Substance Use Disorders, Schizophrenia and Psychotic Disorders Flashcards
List some intoxicating or addictive substances below:
- Alcohol
- Cannabis
- Nicotine
- Opioids
How would you respond to the following statements:
People who are addicted to alcohol and/or other drugs are responsible for their behaviour
No, because some people who are addicted to substances were introduced to it in an early age, some people also become addicted to substances to relieve physical pain or past trauma that they may of experienced. Some people can be drugged by other people as well ie. spiking peoples drinks
How would you respond to the following statements:
Alcohol and other intoxicating substances are a form of self-harm
Yes to some degree, alcohol and other intoxicating substances do harm your body and are a form of self-harm but people in society are not aware or taught of the of the harmful extends that alcohol and drugs can cause to the body.
How would you respond to the following statements:
People who become a risk to themselves and/or others due to intoxication are irresponsible and need to be held accountable.
Yes to some degree, if someone is intoxicated and put’s themselves or other people’s life at risk they should be held accountable, but in some circumstances some people get spiked or drugged and cannot control
Abstinence is the only way to manage addiction
No
Before you complete the activities consider the following questions:
Why do you think people are so reluctant to admit they have a substance-related disorder or another addiction, such as gambling?
- Shame
- Guilt
- Fear of receiving stigma, discrimination and judgement from family, friends and the community
What do you think are some of the attitudes and skills required to work with people with addictions?
- To be compassionate and empathic
- Be able to create a supportive and non-judgemental environment
- Maintain hope and optimism, support the recovery and journey of the individual
- Active listening and effective communication
Nursing intervention: Brief intervention
Brief interventions (talking to people at an early stage in their substance use) are effective ways to prevent later possible complications of substance use. Brief interventions for substance use involve sessions of 5–15 minutes and often include providing self-help materials such as pamphlets or substance use diaries. This may extend to a brief assessment and providing advice, as well as assessing the client’s readiness to change
The components of brief interventions include:
- Assessment
- Providing feedback to the client on risk or impairments due to drug use
- Listening to the client’s concerns and advising the client about the consequences of continued drug use
- Defining treatment goals such as reducing or ceasing drug use
- Discussing and implementing strategies for treatment (e.g. identifying triggers for drug use and strategies to overcome them and offering a follow-up session)
Motivational interviewing: Pre - contemplation
- The client has no intention of changing. They are in “denial” about the need for change. The therapist works to increase the awareness of the problem while consistently remaining non-judgmental and respectful. Rapport is essential during this phase.
Motivational interviewing: Contemplation
The client is aware of their problem, but remain ambivalent about change. The therapist acknowledges the client’s ambivalence while working to tip the decisional balance by weighing the pros and cons of change versus the risks and benefits of continuing substance use. Responsibility for change remains with the client
Motivational interviewing: Preparation
The client intents to change, but might be confused about the best way to do so. The therapist inspires realistic hope, offers a menu of choices to help determine the best course of action and demystifies the change process. Both work to create a plan for change
Motivational Interviewing: Action
Actual behaviour change commences. The client implements a collaborative, realistic plan. Both the therapist and the client monitor the client’s progress, highlighting even small successes, and progressively problem solving
Motivational Interviewing: Maintenance
Behaviour change has been achieved and the client has developed a new lifestyle. The therapist and the client and vigilant to avoid relapse. They have realistic hopes and avoid exaggerated expectations.
Relapse prevention
All clients should have a plan, so that if they do lapse, they have support and strategies available to avoid the more dangerous relapse. A lapse should be viewed as a learning experience for both the client and the clinician. For example: What were the triggers that led to the lapse? How did the client manage to contain their substance use to a lapse and not relapse into old behaviours?, the clinician explores the client’s underlying thoughts and feelings that resulted in the lapse. The clinician’s role is to assist the client to work through the thoughts that contributed to the lapse and replace them with less damaging thought processes for the future
Harm minimisation and harm reduction
Find three more examples of harm reduction strategies used in NZ
Examples of harm-reduction strategies:
* Needle exchange programmes
* Methadone programmes (Opioid Recovery Service)
* Nicotine replacement therapy (NRT)
- NA (narcotics anonymous)
- AA
- Know Your Stuff
Substance withdrawal and detoxification; identify the core information nurses need to develop an understanding of assessment and treatment in the listed categories here.
*this is often assessed in the KN601 exam and your state exam
Alcohol Withdrawal
Common symptoms: Anxiety, agitation, sweating, tremors, nausea, elevated blood pressure, confusion
Pharmacological management:
Benzodiazepines, Thiamine
Nursing management:
Reduce agitation and remain calm, monitor vital signs, keep client calm and reduce exhaustion, hydration
Substance withdrawal and detoxification (five main areas)
* Minimising progression to severe withdrawal
* Decreasing risk of injury
* Eliminating risk of dehydration, electrolyte and nutritional imbalance
* Reducing risk of seizures
* Identifying presence of concurrent of differential diagnosis
What do you see as being stigmatising?
When someone treats someone unfairly by publicly disapproving of them in society
The diathesis-stress model (i.e. stress-vulnerability)
That individuals are exposed to stressful events in the course of their lives and that these events may precipitate symptoms in some people who have a predisposition to mental illness, this vulnerability may be related to genetics,, environmental factors, aberrations in bran anatomy or biochemistry, or more likely a combination of all these things.
Biochemical theories
Chemicals known as neurotransmitters responsible for the transmission of nerve impulses across the synapse have also been thought to be responsible for the development of schizophrenia, schizophrenia relates to an abnormal amount or action of the neurotransmitter dopamine in the brain of the person diagnosed with schizophrenia.
Content of thought: Delusion
Fixed false beliefs that are inconsistent with one’s social, cultural and religious beliefs and not amenable to change, despite conflicting evidence or argumentation
Content of thought: Persecutory
The belief that the person is being harmed or harassed, conspired against, cheated, spied on, followed or obstructed in the pursuit of long-term goals
Content of thought: Somatic
Preoccupation with the person’s organs, health or bodily functions
Content of thought: Religious
Belief that the person has become or is being influenced by religious figures in various ways
Content of thought: Referential
Belief that gestures, comments and/or environmental circumstances are directed at the person
