Substance-Related Disorders Flashcards
criteria for SUD
2-3 criteria - mild 4-5 - moderate 6+ - severe 1. larger amounts and longer than intended 2. wanting to stop but cant 3. time spent getting, using, recovering 4. cravings 5. not managing at work, home, school 6. relational issues - continue to use 7. giving up activities 8. using puts in danger 9. knowing its a problem and continuing to use 10. tolerance 11. relieving withdrawal symptoms by taking more
define addiction
a chronic, relapsing brain disorder that results from the prolonged effects of exposure of the brain to drugs
define intoxication
reversible substance-specific syndrome due to the ingestion or exposure of a substance
withdrawal
a substance-specific maladaptive behavioural change due to stopping or reducing the consumption following heavy and prolonged substance use
remission
a period of partial or complete symptom abatement
relapse
a return to substance use after a drug-free period
craving
experience of a strong desire or urge to take a substance
tolerance
increased amount of substance required to experience the same dopamine-related high over time due to drain adaptation
CIWA assessment
withdrawal of alcohol assessmentmust have 10+ criteria to get valium (long acting benzodiazepine), assessed q2hr or hr after for seizures, BP and pulse must be high\
- Nausea/vomitting
- Anxiety
- sweating
- tactile disturbances (pins and needles)
- visual disturbances
- tremors
- agitation
- cloudy orientation
- auditory disturbances
- headache
* each is rated from 1-7, 10+ points get the drug
substance use assessment elements
start and use pattern amount used frequency of use route past efforts to manage source of substances psychiatric/social history lab tests/medical history collateral history
COWS assessment
pulse sweating restlessness pupil dilation aches GI upset tremor yawning anxiety/irritability piloerection
detoxification
a medical intervention involving the systematic withdrawal from a substance. not treatment but a start
therapeutic approaches of motivational interviewing
listening effectively
eliciting motivational statements, examining ambivalence
avoid arguing, express empathy, develop discrepancy, roll with resistance, support self-efficacy
12 step program therapeutic approach
self determined schedule, relying on higher power, abstinence, social interactions, prescribed behaviours, mobilized psychological process
nursing interventions and alcohol withdrawal
- pharmacotherapeutic-assisted symptoms-triggered detox
- medications to manage symptoms or avoid use
antabuse (disulfiram)
blocks an enzyyme that is involved in metabolizing alcohol intake. get very unpleasant side effects when combined with alcohol
naltrexone
reduces pleasure from ETOH
gabapentin
reduces craving and amount
opioids eg.
naturally occuring- opium, morphine, codeine,
semisynthetic - heroin
synthetic - oxycodone, methadone, fentanyl, carfentanyl,
partial agonists - buprenorphine
diversion
use of prescription medication for unauthorized purposes, or the transfer of medication from lawful to unlawful distribution or use
narcan actions
opioid antagonist - attaches to opioid receptors blocking them and reversing the OD
harm reduction principles
- focus on consequences of use
- minimize use related harms
- understand and consider social and environmental context
- education
- target misinformed policies
risks of poly-substance abuse (opiate and alcohol)
opiate and alcohol challenge for respiratory depression because it is 2 depressants on the body
pharmacological use of methadone in management of opiate use disorder
a synthetic opioid. dont get high, used for detox
management with suboxone (buprenorphine and naloxone)
buprenorphine is a synthetic opioid and naloxone is an opiate antagonist used for tapering
withdrawal symptoms of stimulants
drowsiness and sleep, depressive symptoms, SI,
nicotine replacement therapy
patches, inhalers, gum in dosage that equates roughly with the number of cigarettes/day. increased dose for those that smoke within an hour of waking
