insomnia
- loss of appetite
Amphetamines and related drugs therapeutic uses
- management of narcolepsy
- hyperkinesia
- weight control
Cocaine
- most powerful natural stimulant known
- increases supply of dopamine in brain causing euphoric rush
Cocaine symptoms of use
- CNS stimulation
- euphoria
- hyperactivity
- restlessness
- talkativeness
- ^ HR
- dilated pupils
- rhinitis
Synthetic stimulants symptoms of use
- CNS stimulation
- agitation
- insomnia
- irritability
- dizziness
- dec ability to think clearly
- ^ HR
- CP
Opioids
- brings on rush or spasm of warmth/ecstasy, following by several hours of high
- binds to receptors that receive endorphins, mimic effects of pleasure and calm
- aka narcotics
Opioids symptoms of use
- euphoria
- lethargy
- drowsiness
- lack of motivation
- constricted pupils
Opioids therapeutic uses
- as analgesics, antidiarrheals and antitussives
- methadone in substitution therapy
- heroin has no therapeutic use
Hallucinogens
- produce powerful sensory changes including delusions and hallucinations
- tolerance and withdrawal are rare
- dangers include having a bad trip/flashbacks
Hallucinogens symptoms of use
- visual hallucinations
- disorientation/confusion
- paranoid delusions
- euphoria
- anxiety/panic
- ^ HR
Hallucinogens therapeutic uses
- LSD has been proposed in the treatment of alcoholism and chronic pain
Cannabinols
- produces mixture of depressant, stimulant and hallucinogenic effects
- major active ingredient is THC
Cannabinols symptoms of use
- relaxation
- talkativeness
- lowered inhibitions
- euphoria
- mood swings
Cannabinols therapeutic uses
- marijuana can be used to relieve n/v in chemo and reduced eye pressure in glaucoma
Inhalants
- bugging or huffing
- gasoline, varnish remover, lighter fluid, airplane glue, rubber cement, cleaning fluid, spray paint, shoe conditioner, typewriter correction fluid
Inhalants symptoms of use
- dizziness
- ataxia
- euphoria
- excitation
- disinhibition
Biological predisposing factors
- genetics accounts for 40-60% of a persons vulnerability
- children of alcoholics 4x more likely to follow
Psychological predisposing factors
- low self-esteem, depression, passivity, antisocial personality traits, the inability to relax, ineffective communication increase risk
- “addictive thinking” stems from denial, projection and rationalization
Sociocultural predisposing factors
- individuals can become conditioned to rely on a substance
- cultural factors
Dual diagnosis
- clients with a coexisting substance disorder and mental disorder may be assigned to a special program that targets the dual diagnosis
- peer support groups
- psychodynamic therapy
- 12-step recovery programs
- substance-abuse groups
Major treatment objectives identified for clients with substance abuse disorders
- detoxification
- intermediate care
- rehabilitation
Client/family education: nature of the illness
- effects of substance on the body
- ways the substance affects life
Client/family education: management of the illness
- activities to substitute for substance
- relaxation techniques
- problem solving skills
- the essentials of good nutrition
Client/family education: support services
- financial assistance
- legal assistance
- AA
- one-to-one support person
The chemically impaired nurse
- 10 to 15 percent of nurses suffer from the disease of chemical dependency
- alcohol is the most widely abused drug, followed closely by narcotics
Chemically impaired nurse: state board response
- may deny, suspend or revoke a license
- nurse may avoid discipline by agreeing to treatment
Chemically impaired nurse: peer assistance programs
- a program established by the ANA
- implemented by nurse members of the state associations and nurses in recovery themselves
Alcoholics anonymous
Accepts alcoholism as an illness and promotes total abstinence as the only cure
Pharmacotherapy for alcoholism
- Disulfiram (Antabuse)
- Naltrexone (ReVia)
- Benzodiazepines
Disulfiram (Antabuse) for alcoholism
- admin as a deterrent to drinking
- ingestion of ETOH while this is in the body causes significant discomfort
- symptoms occur w/in 5-10 mins and last as long as it takes for ETOH to be metabolized
Naltrexone (ReVia) for alcholism
Binds to receptors in the brain that produce feelings of pleasure when alcohol or opiates are ingested
Benzodiazepines for alcoholism
- used for substitution therapy in alcohol w/d
- start at high doses and decrease daily until w/d is complete
- additional doses for breakthrough s/s
Types of therapies to treat substance addiction
- counseling
- group therapy
Pharmacotherapy for opioid addiction
- Nalaxone (Narcan), Naltrexone (ReVia), Nalmefene (Revex) = narcotic antagonists
- Methadone, Buprenorphine, Clonidine (Catapres) = substitution
Pharmacotherapy for sedative, hypnotic or anxiolytic addiction
- Phenobarbitol (Luminal) = long-acting barbiturate
Pharmacotherapy for addiction to a stimulant
- Chlordiazepoxide, Haloperiodol (Haldol) = antipsychotics, tranquilizers
Pharmacotherapy for addiction to hallucinogens or cannabinols
Benzodiazepines may be rx to treat anxiety or panic
