wk5: Substance Use & Nursing Care Flashcards

Flashcards covering key vocabulary and definitions related to substance use and nursing care.

AOD – Alcohol and Other Drugs

the use and misuse of substances like alcohol, prescription medications, and illegal drugs, and the support services that help people manage or recover from substance-related issues

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🧠 Key Concepts:

• Covers both legal (alcohol, nicotine, prescription meds) and illegal substances (heroin, meth, cannabis, etc.)

• AOD issues can include:

  • Hazardous use

  • Harmful use

  • Substance dependence

• Strongly linked to mental health, trauma, and social issues (housing, employment, relationships)

👩‍⚕ Nurse's Role in AOD:

• Screening & Assessment: Use tools like ASSIST or AUDIT

• Brief Interventions: Provide harm-reduction advice

• Withdrawal Management: Monitor and treat withdrawal symptoms (e.g., with AWS, COWS)

• Education: About risks, safe use, relapse prevention

• Referrals: To AOD counsellors, rehab, peer support, mental health services

• Use a non-judgmental, trauma-informed approach

Alcohol

a central nervous system depressant commonly consumed as beverages like beer, wine, and spirits. It affects the brain and body, causing relaxation, impaired judgement, and slowed reflexes.

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🔹 Short-Term Effects:

• Relaxation and lowered inhibitions

• Impaired coordination and balance

• Slurred speech

• Reduced reaction times

• Mood changes (euphoria, aggression, or sadness)

• Risk of intoxication and accidents

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⚠ Long-Term Risks of Heavy Use:

• Liver damage (fatty liver, hepatitis, cirrhosis)

• Cardiovascular problems

• Increased risk of certain cancers

• Mental health issues (depression, anxiety)

• Alcohol dependence and withdrawal risk

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🔁 Withdrawal Symptoms:

• Tremors, sweating

• Anxiety, irritability

• Nausea, vomiting

• Hallucinations and seizures (in severe cases, e.g., Delirium Tremens)

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👩‍⚕ Nurse’s Role:

• Assess alcohol use with tools like AUDIT

• Provide brief interventions and education on safe drinking limits

• Monitor for withdrawal symptoms

• Refer to specialist AOD or mental health services as needed

• Support harm reduction and recovery efforts

Amphetamines

central nervous system stimulants that increase energy, alertness, and mood — but can also lead to addiction, mental health issues, and physical harm.

S&S:

• Euphoria → insomnia, psychosis, weight loss use

• rapid speech, dilated pupils, addiction

💊 Common Types:

• Prescription: Dexamphetamine, Adderall (used for ADHD, narcolepsy)

• Illicit: Speed, ice (crystal meth – a potent form)

👩‍⚕ Nurse’s Role:

• Monitor for withdrawal symptoms (fatigue, low mood, cravings)

• Educate on harm reduction and safe use

• Support referral to AOD services

• Manage acute presentations (e.g. ____-induced psychosis)

Harmful Use of Caffeine

Insomnia, anxiety; mixed with alcohol = arrhythmias

Cannabis

side effects: ‘high’, slowed reaction and coordination, lung harm, anxiety

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a depressant drug (with some hallucinogenic and stimulant effects) used for its relaxing, mood-altering, and pain-relieving effects.

🔹 Common Names:

Weed, marijuana, pot, hash, ganja

🧠 Short-Term Effects:

• Feeling relaxed or "high"

• Altered perception of time and senses

• Increased appetite ("munchies")

• Impaired short-term memory

• Slowed reaction time and coordination

• Anxiety or paranoia in some users

⚠ Long-Term or Heavy Use Risks:

• Dependence or tolerance

• Decreased motivation

• Worsened anxiety or depression

• Increased risk of psychosis, especially in young people or those with mental health history

• Impaired learning, memory, and attention

🔁 Withdrawal Symptoms (if dependent):

• Irritability

• Sleep problems

• Decreased appetite

• Anxiety

• Cravings

👩‍⚕ Nurse’s Role:

• Assess use and impact on functioning

• Provide harm minimisation advice

• Refer to AOD or mental health support if needed

• Educate on -substance--psychosis link (esp. in adolescents)

Cocaine

side effects: Cardiac damage, paranoia, short high = binge cycle

a fast-acting stimulant drug that increases energy and alertness but comes with high risk of addiction, heart problems, and mental health issues.

