Addiction and Substance Abuse

Flashcards about Addiction, Substance Abuse, and Related Disorders

Addiction

A neuropsychological disorder defining pervasive and intense urge to engage in maladaptive behaviors providing immediate sensory rewards, despite their harmful consequences.

Dependence

Generally an addiction that can involve withdrawal issues.

Substance abuse

Using a drug in a way that is inconsistent with medical or social norms and despite negative consequences.

Substance dependence

Problems associated with addiction such as tolerance, withdrawal and unsuccessful attempts to stop using the substance.

Intoxication

Use of a substance that results in maladaptive behavior.

Blackout

Results from excessive alcohol consumption; episode during which the person continues to function but has no conscious awareness of his or her behavior at the time or later memory of the behavior (“gaps” in memory) not the same as passing out.

Withdrawal syndrome

Refers to the negative psychologic and physical reactions that occur when use of a substance ceases or dramatically decreases.

Detoxification

The process of safely withdrawing from a substance.

Alcohol

A CNS depressant; initial effects are relaxation and loss of inhibitions.

Alcohol intoxication

Slurred speech, unsteady gait, lack of coordination and impaired attention, concentration, memory and judgment; some become aggressive or display inappropriate sexual behavior; may also experience blackout.

Alcohol-related blackout

Involves losing your memory while you’re still awake and conscious; caused by drinking high quantities of alcohol, which leads to an impairment in the way your brain transfers memories from short- to long-term memory.

Withdrawal from alcohol

Occur 4 to 12 hours after cessation or marked reduction of alcohol intake. Symptoms: coarse hand tremors, sweating, elevated pulse and BP, insomnia, anxiety and nausea or vomiting

Severe untreated withdrawal may progress to transient hallucinations, seizures or delirium called__

delirium tremens

Detoxification from alcohol

Needs to be accomplished under medical supervision because alcohol withdrawal is life threatening.

Excessive alcohol intake (overdosage of alcohol) in a short period of time can result in vomiting, unconsciousness and respiratory depression. This may cause __

aspiration pneumonia or pulmonary obstruction

Alcohol induced hypotension can lead to __

cardiovascular shock and death

Treatment for overdosage of alcohol

Gastric lavage or dialysis.

Safe withdrawal from alcohol

Administration of benzodiazepines such as lorazepam, chlordiazepoxide or diazepam to suppress withdrawal symptoms.

Sedatives, Hypnotics and Anxiolytics

Includes all CNS depressants: barbiturates, nonbarbiturate hypnotics and anxiolytics, particularly Benzodiazepines.

Most frequently abused drugs in this category (sedatives, hypnotics, and anxiolytics)

benzodiazepines and barbiturates

Intoxication symptoms of Sedatives, Hypnotics and Anxiolytics

Slurred speech, lack of coordination, unsteady gait, labile mood, impaired attention or memory, stupor and coma.

Treatment for sedatives, hypnotics, and anxiolytics intoxication

gastric lavage

Withdrawal symptoms of Sedatives, Hypnotics and Anxiolytics

Autonomic hyperactivity (Increased pulse, BP RR and temperature), hand tremor, insomnia, anxiety, nausea and psychomotor agitation.

Tapering

Or administering decreasing doses of a medication; essential with barbiturates to prevent coma and death as a result of abrupt withdrawal.

Stimulants (Amphetamines, Cocaine)

Drugs that excite the CNS and have limited use (except when used to treat ADHD).

Amphetamines (uppers) used for __

weight lost in the past

Cocaine

illegal drug, highly addictive, virtually no clinical use in medicine, it is a recreational drug that causes intense and immediate feeling of euphoria (intense happiness and excitement)

Metamphetamine or “shabu”

dangerous drug, highly addictive and causes psychotic behavior, may cause brain damage when frequently used

Intoxication symptoms from stimulants

High or euphoric feeling, hyperactivity, hypervigilance, talkativeness, anxiety, grandiosity, hallucinations, stereotypic or repetitive behavior, anger, fighting and impaired judgment; physiologic effects: tachycardia, elevated BP, dilated pupils, perspiration or chills, nausea, chest pain, confusion, and cardiac dysrhythmias.

