Substance Use Disorder Flashcards
what is addiction
a brain disease that evolves as a result of drug/alcohol use, sexting, gambling, and overeating
difference between substance abuse and dependence
abuse - use outside of social acceptance/medical necessity - adverse effects to self/others
dependence - tolerance - higher dose to illicit same response - control lost - can be fatal
how does addiction happen
voluntary to compulsive use of a substance
reward circuit is activated (dopamine is released)
what stimulates the reward center leading to addiction
dopamine (responsible for pleasure/pain) - 1st time than can no longer stimulate reward center - addicts seek the dopamine release causing the addiction
special populations r/t substance use/abuse
nurses and pregnant women (should be screened)
most common used and abused substance
alcohol
moderate vs excessive use of alcohol
moderate - 2 glasses for men, 1 for women
excessive - creates problems for all organs, systems
***effects of alcohol on the body
depresses CNS function
enhances GABA inhibition
activates the reward circuit (regulated by dopamine)
2 chronic neuropsychiatric symptoms of alcohol
wernicke’s encephalopathy
korsakoff’s psychosis
s/s of wernicke’s encephalopathy
confusion, abnormal ocular movements caused by thiamine deficiency (diet or alcohol induced suppression of thiamine/b vitamin)
how is wernickes reversed
vitamin B
how is korsakoff’s psychosis reversed
it can not be reversed
effects of korsakoff’s psychosis
inability to convert short term memory into long term memory
chronic effects have a significant impact on cognition function over time, t or f
true - difficulty with memory and problem solving - deteriorates the neurons over time - interferes w/REM sleeping
appearance of alcohol intoxication
slurred speech, uncoordinated, impaired judgement
**s/s of alcohol withdraw
irritable, shaky, tremulous, may have seizures, increase in vital signs
**if withdraw for alcohol (CNS depressants) is not addressed what can happen
alcohol withdraw delirium
difference with withdraw and delirium
withdraw - shaky - delusions - hallucinations
delirium - change in LOC (in and out) - tactile (bugs crawling on the them)
treatment for delirium
IV Librium - haldol
to prevent seizures - dilantin
if trt is not followed for delirium what can occur
death can occur
CNS stimulants examples
caffeine, nicotine, crack cocaine
s/s of stimulant abuse
dilation of pupils
excessive motor activity
dry oronasal cavity
s/s of cocaine/crack intoxication
euphoric, impaired judgment, aggressive
increased HR, sweating, chills
pupils are dilated, hyperactive state
overdose of cocaine/crack can result in
MI, stroke, coma, or death
s/s of withdraw from cocaine/crack
depressed mood, insomnia, craving cocaine
drug of choice for alcohol withdraw
benzos
trt for cocaine/crack withdraw
nothing
**if withdrawing from an CNS stimulant closely monitor pt. for this
suicidal risk - effects neurotransmitters - rebound depression can occur
s/s of methamphetamine use
euphoria, aroused, “can accomplish anything” a lot of strength - mimics a psychotic state (hallucinations)
*do methamphetamine’s cause a physical or psychological dependence
psychological
s/s of methamphetamine withdraw
dysphoria, strong craving of the drug
most common effect of smoking
cardiovascular disease
largest preventable cause of premature death is from smoking, t or f
true
intoxication vs withdraw effects of opiods
intoxication - constricted pupils, decreased VS, decreased respiration’s, euphoric effect
withdraw - rarely fatal, n/v/d, anxious
opiod of choice, most common street drug
heroin - Oxycontin growing in prevalence
opiod overdose s/s
triad - resp. depression, coma, pinpoint pupils
agent used to reverse opiod overdose
narcan
effects of heroin
euphoria, lower abd. sensation similar to orgasm, n/v
opiod similar to morphine
oxycodone
drug most commonly abused by nurses and doctors
meperidine (taken orally)
oxycodone has a physical or psychological dependence
both a physical and psychological dependence
how is oxycodone used
crushed and snorted
Jessie had a blood alcohol level (BAL) of 0.11% upon arrival at the emergency department (ED). She is now your patient in the hospital psychiatric unit, day 4. She tells you, “ I wasn’t drunk. I just had a few beers.” What is an appropriate response?
- “Jessie, your BAL was 0.11%. That clearly indicates
that you had alcohol intoxication.”
A patient comes to an outpatient appointment obviously intoxicated. The nurse should:
D. tell the patient, “We cannot see you today because
you’ve been drinking.
Which nursing diagnosis would likely apply to both patients with paranoid schizophrenia and patients with amphetamine-induced psychosis?
B.Disturbed thought processes
A patient has smoked two packs of cigarettes daily for many years. When the patient does not smoke or tries to cut back, anxiety, craving, poor concentration, and headache result. What does this scenario describe?
C.Substance dependence
