Addiction chapter 19 Addiction is a medical condition that involves the environment, life experience and genetics. Substance abuse is a national health problem, Some of the problem that are assoictaed with alchohol abuse is FAS(fetal acohol syndrome). FAS is when a women is pregnant and consumed too much acohol. The baby that are carried by this women will have a different look in appearance. Acohol abuse is also related to domestic abuse, homicide, child abuse and neglect. Types of substance abuse Alcohol Sedatives, hypnotics, and anxiolytics Stimulants Cannabis Opioids Halluciniation Inhaulants Intoxication- is when you use a substance and cause the person to act in non good behaviors this person may experience non-productive, and dysfunctional. Withdrawl syndrome- Negative mental and physical reation that happen when you aren’t using the drug or when the drug feeling starts to decrease. Detoxification- when a person is showing signs of withdrawal and receives help safely. Substance abuse- is using a drug in a way that is not for medication reasons (an example of this would be a person using percs and not needing them or aginst medical advice). Alcoholism occurs when people are faced with difficulties and they drink this can be a break up etc. Substance Dependance- is when a person is dependant on a drug, and the addiction is the tolerance level itsel. This person may withdrawl and is unable to stop the use of the drug Blackout- is when a person is intoxicated but continue to function, this person is unaware of his or her behavior and cant remember what happened while they was intoxicated. Tolerance- when a person need more of the substance to get he or she feeing the same as they did the first time. Tolerance break- is when a person binge drink to get them drunk and small sip after get them drunk again. An example of this would be to drink a lot at a party and im already drunk. Immediately when I start to feel my high come down I take a sip of liquor and it gets me super drunk again. Spontaneous Remission- is when a person stops drinking on there own without treatment of a program. (Some people might do this because they promised a love one, he or she may relie on family and friends they try to stay away from people who use alcohol)* BIOLOGICAL FACTORS- child that have parent that are addicted to alchol are more likey to have alcoholism. Neurochemical influence- taking in substances that stimulate dopamine pathway in the limbic system, which is a pleasant feeling or high Some people use acholo as a sorce of coping, to relieve stress, increase feeling of power and decrease mental pain (High doses of alchol lead to increased musle tension and nervousness) Seven classes of substances 1. Alcohol A CNS depressant that get absorb quickly into the blood stream, when you are drunk you have a feeling of being free Intoxication of alcohol is slurred speech, unsteady gait, lack of coordination, impaired attention, concentration, memory and judgment. When a person is intoxicated they may experience a blackout. Overdose with alcohol is when a large intake is completed in a small period of time, this can cause respiratory depression, unconciusness, and spitting up. (THE COMBINATION OF THESE CAN CAUSE PNEUMIA OR LUNG OBSTRUCTION, Alcohol induced hypotension can cause shock and death ) A cns stimulant is contradicted The effects of long term alcohol use is Cardiac Myopathy (disease of the heart muscle), Wernicke encephalopathy, which is when there is a onset of confusion, unstable coordination, and and eye abnormalities or Korsakoff psychosis which is a late sign of Wernicke Encephalopathy, Pancreatitis inflammation of the pancreas, Esophagitis, Hepatitis, Cirrhosis is a slowly developed diease that create scarring , Leukopenia a low level of white blood cells Thrombocytopenia low number of platelets in the blood , Ascites is fluid accumulation in the abdomen. Withdrawl and detox began in 4-12 hours, some of the symptoms that are experienced: hand tremors, sweating, elevated pulse and B/P, insomnia, anxiety, nausea and or vomiting. Some of the severs symptoms that are associated with severe alchol withdrawl are haullicination, seizures and delirum. The peak for alchol is day2 and should be over by day 5, this can change overall withdrawl may take 1-2 weeks. Withdrawl can be life threatening so it should be watched under medical supervision. Safe alcohol withdrawl is usually treated with Benxodiazepines: Ativan, valium, or librum(chlordiazepoxide) Ativan can be