ch 19 addictions

the habitual use of a substance that falls outside of medical necessity or social acceptance for single purpose of altering ones mood, emotion, or state of consciousness and resulting in adverse effects of the abuser o or others.

habitual psychological and physiological dependence on the substance or practice beyond one's voluntary control

• craving to compulsive use
• continued use despite the consequences
• loss of control

gambling, shipping and spending, internet abuse, sexual addiction

alcohol

babies with a low birth weight and an increased risk of developmental issues

the need for higher and higher doses to achieve the desired effect

occurs after long periods of continued use so that stopping use results in specific signs and symptoms.

given to people who have overdosed on an opiate

• history of drug abuse
• medical history
• psychiatric history
• psychosocial (work, family, friends, ect)

slurred speech, incoordination, unsteady gait, drowsiness decreased blood pressure, impaired judgment, impaired function, impaired attention, irritability. overdose- reparatory depression or arrest cardio depression or arrest, coma shock, convulsions death.

if awake keep awake, induce vomiting, activated charcoal, vitals Q15, if unresponsive - ET tube, IV fluids, gastric lavage, check fro shock, seizure precautions, and give Romazicon (flumazenil)

nausea, vomiting, tachycardia, diaphoresis, anxiety, irritability, tremors, marked insomnia, grand mal seizures and possible delirium with years ( 5 to 15) of use

abrupt withdrawal can lead to death, detox with similar drug

coca bush leaves

• snorted- 30 min
• injected 30 seconds
• smoked 4-6 seconds

• 15-30 min for cocaine
• 5-7 min for crack

tachycardia, dilated pupils , elevated BP, nausea, vomiting, insomnia, grandiosity, impaired judgment, euphoria

ataxia, hyperpyrexia, coma, convulsions, MI, respiratory distress death

antipsychotics, hyperpyrexia (ambient cooling), convulsions (diazepam), respiratory distress, cardiovascular shock, acidification of urine.

fatigue, depression, agitation, apathy, anxiety, sleepiness, disorientation, lethargy, craving.

• antidepressant (desipramine)
• dopamine agonist (bromocriptine)

• increased energy and wakefulness, hyperthermia, euphoria
• severe effects-paranoid schizophrenia, delusions, psychosis, panic levels of anxiety, potential for violence.

opium, heroin, meperidine (Demerol), morphine, codeine, methadone, dilaudid, fentanyl,

constricted pupils, decreased respirations and BP, slurred speech, psychomotor retardation, initial euphoria followed by dysphoria, impairment of attention, judgment, and memory.

narcan-quickly reverses CNS depression

yawning, insomnia, irritability, runny nose, panic, diaphoresis, cramps, nausea, vomiting, muscle and bone pain, chills, fever, diarrhea, lacrimation (secretion of tears)

methadone tapering, clonidine-naltrexone, vivitrol, buprenorphine ( acts as a substitute)

The state of delirium usually peaks 2 to 3 days (48 to 72 hours) after cessation or reduction of intake

• euphoria, detachment, and relaxation
• Overdose and withdrawal (other than craving) rarely occur.

Pupil dilation, Tachycardia, Diaphoresis, Palpitations, Tremors, Elevated temperature, pulse, respiration, Synesthesia (e.g., colors are heard; sounds are seen), Grandiosity (e.g., thinking one can fly), Hallucinations, although sensorium is clear

• Keep patient in room with low stimuli—minimal light, sound, activity.
• Have one person stay with patient; reassure patient, “talk down” patient.
• Speak slowly and clearly in low voice
• Give diazepam or chloral hydrate for extreme anxiety or tension.

mescaline (peyote), acid, and psilocybin (magic mushroom)

peyote and magic mushroom

angel dust, horse tranquilizer, and peace pill

acute anxiety to acute psychosis as well as aggression, violence, and loss of coordination, The drug produces a generalized anesthesia that lessens the sensations of touch and pain

teenagers (ages 13 through 17)