Substance-Related Disorders

Substance-Related Disorders

Chapter 28 Overview

  • Focus on the understanding of substance-related disorders and their implications on mental health.

Learning Objectives: Substance-Related Disorders

Lesson 28.1 Slide 1 of 2

  • Define five terms relating to substance use and treatment.

  • Explain how chemical dependency affects persons from different age groups.

  • Describe four serious consequences of substance abuse.

  • Classify four categories of abused substances and provide an example from each group.

  • Identify three reasons why inhalants are abused by adolescents and young adults.

Lesson 28.1 Slide 2 of 2

  • Describe the three stages or phases of becoming addicted.

  • Compare the three criteria for the diagnosis of a substance-related disorder.

  • Explain what is meant by the term relapse.

  • Plan at least four interventions for clients diagnosed with substance-related disorders.

Vocabulary of Terms

Slide 1 of 2

  • Substance: A drug of abuse, a medication, or a toxin.

  • Substance use: Ingestion of any chemical that affects the body.

  • Abused substances: Chemicals that alter the individual’s perception by affecting the central nervous system (CNS).

  • Substance (drug) abuse: Excessive use of a substance that differs from societal norms.

Slide 2 of 2

  • Habituation: An individual depends on a substance to provide pleasure or relief.

  • Substance (chemical) dependency: A user must take their usual dose of the drug to prevent the onset of withdrawal signs and symptoms.

  • Addiction: An individual’s dependence on the substance is physical.

  • Abstinence: An addicted individual is not using an addictive substance.

Substance Use and Age

Slide 1 of 3

  • Pregnant Women: There are no safe drugs for pregnant women.

    • Excessive Alcohol Use: Results in fetal alcohol syndrome (FAS).

    • Children with FAS exhibit smaller size, small heads, and fail to develop normally.

    • Cocaine Use: Infants exposed to cocaine in utero may experience sleeping and eating problems, unusual irritation, and high-pitched cries.

    • Substance use occurs throughout the life cycle, from fetus to older adult.

Slide 2 of 3

  • Children: Often abuse substances that are legal and easily available.

    • Alcohol: Most frequently abused drug among adolescents.

    • Patterns of Substance Abuse in Adolescents:

    • Experimentation with drugs.

    • Use in social settings for relaxation or intoxication.

  • Teen Involvement: May lead to illegal activities with addiction.

Slide 3 of 3

  • Substance Abuse in Adults:

    • Approximately 10% of the adult population regularly abuse alcohol.

    • Abuse patterns vary by minority group:

    • Cocaine: More frequent use among African Americans.

    • Alcohol: Preferred by White and Hispanic individuals.

Scope of the Problem Today

  • Individuals with serious mental illness who are also addicted to, or use, chemicals have a dual diagnosis.

  • Many deaths due to falls, drownings, and burns are related to alcohol and drug use.

  • Substance use and dependence result in significant societal costs:

    • Financial Costs: Economic implications regarding healthcare, law enforcement, and loss of productivity.

    • Human Costs: Emotional and psychological toll on individuals and families affected by substance abuse.

Chemicals of Abuse

Slide 1 of 7 - Alcohol

  • Alcohol:

    • Has a depressant effect on the CNS.

    • Effects are dose-dependent; increased tolerance and dependency may develop with continued use.

Slide 2 of 7 - Narcotics

  • Narcotics:

    • Depressants affecting the CNS.

    • Types include:

    • Naturally occurring: Opium, Morphine

    • Semi-synthetic: Heroin, Hydromorphone, Thebaine derivatives.

Slide 3 of 7 - Stimulants

  • Stimulants:

    • Commonly abused substances include:

    • Caffeine, Cocaine, Crack, Prescription Drugs (e.g., Amphetamines, Methylphenidate (Ritalin)).

    • Some stimulants serve as appetite suppressants.

Slide 4 of 7 - Hallucinogens

  • Hallucinogens:

    • Natural and synthetic substances altering perception of reality.

    • Examples include:

    • Peyote cactus (mescaline), LSD, Psilocybin, PCP.

    • Effects range from profound experiences to "bad trips".

Slide 5 of 7 - Opioids

  • Opioids/Narcotics:

    • Include substances such as Heroin, Morphine, Hydromorphone, Fentanyl, and Stimulants such as Amphetamines and Bath salts.

Slide 6 of 7 - Designer Drugs

  • Designer Drugs:

    • Created by altering the molecular structure of existing drugs.

    • Examples include MDMA (Ecstasy), STP, "Ice".

Slide 7 of 7 - Other Substances

  • Other Medications:

    • Medications that have the potential for abuse include:

    • Morphine, Hydromorphone, Amphetamines, Methylphenidate (Ritalin), Diazepam (Valium), and Laxatives/Diuretics.

Inhalants

  • Volatile Substances:

    • Chemical gases inhaled for their psychoactive effects.

    • Examples include alcohol solvents, gasoline, glue, paint thinner, and nicotine.

  • Associated Complications:

    • Sudden death, respiratory depression, hyperactive motor responses, loss of coordination, and seizures.

Characteristics of Substance Use and Abuse

  • Causes of Substance Abuse: Unknown; however, multiple theories exist:

    • Biological Theories: Explain genetic and biochemical variations among ethnic groups.

    • Psychological Theories: Link personality/emotional problems to substance abuse.

    • Environmental Theories: Focus on individual, family, and sociocultural backgrounds influencing substance abuse behavior.

Stages of Addiction

  • Early Stage:

    • Users can still enjoy their substances.

  • Middle Stage:

    • Increasing intoxication; tolerance develops requiring higher doses to achieve the same effects.

  • Chronic (Late) Stage:

    • Characterized by high tolerance and loss of control over behavior due to substance dependency.

Criteria for Diagnosis

  • Substance Use Disorder Criteria Include:

    • Patterns of substance use leading to significant impairment in functioning and distress.

    • Evidence of tolerance, withdrawal symptoms, and dependency must be present.

Guidelines for Intervention

Slide 1 of 4

  • Assessment Areas to Focus On:

    • Central nervous system, head and neck, chest and abdomen, skin, nutritional status, general appearance, behaviors, emotional state, social support, motivation, and diagnostic testing.

Slide 2 of 4

  • Treatment Models:

    • Disease Model: Substance abuse is viewed as a disease needing treatment.

    • 12-Step Process: Focuses on admitting powerlessness and seeking assistance from a higher power.

    • Medical Model: Assesses addictions under public health and disease perspective.

    • Psychiatric Models: Relate substance abuse to underlying emotional conflicts or mental disorders.

    • Sociocultural Models: Suggest that changing the individual's environment can aid treatment.

Slide 3 of 4

  • Relapse:

    • Refers to the recurrence of substance-abusing behaviors after a significant period of abstinence.

    • Relapsed individuals often experience distressing emotions.

Slide 4 of 4

  • Nursing/Therapeutic Process:

    • Nursing diagnoses for substance abuse are based on identified problems and goals.

    • Individualized care plans are essential to meet each client's unique needs.

  • Caring for clients with substance-related problems poses unique challenges and frustrations.

Medications for Substance Use Disorders

  • Information about medications can be found on professional medical sources and platforms, providing continued education on treatment options for substance use disorders.