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Mental Health Care > Week 9 - Important concepts > Flashcards

Week 9 - Important concepts Flashcards

1
Q

Chronic, relapsing medication condition

A

Addiction

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2
Q

Most prevalent medical condition, cause of preventable death and contributor of excess health spending

A

Addiction

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3
Q

State of being determined, influenced, or controlled by something else; subordination to someone or something needed or greatly desired

A

Dependence

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4
Q

When a substance is required for normal physiological or psychological function

A

Dependence

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5
Q

Risk factors for addiction.

Where?

A

Where - doesn’t discriminate - in all societies, cultures, classes, genders

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6
Q

Risk factors for addiction

Who is at risk?

A
  • Genetic factors (40-60%)
  • Males
  • Childhood trauma
  • Learning disorders and ADD/ADHD
  • Mental illness (depression, bipolar disorder, psychosis, ADH)
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7
Q

What are some reasons people use drugs?

A

Feels good, relieves boredom, acceptance and peer pressure, escape, relieve pain, etc.

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8
Q

What are the different addiction theories?

A 
Neurobiologic
Psychologiacl
Social
Spiritual
Public Health
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9
Q

Describe the neurobiologic theories of addictoin.

A

Drugs activate the reward pathway (dopamine) when taken in excess
Prolonged use may alter brain structure/chemistry
Use interferes with voluntary control which persists beyond withdrawal - responsible for relapse

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10
Q

Psychological theories of addiction

  • Addiction is considered a _______ disorder
  • Occurs in a _______ _______,in which an ________ predisposed state determines the ________ that is induced
A

behavioural

vulnerable phenotype, in which an intrinsic predisposed state determines the neuroplasticity that is induced

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11
Q

Describe the social theories of addiction

A

All societies have the problem of addiction.

The issue is related to substance availability, legislation and health policies.

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12
Q

Describe a prominent group related to spiritual theories.

A

Spirituality is an integral component of the 12 step tradition of AA.
However, not necessarily religious, but concept of “something bigger than me”
- doesn’t absolve the person of responsibility, but can guide recovery

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13
Q

Spiritual theories:

- Recovery from addiction is often motivated by or achieved through ________ experiences

A

spiritual

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14
Q

Describe public health theories.

A

Considers interactions between host, agent, vector, environment
Host = individual
Agent = substance
Vector = supplier
Environment = cultural, political, economic contexts

Tries to explain the prevalence and existence of substance use

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15
Q

SUD
- New in the DSM-V is the aspect of ________
- Based on the pathological patterns of ___ behaviours
- Mild - ?
- Moderate - ?
Severe - ?
- Level of severity may fluctuate over _____

A 
culture
11
Mild - 2-3
Moderate - 4-5
Severe - 6+
Level of severity may fluctuate with time
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16
Q

There are 4 categories of behaviour related to SUD. What are they?

A

Impaired control over use
Social impairment
Risky use
Pharmacologic

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17
Q

This isn’t addiction yet, but an earlier intervention can be started.

A

Impaired control of use

18
Q

What are different signs of impaired control of use?

A 
Taking larger doses than prescribed
Excess amounts of illicit substances
Longer duration than recommended
Failed attempts at cessatoin
Cravings
19
Q

Telling feature of an impending SUD

A

Cravings

20
Q

Social impairment:

  • Failure to cope at these locations
  • Continued use despite ______/__________ problems as a direct result
  • Avoiding/ceasing important _______ activities
A

home, work, school
social/interpersonal
social

21
Q

Continued use in hazardous situations

i.e. continued use despite known physical/psychological problems either caused or exarcerbated by substance

A

Risky use

22
Q

Pharmacologic - Category of behaviour - describe

A

Needing to increase dose to achieve same results - i.e. regular dose no longer achieving desired effects

23
Q

What do we see in the pharmacologic category of behaviour in addiction?

A

Tolerance - needing a larger dose to achieve the same effect

Withdrawal - non-specific criteria but generally thought to include cravings, tremors, sweating, vomiting, etc.

