1. Judith Wikel RN BSN MEd MH 4.1

2. Chapter 28 Substance-Related Disorders Abused substances are those chemicals that alter the individual’s perception by affecting the central nervous system.

3. Chapter 28 Substance-Related Disorders Addiction When the dependence on a substance is physical, the term addiction is used.

4. Chapter 28 Substance-Related Disorders Pregnancy and Substance Abuse There are no safe drugs for pregnant women. Every chemical ingested by a pregnant woman poses a potential danger to her unborn child, especially during the first trimester of pregnancy, when the developing fetus is highly sensitive.

5. Chapter 28 Substance-Related Disorders Fatal Alcohol Syndrome (FAS) Children with FAS are smaller at birth, have small heads (microcephaly), and fail to develop normally.

6. Chapter 28 Substance-Related Disorders Children and Substance Abuse A 9 year old who demands Cola drinks day demonstrates the same signs of a caffeine addiction as an adult. 8-year-old boy who has grown up with beer in the house can become an alcoholic just as quickly as his adult counterpart. Hint – substance abuse problems in children and adolescence is very real and happens more often than we realize.

7. Chapter 28 Substance-Related Disorders Substance issues in the adult. Older adults frequently go misdiagnosed or their drug issues are treated inappropriately. Drug reactions in the patient 65 years of older is common possibly due to numerous prescription medications and possible drug interactions.

8. Chapter 28 Substance-Related Disorders Relapse The recurrence of substance-abusing behaviors after a significant period of abstinence.

9. Chapter 28 Substance-Related Disorders Caffeine Is the main active ingredient in coffee, black teas, most cola drinks, and other bottled beverages. Caffeine stimulates the nervous system, relieving fatigue and increasing alertness and the body’s metabolic rate. The most prominent withdrawal symptom from caffeine is headache.

10. Chapter 28 Substance-Related Disorders Stages of Addiction Early stage – individuals are able to use and enjoy their chosen substance. A desire to repeat the first pleasurable experience leads to a frequent patter of use. One begins to prefer being “high” to other activities. Middle stage – intoxicating episodes increase as the body attempts to compensate by adapting to the substance. Chronic stage – tolerance for the chemical is usually quite high. The need for the substance now leads to a loss of control over one’s behavior.

11. Chapter 28 Substance-Related Disorders Psychological tolerance - develops when individuals feel that they cannot function without the use of their chosen chemical. Physical tolerance – occurs when the body has adjusted to living and functioning with the substance in its system.

12. Chapter 28 Substance-Related Disorders Inhalants Breathing in of volatile substances or chemical gases.

13. Chapter 28 Substance-Related Disorders Inhalants The breathing in of volatile substance or chemical gases. Very popular with adolescents and young adults for several reasons: Easily available Rapid onset of effects Inexpensive Complications: Sudden death by cardiac dysrhythmia or respiratory depression.

14. Chapter 28 Substance-Related Disorders CHARACTERISTICS OF SUBSTANCE USE AND ABUSE Some people can use various chemicals to change the way they feel, but the use does not affect their ability to perform the activities of daily life. This would be substance use. Substance abuse is when use of the chemical becomes more important than the activities of daily living leading to significant impaired functioning and distress.

15. Chapter 28 Substance-Related Disorders Treatment The first step to recovery is admitting you have a problem!

16. Chapter 28 Substance-Related Disorders Detoxification Before treatment of the addiction can actually begin, often times the person must first go through detoxification, the process of withdrawing from a substance under medical supervision.

17. Chapter 28 Substance-Related Disorders Disulfiram (Antabuse) A medication taken daily by nonpracticing (dry) alcoholics. It causes very unpleasant physical reactions when combined with alcohol, including intense headache, flushing, nausea, vomiting, low blood pressure, and blurred vision.

18. Chapter 28 Substance-Related Disorders Effects of Alcohol on the Nervous System Please refer to table 28-1 on page 310 Read and understand the approximate number of drinks and the affects on the CNS and behaviors associated related to number of drinks.

19. Chapter 28 Substance-Related Disorders Crack A type of cocaine. Reaches the brain immediately and produces a more intense but shorter-lasting high. Addiction to the drug develops very quickly as users chase the feelings of the first, intense experience.

20. Chapter 28 Substance-Related Disorders Heroin Signs and symptoms of Heroin Use, Overdose, and Withdrawal Please refer to table 28-2 page 312

21. Q & A Question – Cocaine that is processed and made into rocks is called: A) Speed B) Crack C) Highball D) Smack Answer is B

22. Q & A Question - James works 44 hours a week. Once a week, on Saturday nights, he smokes marijuana to “get high,” James: A) is a drug addict. B) is chemically dependent. C) has a chemically dependent D) will go through withdrawal at work. Answer is c

23. Q & A Question - A woman who drinks four whiskey sours a day during her entire pregnancy is at high risk of giving birth to a baby with: A) syphilis B)alcoholism C) spina bifida D) fetal alcohol syndrome Answer is D

24. Q & A Question - In most states, the legal blood alcohol content limit is 0.10%. This would indicate that a person drank how much alcohol during a 4-hour period? A) ½ to 1 ounce B) 1 ½ ounces C) 2 ½ ounces D) 3 ½ ounces Answer is b

25. MH 4.1 Study hard. Use the PowerPoint and objectives as a study guide and focus on all areas talked about in each objective and slide. Good Luck! Judith Wikel RN