Denial hopelessness dependency Depression anxiety low self esteem Various

Denial hopelessness dependency depression anxiety low

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* Denial, hopelessness, dependency * Depression, anxiety, low self-esteem * Various psychiatric disorders > Dual diagnoses ( Comorbidities ) - Psychiatric comorbidities (there is a high prevalence ) * Mood/anxiety disorders , antisocial behaviors, or history of conduct/oppositional disorder (pt with at least one of those comorbidities is more than twice as likely to have a substance use disorder) * Shared risk factors : genetic vulnerabilities, underlying brain defects in common areas/pathways of the brain, environmental factors (including exposure to stress/trauma during early developmental stages) * Brain circuitry associated with dopamine is implicated in addictive disorders, depression, schizophrenia, and other mental health disorders - Medical comorbidities * Hepatitis C, diabetes, cardiovascular disease, HIV, pulmonary disorders * Shared risk factors: stress from symptoms , physiological response to licit and illicit drugs, complications from administration route Discuss current treatment modalities for persons with substance abuse disorder. > Screening methods - SBIRT (Screening, brief intervention, referral to treatment) * Screening : a nurse or HCP in any health setting assesses a pt for substance use problems using standardized screening tools * Brief intervention : the RN/HCP discusses the risks of substance use behaviors with the pt, and provides feedback/advice * Referral to treatment : the RN/HCP suggests a referral for brief therapy or treatment for pts who screen positively - AUDIT (Alcohol use disorders identification test) * Developed for the WHO * Can be administered by a physician or through self-report Discuss short term outcomes for the patient and family relating to withdrawal, treatment and health maintenance, including use of self-help groups (safety measures, treatment plan). > Aim of treatment is self responsibility - Match pt with types of treatment r/t various needs (physiological, psychological, sociocultural processes) > Continuum for substance abuse care - Detox : a medically managed inpatient program with 24-hour medical coverage that is warranted when the individual quits using a substance that causes withdrawal (or when they are already in withdrawal) * Utilized while the pt’s body clears itself of drugs (including the uncomfortable and sometimes fatal side effects of withdrawal, worst with CNS depressants and alcohol) * May also be medically monitored and professionally managed
- Rehabilitation : may be medically managed or medically monitored * Medically managed: 24 hour medical staff; provide intensive and specialized care for pts with either biomedical or psychiatric comorbid conditions * Medically monitored: available for pts with less complex conditions; offer professionally directed evaluation and treatment ~ Short term settings : aid in the recovery of lost skills/function; for those with acute distress, moderate impairment ~ Long term settings : help to improve functioning that never developed and may have led to addictions; for those with chronic distress, severe impairment - Partial hospitalization

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