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HNN222 Exam > Week 5 - Substance use disorders > Flashcards

Week 5 - Substance use disorders Flashcards

1
Q

Define Substance Use Disorder

A

Substance use disorder is the harmful and hazardous use, addiction and dependence on a substance, and is characterised by continued use and impaired control of the substance use, despite significant health consequences

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2
Q

Differentiate between harmful and hazardous substance use

A

Hazardous - has the potential for physical, psychological and social consequences
* MVA
* violence

Harmful - a pattern of substance use that is dangerous to health
* hepatitis from injecting
* liver disease
* depression

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3
Q

Differentiate between addiction and dependence

A

Addiction - use which causes changes to brain circuitry that persists after detoxification. These changes lead to chronic compulsive drug seeking and use
relates to a compulsion to use

Dependence - A behavioural, psychological and cognitive controlling urge to use substances after repeated use
relates to the bodys adaptation to long term misuse
*leads to withdrawal syndrome and tolerance

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4
Q

Alcohol

A

Depressant - decreases CNS activity

Physiological
* impaired coordination
* slurred speech
* N+V
* drowsiness
* blackouts

Psychological
* impaired decision making
* increased confidence
* impaired memory

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5
Q

Cannabis

A

Depressant - decreases CNS activity

Physiological
* tachycardia
* bloodshot eyes
* diminished psychomotor performance

Psychological
* relaxation
* euphoria
* drowsiness
* enhancement of senses
* pain relief
* increased appetite

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6
Q

Stimulants

A

Stimulants - stimulate CNS activity

Physiological
* overstimulation
* tachycardia and hypertension
* increased RR
* dry mouth
* jaw clenching and teeth grinding

Psychological
* euphoria
* confidence
* energy
* alertness
* talkative

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7
Q

Opioids

A

Depressant - decreases CNS activity

Physiological
* drowsiness
* sedation
* decreased RR
* nausea and vomiting
* high risk of overdose due to resp depression

Psychological
* euphoria
* tranquility
* apathy
* memory impairment

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8
Q

The spectrum of substance use

A

abstinent -> experimental -> recreatonal -> regular -> dependent

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9
Q

Physiology of addiction

A
  • The potency of substances stimulates the dopaminergic and endorphin reward pathways in the brain
  • creates euphoria and motivation
  • faster and more intense reward than other behaviours -> positive reinforcement of this behaviour -> excessive use
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10
Q

Explain dependence

A

Suggestive of more severe SUD

However

important to consider dependence without an SUD
* dependence on morphine for pain management
* they will experience withdrawal if abruptly ceased, but do not experience a compulsion

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11
Q

Explain tolerance

A

repeated chronic use of an illicit substance overstimulates the reward pathway

after a while, the body adjusts to excessive dopamine production and decreased high

person now requires increased dose to achieve same effect

tolerance may extend from a decreased pleasure in substance use to decreased pleasure in other areas eg. sex, eating

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12
Q

Explain withdrawal

A

refer to withdrawal syndrome

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13
Q

Biological causes of substance use disorders

A

Genetic vulnerability

Men
* brain development means they are more likely to develop AUD

Women
* more likely to experience harm from alcohol use
* reduced ability to metabolise alcohol
* vulnerability to sexual assault

Adolescence
* substance use in adolesence can compromise pre-frontal cortex development (last part of the brain to develop)
* responsible for executive functioning

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14
Q

Environmental causes of substance use disorders

A

Adolescence
* parents substance misuse
* increased risk taking behaviour, criminality, relationships
* peer pressure
* family dynamic
* abuse and trauma

Exposure to stress

cultural norms

SES
* employment
* education
* where you live
* your own relationships
* availability of substances

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15
Q

High risk populations

culture, high risk aus populations, religion, SES

A

Aboriginal and torres strait islander people, people living in rural and remote communities, and LGBTQI+ communities are more likely to consume more substances and experience substance related harm

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16
Q

Alcohol use disorder and consequences

A

A problematic pattern of alcohol usage leading to significant impairment or distress
* impaired control over usage
* social impairment due to usage
* craving
* effort to obtain
* recurrent use
* excessive use
* unsuccessful efforts to cut down

encompassing harmful and hazardous use, addiction and dependence with a continued use despite significant health impacts

Consequences include
* CV disease
* liver disease
* obesity
* Wernickes encephelopathy
* mood disorderws
* suicide and violence

17
Q

Cannabis use disorder and consequences

A

A problematic pattern of cannabis usage leading to significant impairment or distress
* impaired control over usage
* social impairment due to usage
* craving
* effort to obtain
* recurrent use
* excessive use
* unsuccessful efforts to cut down

encompassing harmful and hazardous use, addiction and dependence with a continued use despite significant health impacts

