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• Alcoholism


  Illness characterized by compulsion, loss of control and continued pattern of abuse despite perceived negative consequences
• Drug abuse


  Maladaptive and consistent use of a drug despite social, occupational, psychological, or physical problems
• Drug dependence


  Impaired control of drug use despite adverse consequences, the development of tolerance, and the occurrence of withdrawal symptoms when drug intake is reduced or stopped
• Tolerance


  Person's ability to obtain desired effect from specific dose of drug
• Classes of psychoactive substances

  • Alcohol
  • Narcotics (Opioids, synthetics)
  • Sedatives-Hypnotics
  • Stimulants (Caffeine, Nicotine, Cocaine)
  • Hallucinogens
  • Cannabis
  • Inhalants
• Alcohol


  • Central nervous system depressant that causes false self-confidence, false sense of belonging, and lowering of inhibition
• Alcohol-induced disorders


  • Intoxication
  • Alcohol withdrawal
  • Alcoholic hallucinosis
  • Alcoholic amnesic disorder
• Drinking alcohol leads to loss of coordination, poor judgment, slowed reflexes, distorted vision, memory lapses, lowered inhibitions, and impaired judgment
• Effects of alcohol use

  • Liver failure
  • Bleeding pancreas
  • Sores
• Sedatives-Hypnotics


  • Abused drugs that lead to slurred speech, impaired memory, and mood swings
• Narcotics (Opioids, synthetics)


  • Clients may exhibit mood swings, psychomotor agitation, and impaired judgment
• Cocaine


  • Short-acting CNS stimulant substance that is extracted from leaves, available in powder, injection, and pipe-smoked forms, and can lead to cocaine psychosis
• Cannabis (Marijuana)


  • Affects mood, thinking, behavior, and judgment
• Effects of marijuana use

  • Physical effects: Dry mouth, nausea, headache, decreased coordination, increased heart rate, reduced muscle strength, increased appetite and eating
  • Mental effects: Anxiety, paranoia, confusion, anger, hallucinations, tiredness, possible suicidal thoughts
• If used during pregnancy, marijuana can decrease the size of the baby and increase the risk of the baby developing leukemia later in life
• Stimulants (Caffeine, Nicotine)


  • Some individuals display aspects of dependence and tolerance
• Inhalants


  • Chemicals that are "huffed" or "sniffed" like paint thinners, gasoline, glue, lighters, nail polish remover, etc., and can cause slowed body functioning, loss of body control, passing out, permanent hearing loss, permanent muscle spasms and twitches, cancer, brain damage, bone damage, liver & kidney damage, heart failure and possible death
• Club drugs (Rohypnol, Ketamine)


  • Man-made drugs used in nightclubs and bars that can cause seizures, amnesia, anxiety, tremors, sweating, coma, high body temperature that can lead to death
• Hallucinogens (Lysergic acid, Angel Dust, Mushrooms or Shrooms)


  • Alter the perception of time, reality and environment, and can lead to long-term effects like schizophrenia and severe depression
• Methamphetamine


  • Taken by mouth, snorting powder, needle injection, and smoking, and can cause brain damage, confusion, anxiety, paranoia, anger, stroke, high body temperature, and convulsions which can lead to death
• Physical effects of drug use

  • Brain damage
  • Confusion
  • Anxiety
  • Paranoia
  • Anger
  • Stroke
  • High body temperature
  • Convulsions
• Treatment options for substance abuse

  • Heroin: Methadone
  • Narcotics: Methadone
  • Alcohol: Disulfiram
  • Benzodiazepines: Diazepam, haloperidol
  • Cannabis: Anxiolytic, antipsychotic, antidepressant
• Nursing process for substance abuse

  1. Assessment: History, vital signs, potential for suicide/violence, present drug history, physical examination, laboratory findings, psychological assessment

  2. Nursing diagnosis: Risk for injury, risk for violence to self, ineffective denial, ineffective coping, low self-esteem, risk for infection, imbalanced nutrition

  3. Nursing interventions: Manage withdrawal symptoms, provide vitamin/mineral supplements, encourage dental care and balanced meals, teach family communication skills, help explore appropriate expression of emotions

  4. Evaluation: Client experiences minimal discomfort from withdrawal, improves health status, family manages functions and conflicts effectively