WEEK 13 SUBSTANCE RELATED DISORDERS

• Substance related disorder or drug abuse


  is when you use any substance, whether prescribed or recreational, excessively to a point that it leads to significant problems or even long-term damage
• Ingestion of mood-altering substances

  stimulates dopamine pathways in the limbic system, which produces pleasant feelings or a "high" that is a reinforcing, or positive, experience
• Younger people


  use substances that carry less social disapproval such as alcohol and cannbis
• Older people


  use drugs
• Substance-use disorders


  are patterns of symptoms resulting from the use of a substance that you continue to take, despite experiencing problems as a result
• Substance-induced disorders


  including intoxication, withdrawal, and other substance/medication-induced mental disorders, are detailed alongside substance use disorders
• Mild substance use disorder


  two or three symptoms
• Moderate substance use disorder

  four or five symptoms
• Severe substance use disorder

  six or more symptoms
• Common Abused Substances

  1.Central Nervous System Depressants

  2. Central Nervous System Stimulant

  3. Hallucinogens

  4. Cannabis

  5. Inhalants
• CNS depressants include

  Alcohol

  Sedatives-Hypnotics and Anxiolytics

  Opioids
• CNS stimulants include

  Caffeine

  Nicotine

  amphetamine

  Cocaine
• Alcohol


  a CNS depressant that is absorbed quickly into the blood stream
• Consuming more than one beverage per hour can lead to intoxication, raising individual's blood alcohol content (BAC) with each drink
• Mild Intoxication

  0.1 % - 0.2 %
• Moderate Intoxication

  0.2 % - 0.3 %
• Severe Intoxication

  0.3 % and above
• Withdrawal symptoms of alcohol 3-24 hours after last drink

  SHAKES or Mild Tremors
• Withdrawal symptoms of alcohol 36-72 hours after the last drink

  results to Delirium Temens or hallucination occurs within 48 hours
• Pre-alcoholic phase


  social drinking until tolerance begins to develop
• Prodromal phase


  blackout occurs, alcohol becomes a need, and denial begins to develop
• Crucial phase


  cardinal signs of alcoholism develop; loss of control over drinking
• Chronic phase


  becomes intoxicated all day to prevent symptoms of withdrawal
• Common defense mechanisms used by an alcoholic

  Denial

  Rationalizations

  Projection

  Minimization
• Treatment for Alcoholism

  Folic Acid (Folate)

  Cyanocobalamin (Vitamin B12)

  Thiamine (Vitamin B1)

  Benzodiazepine

  Naltrexone (Revia, Trexan)

  Disulfiram (Antabuse)
• Treatment for Alcoholism: Folic Acid (Folate)

  1 - 2 mg / day
• Treatment for Alcoholism: Cyanocobalamin (Vitamin B12)

  25 - 50 mg / day to treat nutritional deficiency
• Treatment for Alcoholism: Thiamine (Vitamin B1)

  100 mg / day to prevent or treat Korsakoff's - Wernicke's Syndrome
• Treatment for Alcoholism: Benzodiazepine

  50 mg - 100 mg repeat in 2-4hrs if necessary but should not exceed 300 mg / day. It supresses the symptoms of abstinence
• Treatment for Alcoholism: Naltrexone (Revia, Trexan)

  50 mg / day for 12 weeks to reduce alcohol craving
• Treatment for Alcoholism: Naltrexone (Revia, Trexan)

  350 mg / week given in 3 divided doses to treat opioid abuse (blocks the effects of opioids)
• Treatment for Alcoholism: Disulfiram (Antabuse)

  250 - 500 mg / day for 1-2 weeks then 125 mg / day as maintenance to help client maintain abstinence from alcohol
• Alcoholic anonymous


  Alcoholics in self help groups
• Al-Anon


  wives of alcoholics in self help groups
• Ala-teen


  children of alcoholics in self help groups
• Sedative-Hypnotics and Anxiolytics


  slow down the activity of the brain
• Sedative-Hypnotics and Anxiolytics are sometimes called "depressants" and antianxiety drugs
• With short-acting medications of Sedative-Hypnotic and Anxiolytic drugs

  Withdrawal symptoms begin 12-24 hours after the last dose and peak at 24 - 72 hours
• With longer-acting medications of Sedative-Hypnotic and Anxiolytic drugs

  Withdrawal symptoms begin 24-48 hours after the last dose and peak within 5-8 days
• Opioids


  desensitize the user both physiologic and psychological pain and endure a sense of euphoria and well-being