substance abuse

Substance Abuse

Page 2: Understanding Substances

  • Definition of Substance: Ingestion of substances can alter CNS effects.

  • Intoxication: Involves changes in mood and behavior.

  • Abuse: Daily use needed to function; inability to stop.

  • Dependence: Physiological reliance on substance.

  • Tolerance: Need for increased amounts to achieve the same effect.

  • Withdrawal: Symptoms present upon cessation of substance use.

  • Substances taken nonmedically to alter mood or behavior.

Page 3: Alcohol Use and Abuse

  • Safe Consumption Guidelines:

    • Women: Up to 1 drink per day.

    • Men: Up to 2 drinks per day.

  • Binge Drinking: 4 drinks for women and >5 drinks for men in 2 hours.

  • Heavy Drinking: 8 drinks for women and >15 drinks for men per week.

  • Drug Interactions: Combining alcohol with prescription or OTC medications can alter metabolism.

Page 4: Prevalence of Alcohol Use

  • Statistics on Alcohol Consumption: Over 70% of adults aged 18+ report drinking in the past year.

  • History of alcohol consumption is a significant risk factor for comorbidities.

Page 5: Illicit Drug Use

  • Common Illicit Drugs:

    • Marijuana

    • Cocaine

    • Heroin

    • Hallucinogens

    • Inhalants

    • Methamphetamine

  • Non-medical use of psychotherapeutics: Prescription pain relievers, tranquilizers, stimulants, and sedatives.

Page 6: Diagnosing Substance Abuse

  • Nature of Substance Abuse: Substance abuse and addiction are brain diseases.

  • Drug and alcohol use activate brain's reward circuits, releasing dopamine.

  • Continued use leads to brain changes affecting executive function.

Page 7: Subjective Data Collection

  • Assessment Questions:

    • Frequency of beer, wine, or alcohol beverage consumption?

    • Number of occasions in the last year with 5+ (men) or 4+ (women) drinks?

    • Average number of drinking days per week?

    • Typical number of drinks per day when consuming?

Page 8: Alcohol Use Patterns Assessment

  • AUDIT Tool: Full AUDIT to assess alcohol use; helps identify patterns.

  • Risk Levels and Interventions:

    • Zone I: 0-7, Alcohol Education

    • Zone II: 8-15, Simple Advice

    • Zone III: 16-19, Simple Advice + Brief Counseling

    • Zone IV: 20-40, Referral to Specialist

  • Link to AUDIT: Alcohol Use Disorders Identification Test.

Page 9: CAGE Questionnaire

  • CAGE Tool: Quick assessment: 4 yes/no questions.

    • Addresses cutting down, annoyance, guilt, and need for an eye-opener.

Page 10: Objective Data Collection

  • CIWA Assessment: Clinical Institute Withdrawal Assessment (CIWA) for withdrawal symptoms.

  • Signs/symptoms include disorientation, slurred speech, poor dexterity.

  • Assessment performed every 2 hours for 72 hours.

  • Monitor vital signs: tachycardia, hypertension, fever.

  • CIWA-Ar assessment for pharmacological intervention.

Page 11: Nurse Check

  • Screening Tools: A nurse should use CIWA to assess alcohol withdrawal symptoms in patients.

Page 12: Assessing Illicit Substance Use

  • Questions for Illicit Drugs:

    • Do you take illicit or street drugs?

    • When was the last use? How much was taken?

Page 13: Engaging with Adolescents regarding Substance Abuse

  • Next Questions for Adolescents:

    • Follow-up question: Who are your friends?

    • Is this usage a regular habit?

    • Are your parents aware of your usage?

    • When was the last time you used marijuana?