Wk 8: substance use and misuse Flashcards
What are the three areas of harm that result from substance use and misuse?
- health harm
- social harm
- Economic harm
Does substance use physiologically impact the health of one group of the population more?
No and this is key to remember!
It impacts people regardless of their;
- age
- sex
- gender
- religion
= a complex public health issue
What are the economic impacts of substance use and misuse?
- significant personal financial costs
- significant costs to the community
- health illness
- job related issues (sick leave)
- physical impacts
What are specific examples of health harm that are linked to substance use and misuse?
- injury
- chronic conditions and preventable diseases
- diseases/disorders (e.g. lung cancer cardiovascular disease, fetal alcohol spectrum disorder)
- mental health problems
- road trauma
What are specific examples of social harm that are linked to substance use and misuse?
- violence
- crime and other
- unhealthy childhood development and trauma
- intergenerational trauma
- low drive to be social
- stigma around taking medication (particularly for those with mental health problems)
What are specific examples of economic harm that are linked to substance use and misuse?
- health care costs
- decreased productivity
- loss of income/employability (e.g. getting fired because you have an addiction to illicit substances or even alcohol in our system)
What is the impact of substance use on mental health?
- use of tobacco, alcohol and other drugs can interact with a person’s mental health.
- Mental disorders can be induced by substance use e.g. psychosis
- Can have serious adverse effects on areas of functioning (e.g. work, relationships, health, safety)
- Can cause co-occurring disorder (occurrence of substance use disorder with one or more mental health disorders)
Define co-occurring disorders
Co-occurring disorder: occurrence of substance use disorder with one or more mental health disorders
- Can also occur with physical health conditions (e.g. cirrhosis, hepatitis, intellectual/learning disabilities, cognitive impairment)
What are the DSM 5 10 different drug criteria?
- alcohol
- caffeine
- cannabis
- hallucinogens
- inhalants
- opioids
- sedatives/hypnotics/anxiolytics
- stimulants
- tobacco
- other unknown substances
What are the DSM5’s 2 types of substance-related disorders? and what they?
Substance-use disorders: occurs when the use of a substance affects a person’s brain and behavior, resulting in symptoms that affects and leads to an inability to control the use of a substance; severity ranges from mild to severe based on symptoms experienced.
- Overtime, the person might build up tolerance
Substance-induced disorders: occurs as a result of the use of a substance known to produce mental changes that may mimic another mental disorder, and are the result of intoxication, or withdrawal.
Explain the DSM 5 11 criteria points for problems associated with substance use disorder and how it is used.
Used to gauge the severity of the disorder. The number of problems experienced correlated to the severity in the key below;
- Mild substance use disorder = 2 or 3 symptoms
- Moderate substance use disorder = 4 or 5 symptoms
- Severe substance use disorder: 6 or more symptoms
DSM 5 outlines 11 criteria for problems associated with substance use:
1. Taking the substance in larger amounts or longer than intended
2. Wanting to cut down but not able to
3. Spending a lot of time getting, using, or recovering from use
4. Cravings and urges
5. Inability to do what you need to do (e.g. work, home, school)
6. Continuing to use even when it causes problems in relationships
7. Giving up important events (e.g. social, occupational, recreational)
8. Continually using when it is physically hazardous
9. Continual use despite physical/psychological problem that could have been caused by or made worse by the substance
10.Needing more of the substance (tolerance)
11.Experience of withdrawal symptoms (can be relieved by taking moreof the substance)
Define a substance-induced disorder and what it does?
= it occurs as a result of the use of a substance known to produce mental changes that may mimic another mental disorder, and are the result of intoxication, or withdrawal
- Symptoms experienced are a direct result of the substance use
- Can range from mild anxiety to mania and psychosis
- Can occur with use of alcohol, caffeine, cocaine, amphetamines, hallucinogens, nicotine, opioids, sedatives
Define intoxication
= any change in a person’s perception, mood, cognition, or behaviour after using a drug
What are the impacts of intoxication that nurses and midwives need to consider?
- complicates assessments
- complicated treatment/management
- can mask illness/injury (e.g. infection, hypoxia, injuries, pain levels)
- Can be life-threatening due to altered physical function (e.g. respiratory depression, temperature dysregulation), changes in mental state (e.g. paranoia)
Define withdrawal?
= process that occurs after stopping the use of a drug, or reducing the amount that is used.
What are key considerations of withdrawal symptoms?
- Signs, symptoms and length of withdrawal vary depending on the drug and the amount used
- Mostly, symptoms of withdrawal are the opposite of what is observed during intoxication
- Range from mild or uncomfortable to life-threatening
Define dependence
= occurs when withdrawal symptoms occur when the substance is not being used.
- Can be physical (physical symptoms of withdrawal e.g. sweating, nausea) or
- Psychological (cravings for substance when not using)
Define tolerance
= The need for more of a substance in order to achieve the same effect
Define overdose
= occurs as a result of accidental or intentional use of a drug in an amount that is higher than normally used, or higher purity of the substance.
What is associated challenges and effects are associated with co-occurring mental health disorders?
- complex challenges for staff
- serious adverse effects
- complicated other treatments
- More severe symptoms of mental disorder
- Reduced effectiveness of medications and adherence
- Reduced quality of life
- Family/social support disruptions
How do we categorise drugs? and what are they?
by their impact on the body
- stimulants
- Depressants
- Hallucinogens
- Cannabinoids*
What specific population groups are recognised by the National drug strategy are recognised as disproportionately more likely to increase harm associated with alcohol, tobacco and other substance use?
- people with mental health problems
- young people
- ATSI people
- The elderly
- Culturally and linguistically diverse people
- people in contact with those in the criminal justice people
- those who identify as in the LGBTIQA+ community
Describe the effect of stimulants, what are some symptoms and give examples of drugs in this category.
= Increase/speed up function of CNS
Symptoms: increased HR, increased BP, increased resps, reduced appetite, agitation, sleeplessness
- Larger doses can cause anxiety, panic, seizures, paranoia
E.g. amphetamines, caffeine, cocaine, ice, nicotine
Describe the effect of depressants, what are some symptoms and give examples of drugs in this category.
= Decrease/slow down function of CNS
Symptoms: affect concentration and coordination
- Small doses can cause relaxation, sense of calm and inhibition
- Larger doses can cause sleepiness, nausea and vomiting, unconsciousness, death
E.g. alcohol, benzodiazepines, GHB, kava