Substance Use Disorder

what is dependence defined as

the state of relying on or being controlled by someone or something else

what is tolerance defined as

need for markedly increased amounts of alcohol to achieve intoxication or desired effect; a markedly diminished effect

what is alcohol use disorder

a problemtic pattern of alcohol use leading to clinically significant impairment or distress

What are the manifestation criteria for alcohol use disorder

2 of these:

large amounts + long period of time

unsuccessful attempts to control

excessive time spent in alcohol activities

craving

failure to fulfill obligations

continued use despite social/interpersonal/physical/psych problems

reduced usual activities

use in physically hazardous situations

tolerance withdrawal

Symptoms of early mild alcohol withdrawal

anxiety, agitation, restlessness, insomnia, tremor, diaphoresis, palpitations, headache, alcohol craving, loss of appetite, nausea, vomiting

moderate severe withdrawal symptoms

hallucinations, seizures, delirium, tremens(agitation, rapid heart rate, fever, and sweating)

What is withdrawal delirium or delirium tremens and when does it begin

rapid-onset fluctuating disturbance of attention and cognition - sometimes with hallucinations in the presence of alcohol withdrawal

72-96 hours after patients last drinks

what are symptoms of severe withdrawal delirium

autonomic hyperactivity, fever, tachycardia, hypertension, sweating

What is nursing care for alcohol withdrawal

assess risk, establish severity, decrease agitation and prevent withdrawal progression, provide supportive care, maintain fluid and electrolyte balance, initiate case management services for future rehabilitation treatment

What is opioid use disorder

problematic pattern of opioid use that leads to serious impairment or distress

what are symptoms of opioid use disorder

an overpowering desire to use opioids

increased opioid tolerance

withdrawal syndrome when opioids are no longer in use

can range from dependence to addiction

what are the benefits of medication assisted treatment programs

improve patient survival rates, increase retention in SUD treatment and recovery services, decrease illicit opiate use and other illicit activity among people with SUDs, increase patients ability to gain and maintain employment, improve birth outcomes among women who have SUDs and are pregnant

What are opioid receptor agonist + example

medications attach to opioid receptors in the brain to block withdrawal symptoms and cravings

methadone

opioid receptor partial agonist and examples

medications attach to and partially activate opioid receptors in the brain to ease withdrawal symptoms

buprenorphine, buprenorphine/naloxone

what is an opioid receptor antagonist

medications attach to and block activity of opioid receptors in the brain, antagonist medications that treat substance use disorders do so by preventing euphoric effects of opioids and alcohol by reducing cravings

antagonist medication used to treat opioid overdoses do so by reversing dangerous effects like slowing/stopping breathing

What are examples of opioid receptor antagonist

naltrexone

naloxone

nalmefene

buprenorphine/naloxone

what is an adrenergic receptor agonist + example

a medication that attaches to activates adrenergic receptors in the brain and helps alleviate withdrawal symptoms

lofexidine

what is spontaneous opioid withdrawal

pt who is physiologically dependent on opioids reduces/stops opioid use abruptly

what is precipitated opioid withdrawal

withdrawal when a patient who is physiologically dependent and recently had opioids in their system is administered an opioid antagonist(naloxone, naltrexone, nalmefene) or partial agonist buprenorphine

Signs and symptoms of withdrawal

drug craving, anxiety, restlessness, GI issues, diaphoresis, tachycardia

hypertension, insomnia, agitation, restless leg syndrome, tremors, low grade temperature

What do A2 agonists treat/examples

withdrawal symptoms of tachycardia, HTN, hyperthermia, diaphoresis, lacrimation, rhinorrhea, piloerection, mydriasis, yawning

clonidine, lofexidine

treatments for anxiety/insomnia

antihistamine(diphenhydramine/hydroxyzine), sedating antidepressant(trazadone)

treatment for myalgia/bone pain

acetaminophen, ibuprofen

treatment for abdominal cramps

antipasmodic (dicyclomine

Treatment for nausea and vomiting

antiemetic

prochlorperazine, promethazine, ondansetron

diarrhea treatment

antidiarrheal loperamide