Substance Use

Question 1

What are the alcohol withdrawal symptoms? when do they begin and peak?

Answer 1

• begins 6-72 hours after sudden cessation or decrease in alcohol

Symptoms:

• N/v, elevated VS, anxiety, confusion
• agitation, sweating, tremors
• hallucinations, headache
• delirium tremors, seizures and convulsions (usually within 48 hours)
• peak on day 2

Question 2

Explain the main treatment option for alcohol withdrawal

Answer 2

Benzodiazepines

• 1st line option for symptom management
• may be fixed dosing or titrated based on CIWA score

Question 3

what are secondary treatment options for alcohol withdrawal

Answer 3

• Banana bag: thiamine 100, folic acid 1mg, mag 1-2 g, and MVI in 1 liter NS
• antiemetic meds
• glucose monitoring (due to malnutrition potential)

Question 4

What are the recovery medications for alcohol abuse

Answer 4

• Disulfiram (Antabuse): deters drinking by causing severe reaction
• Naltrexone (ReVia): reduces craving; daily for 3 months; use with opioids
• Acamprosate (Campral): reduces cravings, take 2 tabs 3x daily; not for those with renal issues

Question 5

What are the withdrawal symptoms of sedatives, hypnotics, and anxiolytics

Answer 5

• opposite of drugs desired effect

- agitation, hyperactivity, irritability, elevated VS, hand tremors, insomnia, N/V, hallucinations, seizures

Question 6

What are the withdrawal symptoms for stimulants

What is the treatments

Answer 6

• fatigues, vivid and unpleasant dreams, psychomotor agitation and crave the drug
• can cause a crash (agitated and lethargic) monitor closely

Treatments:
- Chlorpromazine (Thorazine), propranolol for BP, Topamax to prevent seizures

Question 7

What are the symptoms of opioid withdrawal

Answer 7

• anxiety, restlessness, aches, pain in back and extremities
• longer time = yawning, runny nose, fever, N/v, dysphoria, insomnia
• peaks within 2-3 days and subsides 5-7 or longer

Question 8

What are the treatments for opioid withdrawal

Answer 8

• Methadone: replacement for opioid
• naltrexone: blocks effects of opioids
• Levomethadyl (Orlaam): helps with pain killer addictions when other options fail; cardiac arrhythmias may occur

Question 9

Define difference between tolerance and dependence

Answer 9

Tolerance = body getting used to taking a substance and requiring high doses

Dependence = physical or psychological symptoms that occur that make someone feel like they must continue taking a substance

Question 10

What is codependency

Answer 10

emotional and behavioral condition that prevents a person from living productive life and from experiencing mutually satisfying relationships because they are often one sided, emotionally destructive and/or abusive