ChemDep

• CHEMICAL DEPENDENCY
• Substance and Alcohol Consumption


  Alcohol: 28,320

  Marijuana: 14,207

  Methamphetamine: 1524

  Cocaine: 1284

  Heroin: 691
• Young adults, especially males, become the victims of drug abuse
• From the population, 22% males and 17% females abused illicit drugs in 2020
• Substance abuse


  Pathological use of substances
• Substance dependence


  Pathological use of substances
• The 11 DSM-5 criteria for a substance use disorder

  • Took more extensive amounts/extended time
  • Repeated efforts to control use or quit
  • Full time spent using
  • Craving
  • Disregarded major roles
  • Social or interpersonal dilemmas
  • Missed activities
  • Hazardous use
  • Physical or psychological problems
  • Tolerance
  • Withdrawal
• Causes of substance use disorder


  • Unknown
  • Biologic Factors
  • Psychological Factors
  • Social & Environmental factors
• Types of substance use disorder

  • Alcohol
  • Sedatives, hypnotics and anxiolytics
  • Stimulants
  • Cannabis
  • Opioids
  • Hallucinogens
  • Inhalants
• Alcohol


  Central nervous system depressant, absorbed rapidly into the bloodstream, initial effects are relaxation and loss of inhibition with intoxication, there is slurred speech, unsteady gait, lack of coordination, and impaired attention, concentration, memory and judgment
• Sedative, hypnotics, anxiolytics


  Central nervous system depressants, barbiturates, nonbarbiturates hypnotics, anxiolytics particularly benzodiazepines, The effects of the drugs, symptoms of intoxication and withdrawal symptoms are similar to those of alcohol
• Stimulants (Amphetamines/Cocaine)


  Stimulates or excite the central nervous system, intoxication from stimulants develops rapidly, effects include the high or euphoric feeling, hyperactivity, hypervigilance, talkativeness, anxiety, grandiosity, hallucinations, stereotypic or repetitive behavior, anger, fighting and impaired judgment
• Cannabis (Marijuana)


  The most widely used illicit substance, it shows that cannabis has short term effects of lowering intraocular pressure, symptoms of intoxication include impaired motor coordination, inappropriate laughter, impaired judgment and short term memory and distortions of time and perception
• Opioids


  Popular drugs of abuse, it desensitize the user to both physiologic and psychological pain and induce a sense of euphoria and well being, opioid intoxication develops soon after the initial euphoric feeling, symptoms include apathy, lethargy, listlessness impaired judgment, psychomotor retardation or agitation, constricted pupils, drowsiness, slurred speech and impaired attention and memory
• Hallucinogens


  Substances that distort the user's perception of reality and produce symptoms similar to psychosis, including hallucinations and depersonalization, hallucinogen intoxication is marked by several maladaptive behavioral or psychological changes, anxiety, depression, paranoid ideation, ideas of references, fear of losing one's mind and potentially dangerous behavior such as jumping out the window in the belief that one could fly
• Inhalants

  Diverse group of drugs that includes anesthetics, nitrates and organic solvents that are inhaled for their effects, the most common substances in the category are aliphatic and aromatic hydrocarbons found in gasoline, glue, paint thinner and spray paint, inhalant intoxication involves dizziness, nystagmus, lack of coordination, slurred speech, unsteady gait, tremor, muscle weakness and blurred vision
• Marijuana (Cannabis)


  Refers to the dried leaves, flowers, stems, and seeds from the Cannabis sativa or Cannabis indica plant. The plant contains the mind-altering chemical THC and other similar compounds. Extracts can also be made from the cannabis plant
• Phencyclidine


