Substance abuse disorders

  1. Substance use disorder
    • substance addiction
    • physical dependence
    • psychological dependence
  2. Substance Use disorder
    DSM V
    Substance use disorder involves repeated use of chemical substance, leading to clinically significant impairment during 12 month period and two of the following criteria is met
  3. DSM V SUD
    • use of substance interferes with ability to fulfill obligations
    • attempts to cut down or control use fail
    • intense craving for substance
    • continued use despite social or intrapersonal problems associated with use
  4. More criteria fromDSM V
    • causes difficulty with interpersonal relationships or becoming socially isolated (state dependent learning)
    • engages in hazard activity when on substance ie driving
    • tolerance develops and the amt required to achieve the desired effect incr
    • - problem can be respiratory center supression- can't tell
    • substance-specific symptoms occur upon discontinuation of use
    • spend considerable amt time obtaining, using or recovering from the effects of substance and exhibits withdrawal
  5. Substance intoxication
    • development of a reversible syndrome of symptoms following excessive use of substance
    • direct effect on the CNS
    • disruption in physical and psychological functioning
    • judgement is disturbed and social and occupational functioning is impaired
  6. Substance withdrawal
    • development of symptoms that occurs upon abrupt reduction or discontinuation of a substance that has been used
    • symptoms are specific to whatever you are using
    • disruption in physical and psychological functioning with disturbances- thoughts, feelings, behaviors
  7. Classes of Pyschoactive substance
    • alcohol
    • caffeine
    • cannabis
    • hallucinogens
    • inhalants
    • opioids
    • sedatives/hypnotics
    • stimulants
    • tobacco
  8. Predisposing factors
    Biological factors
    • Genetics- alcohol
    • biochemical- alchol can produce morphine like
    • use before adding ??
    • used before 14yrs 44%
    • more addictive
  9. Predisposing factors
    Psychological factors
    • certain personality traits are thought to inc a tendency toward addictive behaviors
    • such:
    • low self esteem
    • depression
    • instant gratification
    • person w/inability to relax
    • peeps cant communicate effectively
    • people who love taking risk
  10. Predisposing factors
    sociacultural factors
    • social learning- home parents modeling
    • peer group- promoting it
    • coping- at times of stress, death of a love one, retirement, socially isolated
    • cultural/ethnic influences-more use- like american indian
    • behavioral conditioning- peeps who get pleasurable effect using, events, parties, social gatherings
  11. Consideration for special population *
    • approx half of college students participate in binge drinking or substance use every month
    • the % of college students who use substance is higher than the general population
    • anabolic steroid use is growing, called juicing, gym candies, or stackers can be taken orally or by injection to enhance performance & physically appearance. negative effects include liver damage HTN infertility
    • older adults are prone to falls, memory loss and reduced ability to care for self. the may show effects of alcohol use earlier and the potential for interaction with rx drugs is high. older adults are at high risk for substance use following retirement
  12. Dynamics of Substance-related disorders
    alcohol use disorder pr 283
    • 1. phase I Pre-alcoholic phase- use of alcohol to relieve everyday stressors of life
    • 2. phase II: early alcoholic phase person may blackout. alcohol is now required by the person
    • 3. Phase III: the crucial phase- person loss control. physiological dependence. no choice- binge drinking several weeks
    • 4. Phase IV: the chronic phase- emotional and physical desinegration. more intoxication than sober
  13. dynamics of SUD- nerve damage
    effects on alcohol in the body
    • Effects of alcohol on the body
    • - peripheral neuropathy- is characterized by peripheral nerve damage
    • s/s
    • pain
    • burning
    • tingling
    • prickling sensation of extremities
  14. dynamics of SUD
    effects of alcohol the body
    Alcoholic myopathy
    • Acute: sudden onset of muscle pain, swelling, and weakness, reddish tinge to the urine, rapid rise in muscle enzyme in the blood
    • Vita b12 defencies
    • myoglobin leaking out of muscle- going to urine- red tinge
    • chronic- gradual wasting and weakness in skeletal muscle
  15. Dynamics SUD
    effects of alcohol on hte body
    wernicke encephalopathy
