Substance Use Disorder (Final)

Question 1

Addiction

Answer 1

-Is a DISEASE, known as substance use disorder: affected by both environmental and biological factos

Question 2

Rewarding effects of drugs come from large and ripd upsurges of

Answer 2

dopamine

Main neurotransmitter we focus on for addiction and substance use disorder

Mimics regular pleasure response, but greatly exceeds it

Lots of dopamine surges disturb normal dopamine pathways, thereby disturbing normal brain pathways/hierarchy (receptor down regulation)

Question 3

Addiction is associated with issues in the

Answer 3

Prefrontal cortex

Question 4

Bain changes in Substance Use Disorder

Answer 4

-Looking at dopamine transporters, red indicates high activity, yellow indicates moderate, green indicates little

-Over time our brain can go back to functioning normally

Question 5

Substance Use Disorder: Risk Factors

Answer 5

-Aggressive childhood behavior

-Lack of parental supervision

-Poor social skills

-Drug experimentation

-Availability of drugs at school

-Community poverty

Question 6

Substance use disorder: Protective factors

Answer 6

-Good self control

-Parental monitoring and support

-Good grades

-School anti-drug policies

-Neighborhood resources

Question 7

Treatment of substance use disorder

Answer 7

-No single treatment is appropriate for everyone

-Therapy is crucial
CBT
12 step program
Motivation enhancement therapy
Family therapy
Contingency management

-Treatment must address the whole person

Question 8

Medically assisted detoxification

Answer 8

-Rehab can be a first step

-Goes through withdrawal in a place with medically supervision

-Safest way to manage acute withdrawal symptoms associated with substance use disorders

Question 9

Treatment programs

Answer 9

-Need to test patients for other disease associated with substance use disorder

-Blood borne pathogens are very likely to be transmitted

Question 10

Endocarditis

Answer 10

-Side effects seen with long term IV drug use

-10 more likely to die or need surgery

-Cost a lot for our health care system

Question 11

Opioid Withdrawal Timeline (Heroin and Prescription Painkillers)

Answer 11

Onset: 12-24 hours
Peak: 72 hours
Duration: 5-10 days

Question 12

Opioid Withdrawal: S/S

Answer 12

-Flu-like symptoms, nausea, vomiting, stomach cramps, diarrhea, goosebumps, depression, craving, anxiety, sweating, muscle aches, fever

-Feel like you are dying

-Supportive treatment and MAT

Question 13

Opiate Withdrawal Timeline tbc

Answer 13

72 hours physcial symptoms peak

1 week physical symptoms start to lessen

2 week psychological and emotional symptoms begin

1 month cravings and depression

Question 14

Benzodiazepine and Alcohol Withdrawal

Answer 14

-Benzo’s and Alc both act on GABA receptors, therefore the withdrawal symptoms and treated the same

-Both have dangerous symptoms that can lead to death

Question 16

Benzo and Alc withdrawal: S/S

Answer 16

-Sleep disturbances, dry retching, irritability, nausea, increased tension, weight loss, anxiety, palpitations, panic attacks, anxiety, headache, muscle aches, sweating, difficulty concentration, and perceptual changes

Question 17

Dangerous symptoms of Benzo and Alc

Answer 17

-Seizures
-Hallucinations
-Delirium tremens (DT’s)
-Wernicke’s encephalopathy

Question 18

Wernicke’s Encephalopathy: 3 traits

Answer 18

1. Encephalopathy-profound disorientation, indifference, inattention
2. Oculomotr dysfunction (nystagmus, lateral rectus palsy and conjugate gaze palsy)
3. Gait ataxia

Question 19

Delirium Tremens

Answer 19

Hallucination

Disorientation

Tachycardia

Hypertension

Fever

Agitation

Diaphoresis

Question 20

Benzodiazepine Withdrawal Time Line

Answer 20

Onset: 1-4 days
Peak: 2 weeks
Duration: Months to years

Question 21

Signs and Symptoms of Benzo Abuse

Answer 21

-Drowsiness
-Memory Issues
-Irritability
-Slower thinking
-Increased anxiety
-Muscle weakness
-Sleeping and Eating changes

Question 22

Alcohol withdrawal timeline

Answer 22

Onset: 8 hours (Anxiety and insomnia)

Peak: 1-3 day peak (High BP, increased body temp)

Duration: 1 week (Hallucinations - Fever - Seizures - Agitation)

Question 23

Treatment of Alc and Benzo Withdrawal

Answer 23

Benzodiazepine taper

Helps prevent DT and Seizures

12 step treatment and therapy is also recommended

Vitamine supplementation (thiamine vitamin B1)

Question 24

methadone: Class

Answer 24

opioid

Question 25

Methadone: MOA

Answer 25

Mu agonist

Take up opioid receptor that would be empty

Question 26

methadone: Indications

Answer 26

-Used as medications treatment (MAT)

-Opioid withdrawal symptoms

-Heroin withdrawals

Question 27

Methadone Nursing implications

Answer 27

-once daily dose in methadone clinics

-Can cause access problems. hard to get to clinics at the same time everyday

-stays steady to they done feel high or sick. Keeps them straight

Question 28

Buprenorphine and naloxone

Answer 28

Opioid agonist and opioid antagonist

Suboxone

Combining helps patients recover more quickly from addictions

Still have potential for abuse but much less than methadone and buprenorphine alone

Sublingual and Buccal