24
Q

What is London’s biggest drug problem?

A

Meth

25
Q

SUD in nurses

  • prevalence in relation to the general population
  • reluctance to acknowledge issues as a ________
A

similar to, or greater than in general population

reluctance to acknowledge issue as a profession

26
Q

What is the bigger issue related to SUD in nurses?

A

Impaired nurse - can’t have them caring for individuals

27
Q

Precipitating factors to SUD development in the psychiatric nursing domain.

A

Family/social history
Emotional/behavioural complexities
Trauma

28
Q

Often, in the physical domain, we assess for _______ that may go along with substance abuse.
Screen for these.
Physical signs in drug useage/stoppage.
What are some tests done?

A

comorbidities
Screen for infection/communicable diseases
Risk for overdose/withdrawal
Lab values - liver function tests, kidney function test (BUN/creatinine), pregnancy, CBC

29
Q

Nursing interventions - SUD

  • Brief intervention - _____
  • CBT
  • __________ interviewing
  • _________ management
A

FRAME
motivational
withdrawal

30
Q

Describe an example in reduction of severity in drug use.

What is the ultimate goal of treatment for SUD?

A

Heroin to methodone

Abstinence is the ultimate goal, but not something we typically start off with

31
Q

Principles of addictions treatment:

  • Recognize addiction as a ________ disease
  • Must be readily available to do this
  • Focuses on ________ issues within the individual, not just the drug addiction
  • ________ therapies effective
A

chronic
readily available to capitalize on pts willingness to quit/change
individual issues - not just addiction
behavioural

32
Q

Any ________ addict will always be (same word) ________.

A

recovering

33
Q

Addictions treatment principles:

  • ________ are important for many patients
  • must consider concurrent ________ ________
  • involuntary treatments efficacy?
  • _________ will happen
A

medications
mental disorders
involuntary treatments may still be effective
relapses will happen

34
Q

Alcohol Addiction - the 12 step program:

  • Reinforces addiction as a ________, progressive disease that is _________, but not ________
  • AA established in the _______
  • Only entrance requirement is this
  • Acknowledgement of this is a central concept
  • ______ is the key to success
  • Large _______ component
A

chronic
managed, not cured
1930s
only entrance requirement is the desire to quit drinking
acknowledgement of higher power is a central component
support is the key to success
Large peer component

35
Q

AA, as a _______ therapy has been proven to be ___________.

A

group

effective

36
Q

Most widely used illicit drug in Canada?

A

Cannabis

37
Q

Syndrome related to cannabis use, especially in this population.
High potency strains can produce these symptoms.
___-___% of those involved in MVAs had THC on board.

A

Cannabinoid hyperemesis syndrome - violent, prolonged vomiting occurring as the result of too much marijuana - prevalent in young HS kids
4-14%
High potency strains can produce psychotic symptoms

38
Q

Opioids
- CNS ________
- example of a naturally occuring one? semi-synthetic? Synthetic?
- Indication?
- Overdose often leads to?
What is a large contributor to the opioid epidemic?

A 
depressants
morphine - natural
heroine - semi
fentanyl - synthetic
Analgesic
Respiratory depression
Injudicious prescribing (i.e. over-prescribing) is a large contributor
39
Q

Examples of stimulants?
What is the most deadly 2 drug combo leading to death?
Describe the typical cocaine high and withdrawal pattern.

A

Cocaine, methamphetamine, methylphenidate (Ritalin)
Cocaine/alcohol compo is the most common 2 drug combo resulting in death
Cocaine high followed by a very intense low
Cocaine withdrawal mostly uncomplicated

40
Q

Most vulnerable life stage for SUD development.
Peak lifetime alcohol consumption occurs at this age.
Harm reductoin strategies are often used for these individuals with SUD.
Very large issue in this population.
Risk for these diseases as a result of drug use.

A

Adolescence
Late teens to early 20s
Harm reduction for pregnancy and lactation
Large issue in aboriginal populations
Risk for HIV/AIDS and other communicable illnesses

Mental Health Care (11 decks)

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