Care of the Patient with an Addictive Personality Substance Abuse Mental Health Unit III

Theories of Etiology for Abuse Exact Cause is unknown Genetic component Learned Behavior Risk Factors

Drug Seeking Behaviors Best viewed as “Learned Instrumental”

Definitions….. Abuse Addiction Alcoholism

Addictive Personality Traits Low stress tolerance Dependency Negative self-image Feelings of insecurity Depression

Brief History …. Alcohol & drugs as medicine Temperance Movement Prohibition Small drop in ETOH use (2%), many people still use illicit drugs 4.4 million chronic drug uses (NIDA) 1970 Comprehensive Drug Abuse and Controlled Substances Act

National Institute on Alcohol Abuse and Alcoholism states… In 2013, people > 18 y.o. reported: 86.8%  used alcohol at some point 24.6%  engaged in “binge drinking” in the past month 16.6 million had an AUD 1.3 million received treatment for an AUD

Facts & Statistics ( cont’d) Nearly 88,000 die from alcohol-related causes annually in 2012, 3.3 million deaths were attributed to alcohol consumption Alcohol contributes to over 200 disease & injury related health cond. More than 10% of U.S. children live w/ a parent w/ alcohol problems

3 Stages of Dependence Early Middle Late

Early Stage Critical Thinking Q’s 1) What are the characteristics of a person in the “Early Stage”?? 2) What is the prognosis?

Middle Stage Critical Thinking Q’s 1) What are the characteristics of a person in the “Middle Stage”?? 2) What is the prognosis?

Late Stage Critical Thinking Q’s 1) What are the characteristics of a person in the “Late Stage”?? 2) What is the prognosis??

Alcohol Abuse and Alcoholism Factors contributing to development Biologic Genetic Ethnicity Personality Cultural Differences

Etiology & Pathophysiology Effects on brain Diuretic affect Intestinal mucosa Nutritional value

Disorders Associated with Alcoholism Fetal alcohol syndrome Alcohol Withdrawal Syndrome Delirium Tremens Korsakoff psychosis & Wernicke’s Encephalopathy

Assessment Subjective Data: Normal dietary patterns Presence of other disease and Rx OTC drugs

Subjective Data (con’t) History Problems with family, occupation or legal Family history of substance dependency

Critical Thinking Q What objective data is important to obtain??

Diagnostic Tests Blood and urine for toxins Liver enzymes Glucose HIV and hepatitis

Nursing Diagnosis Early Stage Middle Stage Late Stage

Interventions Detoxification Safety IV fluids Seizure precautions Medications Reduce stimuli

Interventions con’t Provide good nutrition Cardiorespiratory distress Therapeutic communication Provide good nutrition

Rehabilitation What is the object of treatment?? Treatment programs

Types of Treatments Group Therapy Alcoholics Anonymous Treatment Centers

Other Addictive Substances

Pain Management Use of addictive substances Nonopiod Opiod Antianxiety Nonchemical

Drug Abuse Illegal drugs Prescription drugs OTC Club drugs

Drug Abuse Affects Us All… Adolescence Mental Illness Homelessness Crime Education The Workplace Consequences of Drug Abuse

Depressants (CNS) Sedative-hypnotic drugs Barbiturates Benzodiazepines

Depressants (con’t) Opiod analgesics Heroin Morphine sulfate “ Cold Turkey??” S/S of Withdrawal?? Methodone? Narcan

Stimulants Caffeine Nicotine Cocaine Amphetamines Methamphetamine

Hallucinogens PCP: phencyclidine LSD: lysergic acid diethylamide

Hallucinogens con’t MDMA: Ecstasy Ketamine Mescaline and Psilocybin

Cannabis Sativa Marijuana Hashish THC What is “Amotivational Cannabis Syndrome”?

Inhalants Solvents Glues Lighter fluid Cleaning fluid Anesthetic gases

SURPRISING ADDICTIONS COULD YOU BE HOOKED ? SURPRISING ADDICTIONS

COULD YOU BE HOOKED??? Smartphones Coffee Chocolate & other sweets Shopping Gambling Plastic Surgery Tanning Exercise

Social Media Sex How does Addiction start?? Are all addictions the same??

Chemically Impaired HCW Indicators of abuse Peer assistance programs Healthcare Integrity and Protection Data Bank (HIPDB)

Domestic Violence