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Substance Abuse Chapter 11
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Substance Abuse Self-administration of a drug in a manner that does not conform to the norms within the patient’s own culture and society Drugs all have in common the ability to impact the brain and central nervous system
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Substance Dependence Overwhelming desire to take a drug Cannot stop taking drug Two categories Physical dependence Psychological dependence
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Withdrawal Syndrome Prescription drugs may be used to reduce severity May be particularly severe for those who are dependent on alcohol or sedatives Abusers often associate use of substance with their conditions and surroundings Counselors encourage distance from past social contacts
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Opioid Withdrawal Symptoms Excessive sweating, restlessness, and dilated pupils Agitation, goose bumps, tremor, and violent yawning Increased heart rate and blood pressure Nausea/vomiting and abdominal cramps and pain Muscle spasms and weight loss
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Alcohol Withdrawal Symptoms Tremors, fatigue, and anxiety Abdominal cramping and hallucinations Confusion, seizures, and delirium
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Nicotine Withdrawal Symptoms Irritability, anxiety, and restlessness Headache, increased appetite, and insomnia Inability to concentrate Decrease in heart rate and blood pressure
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Tolerance Body adapts to repeated administration of a drug Requires higher doses of drug to produce initial effect Common in substances that affect nervous system Does not indicate addiction or substance abuse
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CNS Depressants Cause patients to feel sedated or relaxed Barbiturates Nonbarbiturate sedative–hypnotics Benzodiazepines Alcohol Opioids
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Opioids Prescribed for Severe Pain Also known as narcotic analgesics Range of CNS effects Addiction can occur rapidly Intense withdrawal symptoms Not life threatening, as with barbiturate withdrawal High psychological dependence
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Ethyl Alcohol One of most commonly abused Effects directly proportional to amount consumed Psychological and physical dependence can occur Withdrawal can be severe to life-threatening
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Ethyl Alcohol Symptoms recognizable, but nurse must take care not to assume alcohol is only drug in system Food in stomach slows onset of absorption Metabolism occurs at slow, constant rate Benzodiazepines are the preferred drug class for treatment of acute withdrawal
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Adverse Effects of Chronic Alcohol Consumption Large number of adverse health effects Liver failure - cirrhosis Delirium tremens (DT) may occur with very long- term consumption hallucinations, confusion, disorientation Withdrawal can be combated with antiseizure medications Disulfiram can discourage relapses
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Nicotine Affects nervous, cardiovascular, and endocrine systems stimulates the CNS directly Psychological and physical dependence occurs quickly Patients tend to continue their drug use for many years
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Nurse Serves Key Role in Substance Abuse Prevention, Diagnosis, Treatment Thorough medical history must include substance abuse if present Be firm in disapproving of substance abuse, yet compassionate in trying to help the patient receive treatment Attempt to involve family members when possible
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With IV-Drug Users Nurse Must Consider HIV infection Hepatitis Tuberculosis
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