addictive behavior, substances, and substance abuse

Symptom Groups in Substance Use Disorders

  • Impaired Control

    • Definition: The inability of a person to control their intake of a substance.

  • Social Impairment

    • Awareness: Knowledge of street drug names is important for mental health professionals working with individuals facing substance use issues.

Drug Slang and Substance Schedules

  • Street Drug Names

    • Importance: Familiarity with the slang used on the streets can enhance communication with patients.

  • Drug Enforcement Administration (DEA)

    • Role: The DEA ranks drugs according to their potential for abuse and medical utility.

    • Schedule Classification:

    • Schedule I: Drugs with high potential for abuse and no accepted medical use.

    • Schedule II: Includes stimulants like Adderall and Zurelin, drugs typically prescribed for ADHD.

    • Schedule III: Moderate potential for misuse, includes medications like testosterone and codeine.

    • Schedule IV: Low risk for misuse, includes benzodiazepines like Ativan.

Medication for Opioid Use Disorders

  • Suboxone

    • Use: Treats individuals with opioid use disorders; it blocks euphoric effects of opioids.

    • Mechanism: Does not provide a high, but can still be abused by patients.

    • Analogy: Comparison to diabetes management.

    • Importance of treatment adherence despite occasional non-compliance with lifestyle choices.

Key Terminology in Substance Use Disorders

  • Intoxication

    • Definition: The state of using a substance to excess.

  • Tolerance

    • Definition: The need for increased doses of a substance to achieve the same initial effect.

Epidemiology of Substance Use Disorders

  • Alcohol Abuse

    • Statistics: Approximately 15 million people are addicted to alcohol; around 8 million to other substances.

    • Perception of Alcohol: Socially acceptable with potential for leading to addiction.

  • Comorbidities

    • Definition: Presence of two or more substance use disorders combined with mental health disorders.

    • Explanation: Self-medication or worsening of mental illness due to substance use.

  • Risk Factors for Addiction

    • Genetic: Familial patterns of addiction increase a person's risk.

    • Neurobiological: Brain structures can predispose an individual to addiction.

    • Environmental: Socioeconomic status influences access and types of substances.

Environmental Factors and Addiction

  • Socioeconomic Status: Increased availability of substances in lower-income communities, evidenced by the density of liquor stores and fast food outlets.

Case Study: Anthony

  • Scenario: Anthony, a 20-year-old, found in a semi-comatose state; emotional and struggling in recovery.

Use and Effects of Common Psychoactive Substances

  • Caffeine

    • Effects: Withdrawal can lead to headaches and fatigue.

  • Cannabis

    • Potency: Current marijuana is more potent than in previous decades, linked to worsening schizophrenia symptoms for predisposed individuals.

  • Hallucinogens and Solvents

    • Effects: Cause mood alterations and potential for addiction leading to psychosis.

Theoretical Frameworks

  • Comparison of chronic substance use to chronic medical conditions (e.g., diabetes).

Treatment Modalities for Opioid Use Disorders

  • Withdrawal Symptoms

    • Opioid withdrawal can cause tachycardia, hyperthermia, and hyperreflexia.

  • Medication Indicated

    • Methadone, clonidine, buprenorphine, and Suboxone are used to manage withdrawal and cravings.

Clinical Management of Opioid Overdose

  • Opioid overdose symptoms: Respiratory distress, unresponsiveness, pinpoint pupils.

  • Treatment: Naloxone (Narcan) as an emergency treatment, noting its temporary effects and necessity for medical follow-up.

Alcohol Use Disorder

  • Definition: Describes problematic drinking patterns through the DSM-5 classification.

  • Prevalence: Higher in specific demographics, such as American Indians.

  • Withdrawal Symptoms

    • Timeline: Symptoms can begin within 8 hours after the last drink.

    • Treatment: Benzodiazepines for seizure prevention during withdrawal.

Long-Term Effects of Alcohol on Health

  • Liver Damage

    • Stages of Liver Disease: Fatty liver, alcohol hepatitis, cirrhosis, detailing progression and treatability.

  • Increased Cancer Risk

    • Correlation of alcohol consumption with breast, throat, and oral cancers.

  • Neuroadaptation

    • Changes in brain functioning after prolonged alcohol use can lead to relapse risk with exposure to alcohol.

Screening Tools for Substance Use Disorders

  • CAGE Questionnaire

    • Tool for screening substance use, focuses on cut down, annoyance, guilt, and eye-openers concerning drinking patterns.

Nursing Process in Addiction Treatment

  • Assessment: Importance of family history, social support, and individual accountability.

  • Implementation: Educating patients on medication (e.g., Antabuse and its side effects).

Relapse Prevention Strategies

  • Continual assessment of a patient’s environment, support systems, and motivational levels to customize treatment plans.