Week 10 Addictions Flashcards
Addiction risk factors
Genetic Predisposition
- certain brain characteristics that can make someone more vulnerable to addictive substances than the average person
Psychological factors
- eg., stress, personality traits such as high impulsivity or sensation seeking, depression, anxiety, eating disorders, personality and other psychiatric disorders
Environmental factors
- eg., exposure to abuse or trauma, substance use or addiction in family/ peers, access, culture that encourages substance use, starting use at an early age
Addiction consequences
Physiological
- alcohol is generally metabolized slower in females than males and more likely to develop higher blood alcohol levels per drink
- females may be more likely to experience physical consequences of heavy ETOH use (eg., liver disease)
Psychological/ Psychosocial
- depressed/ anxious mood
- increased suicidality
- decreased social and occupational functioning (eg., relationship difficulties, absenteeism from work, decreased school performance)
- accidents (driving, workplace, etc)
There are 2 categories related to substance use
- Substance Use Disorders (SUD)
“Cognitive, behavioural, and physiological symptoms that indicate the individual continues to use the substance despite its negative consequences” - Substance Induced Disorders (SID)
- substance intoxication
- substance withdrawal
Substance intoxication definition
The development of a reversible substance-specific syndrome from recent ingestion
Substance withdrawal definition
Development of a substance-specific maladaptive behavioural change that is due to the cessation, or reduction, of heavy and prolonged substance
Acute alcohol withdrawal syndrome
Is a life-threatening condition that may occur unexpectedly whenever long-term daily alcohol consumption is abruptly discontinued
Alcohol detoxification
Treatment consists of achieving safe withdrawal from alcohol followed by supportive interventions/ referrals
When does alcohol withdrawal syndrome develop?
Usually develops in alcohol-dependent patients within 6-24 hours after abrupt discontinuation or decrease in alcohol consumption
AWS: Minor withdrawal
6-12 hours after last drink
- anxiety
- nausea/ vomiting
- coarse tremor
- sweating
- tachycardia
- hypertension
AWS: Intermediate
12-72 hours after last drink
- remain oriented and alert
- seizures (grand mal type)
- dysrhythmias
- hallucinations (auditory/ visual/ tactile)
- vitals can be normal
AWS: Major
5-6 days after severe, untreated
- delirium tremens (DTs) (tremors, hallucinations, anxiety, and disorientation)
- severe agitation
- gross tremulousness
- global confusion
- disorientation
- auditory, tactile, visual hallucinations
- psychomotor and autonomic hyperactivity (eg., htn, fever)
Assessment: history of alcohol use
Time of Last Drink
CAGE
CAGE abbreviation
- Have you felt you ought to Cut down on your drinking?
- Have people Annoyed you by criticizing your drinking?
- Have you felt Guilty about your drinking?
- Have you had a drink first thing in the morning to steady your nerves or get yourself going for the day?
Treatment of Alcohol Withdrawal Medications
Benzodiazepine (Lorazepam/ Diazepam)
Antiemetic PRN (Metoclopramide/ Ondansetron)
Haldol PRN
Multivitamin
Folic Acid
Thiamine
Hold diazepam or lorazepam if:
Systolic BP < 90 mmHg OR respiratory rate < 10 bpm
