Substance-related and addictive disorders

Terms Definitions
Biochemical; Alcohol may produce which substances that are responsible for alcohol addiction
Morphine-like substance
Tendency to become an alcohol is What and becomes active when the person drinks to relieve WHAT or as a means of WHAT
Inherited; stress; coping
Have you ever felt that you should cut down on your drinking?
Have people annoyed you by criticizing your drinking?
Have you ever felt bad or guilty about your drinking?
Have you ever had a drink first thing in the morning to steady you nerves(eye-opener)
CAGE Questionnaires
Alcohol is considered a CNS
Depressant
Alcohol us metabolism by What organ and eliminated by what organ
Liver; Kidneys
Functions normally, later has recent memory loss
Blackouts
Most serious form of withdrawals syndrome; biggest risk is 48 hours after last drink
Delirium Tremens (DT) Last drink was Sunday s/s of DT is Tuesday
peripheral neuropathy, alcoholic myopathy, alcoholic cardiomyopathy, esophagitis, gastritis, pancreatitis, alcoholic hepatitis, cirrhosis of the liver (including complications of portal hypertension, ascites, esophageal varices, hepatic encephalopathy), leukopenia, thrombocytopenia, sexual dysfunction, fetal alcohol syndrome are all medical consequences of
Alcohol
Includes physical, mental, behavioral, and/or learning disabilities with life long implication. There may be problems with learning, memory, attention span, communication, vision, hearing, or a combination of these
Fetal alcohol syndrome
Most serious form of thiamine deficiency in alcoholics. Symptoms includes paralysis of the ocular muscles, diplopia, ataxia, somnolence, and stupor. If thiamine replacement therapy is not undertaken quickly, death will ensure
Wernicke's encephalopathy
Syndrome of confusion, loss of recent memory, and confabulation (Creation of imaginary events to fill memory gap)
Korsakoff's Psychosis
Alcoholic amnestic disorder; combination of
Wernicke's encephalopathy and Korsakoff's Psychosis
Nutritional neurological disorder caused by lack of thiamine (Vit B2) depletion results in
ataxia (loss ability to coordinate movement), confusion, amnesia, ( Partial/total loss of memory)
confabulation-Q (Creation of imaginary events to fill memory gap),
psychosis
Decrease seizures, hallucinations, DT's. for CNS depressant withdrawal and anticonvulsant qualities
Benzodiazepine or Barbiturates (Phenobarbital)
Antianxiety med such as Ativan and Valium
Aversion therapy; blocks breakdown of alcohol. this med is not to be taken with alcohol as it causes: N/V, headaches, dizziness, decreased BP, SOB and flushed hot feeling. Sensitivity may last for 2 weeks after med is discontinued. Clients receiving this therapy should be aware of alcohol containing substance such as: Liquid cough and cold preparations, vanilla extracts, aftershave lotion, colognes, mouthwash, nail polish removers and isopropyl alcohol
Antabuse (Disulfiram)
Reduces the physical distress and emotional discomfort (sweating, anxiety, sleep disturbances) people usually experience when they quit drinking; usually prescribed up to 12 months after abstinence
Campral
Prevents Wernicke's Korsakoff's syndrome
Thiamine
Opioid receptor antagonist blocks the effects; brand name ReVia; also used for alcohol dependence
Naltrexone
Amino acids that helps with craving from alcohol consumption
Tropamine plus and Neurecover
Some studies have shown decreased craving from alcohol while using
Ginseng, Evening Primrose and Bitter Gourd (Melon)
Substance abuse (i.e. alcoholism, drugs) in addition to psychiatric problem
Dual diagnosis
Not a drug of choice for detox (opiate)
Benzodiazepine
Detox for opiate given on the fist day in a dose sufficient to suppress withdrawal symptoms. Converts from illicit drug to legal controlled drugs
Methadone
Given to IV drug addicts for opiate detox. This med is given parentally (IV) only
Buprenex/Subutex
Opiate antidote used for maintenance
Narcan
Less powerful than methadone but safer with fewer side effects. Usually given the first few days for detox
Sub-buprenorphine (Subutex)
Carefully planned surprised techniques used to help get the addict into treatment
Intervention
Number one ego defense mechanism used is for substance and addition disorder
Denial
All substance abuse nursing diagnoses is
Ineffective denial
Nursing diagnoses for alcohol, sedative-hypnotics withdrawal
Risk for injury
Nursing diagnoses for cocaine/CNS stimulants withdrawal
Risk for Self-directed Violence or Risk for Suicide
Nursing diagnoses for opiate withdrawal
Pain
Based on the concept of peer support, acceptance, understanding from others who have experienced the same problem; spiritually based.
Let the patient know that they have to attend 90 meetings in 90 days
Self-help Group like Alcoholic Anonymous (A.A.)
Employs the cognitive approach utilizing rational emotive behavior training (REBT); not spiritual based; individuals examine their own actions and accept responsibility
Self-management and recovery training (SMART)
Three major lifestyle changes for sobriety (triggers for relapse)
People, Place and things
Hunger, angry, lonely and tired (HALT)
Defined by dysfunctional behaviors that are evident among members of the family of a chemically dependent person, or among family members who harbor secret of physical or emotional abuse, other cruelties, or pathological conditions.
Codependency
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