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Care of the Patient with an Addictive Personality
Substance Abuse Mental Health Unit III
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Theories of Etiology for Abuse
Exact Cause is unknown Genetic component Learned Behavior Risk Factors
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Drug Seeking Behaviors
Best viewed as “Learned Instrumental”
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Definitions….. Abuse Addiction Alcoholism
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Addictive Personality Traits
Low stress tolerance Dependency Negative self-image Feelings of insecurity Depression
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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
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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
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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
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3 Stages of Dependence Early Middle Late
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Early Stage Critical Thinking Q’s
1) What are the characteristics of a person in the “Early Stage”?? 2) What is the prognosis?
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Middle Stage Critical Thinking Q’s
1) What are the characteristics of a person in the “Middle Stage”?? 2) What is the prognosis?
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Late Stage Critical Thinking Q’s
1) What are the characteristics of a person in the “Late Stage”?? 2) What is the prognosis??
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Alcohol Abuse and Alcoholism
Factors contributing to development Biologic Genetic Ethnicity Personality Cultural Differences
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Etiology & Pathophysiology
Effects on brain Diuretic affect Intestinal mucosa Nutritional value
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Disorders Associated with Alcoholism
Fetal alcohol syndrome Alcohol Withdrawal Syndrome Delirium Tremens Korsakoff psychosis & Wernicke’s Encephalopathy
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Assessment Subjective Data: Normal dietary patterns
Presence of other disease and Rx OTC drugs
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Subjective Data (con’t)
History Problems with family, occupation or legal Family history of substance dependency
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Critical Thinking Q What objective data is important to obtain??
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Diagnostic Tests Blood and urine for toxins Liver enzymes Glucose HIV and hepatitis
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Nursing Diagnosis Early Stage Middle Stage Late Stage
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Interventions Detoxification Safety IV fluids Seizure precautions Medications Reduce stimuli
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Interventions con’t Provide good nutrition Cardiorespiratory distress
Therapeutic communication Provide good nutrition
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Rehabilitation What is the object of treatment?? Treatment programs
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Types of Treatments Group Therapy Alcoholics Anonymous
Treatment Centers
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Other Addictive Substances
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Pain Management Use of addictive substances Nonopiod Opiod Antianxiety
Nonchemical
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Drug Abuse Illegal drugs Prescription drugs OTC Club drugs
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Drug Abuse Affects Us All…
Adolescence Mental Illness Homelessness Crime Education The Workplace Consequences of Drug Abuse
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Depressants (CNS) Sedative-hypnotic drugs Barbiturates Benzodiazepines
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Depressants (con’t) Opiod analgesics Heroin Morphine sulfate
“ Cold Turkey??” S/S of Withdrawal?? Methodone? Narcan
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Stimulants Caffeine Nicotine Cocaine Amphetamines Methamphetamine
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Hallucinogens PCP: phencyclidine LSD: lysergic acid diethylamide
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Hallucinogens con’t MDMA: Ecstasy Ketamine Mescaline and Psilocybin
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Cannabis Sativa Marijuana Hashish THC What is “Amotivational Cannabis Syndrome”?
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Inhalants Solvents Glues Lighter fluid Cleaning fluid Anesthetic gases
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SURPRISING ADDICTIONS
COULD YOU BE HOOKED ? SURPRISING ADDICTIONS
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COULD YOU BE HOOKED??? Smartphones Coffee Chocolate & other sweets
Shopping Gambling Plastic Surgery Tanning Exercise
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Social Media Sex How does Addiction start?? Are all addictions the same??
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Chemically Impaired HCW
Indicators of abuse Peer assistance programs Healthcare Integrity and Protection Data Bank (HIPDB)
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Domestic Violence
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