ADDICTION
ADDICTION
Presentor: DeviAnne Jane E. Daiz
Page 2: Learning Outcomes
Characteristics of Substance Use Disorders (SUD):
Discuss implications and dynamics of family related to substance use.
Trends in substance abuse and management strategies.
Self-evaluate feelings and responses towards clients with SUD.
Page 3: Neuroscience Review
What is Dopamine?
Definition: A neurotransmitter involved in reward, pleasure, and motivation.
Page 4: Dopamine Levels
Normal Dopamine Levels: 50 nanograms per deciliter as a base average.
Page 5: Dopamine Variability
Ranges in dopaminergic response:
Best day: 100 ng/dL
Normal day: 40 ng/dL
Worst day: 94 ng/dL
Page 6: Substance Effects on Dopamine
Substances and Dopamine Production
Heroin: 1,100 ng/dL
Alcohol: 900 ng/dL
Methamphetamine: 10x increase in dopamine response compared to normal production.
Page 8: Behavioral Implications
Low dopamine levels lead to:
Cravings for substances.
Survival mode behaviors.
Primal actions driven by instinctive responses.
Page 9: Treatments for Craving
Strategies include:
Augmenting dopamine levels.
Medications such as Buprenorphine and methadone to stabilize dopamine and manage cravings.
Behavioral therapy as effective intervention.
Page 10: Substance Abuse Overview
Definition: Use of substances to alter mood or behavior, often outside of legitimate medical purposes.
Polysubstance Abuse: Abuse of multiple substances simultaneously.
Page 11: Intoxication and Blackouts
Intoxication
Maladaptive behavior due to substance use.
Blackout
Episodes of functioning without conscious memory during and after substance use.
Page 12: Withdrawal Syndrome
Definition: Negative physiological and psychological effects post-substance cessation.
Detoxification
Safe process of withdrawal from a substance.
Page 13: Tolerance and Dependence
Drug Tolerance
Reduced response to a drug due to repeated use.
Dependence
State of compulsive substance use despite knowing the risks and consequences.
Page 14: Categories of Drugs
Alcohol, Sedatives, Stimulants, Cannabis, Opioids, Hallucinogens, Inhalants.
Page 15: Contributing Factors to Substance Abuse
Biological factors: Genetic vulnerability.
Psychological factors: Family dynamics.
Social and Environmental factors: Cultural norms and laws, peer influences.
Page 16: DSM 5 Criteria for SUD
Categories:
Impaired Control
Social Impairment
Risky Use
Pharmacological Properties.
Page 17: Symptoms of Substance Use Disorders
Impaired Control: Overuse, inability to cut down.
Social Problems: Neglecting responsibilities.
Risky Use: Continued use despite risks.
Physical Dependence: Withdrawal symptoms on cessation.
Page 18: Severity of Substance Use Disorder
Severity classification:
2-3 symptoms: Mild,
4-5 symptoms: Moderate,
6 or more: Severe.
Page 19: Alcohol - Intoxication and Overdose
Alcohol: CNS depressant with toxic effects.
Medical emergencies: Blood levels >400 mg/dL.
Page 20: Signs and Symptoms of Alcohol Intoxication
Symptoms include:
Slurred speech, incoordination, ataxia, belligerent behavior, respiratory depression.
Page 21: Blood Alcohol Concentration (BAC) Effects
BAC levels categorized by effects:
20-99 mg/dL: Impaired coordination.
100-199 mg/dL: Poor judgment, labile mood.
400+ mg/dL: Respiratory failure, coma.
Page 22: Management of Alcohol Overdose
Interventions:
Protect airway, monitor respiratory CNS function, check for trauma, administer IV fluids, Thiamine for syndrome prevention.
Page 23: Alcohol Withdrawal Timeline
Symptoms commence within 4–12 hours of cessation, peaking on the second day, lasting up to two weeks.
Page 24: Alcohol Withdrawal Symptoms
Symptoms include: Tremors, anxiety, hallucinations, seizures, delirium tremens.
Page 25: Benzodiazepines in Alcohol Withdrawal
Medications like Lorazepam, Chlordiazepoxide, Diazepam for safe withdrawal.
Page 26: Barbiturates Overview
Sedatives like Pentobarbital and GHB can cause significant respiratory depression and impaired consciousness.
Page 27: Management of Barbiturate Overdose
Requires respiratory and cardiovascular supports, potentially intubation, and antidotes for reversal.
Page 28: Non-Barbiturate Sedatives
Examples: Diazepam; effects mirror barbiturates but may differ in management.
Page 29: Amphetamine-type Drugs
Common stimulants: Cocaine, Methamphetamine with various psychological and physiological effects.
Page 30: Management of Stimulant-Related Issues
Protocols include gastric evacuation, normal thermoregulation, and antiarrhythmics for cardiac issues.
Page 31: Hallucinogen Effects
Examples include LSD, Psilocybin; symptoms encompass anxiety, hallucinations, and convulsions.
Page 32: Dronabinol and Nabilone
Approved for nausea relief in chemotherapy patients.
Page 33: Opioid Overview
Main opioids: Heroin, Morphine; symptoms include pinpoint pupils and respiratory distress.
Page 34: Management of Opioid Overdose
Respiratory support and Naloxone for opioid reversal and monitoring.
Page 35: Inhalants Effects and Management
Includes various household substances; management focuses on dysrhythmias and life support.
Page 38: Rehabilitation Phases
Comprehensive approach: 1) Intake, 2) Detox, 3) Rehabilitation, 4) Recovery/Aftercare.
Page 39: Alcohol Treatment Medications
Key medications include:
Lorazepam and Chlordiazepoxide for alcohol withdrawal, disulfiram for abstinence.
Page 40: Additional Alcohol Treatment Medications
Naltrexone, Acamprosate for cravings and vitamin supplementation for bodily health.
Page 41: Opioid Treatment Medications
Methadone for maintenance, Buprenorphine for cravings, Naltrexone for blockage of effects.
Page 42: Care Strategies for SUD Clients
Address denial, prioritize detoxification, involve family in treatment, and develop coping strategies.
Page 43: Key Points to Remember
Substance abuse as a chronic illness with implications for family dynamics.
The importance of objective attitudes in treatment.