  An infamous hallucinogenic sought for its ability to induce the illusion of euphoria, omnipotence, superhuman strength, and social and sexual prowess. AKA "Angel Dust". It acts on your brain (central nervous system) and changes your mood, behavior, and the way you relate to the world around you. Scientists think it blocks the normal actions of certain brain chemicals. PCP is in a class of drugs called hallucinogens
• The full spectrum of SAD's represents one of the nation's leading health problems. In 2007, approximately 22.3 million adults were classified as having substance dependence or abuse disorders. Among this population, an estimated 3.2 million were dependent on or abused both alcohol and illicit drugs, another 3.7 million were dependent on or abused alcohol alone. The rate of abuse and dependence was twice as high for males as it as for females (12.5 vs 5.7%). Illicit drug use among those aged 50 - 54 increased from 3.4 % in 2002 to 5.7% in 2007. The most popular illicit drugs in the 2007 survey were marijuana (3.9 million), pain relievers (1.7 million) and cocaine (1.6 million)
• Various diagnostic studies may also demonstrate evidence of SADs related organ dysfunction. Hematology includes mild anemia with macrocytosis, folate deficiency, thrombocytopenia, granulocytopenia, abnormal liver function tests, hyperuricemia and elevated triglycerides
• Alcoholics Anonymous (AA)


  Founded in the 1930's by alcoholics. A self help ground developed the 12 step program model for recovery, which is based on the philosophy that total abstinence is essential and that alcoholics need the help and support of others to maintain sobriety
• Pharmacologic treatment in substance abuse

  To permit safe withdrawal from alcohol, sedative hypnotics, and benzodiazepines and to prevent relapse
• Benzodiazepines


  Used to suppress the symptoms of alcohol withdrawal
• Disulfuram (Antabuse)


  May be prescribed to help deter clients from drinking
• Acamprasate (Campral)


  Prescribed for clients recovering from alcohol abuse or dependence to help reduce cravings for alcohol and decrease the physical and emotional discomfort that occurs especially in the first few months of recovery
• Methadone


  A potent synthetic opiate used as a substitute for heroin in some maintenance programs
• Levomethadyl


  A narcotic analgesic whose only purpose is the treatment of opiate dependence
• Naltrexone (ReVia)


  An opioid antagonist often used to treat an overdose. It can be used to treat alcohol abuse
• Nursing assessment of a client with substance abuse disorder

  • History

  Thought process and content

  Sensorium and intellectual process

  General appearance and motor behavior

  Self concept
• Nursing diagnoses for substance abuse

  • Risk for injury related to substance intoxication or withdrawal

  Ineffective denial related to underlying fears and anxieties

  Ineffective coping related to inadequate support system or coping skills

  Imbalance nutrition: less than body requirements related to drinking alcohol instead of eating nourishing food

  Chronic low self-esteem related to retarded ego development
• Treatment outcomes for clients with substance use

  • The client will abstain from alcohol and drug use

  The client will express feelings openly and directly

  The client will verbalize acceptance of responsibility for his or her own behavior

  The client will establish an effective after care plan
• Nursing interventions for a client with substance abuse

  • Providing health teaching for client and family

  Addressing family issues

  Promoting Coping Skills
• Evaluation of goals for a client with substance abuse

  • The client as able to abstain from alcohol and drug use

  The client was able to express feelings openly and directly

  The client was able to verbalize acceptance of responsibility for his or her own behavior

  The client as able to practice nonchemical alternatives to deal with stress or difficult situations

  The client was able to establish an effective after - care plan
• Documentation guidelines for a client with substance abuse disorders

  • Individual findings, including factors affecting interactions, nature of social exchanges, specifics of individual behavior

  Cultural and religious belief and expectations

  Plan of Care

  Teaching plan

  Responses to interventions, teaching and actions performed

  Attainment or progress toward the desired outcome
• Substance


  Any drugs, medication or toxic that shares the potential for abuse
• Substance use


  Condition arising from the abuse of alcohol, psychoactive drugs and other chemicals such as volatile solvents
• Substance dependence


  Use of drugs or alcohol that continues even when significant problems related to their use have developed
• Addiction


  A physiologic and psychologic dependence on alcohol or other drugs of abuse
• Abuse


  Maladaptive pattern of substance use that impairs health in a broad sense
• Dependence


  Certain physiological and psychological phenomena induced by the repeated taking of a substance