Substance Use and Addictive Disorders Flashcards
Severity scale for substance use disorder
0-1 criteria
No diagnosis of substance use disorder
Substance use disorders
Involve repeated use of chemical substances, leading to clinically significant impairment during a 12-month period.
Severity scale for substance use disorder
2-3 criteria
mild substance use disorder
Severity scale for substance use disorder
4-5 criteria
moderate substance use disorder
Severity scale for substance use disorder
6 or more criteria
severe substance use disorder
Non-substance related addictive disorders
- gambling
- sexual behaviors
- shopping/spending
- internet use, such as gaming
Addiction is characterized by
- Loss of control due to addictive behavior
- Participation continues despite continuing associated problems
- A tendency to relapse back into the addictive behavior
Risk Factors
- Genetics
- Lowered self-esteem
- Lowered tolerance for pain and frustration
- Few meaningful personal relationships
- few life successes
- Risk-taking tendencies
- Sociocultural theories
Native American groups
have a high percentage of members who have alcohol use disorders.
Asian groups have a low percentage of alcohol use disorders.
Central Nervous System Depressants
- Alcohol (Ethanol)
Alcohol (Ethanol)
General Information
- A BAC of 0.08% (80g/dL) is considered legally intoxicated for adults.
- Death can occur from levels greater than 0.35%
- BAC depends on body weight, gender, concentration of alcohol, gastric absorption rate, individuals tolerance level.
Alcohol (Ethanol)
Intended Effects
Relaxation, decreased social anxiety, stress reduction
Alcohol (Ethanol)
Effects of intoxication
slurred speech, nystagmus, memory impairment, altered judgment, decreased motor skills, decreased LOC, respiratory arrest, peripheral arrest, and death.
Alcohol (Ethanol)
Withdrawal manifestations
- usually start within 4-12 hours of last intake of alcohol, peak after 24-48 hr. then suddenly disapper
- vomiting, abd cramping, tremors, restlessness, inability to sleep, increased HR, RR, Temp, and tonic-clonic seizures.
- Alcohol withdrawal deliurium may occur 2-3 days after cessation of alcohol. A medical emergency. Severe disorientation, hallucinations, HTN, cardiac dysrhythmias, delirium.
Sedative/ Hypnotics
General Information
- Benzodiazepines, diazepam (Valium), or barbituates- phenobarbital
- Can be taken orally or injected
Sedative/ Hypnotics
Intended Effects
Decreased anxiety, sedation
Sedative/ Hypnotics
Effects of intoxication
- drowsiness, sedation, agitation, slurred speech, uncoordinated motor activity, nystagmus, disorientation, nausea, vomiting.
- Respiratory depression and decreased LOC, may be fatal
- Antidote- Romazicon- IV use for benzodiazepine toxicity
- No antidote for barbituate toxicity.
Sedative/ Hypnotics
Withdrawal Manifestations
- Anxiety, insomnia, HTN, diaphoresis, hallucinations, illusions, seizure activity.
Antidote for benzodiazepine toxicity
flumazenil (Romazicon) - IV
Cannabis
General Info
Marijuana, Hashish - smoked or orally ingested.
Cannabis
Intended effects
Euphoria, sedation, hallucinations, decrease of nausea and vomiting secondary to Chemo, management of pain.
Cannabis
Effects of intoxication
Chronic use- lung cancer, chronic bronchitis, and other respiratry effects
in high doses- paranoia, delusions, and hallucinations, increased appetite, dry mouth, tachycardia.
Cannabis
withdrawal manifestations
Irritability aggression, anxiety, insomnia, lack of appetite, restlessness, depressed mood, abdominal pain, tremors, diaphoresis, fever, headache.
Antidote for Morphine or dilaudid
naloxone (Narcan) IV
Wernicke-Korsakoff Syndrome
- Occurs when patient has improper nutrition and experiences alcohol withdrawals
- Memory disturbance, unable to form new memories
- If memory is jogged information may be recalled
- Retrospective memory gap
- Intellectual grasp is quite well retained.
Delirium Tremens
- 72 hours after drinking has stopped (up to 7-10 days)
- Lack of carbohydrate and food intake
S/S
- Body Tremors
- Changes in mental function
- Agitation
- Mood changes
- Hallucinations
- Sleeping for 24 hours or longer
Detox from Alcohol
- Valium
- Folic Acid
- B12
Stimulants
Names
Amphetamines & Cocaine
Street names: Speed, uppers, bennies, ice Ecstasy, and crank
Stimulants
Effects
- (Adrenaline like) Users feel awake, alert, energetic, sexual arousal, and a feeling of well-being
- Meth stays in the body up to 4 days- tolerance quickly develops and addiction within 4 to 6 months
- Side effects- anxiety, hallucinations (tweaking), paranoia, depression and suicide. Pupil dilation when high- may be constricted when they are not on the drug.
- Weight loss, picking at skin, ability to stay up all night.
Opioids
- Heroin, Vicodin, Oxycodone, Norco, Morphine
- Opioid analgesics suppress your perception of pain and calm your emotional response to pain by reducing the number of pain signals sent by the nervous system and the brains reaction to those pain signals.
Suboxone/Methadone
- Suboxone- treatment for opioid addiction, Sublingual tablet, works by filling the receptor cites so pt. does not feel withdrawal symptoms. You can ween down the does until the pt. no longer feels symptoms
- Methodone used to be treatment, however, it still gives a high and is highly addictive.
Hallucinogens
- Derived from plants and mushrooms
- LSD- one of the most potent mood changing chemicals. Lasts up to 8 hours.
- PCP- for smoking, often applied to a leafy material such as mint, parsley, oregano, or marijuana. Can last 4-6 hours.
Common psychiatric illnesses linked with Substance Abuse
- Schizophrenia
- Schizophreniform disorder
- Antisocial personality disorder
- Anxiety disorders
- Mood disorders
Manifestations of Fetal Alcohol Syndrome
- Prenatal and Postnatal growth deficiency
- Facial malformations
- CNS dysfunction
- Varying degrees of major organ system malfunction
2 Major objectives for treatment for clients with substance disorders
- Safe removal of the chemical from their bodies (detoxification)
- Breaking through the denial that perpetuates the illness (rehabilitation)
5 Most common reasons for not obtaining treatment for substance abuse
- Not ready to stop using
- Could not afford the cost
- Did not know where to go for help
- Fear of negative effects on the job
- Worry that neighbors/community would have a negative opinion
