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Flashcards covering key vocabulary and definitions related to substance use and nursing care.
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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
🧠 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.
🔹 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
⚠ 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
🔁 Withdrawal Symptoms:
Tremors, sweating
Anxiety, irritability
Nausea, vomiting
Hallucinations and seizures (in severe cases, e.g., Delirium Tremens)
👩⚕ 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
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
—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
👩⚕ 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.
🩸 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”)
👩⚕ 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.
🧠 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:
Alcohol consumption
Drinking behaviour/dependence
Alcohol-related harm
🧾 Examples of AUDIT Questions:
How often do you have a drink containing alcohol?
How many drinks do you have on a typical day?
How often do you have 6 or more drinks on one occasion?
Have you felt guilt/remorse after drinking?
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.
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
Sample Questions from DUDIT
The DUDIT has 11 questions covering drug use patterns, dependence, and harm. Examples:
How often do you use drugs (not including alcohol)?
How many different drugs do you use regularly?
Have you felt a strong desire or urge to use drugs?
Have you tried to cut down or stop using drugs but failed?
Have you neglected your responsibilities because of drug use?
Have you had withdrawal symptoms when not using drugs?
Have you experienced health, social, or legal problems due to your drug use?
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.
📝 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
📍 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