Substance Use (Exam 3)

Question 1

Alcohol use demographics

Answer 1

• 70% of adults ages 18+ report drinking in past year
• 54% reported drinking past month
• 25% of people reported binge drinking past month
• 18.5% of all emergency department visits are cause of alcohol
• more than 10,000 people die each year in alcohol related driving deaths

alcohol is the most used and abused psychoactive drug in the us

Question 2

Binge drinking

Answer 2

consuming 4+ drinks in 2 hours for women
5+ drinks in 2 hrs for men
higher for individuals 18-22 yrs

Question 3

Low/moderate drinking

Answer 3

2 or less drinks a day for men
1 or less drinks a day for women

Question 4

Heavy drinking

Answer 4

15 or more drinks per week for men
8 or more drinks for women

Question 5

Standard drink comparisons

Answer 5

• 12 oz. of beer/cooler (5% alcohol)
• 8-9 oz of malt liquor (7% alcohol)
• 5 oz of table wine (12% alcohol)
• 3-4 oz fortified wine (sherry/port) (17% alcohol)
• 1.5 oz spirits (40% alcohol)
• 3 oz martini=2 standard drinks (40% alcohol)

Question 6

Categories of illicit drug use

Answer 6

• marijuana
• coke
• heroin
• hallucinogens
• inhalants
• meth
• nonmedical use of psychotherapeutics (prescription pain relievers, tranquilizers, stimulants, sedatives)

Question 7

Subjective Data

Answer 7

screen for alcohol use/dependance
screen by asking general questions or using abuse tool
interview should be private, confidential, nonconfrontational

Question 8

AUDIT domains

Answer 8

alcohol consumption
drinking behavior/dependance
adverse consequences from alcohol

AUDIT-C: abbreviated version for acute/critical care

Question 9

CAGE screening tool

Answer 9

tests for lifetime alcohol use/dependence
less effective for women and minority groups

Question 10

Screening women for alcohol problems

Answer 10

identify at risk drinking in women especially pregnant people
is teams of the guilt question from CAGE, TWEAK includes a question that measures tolerance

Question 11

TWEAK

Answer 11

Tolerance (2)

Question 12

TWEAK

Answer 12

Worry (2)

have close friends or relatives worried or complained about your drinking?

Question 13

TWEAK

Answer 13

Eye-opener (1)

Question 14

TWEAK

Answer 14

Amnesia (1)

Question 15

TWEAK

Answer 15

Kut down (1)

do you sometimes feel the need to cut down on your drinking?

Question 16

SMAST-G

Answer 16

use for older adults who report social/regular drinking of any amount of alcohol
can reveal an alcohol problem and need for more in depth assessment

Question 17

Objective Data

Answer 17

• lab findings (GGT, CDT, AST, MCV)
• breath alcohol
• BAC (0.08% or more is legal intoxication in most states, equal to 3 standard drinks)

Question 18

CIWA (Clinical Withdrawal Assessment)

Answer 18

measures progress of alcohol withdrawal
elevated scores prompt interventions to avoid advanced withdrawal stages (delirium tremens)

8 or more; take vitals every hour for 8 hrs
8; may trigger PRN meds
15 or more; triggers scheduled meds

Question 19

Appearance and Behavior: Alcohol

Answer 19

• unsteady gait
• incoordination
• nystagmus
• flushed face
• sedation
• relief of anxiety
• impaired judgement
• uninhibited behavior
• talkativeness
• slurred speech
• impaired memory
• irritability
• depression

Question 20

Appearance and Behavior: Sedatives/Hypnotics (Benzos)

Answer 20

• unsteady gait
• incoordination
• talkativeness
• slurred speech
• impaired memory
• irritability
• emotional lability
• sexual aggression
• impaired judgment
• impaired social/occupational functioning

Question 21

Appearance and Behavior: Nicotine

Answer 21

• alert
• increased systolic BP and HR
• vasoconstriction
• nausea
• vomiting
• loss of appetite
• head rush
• dizziness
• mild stimulant

Question 22

Appearance and Behavior: Weed

Answer 22

• red eyes
• tachycardia
• dry mouth
• increased appetite, especially for junk
• loss of coordination and balance
• euphoria
• pleasant state of relaxation and tranquility
• slowed time perception
• increased perceptions
• impaired judgment
• social withdrawal
• anxiety
• suspiciousness or paranoid ideation

Question 23

Appearance and Behavior: Coke and crack

Answer 23

• dilated pupils
• tachycardia/bradycardia
• elevated or lowered BP
• sweating
• chills
• n/v
• weight loss
• euphoria
• talkativeness
• hyper vigilance
• pacing
• psychomotor agitation
• impaired social/occupational functioning
• fighting
• grandiosity
• visual/tactile hallucinations

Question 24

Appearance and Behavior: Amphetamines

Answer 24

• dilated pupils
• tachycardia/bradycardia
• elevated or lowered BP
• sweating
• chills
• n/v
• weight loss
• elation
• talkativeness
• hyper vigilance
• psychomotor agitation
• impaired social/occupational functioning
• fighting
• grandiosity
• impaired judgement

Question 25

Appearance and Behavior: Opiates (morphine, heroin, meperidine)

Answer 25

• pinpoint pupils • decreased BP, pulse, RR, and temp • lethargy • somnolence • slurred speech • initial euphoria followed by apathy, dysphoria, psychomotor retardation • inattention • impaired memory/judgement • impaired social or occupational functioning

Question 26

Intoxication

Answer 26

ingestion of substance provides maladaptive behavioral changes because of effects on CNS

Question 27

Abuse

Answer 27

daily use needed to function, inability to stop, impaired social and occupational functioning, recurrent use when it is physically hazardous, substances related legal problems

Question 28

Dependance

Answer 28

physiological dependence on substance

Question 29

Withdrawal

Answer 29

cessation of substance produces syndrome of physiologic symptoms