Substance-Related or Addictive Disorder Unit 3 (2) Flashcards
Groups at Risk for Substance Abuse
- Teenagers
- Psychiatric Clients
- Women
- Hospital Clients
- Elderly
- Health Care Providers
Which basic needs are affected by substance abuse?
- Physical needs
- Safety and Security
- Love and belonging
- Self Esteem
CAGE Assessment
- Cut down? (has anyone asked you to cut down use)
- Annoyed you? (has anyone annoyed you by asking about your use)
- Guilty? (do you feel guilty about your use)
- Eye opener? (have you ever did something that made you think you have a problem)
Assessment
- Which drug is being used
- Signs of intoxication, overdose, and withdrawal
- Assess basic and higher level needs
- Assess body systems affected by chronic alcohol or other substance use
- Assess client’s ability to meet own needs
Reasons for Relapse
- Cravings
- Brain neurotransmitters are depleted, which causes cravings
- Can take several weeks for the brain to start making neurotransmitters
- Motivation forchange
- Family dynamics
- Some substances can be stored in the brain for several weeks (THC)
Defense mechanisms used by substance users
- Denial: deny that they have a problem or minimize the consequences
- Projection: project or blame their difficulties on others,especially a spouse
- Rationalization: Making excuses for using substances. Also stating, “I know I shouldn’t but my life is awful.”
Behaviors associated with substance users
- A means for clients getting what they want
- Progressive worsening of lifestyle/choices overtime
- Conning/Manipulating: Abusers con themselves first
- Bargaining: “I’ll just use a little and then stop”
- Feigning: injury or illness to get to drugs
Acute Detoxification CarePlan
- Provide a safe and supportive environment
- Life-threatening physiological symptoms are attended to first
- WIthdrawal protocols: CIWAA, COWS
- Monitor VS and withdrawal symptoms
- Assess thinking and perceptions
- Apply ice packs for fever
- Decrease stimulation, provide a darkened quiet room
- Point out reality
- Provide adequate nutrition, fluids, hygiene and elimination
- Assess LOC
- Monitor I&O
- Promote Skin Integrity
- Maintain non-judgmental, positive attitude
- Offer emotional support and encouragement to the client and his or her family
- Provide accurate information, education and assistance during the course of detoxification treatment to client and family
- Provide explanations for physical symptoms
- Refer client to community resources for recovery program
Substitution Therapy
- Ativan
- Librium
- Naloxone/Narcan
- Methadone
Ativan
Helpful in controlling anxiety and agitation. Offers symptom relief from alcohol withdrawal
Librium
Longer acting than Ativan with same effects
Naloxone/Narcan
For the treatment of alcohol dependence, heroin abuse, opioid intoxication
Methadone
- Long acting (24-36 hours)
- Safe, synthetic opioid that is administered as a daily dose
- Works on the same receptors in the brain that produce the feelings of pleasure when heroin and opiates bind to them but it does not produce the narcotic high.
- Methadone is addictive
- Alleviates the cravings for opiates
Methadone Detoxification
- Clients recieve methadone for 3-5 days in decreasing doses
- Withdrawal symptoms often appear
- Clonidine (Catapres) is begun and given inincreasing doses until withdrawal symptoms are alleviated
- Clonidine blocksthe withdrawal symptoms, making the detox process less painful and more rapid than with methadone alone. The client feels less anxious and depressed.
- Methadone is eventually discontinued
Methadone Maintenance
- The majority of individuals withdrawing from methadone return to opiate use within one year.
- Federal regulations allow methadone maintenancein licensed facilities to last as long as needed
Suboxone
First synthetic opiod medication approved for the treatment of opiod dependence in an office-based setting
Suboxone Facts
- Can be taken home
- Buprenorphin HCL and naloxone HCL, administered sublingually
- Buprenorphin when placed under the tongue decreases the symptoms of opiod withdrawal
- Little naloxone is absorbed under the tongue
- If suboxone is injected, naloxone will cause a person dependant on an opiod to quickly go into withdrawal thus preventing people from abusing the medication