Consequences include
* Chronic resp symptoms and lung cancer
* cognitive problems
* appetite problems
* systemic problems in CV, immune, reproductive, neuromuscular systems
* exacerbation and emergence of a range of mental health issues eg. depression, anxiety, bipolar, psychosis, suicide

18
Q

Stimulant use disorder and consequences

A

A problematic pattern of stimulant usage leading to significant impairment or distress
* impaired control over usage
* social impairment due to usage
* craving
* effort to obtain
* recurrent use
* excessive use
* unsuccessful efforts to cut down

encompassing harmful and hazardous use, addiction and dependence with a continued use despite significant health impacts

Complications include
* liver and kidley failure
* cardiopulmonary problems
* respiratory problems (snorting)
* blood borne viruses and infection (injecting)
* tooth decay
* development of other mental health issues eg. anger, anxiety/panic

19
Q

Opioid use disorder and consequences

A

A problematic pattern of opioid usage leading to significant impairment or distress
* impaired control over usage
* social impairment due to usage
* craving
* effort to obtain
* recurrent use
* excessive use
* unsuccessful efforts to cut down

encompassing harmful and hazardous use, addiction and dependence with a continued use despite significant health impacts

Complications include
* nausea
* constipation
* amenorrhea
* CV and resp problems related to sedation
* Blood borne viruses, infections, and ‘track marks’ related to IV

20
Q

Wernickes encephalopathy

A

excessive and prolonged alcohol misuse -> depletion of vitamin B1 which is essential for CNS function

results in necrotic lesions on the brain stem

Symptoms (only one required for diagnosis)
* confusional state
* ocular disturbance
* ataxia - wide based steps

Nursing management
* reverse condition with IM B1 injection

21
Q

Delerium tremens

A

A severe form of alcohol withdrawal in heavy user. Medical emergency
1-5 days post withdrawal

Symptoms
* disorientation
* agitation
* labile blood pressure
* hallucinations
* nightmares

Nursing management
* manage agitation
* administer benzodaizepines to prevent seziures and death
* monitor vital signs
* assess withdrawal symptoms
* reorient person
* manage anxiety
* rehydrate

22
Q

Overdose and opioids

A

Opioids cause CNS depression and affect the part of the brain that regulates breathing

Signs of overdose
* cyanosis
* vomiting
* pinprick pupils
* slow respiration
* loss of consciousness
* pale and limp

Nursing management
* Naloxone administration and resus

Overdose risk is increased when mixing with other drugs

23
Q

Suicide

A

risk increases with substance use and again when in the presence of a mental health condition

Intentional and unintentional

Assessing for substance use in MSE and risk assessment is essential in deciding on risk of suicide

24
Q

During pregnancy

A
  • impacts foetal development
  • impacts birth
  • poor prenatal and postnatal care outcomes
  • Mother at risk of PND or PPP
25
Q

Define intoxication

A

The manifestation of significant behavioural and psychological changes which develop after substance consumption

26
Q

Explain the stages of stimulant withdrawal

A

Crash - extreme fatigue and lethargy 1-3 days post

Acute - depression, fatigue, vivid unpleasant dreams, insomnia etc. until 7-10 days post

Sub-acute - more extended less intense symptoms

Nursing care
* re-establish sleep
* manage agitation
* promote nutrition

27
Q

CAGE-AID

To screen for potential substance misuse

A

C - have you ever felt that you should cut down on your drinking and drug use

A - have people annoyed you by criticising your drinking/drug use

G - have you ever felt guilty about your drinking/drug use

E - Eye opener - have you ever had alcohol or drugs first thing in the morning to steady nerves or get rid of a hangover

28
Q

3 pillars of harm minimisation

A

Harm reduction
* clean injecting sites - reduce infection
* brief interventions
* peer education
* protecting children from exposure

Supply reduction
* legal restrictions on consumption and sale
* regulating and patrolling for illicit exchanges and use

Demand reduction
* education on impacts of substances
* encouraging help seeknig
* treatment services and brief community intervention

29
Q

Early intervention for SUD

A
  • Education programs
  • positive role modelling
  • counselling for substance use
  • clean injecting sites
30
Q

Tertiary treatment for SUD

A
  • SUD detox and withdrawal
  • CBT
  • relapse prevention and mindfulness based relapse prevention
  • self-help programs
31
Q

Nursing intervention and rationale for SUD

A

Comprehensive AOD assessment on admission and regularly throughout admission
* reduce mortality
* implement interventions eg. tapered withdrawal

MSE and risk assessment

Monitor for withdrawal symptoms

Monitor for symptoms of overdose

Build trusting relationship with consumer

Safe space for withdrawal to take place

discuss goals of recovery eg. harm minimisation or abstinence from substance and practice to achieve this

Support/encourage nutrition, sleep, personal hygeine

implement routine and stability

Psychoeducation

HNN222 Exam (8 decks)

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