Substance-Related And Addiction Disorders Flashcards
A state of disturbance in cognition, perception, behavior, level of consciousness, judgment, and other functions directly attributable to a psychoactive drug’s effects may be marked by a physical and mental state of exhilaration and emotional frenzy or lethargy and stupor.
Intoxication
*Reversible syndrome of symptoms after excessive use of a substance
*Direct effect on the central nervous system
*Disruption in physical and psychological functioning
*Social and occupational functioning is impaired
*Judgement disturbed – the sole focus is on getting the reward.
Substance Intoxication
The Physiological and mental readjustment that accompanies the discontinuation of an addictive substance
*Abrupt reduction or discontinuation of a substance used regularly over a prolonged period of time
Substance Withdrawal
*Clinically significant s/s as well as psychological changes such as disruption in thinking, feeling and behavior
*Often substance specific features
Substance-specific Syndrome
Pre-alcoholic Phase
Relieving everyday stress or tensions
*Tolerance may build up, and it takes one drink initially and later 2 or 3 to get the desired effect.
Alcohol Use Disorder
Phase I:
Early alcoholic phase
Blackouts, alcohol not the source
* No longer a pleasure, but a craving builds. Blackouts are common. Sneaking drinks. Guilt and defensiveness start to be common coping mechanisms. Denial and rationalization common
Alcohol Use Disorder
Phase II:
The crucial phase
Lost the ability to choose whether to drink;
Extremely ill
*Lost control of use completely, and addiction is evident. Binge drinking for hours or days even occurs. The individual is very ill in this phase. Anger and aggression are common manifestations. Drinking is the sole focus, and the person is willing to risk everything for the drink. Often in this phase, loss of job, marriage, family, friends, and self-respect are noted.
Alcohol Use Disorder
Phase III:
The chronic phase;
Emotional and physical disintegration;
Helplessness and life-threatening
*Emotional and physical disintegration. The person is usually intoxicated more often than not, and emotional disintegration is evidenced by profound helplessness and self-pity. Impaired reality testing may result in psychosis. Withdrawal triggers symptoms of hallucinations, tremors, convulsions, severe agitation, and panic.
Alcohol Use Disorder
Phase IV:
Nerve damage resulting in pain, burning, tingling, and prickly sensation in extremities.
*Research believes this is due to a Thiamine (Vit B) deficiency. Nutritional deficits are common in alcoholism as there is an insufficient intake of nutrients, and the toxic effects of alcohol result in the malabsorption of nutrients.
Effects of Alcohol: Peripheral Neuropathy
B Vitamin Deficiency mediated
*Acute alcoholic necrotizing myopathy or alcoholic rhabdomyolysis with a sudden onset of muscle pain, swelling, weakness, and myoglobinuria (coffee or red-tinged urine). This can extend to elevated CPK levels, and AST levels as no organs are spared. The chronic version of this is slow muscle wasting without laboratory findings.
Effects of Alcohol: Alcoholic Myopathy
The most serious form of Thiamine deficiency.
*Symptoms can include paralysis of ocular muscles, diplopia, ataxia, somnolence, and stupor. If thiamine is not replaced quickly, death will follow.
Effects of Alcohol:
Wernicke’s Encephalopathy
Syndrome of confusion, loss of recent memory, and confabulation.
*Frequently found in clients recovering from Wernicke’s Encephalopathy. The two disorders seem to go together in a progression. Oral Thiamine is the treatment.
Effects of Alcohol: Korsakoff’s Psychosis
*Esophagitis also esophageal varices
*Alcoholic Cardiomyopathy
*Gastritis
*Pancreatitis – acute or chronic
*Alcoholic Hepatitis
*Leukopenia
*Thrombocytopenia
*Sexual Dysfunction
Effects of Alcohol
The end stage of alcoholic liver disease results from long-term chronic alcohol abuse. Fibrous (scar) lesions replace widespread liver destruction.
Effects of Alcohol: Cirrhosis of the Liver
Complications Include:
Portal Hypertension
Ascites
Esophageal Varices
Hepatic Encephalopathy
Cirrhosis of the Liver
Complications Include:
Blood Alcohol levels between 100 and 200mg/dL
Alcohol Intoxication:
Within 4-12 hours of cessation of or reduction of alcohol in heavy/prolonged alcohol use
Alcohol Withdrawal
hallucinations, tremors, convulsions, severe agitation, and panic. Depression and suicidal ideations are common. Long-term heavy use- abrupt withdrawal can be fatal.
Unmanaged or acute withdrawal from alcohol results in a syndrome of symptoms that include
It can induce varying degrees of CNS depression. They include tranquilizing relief from anxiety to anesthesia, coma, and even death.
*Barbiturates
*Nonbarbiturate
*hypnotics
*Antianxiety agents
*Club Drugs
Sedative Drug classes:
All generics in this group end in “barbital”
Barbiturates
Estazolam, Restoril, Halcion, Lunesta, Zolpidem or Ambien – referred to as sleepers
Nonbarbiturate hypnotics
Xanax, Clonazepam, Diazepam, Lorazepam are most common. Green and white pills. Color often helps determine dose.
Antianxiety agents (Benzodiazepines)
Flunitrazepam, GHB commonly called Roofies, Liquid X, GHB, and rope or Rohypnol
Club drugs