👩‍⚕ Nurse’s Role:

• Support withdrawal and mood monitoring

• Provide education and relapse prevention strategies

• Refer to AOD and mental health services

• Be alert for risk of suicide during withdrawal phase

GHB (Gamma-Hydroxybutyrate)

side effects: OD risk, resp. depression, memory loss, seizures (esp. with alcohol), N + V, LOC

extra info:

a depressant drug that can cause sedation, unconsciousness, overdose, and addiction when misused.

🧠 Why It’s Important in Mental Health Nursing:

• Assess for -substance- use in clients with unexplained blackouts or extreme sedation

• Monitor closely during withdrawal—can mimic psychosis or delirium

• Provide harm reduction education and referrals to AOD services

Meth/‘Ice’ (Methamphetamine)

Addiction, psychosis, skin sores, increased HR/BP, tremor, cheap and accessible

• a powerful stimulant drug that can cause serious physical, psychological, and neurological side effects, especially with regular or high-dose use.

👩‍⚕ Nurse’s Role:

• Monitor for signs of psychosis or overdose

• Provide education on harm reduction

• Support withdrawal management and referral to AOD treatment services

MDMA (Ecstasy / Molly)

side effects: Euphoria and feelings of closeness/empathy, dehydration, overheating, mixed pills, comedown, alcohol combo = harm

👩‍⚕ Nurse’s Role:

• Monitor for signs of overheating and dehydration

• Support hydration (but avoid overhydration)

• Educate on safe use and harm reduction

• Assess for mental health symptoms post-use

• Refer to counselling or AOD services if needed

Harmful Use of Nicotine

Cancers, CVD, addiction; vaping = worse

an addictive stimulant found in tobacco products (cigarettes, vapes, chewing tobacco) that affects the brain and body.

🧠 Side effects Effects:

• Stimulates dopamine release → brief pleasure or calm

• Addiction (very strong dependence)

• Heart disease

• Lung diseases (chronic bronchitis, emphysema, cancer)

🚭 Withdrawal Symptoms:

• Irritability

• Anxiety

• Cravings

• Trouble concentrating

• Increased appetite

👩‍⚕ Nurse’s Role:

• Ask about smoking/vaping status

• Support with quit plans

• Offer NRT (Nicotine Replacement Therapy): patches, gum, lozenges

• Refer to quitline or smoking cessation programs

Pharmaceutical Opiates

risks: pain relief, dependency, overdose > illicit, resp depression

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—strong pain-relieving medications used to treat moderate to severe pain, but they can lead to dependence, overdose, and withdrawal if misused.

🧾 Common Examples:

• Morphine

• Oxycodone (Endone, OxyContin)

• Codeine

• Fentanyl

• Methadone (also used for opioid dependence treatment)

• Buprenorphine (Subutex, Suboxone)

🧠 Effects:

• Pain relief

• Euphoria (can lead to misuse)

• Drowsiness

• Constipation

• Slowed breathing and heart rate

• Nausea and confusion

⚠ Risks:

• High risk of dependence and tolerance

• Overdose risk, especially if mixed with alcohol or benzodiazepines

• Respiratory depression (life-threatening)

• Diversion and misuse of prescription meds

🔁 Withdrawal Symptoms:

• Muscle aches, chills

• Nausea, vomiting, diarrhoea

• Anxiety, irritability

• Sweating, runny nose

• Insomnia

• Cravings

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👩‍⚕ Nurse’s Role:

• Monitor for signs of misuse or dependence

• Educate on safe use, storage, and disposal

• Use tools like COWS (Clinical Opiate Withdrawal Scale)

• Support withdrawal with medications (e.g. methadone, buprenorphine)

• Refer to AOD and pain management services

Opiates (illicit)

Respiratory arrest, OD reversed with Naloxone

highly addictive depressants that act on the central nervous system to produce pain relief, euphoria, and sedation, but can lead to overdose and severe withdrawal symptoms.

