substance use disorders

Learning Objectives

  • Impact of substance-related and addiction disorders on health.

  • Epidemiological and etiological risk factors for these disorders.

  • Clinical presentation differentiation of substance-related and addiction disorders.

  • Role of nurses in client care for these disorders.

  • Application of the nursing process in clinical judgment for treatment.

  • Explore values related to healthcare professionals who are chemically impaired.

Alcohol Use Disorder

  • National health issue; affects 16.6 million adults and 697,000 adolescents.

  • Third leading preventable cause of death in the U.S.

  • Associated with absenteeism, increased violence, and prenatal exposure risks.

Opioid Crisis

  • Causes approximately 130 overdose deaths daily in the U.S.

  • Affects all demographics.

  • 2019 DHHS five-point program aims to manage the crisis via prevention, treatment, and research.

Drug Categories

  • Include alcohol, sedatives, stimulants, cannabis, opioids, hallucinogens, and inhalants.

Substance Use Disorders Terminology

  • Key terms: Intoxication, withdrawal syndrome, detoxification, substance abuse, dependence, use.

Clinical Onset & Course

  • Adolescents are at the highest risk for substance use; often self-medicate mental health issues.

  • Relapse rates for substance use disorders can be as high as 90%.

Reward Pathway

  • Dopamine release in the limbic system associated with euphoria.

  • Compulsive behaviors driven by the prefrontal cortex and amygdala involvement.

Etiology of Addiction

  • Risk factors: mental illness, stress, genetics, peer pressure, abuse.

  • Protective factors: family support, positive relationships, community resources.

Comorbidities

  • Include heart disease, stroke, dental issues, hepatitis, cirrhosis, and mental illnesses.

Clinical Presentation by Substance

  • Alcohol: Mood changes, coordination problems, withdrawal symptoms may include DTs.

  • Opioids: Euphoria, analgesia, withdrawal includes muscle pain and insomnia.

  • Stimulants: Increased alertness, potential severe dysphoria during withdrawal.

  • Hallucinogens: Symptoms similar to psychosis; no withdrawal syndrome.

Role of the Nurse

  • Focus on prevention, treatment management (withdrawal symptoms), and client education.

Dual Diagnosis

  • Substance abuse often co-occurs with psychiatric disorders, requiring integrated treatment approaches.

Treatment Settings

  • Options range from outpatient treatment to residential facilities.

Community-Based Care

  • Involves outpatient services, aftercare programs, and individual counseling for recovery.

Impaired Health Care Professionals

  • Face ethical and legal responsibilities; signs include performance drop and isolation.

Self-Awareness Issues

  • Important for healthcare professionals to reflect on personal beliefs about substance use and remain objective.