Physiologic effects of intoxication of stimulants

tachycardia, elevated BP, dilated pupils, perspiration or chills, nausea, chest pain, confusion, and cardiac dysrhythmias

Overdosage of stimulants

seizures, coma, deaths are rare

Treatment for stimulant intoxication

chlorpromazine (Thorazine), an antipsychotic, controls hallucinations, lowers BP and relieves nausea

Withdrawal from stimulants

Marked dysphoria(unhappy) accompanied by fatigue, vivid and unpleasant dreams, insomnia or hypersomnia, increased appetite and psychomotor retardation or agitation. Not life threatening

Cannabis sativa (marijuana)

Hemp plant widely cultivated for its fiber used to make rope and cloth and for oil from its seeds. Refers to the upper leaves, flowering tops and stems of the plants.

Intoxication from Cannabis

Begins to act less than 1 minute after inhalation; peak effect: occur 20-30 minutes and lasts at least 2 to 3 hours

Symptoms of intoxication of cannabis

impaired motor coordination, inappropriate laughter, impaired judgment and short term memory and distortions of time and perception

Physiologic effects of intoxication of cannabis

blood shot eyes, dry mouth , hypotension and tachycardia.

Withdrawal symptoms of cannabis

muscle aches, sweating, anxiety and tremors

Opioids

Popular drugs that desensitize the user to both physiologic and psychologic pain and induce a sense of euphoria and well being.

Intoxication symptoms of Opioids

Apathy, lethargy;listlessness, impaired judgment, psychomotor retardation or agitation, constricted pupils, drowsiness, slurred speech, impaired attention and memory

Severe intoxication of opioids may lead to?

coma, respiratory depression, pupillary constriction, unconsciousness, and death.

Treatment of choice for Opioid intoxication

Administration of naloxone (Narcan), an opioid antagonist, it reverses all signs of opioid toxicity.

How is narcan administered?

given every few hours until opioid level drops to non toxic ,process may take days

Withdrawal symptoms of Opioids

Anxiety, restlessness,aching back and legs cravings for more opioids, N & V, dysphoria, lacrimation, rhinorrhea, sweating, diarrhea, yawning, fever, insomnia.

Hallucinogens

Substances that distort the user’s perception of reality and produce symptoms similar to psychosis including visual hallucination and depersonalization; may cause increased pulse, BP and temperature; dilated pupils and hyperreflexia.

Intoxication symptoms of Hallucinogens

Anxiety, depression, paranoid ideation,ideas of reference, fear of losing one’s mind and potentially dangerous behavior.

Inhalants

Anesthetics, nitrates, organic solvents; can cause significant brain damage, peripheral nervous system damage, liver disease.

Most common substances (inhalants)

glue, paint thinner and spray paint

Intoxication symptoms of Inhalants

Dizziness, nystagmus(involuntary eye movements), lack of coordination, slurred speech, unsteady gait, tremor, muscle weakness, blurred vision, stupor(near unconsciousness) and coma can occur

behavioral symptom of inhalant intoxication

hostility, aggression, apathy, impaired judgment and inability to function.

Acute toxicity (inhalants)

anoxia, respiratory depression(slows down brain activity) vagal stimulation and dysrhythmias

(inhalant) death may occur from?

bronchospasm(tightening of bronchial airways), cardiac arrest, suffocation or aspiration of compound or vomitus

Treatment of Inhalant toxicity

Supporting respiratory and cardiac functioning until substance is removed from the body.

AA: ALCOHOLICS ANONYMOUS

founded in the 1930s by alcoholics, a self-help grouped that developed the 12 step program model for recovery; Philosophy: total abstinence is essential and that alcoholics need the help and support of others to maintain sobriety.

Vit B (thiamine) is prescribed to combat or prevent __

Wernicke-Korsakoff syndrome

2 main purpose of pharmacologic treatment

permit safe withdrawal and prevent relapse