    korsakoff psychosis
    • Wernicke's encephalopathy: abnormal brain function- thiamine defencies (b1 vitamine)- serious
    • Korsakoff's psychosis: confusion, loss of recent memory (alcohol)
  16. dynamics SUD
    effects of alcohol on the body
    Alcoholic cardiomyopathy
    • heart
    • too much lipids in myocardial cells
    • weakens heart and enlarges it
  17. dynamics SUD
    effects of alcohol on the body
    inflammation and pain in the esophagus occurs bc of the toxic effects of alcohol on the esophageal mucosa
  18. dynamics SUD
    effects of alcohol on the body
    • effects of alcohol on the stomach include inflammation of the stomach lining
    • throwing up HCL acid
    • engastric distress
    • n/v distention
  19. dynamics of SUD
    effects on alcohol on the body
    • acute: usually occurs 1 or 2 days after a bine of excessive alcohol consumption
    • symptoms:
    • - acute epigastric pain- severe
    • - n/v
    • chronic: leads to pancreatic insufficiency
    • resulting in- steatorrhea (mad smelling), malnutrition, wt loss, DM
    • - abd distention
  20. dynamics SUD
    effects on alcohol on the body
    alcohol hepatitis
    • caused by long term heavy alcohol use
    • symptoms:
    • - enlarged tender liver
    • - n/v
    • - lethargic
    • - anoerexia
    • - inc WBC
    • - fever
    • - jaundice
    • - ascites
    • - wt loss in severe cases
  21. dynamic SUD
    effects on alcohol on the body
    cirrhosis of the liver
    • cirrhosis end stage of alcohol liver disease and it is believed to be caused by heavy alcoholic use
    • there is widespread- damage to liver cells, scar tissue
    • portal htn- elevation of bp through the portal circulation
    • -results from
    • blood can't flow thru
  22. dynamics of SUD
    effects on alcohol on the body
    • a condition in which an excessive amt of serous fluid accumulates in abd cavity
    • occurs
  23. dynamic SUD
    effects on alcohol on the body
    esophageal varices
    • distended
    • sensitive
    • can bleed easily
    • aspiration
    • medical emergency
  24. dynamic SUD effects on alcohol on the body
    hepatic encephalopathy
    cannot excrete ammonia thru the gi tract. not able to go thru liver..ends up in the blood stream and goes to the brain
  25. dynamic SUD effects on alcohol on the body
    • leukopenia- dec wbc- impaired production of wbc
    • thrombocytopenia- dec platelet production- no clotting factor
  26. dynamic SUD effects on alcohol on the body
    sexual dysfuction
    • short term- enhance libido, failure of erection
    • long term- gynomastia, incr libido, sterile/impotence
  27. Dynamics of Substance-related disorder
    • alcohol used during pregnancy can result in fetal alcohol spectrum disorders (FASDs) include following:
    • - fetal alcohol syndrome (FAS)
    • - alcohol-related neurodevelopment disorder (ARND)
    • - alcohol related birth defects (ARBD)
    • problems w/learning, memory, attention span, communication, vision/hearing
  28. Dynamics of Substance-related disorder
    cont pregnancy
    • no amt of alcohol during pregnancy is considered safe
    • it could damage fetus at any stage of the pregnancy
    • since FAS covers a wide range of problems, there are many possible symptoms. ranges from mild to severe
  29. characteristics of FAS
    • abnormal facial features
    • small head size
    • shorter than average height
    • low body wt
    • poor coordination
    • hyperactive behavior
    • difficulty paying attention
    • poor memory
    • difficulty in school
    • learning difficulties
    • speech and language delays
    • intelluctual disability
    • poor reasoning skills
    • sleep and sucking problems as a baby- lead to aspiration
    • vision or hearing problems
    • problems w/heart kidneys, or bones
  30. Dynamics of Substance-related disorder
    alcohol intoxication
    • occurs at blood alcohol levels between 100-200 mg/dl
    • s/s:
    • - peak withdrawal 24-48hrs
    • - 2-3 days do thru DT
    • - DT last 2-3 days
    • - s/s DT: severe disorientation, pyschotic symptoms, hallucination, severe HTN, cardiac dysrhythmia, delirum,
    • alcohol and benzo progress to death
    • death reported with levels between 400-700
  31. Dynamics of Substance-related disorder
    alcohol withdrawal
    • occurs within 4-12 hours of cessation of reduction in heavy and prolonged alcohol use
    • s/s
    • monitoring:
    • administer meds
    • aware of s/s
    • dec stimuli environment
    • rest and nutrition
    • vita B
    • fluidsa
    • provide reality orientation
    • can give librium or serax (if liver damager)
    • antibuse will get u sick
Card Set
Substance abuse disorders
moral weakness