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DEPRESSANTS (BARBITURATES, NONBARBITURATES, HYPNOTICS AND ANXIOLYTICS, OPIOIDS) DSM-IV SEDATIVE-, HYPNOTIC-, OR ANXIOLYTIC-INDUCED DISORDERS 292,89 Sedative, hypnotic, or anxiolytic intoxication 292.0 Sedative, hypnotic, or anxiolytic withdrawal 292.81 Intoxication delirium 292. 84 Induced mood disorder OPIOID-RELATED DISORDERS 292.89 Opioid intoxication 292.81 Intoxication delirium 292.0 Opioid withdrawal (For further listings, consult DSM-IV. ) CNS depressants are drugs that slow down the central nervous system. They are usually divided into  four types: barbiturates, antianxiety agents, sedative-hypnotics, and narcotics (opioids such as morphine,  heroin). CNS depressants prescribed for symptoms of anxiety, depression, and sleep disturbances are among  the most widely used and abused drugs. These drugs are very likely to be abused when the underlying  conditions remain untreated. Sometimes these drugs are used in conjunction with stimulants, with the user  developing a pattern of taking a stimulant to be “up,” then needing the depressant drug to “come down.” Several principles apply to all CNS depressants: (1) The effects are interactive and cumulative with  one another and with the behavioral state of the user; (2) there is no specific antagonist that will block the  action of these drugs; (3) low doses produce an initial excitatory response; (4) they are capable of  producing physiological and psychological dependency; and (5) cross-tolerance and cross-dependence may  exist between various CNS depressants. Although the margin of safety of these drugs is great, they have a  characteristic syndrome of withdrawal that can be very severe. This plan of care addresses acute intoxication / withdrawal and is to be used in conjunction with CP:  Substance Dependence / Abuse Rehabilitation. ETIOLOGICAL THEORIES Psychodynamics Individuals who abuse substances fail to complete tasks of separation-individuation, resulting in  underdeveloped egos. The person has a highly dependent nature, with characteristics of poor impulse  control, low frustration tolerance, and low self-esteem. The superego is weak, resulting in absence of guilt  feelings. Underlying psychiatric status must be assessed, as these individuals may use stimulants for  varying self-medication reasons. Psychostructural factors (e.g., personality) are seen as significant. The defect is believed to precede  the addiction, with the ego structure breaking down and the substance being used as a maladaptive coping  mechanism. Characteristics that have been identified include impulsivity, negative self-concept, weak ego,  low social conformity, neuroticism, and introversion.
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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