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🩸 Common substance:

• Heroin

• Illegally obtained morphine, oxycodone, fentanyl

• Often injected, snorted, or smoked

😵‍💫 Short-Term Effects:

• Euphoria (“rush”)

• Warm, drowsy feeling

• Slowed breathing and heart rate

• Nausea and vomiting

• Itching

• Pinpoint pupils

☠ Risks of Use:

• Overdose (very high risk, especially with fentanyl)

• Respiratory depression → death

• Infections (Hep C, HIV from needle use)

• Collapsed veins, abscesses

• Addiction and dependence

🔁 Withdrawal Symptoms: (Begins 6–12hrs after last dose, peaks at 1–3 days)

NOT life-threatening, but extremely distressing

Symptoms:

• Intense cravings

• Sweating, chills

• Muscle aches and joint pain

• Yawning

• Nausea, vomiting, diarrhoea

• Insomnia

• Runny nose, watery eyes

• Irritability, anxiety

• Dilated pupils

• Goosebumps (“cold turkey”)

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👩‍⚕ Nursing Considerations:

• Use COWS (Clinical Opiate Withdrawal Scale) to assess severity

• Administer withdrawal meds if ordered (e.g. buprenorphine, methadone)

• Monitor for dehydration, electrolyte imbalance

• Provide psychosocial support + referral to AOD services

• Educate on overdose prevention (e.g. naloxone/Narcan use)

Harmful Use of Psychedelics

Bad trips, paranoia, lab-made = overdose risk

AUDIT – Alcohol Use Disorders Identification Test

a screening tool (developed by the WHO) to identify risky or harmful alcohol use, alcohol dependence, and related problems.

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🧠 Purpose:

• Detect early signs of hazardous and harmful drinking

• Support brief interventions and referrals

• Widely used in hospitals, GP clinics, and community settings

📋 Structure:

10 questions covering 3 key areas:

1. Alcohol consumption

2. Drinking behaviour/dependence

3. Alcohol-related harm

🧾 Examples of AUDIT Questions:

1. How often do you have a drink containing alcohol?

2. How many drinks do you have on a typical day?

3. How often do you have 6 or more drinks on one occasion?

4. Have you felt guilt/remorse after drinking?

5. Has someone suggested you cut down?

🧮 Scoring:

• Each question scored 0–4

• Total score out of 40

• Risk levels:

  • 0–7: Low risk

  • 8–15: Hazardous use

  • 16–19: Harmful use

  • 20+: Possible dependence → further assessment

👩‍⚕ Nurse’s Role:

• Administer the AUDIT in a non-judgmental, private setting

• Use results to offer brief advice, monitor, or refer to AOD services

• Document scores and follow-up plans clearly

Drug Use Disorders Identification Test (DUDIT)

a screening tool used to identify problematic drug use (excluding alcohol) and potential drug use disorders.

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Why is Used?

• To screen for drug-related problems (excluding alcohol) quickly and effectively

• To identify hazardous, harmful, or dependent drug use early

• Helps guide clinical decisions: whether to provide brief advice, monitor, or refer for specialist treatment

• Used in hospitals, clinics, mental health, and AOD settings

• Easy to administer and score

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Sample Questions from DUDIT

The DUDIT has 11 questions covering drug use patterns, dependence, and harm. Examples:

1. How often do you use drugs (not including alcohol)?

2. How many different drugs do you use regularly?

3. Have you felt a strong desire or urge to use drugs?

4. Have you tried to cut down or stop using drugs but failed?

5. Have you neglected your responsibilities because of drug use?

6. Have you had withdrawal symptoms when not using drugs?

7. Have you experienced health, social, or legal problems due to your drug use?

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Scoring:

• Each question scored 0–4

• Higher total scores suggest greater severity and need for intervention

ASSIST

Alcohol, Smoking and Substance Involvement Screening Test - a questionnaire to screen and identify risky use of alcohol, tobacco, and other substances.

extra info:

📋 Structure:

• 8 questions

• Asks about:

  • Lifetime use

  • Use in past 3 months

  • Cravings

  • Health, social, legal impacts

  • Failed attempts to stop

🎯 Why It’s Useful in Nursing:

• Helps identify substance use early

• Supports brief interventions

• Informs referral for further treatment

👩‍⚕ Nurse's Role:

• Administer the ASSIST tool in a non-judgmental way

• Provide education and support

• Refer clients for AOD treatment services as needed

AWS (Alcohol Withdrawal Scale)

to assess the severity of alcohol withdrawal symptoms in patients.

