Maladaptive Behavior: Substance Use Disorders, Intoxication, Overdose, and Detoxification

Vocabulary flashcards covering core definitions, clinical manifestations, assessment tools, and medical interventions for substance use disorders, intoxication, overdose, and detoxification.

Substance

A psychoactive compound with the potential to cause health and social problems.

Intoxication

A disturbance in behavior or mental function during or after a substance's consumption.

Overdose

The biological response of the human body when too much of a substance is ingested.

Substance Use Disorder (SUD)

A disease process caused by repeated misuse of substances that directly activates the brain reward system so intensely that normal life activities may be neglected.

Tolerance

A condition defined either by a need for markedly increased amounts of a substance to achieve intoxication or the desired effect, or by a markedly diminished effect with continued use of the same amount.

Withdrawal

A cluster of symptoms that occur when substance use is cut back or stopped following a period of prolonged use.

Alcohol Overdose

A dangerous state marked by mental confusion or stupor, inability to wake up, vomiting, seizures, slow respiratory rate ($< 8\text{ breaths per minute}$), irregular breathing ($\ge 10\text{ seconds}$ between breaths), slow heart rate, clammy skin, lack of gag reflex, extremely low body temperature, and cyanosis or paleness.

Delirium Tremens (DTs)

A rapid-onset, fluctuating disturbance of attention and cognition typically beginning between $48$ and $96\text{ hours}$ after the last drink, accompanied by agitation, visual or tactile hallucinations, and extreme autonomic hyperactivity including fever, severe tachycardia, hypertension, and drenching sweats.

Wernicke's Encephalopathy and Korsakoff's Syndrome

Neurological disorders associated with thiamine and magnesium depletion from chronic alcohol use, prevented during withdrawal treatment by administering intravenous thiamine along with dextrose.

Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar)

A 10-item assessment tool used to monitor the severity of alcohol withdrawal symptoms; prophylactic withdrawal medication is started for a total score of $8$ or greater, and additional PRN medication is administered for a score of $15$ or greater.

Opioid Overdose

A life-threatening condition characterized by pinpoint pupils, severe respiratory depression (slow/shallow breathing, choking, or gurgling/snoring noises), respiratory arrest, cyanosis, and decreased level of consciousness or coma.

Naloxone

An opioid antagonist medication administered during opioid overdose with respiratory depression; response is monitored and doses are repeated as needed every $2\text{ to }3\text{ minutes}$.

Clinical Opiate Withdrawal Scale (COWS)

An 11-item clinician-administered assessment scale used in inpatient and outpatient settings to rate signs and symptoms of opiate withdrawal and measure physical dependence.

COWS Severity Scoring

The total score range used to determine opiate withdrawal stage: mild ($5\text{--}12$), moderate ($13\text{--}24$), moderately severe ($25\text{--}36$), and severe (greater than $36$).

Flumazenil

An antidote used for sedative/hypnotic overdose that must be administered cautiously in individuals with benzodiazepine tolerance due to the risk of precipitating seizures.

Hyperthermia Management in Stimulant Overdose

Control of severe hyperthermia ($> 41^\circ\text{C}$) achieved through sedation, fluid resuscitation, and external cooling techniques, excluding antipyretics because elevated body temperature stems from muscular activity rather than a change in hypothalamic set point.

Physical Restraints Hazard in Stimulant Toxicity

The severe risk associated with physical restraints in agitated stimulant users, where struggling causes isometric muscle contractions leading to lactic acidosis, hyperthermia, sudden cardiac collapse, and death.

Inhalant Intoxication and Overdose

Toxicity caused by volatile organic solvents or aerosol sprays leading to nystagmus, ataxia, lethargy, double vision, stupor, life-threatening seizures, sudden cardiac arrest, and coma; managed with $100\%$ oxygen via rebreather mask and CPR/ventilation.

Benzodiazepine Withdrawal Treatment

Management involving the administration of a long-acting benzodiazepine (such as diazepam) titrated to prevent withdrawal symptoms without causing excessive sedation or respiratory depression.

Opioid Withdrawal Medications

Pharmacologic agents administered to manage opioid withdrawal symptoms, including buprenorphine, methadone, and alpha-2 adrenergic agonists such as clonidine and lofexidine.