Substance Related & Addictive Disorders Flashcards
What cultural groups are at a higher risk of alcohol use disorder?
Alaska Natives + Native Americans
The Asian Culture has what kind of rate of alcohol use disorder?
A Low Rate
The rate of alcohol use disorder is most frequent in what age group?
18-25 Years Old
Cocaine use is decreased among adolescents.
True or false?
False
About half of the adolescent population reports having access to-
Marijuana
Substance use while pregnant can cause an increased risk of-
Premature birth, low birth weight, and neonatal accident syndrome
Older adults who use substances are especially prone to -
Falls and other injuries
Memory Loss
Somatic Complaints (Things that bother the body physically like pain, weakness, or SOB)
Sleep pattern changes
List some indications of alcohol use in older adults:
Lack of self care
Urinary Incontinence
Manifestations of Dementia
Do older adults show symptoms of alcohol use at smaller doses than young adults?
Yes
Any medication regimen where there are more than 5 medications involved =
Polypharmacy
List the different standardized screening tools for substance use:
The CIWA-Ar
The CAGE Questionnaire
The AUDIT
The SBIRT
What does the CIWA-Ar measure?
How many symptoms of alcohol withdrawal that the patient is being affected by.
This can help determine if they are going through mild to severe alcohol withdrawal.
1.) For the CIWA-Ar, what score indicates minimal to mild alcohol withdrawal?
2.) What score can indicate moderate withdrawal?
2.) What score can indicate severe withdrawal?
1.) A score of less than 8 to 10.
2.) A score of 8 to 15.
3.) A score of 15 or higher.
What is the CAGE Questionnaire used to do?
It’s used to test for alcohol use disorder in adults.
It is not used as a way to diagnose but really just to tell you if an alcohol problem might exist.
What score on the CAGE Questionnaire is considered to be clinically significant and is indicative of alcohol problems?
A score of 2 or greater
What is the AUDIT Questionnaire used to do?
Determine how at risk that you are for alcohol abuse
1.) You have just taken an AUDIT Questionnaire, what score indicates that you are at no risk or low risk for alcohol abuse?
2.) You have just taken an AUDIT Questionnaire, what score indicates that you are at a medium risk for alcohol abuse?
3.) You have just taken an AUDIT Questionnaire, what score indicates that you are at a high risk for alcohol abuse?
4.) You have just taken an AUDIT Questionnaire, what score indicates that you are likely addicted to alcohol?
1.)
For a woman = 0 - 6
For a man = 0 - 7
2.)
For a woman = 7 - 15
For a man = 8 - 15
3.) 16 - 19
4.) 20+
What is the SBIRT and what is it used to do?
It is an evidence-based approach to identifying the people who use alcohol and other substances at risky levels
What are the 4 phases of the SBIRT in order?
Establish a Rapport & Begin Screening.
Elicit their thoughts. Give feedback and education.
Assess and enhance their motivation.
Negotiate on a plan and summarize.
What involves routine wellness screenings, reduces risk for drinking and related harms, promotes safer drinking, increases help for seeking people who need it?
The SBIRT
Ecstasy is a-
Designer / Club Drug
What are the effects of opioid withdrawal?
A lot of physical complaints, such as:
Abdominal cramping, diarrhea, headaches, elevated BP, vomiting, shaking, goose bumps, sweating
A common medication that is on an opiate protocol to combat the high BP =
Clonadine
You have a patient who’s came in and they’re suffering from withdrawal from opioids. What must you do first before giving any Clonidine?
You’ve gotta take their apical pulse and their BP.
A pulse rate under 60 = Don’t give Clonidine.
A BP that’s under 90/60 mm Hg = Don’t give Clonidine.
Huge pupils can be a symptom of-
Opioid Withdrawal
What’s the antidote for Opioids?
Naloxone (Brand Name = Narcan)
What is considered illegally intoxicated for adults?
0.08%
What level of alcohol intoxication can cause acute toxicity and kill you?
Levels higher than 0.4%
What are the symptoms of Fetal Alcohol Syndrome?
Microcephaly (Baby’s head is smaller than expected)
Craniofacial Malformations (Upturned nose, thin upper lip, flat nasal bridge, etc.)
Limb & Heart Defects
Smooth Philtrum (No crease above the lip)
Other Developmental Problems
What is Delerium Tremins?
Severe alcohol withdrawal symptoms (shaking, confusion, hallucinations).
Delerium Tremens is very high risk.
What’s important to remember about patients that are having Delerium?
It is considered to be a medical emergency, NOT a psychiatric emergency
Delirium = not medically clear to be in a psychiatric unit and is also not stable.
True or false?
True
If a patient is in the psychiatric unit with Delerium, where should they be sent to?
The ICU
Club drugs can be taken via what route?
Orally or Injected
Is there an antidote to reduce Barbiturate toxicity?
No
Second most prevalent lifetime disorder =
Alcohol Abuse
What are Anxiolytics?
Anxiolytics include drugs like-
Anxiolytics are a class of drugs that are used to treat PT’s with General Anxiety, Panic Disorders, etc.
Anxiolytics can include things like:
Sedatives (Hypnotics)
Benzodiazepines (Lorazepam, Diazepam)
Barbiturates (Pentobarbital, Club Drugs)
Symptoms & Signs of Alcohol Withdrawal:
Anxiety, Insomnia, Diaphoresis, Hypertension, Possible Psychotic Reactions, Hand Tremors, Nausea & Vomiting, Possible Seizure Activity, Agitation
Can you have toxic doses of Cannabinoids?
Yup
Withdrawal symptoms of Cannabis:
Irritability, Aggression, Anxiety, etc.
You give a patient a drug screening. It comes back as negative. Does this mean that the patient is for sure not using substances?
No, they could be using synthetic drugs that won’t show up on a drug screening or they may have just been without them for a few days
Cocaine, Methamphetamine, Inhalants (Tobacco Use, Cigarettes/Cigars, Vaping, etc.), Hallucinogens, Caffeine, and other Stimulants can be called-
CNS Stimulants
You can be intoxicated by caffeine.
True or false?
True
What are the symptoms of CNS stimulants?
Tachycardia, Arrhythmias, Flushed Face, Muscle Twitches, Restlessness, Diuresis (Kidneys filter too much body fluid), GI Disturbances, Anxiety, Insomnia
What are the withdrawal symptoms of CNS stimulants?
Headache, Nausea & Vomiting, Muscle Pain, Irritability, Inability to Focus, Drowsiness
What can be used to treat nicotine addiction?
Nicotine Patches, Nicotine Gum
(Too much of these can be bad too)
Snuff or chewing tobacco symptoms:
Irritation to oral mucous membranes + Cancer
Symptoms of smoking Tobacco products include:
CV Disease, Hypertension, Stroke, & Respiratory Diseases like Lung Cancer & Emphysema (Which causes SOB and has no cure)