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📝 Key Features:

• Scores various symptoms like tremors, sweating, anxiety, headache, nausea, agitation, hallucinations, orientation

• Helps determine when to start or adjust medication (e.g., benzodiazepines)

• Guides monitoring frequency and level of care needed

• Used to prevent severe complications like seizures or delirium tremens

⚙ Common Symptoms Assessed:

• Tremors (shaking)

• Sweating

• Anxiety

• Headache

• Nausea and vomiting

• Agitation

• Hallucinations

• Orientation and clouding of sensorium

👩‍⚕ Why It’s Important:

• Provides standardised, objective assessment

• Ensures timely intervention

• Improves patient safety and outcomes

Hazardous substance use

Substance use that increases the risk of harmful consequences

—(but doesn’t meet criteria for addiction or dependence)

Harmful substance use

Substance use causing damage to health.

Tolerance

Needing more of the substance to achieve the same effect.

Addiction

Chronic condition with compulsive use, despite harmful consequences.

Withdrawal

Physical/mental symptoms after stopping a substance.

🚨 Alcohol

Starts: 6–24 hrs after last drink
Symptoms:

• Tremors

• Anxiety

• Nausea/vomiting

• Sweating

• Insomnia

• Seizures (12–48 hrs)

• Delirium Tremens (DTs) (48–72 hrs): confusion, hallucinations, fever, high BP

2. Nicotine

Starts: Within hours, peaks at 2–3 days
Symptoms:

• Irritability

• Anxiety

• Cravings

• Poor concentration

• Increased appetite

• Insomnia

3. Benzodiazepines (e.g. diazepam, alprazolam)

Starts: 1–4 days after stopping (longer for long-acting)
Symptoms:

• Anxiety

• Irritability

• Tremors

• Sweating

• Insomnia

• Seizures

• Rebound anxiety or panic

4. Opioids (e.g. heroin, morphine, codeine)

Starts: 6–12 hrs (short-acting), up to 30 hrs (long-acting)
Symptoms:

• Muscle aches

• Yawning

• Sweating

• Diarrhoea

• Nausea/vomiting

• Anxiety

• Runny nose

• Cravings
  (Not usually life-threatening, but very distressing)

5. Amphetamines / Meth (Ice)

Starts: Within 24 hrs
Symptoms:

• Fatigue

• Depression

• Increased appetite

• Sleepiness

• Irritability

• Cravings

• Suicidal thoughts (risk in severe cases)

6. Cannabis

Starts: 1–3 days
Symptoms:

• Irritability

• Insomnia

• Decreased appetite

• Mood swings

• Anxiety

• Vivid dreams

Dependence

when the body needs drugs to function normally and avoid withdrawal

Wernicke’s Encephalopathy

medical emergency caused by Thiamine (B1) deficiency → confusion, eye issues ataxia.

extra info:

• reversible with IM thiamine

• If untreated, it can lead to Korsakoff’s syndrome (chronic memory loss and brain damage).

Korsakoff's Syndrome

Chronic memory impairment

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📍 Cause:

• Long-term alcohol use → poor thiamine absorption → brain damage (especially in memory areas)

💊 Nurse's Role:

• Monitor nutrition and alcohol intake

• Give thiamine supplements

• Educate on alcohol-related brain injury

• Support cognitive and social function

Delirium Tremens (DTs)

a severe and life-threatening form of alcohol withdrawal, marked by confusion, shaking, hallucinations, and seizures.

Symptoms (SHAKE):

• S – Sweating, fever

• H – Hallucinations (visual, tactile)

• A – Agitation, anxiety

• K – (K)onfusion (disorientation)

• E – Elevated vital signs (↑HR, ↑BP, ↑Temp)

🚨 Why It’s Dangerous:

• Can be fatal without treatment

• Requires urgent medical care

• Can lead to cardiac arrest, dehydration, or severe seizures

💉 Treatment Includes:

• IV benzodiazepines (e.g. diazepam) to control agitation and prevent seizures

• Thiamine (Vitamin B1) to prevent Wernicke’s encephalopathy

• Fluids, electrolytes, monitoring in hospital

👩‍⚕ Nurse’s Role:

• Use Alcohol Withdrawal Scale (AWS) to monitor severity

• Ensure safety (falls risk, agitation)

• Administer meds as ordered

• Educate patient about ongoing alcohol support options