Chapter 23 (2)

What are the two groups of substance-related disorders?

Substance-use disorders (addiction) and substance-induced disorders.

Define addiction.

Addiction is a compulsive or chronic requirement for a substance that generates distress if unmet.

What is the definition of intoxication?

A state of disturbance in cognition, perception, behavior, level of consciousness, judgment, and other functions due to psychoactive drug effects.

What does the DSM-5 specify about substance use disorders?

Individuals are considered to have a substance use disorder when their substance use interferes with fulfilling role obligations.

Describe withdrawal in terms of substance use.

Withdrawal is the physiological and mental readjustment that accompanies the discontinuation of an addictive substance.

What are two biological factors influencing substance use?

Genetics and biochemistry.

How does genetics influence the risk of developing alcoholism?

Children of alcoholics are four times more likely to become alcoholics themselves.

What role does biochemistry play in substance use?

Changes in brain structure and neurochemistry occur with the development of addiction.

What psychological factors influence substance use?

Developmental influences, personality factors, and cognitive factors.

What are the phases of alcohol use according to Jellinek?

1. Prealcoholic phase; 2. Early alcoholic phase; 3. Crucial phase; 4. Chronic phase.

What characterizes the crucial phase of alcohol use?

Loss of control over drinking, binge drinking, and significant negative consequences.

What are common effects of alcohol abuse on the body?

Peripheral neuropathy, alcoholic myopathy, and Wernicke's encephalopathy.

What is Wernicke's encephalopathy?

The most serious form of thiamine deficiency in alcoholics, with symptoms including paralysis of ocular muscles and confusion.

How does alcohol affect the cardiovascular system?

Alcohol can induce cardiomyopathy and changes that may lead to congestive heart failure or arrhythmias.

List complications associated with cirrhosis of the liver.

Portal hypertension, ascites, esophageal varices, and hepatic encephalopathy.

What is the purpose of disulfiram (Antabuse) in alcohol use treatment?

It acts as a deterrent to drinking, causing unpleasant reactions when alcohol is consumed.

What are the withdrawal symptoms of alcohol?

Tremors, nausea, irritability, and potential seizures.

Describe the effects of cannabis on the body.

Increases heart rate, may cause bronchodilation, changes in sexual function, and psychological effects of euphoria and altered perception.

What is the effect of opioids on the body?

Euphoria, analgesia, drowsiness, and potential respiratory depression.

Describe symptoms of opioid withdrawal.

Dysphoria, muscle aches, nausea, sweating, and abdominal cramping.

What is a key component of Alcoholics Anonymous (AA)?

Peer support and acceptance among individuals with a common goal of sobriety.

List examples of medications used in opioid withdrawal treatment.

Methadone, buprenorphine, naltrexone, and clonidine.

What role do behavioral therapies play in the treatment of gambling disorder?

They help individuals recognize harmful gambling patterns and develop coping strategies.

What are some symptoms of gambling disorder?

Persistent gambling behavior leading to significant impairment, anxiety, and loss of control.

What is a significant risk factor for developing gambling disorder?

Genetic predisposition and exposure to gambling activities during childhood.

What are common treatment modalities for gambling disorder?

Behavior therapy, SSRIs, and participation in support groups like Gamblers Anonymous.

Define substance use disorder as per the DSM-5 criteria.

A problematic pattern of substance use leading to clinically significant impairment or distress.

What percentage of adults are reported to have used marijuana at least once in their life?

About 45.3% of adults aged 12 years or older.

What is the relationship between codependency and addiction?

Individuals with codependent tendencies often prioritize others' needs over their own and may enable addiction.

What are the characteristics of a codependent personality?

Taking care of others at the expense of oneself, low self-esteem, and needing approval from others.

What is the main focus of motivational interviewing in substance abuse treatment?

Empowering patients and actively engaging them in their recovery process.

Identify a common outcome criterion for patients with substance use disorder.

Displaying adaptive coping mechanisms instead of relying on substances.

When is medication-assisted treatment typically required?

For substance use disorders involving alcohol, opioids, and certain CNS depressants.

A 35-year-old patient presents with severe anxiety and avoidance behavior in social situations. What diagnosis should be considered?

Social Anxiety Disorder.

A nurse finds a patient pacing and appearing frantic. What is the priority nursing intervention?

Assess the patient's level of anxiety and ensure safety.

During a mental health assessment, a patient exhibits flat affect and lacks motivation. What condition might this indicate?

Major Depressive Disorder.

In group therapy, a patient expresses anger toward others. How should the nurse respond?

Encourage the patient to explore and express those feelings in a constructive manner.

A client with schizophrenia believes that their thoughts are being controlled by an external force. What type of delusion is this?

Delusion of control.

A patient states, 'I can’t talk to anyone; I'm not worth it.' How should the nurse respond?

Validate the patient's feelings and explore reasons for their self-assessment.

What is an appropriate nursing action for a patient experiencing panic attacks?

Teach deep breathing and relaxation techniques.

A patient diagnosed with bipolar disorder is in a manic phase. What is the priority nursing diagnosis?

Risk for injury related to hyperactivity and impulsivity.

A patient expresses feelings of hopelessness and plans to ‘end it all.’ What is the immediate nursing intervention?

Ensure patient safety by conducting a suicide risk assessment.

A nurse is caring for a patient with borderline personality disorder. What behavior should the nurse monitor closely?

Self-harming behaviors or suicidal ideation.

What are the dangers of using stimulants?

Potential for cardiac issues, increased blood pressure, and heightened risk of addiction.

What is methamphetamine?

A powerful and highly addictive stimulant that affects the central nervous system.

Describe the effects of hallucinogens.

Altered perceptions, mood changes, and distorted reality.

What treatment is often used for opioid overdose?

Naloxone, an opioid antagonist that can reverse the effects of opioid toxicity.

What are synthetic cannabinoids?

Man-made chemicals that mimic THC, the active ingredient in marijuana, but can have unpredictable effects.

What is the role of buprenorphine in opioid addiction treatment?

It helps to reduce withdrawal symptoms and cravings by partially stimulating opioid receptors.

What is the main concern with prescription drug abuse?

Increased risk of addiction, overdose, and interaction with other substances.

What are common signs of substance use disorder?

Inability to control use, continued use despite problems, and cravings for substance.

What is the purpose of a drug intervention?

To encourage someone to seek treatment for substance use issues.

What is harm reduction in substance use treatment?

Strategies that minimize negative consequences of substance use rather than focusing solely on cessation.