given to a older adult who is experiencing withdrawl due to half life not as strong as valium which can last up to 18 hours. Alcohol withdrawl delierm is usually result in sepsis, MI, fat embolism, peripheral vascular collapse also know as gangrene, fever, electrolye imbalance, suicide. To determine the frequency a Clinical institute Withdrawl Assessment (CIWA) is used. A score 1-8 is mild, 8-15 is moderate and 15+ is severe. Another factor that is used to determnine Alcoholism is CAGE Have you felt the need to Cut the drinking? Do people Annoy you when they ask about your drinking? Have you felt Guilty about drinking? Have you had a drink in the morning like a Eye-opener drink? 2. Sedatives, Hypnotics, and Anxiolytics Is a all central nervous system depressants: barbiturates, nonbarbiturate hypnotics, and anxiolytics, particularly benzodiazepines. Benzodiazepines and barbiturates. The effects of these drugs are similar to alcohol. Intoxication Benzodiazepines and barbiturates are the most common drug used in this category. The effects depend on the type of drug. The intoxication of these types of drug are simular to those of alcohol. With intoxication of benzodiazepine and barbiturates symptoms my include slurred speech, lack of coordination, unsteady walking, impaired attention or memory. Overdose Benzodiapine when taken alone tend not to be fatal but this peron will be lethrgic and confused. Treatemnt to remove benzon id gastric levage (which is to pump or sutching the stomach) or activated charcoal: if symptoms are severe dialysis can be use. Barbituates can be lethal when overdosed. Barbituates can cause coma, Respitory arrest, cardiac failure and death. To treat this you can use a dialysis or lavage(pump the stomach). Withdrawl and detox the withdrawl symptoms depend on the half life. Ativan last about 10 hours and you can produce withdrawl symptoms in 6-8 hours. Longer acting benzos like valim you may not experice withdrawl symptoms for a week. (WITHDRAWL SYNDROME) is when you are expericing symptoms that are opposite of acute affects of the drug so this person may experience HIGH pulse, B/P, RR, temp, hand tremors insomnia, anxiety, nausea, and agitation. Seizure and hallucination may be experienced with severe withdrawl symptoms. DETOX from sedatives, hypnotics and anxiolytics is managed by TAPERING, This is essential for Barbituates to prevent coma or death, this should not be stopped abruptly. 3. Stimulants Are drugs that excite the CNS, there drug arent use clinically but with an exception of ADHD. Amphetamines are (uppers) they were used by people who wanted to lose weight quickly or stay awake. Cocaine, an illegal drug with no clinical use in medicine, is highly addictive and a popular recreational drug because of the intense and immediate feeling of euphoria(a extreme feeling of happiness and pleasure and excitement) Intoxication and overdose of stimulant develop quickly the feeling is euphoric, hyperactivity, hypervigilance, talkativeness, anxiety, hallucinations, stereotypic or repetitive behavior, anger, fighting, and impaired judgment. Physiological effects include tachycardia, elevated blood pressure, dilated pupils, perspiration or chills, nausea, chest pain, confusion, and cardiac dysrhythmias. Overdoses of stimulants can result in seizures and coma. With the stimulant you want to treat the symptom such as High B/P, hallucinations, nausea. Withdrawl and detox this can occur within a few hours to several days. the main symptom od this is dysphoria(which is when a person feels uphappy with life) this person my also feel fatigue, unpleasant dreams, insomnia, high appitie, agitation and feeling od crashing which is SUCIDE. This isn’t treated with any pharm medication. 4. Cannabis Has short term effects that lower intraocular pressure, relieve nausea and vomiting in chemotherapy, anorexia and weight loss of AIDS. Intoxication and Overdose can begin to act in less then 1 min and peak 20-30 mins, it last 2-3 hours. ASK TEACHER BALANCE AND STIBILITY IS IMPAIRED FOR UP TO 8 HOURS Symptoms that are included is relaxiation, increased laughter, impaired judgement, short term memory, Anxiety, dysphoria and social with drawl. Some of the more serious sign are dry mouth, low b/P, tachycardia, and blood red eyes Physical: bronchitis, weakening of heart contractions, immunosuppression, & decreased serum testosterone & sperm count. Withdrawl and detoxification sweating, anxiety, muscle aches and tremors. OTHER: Can remain in the body for up to 6 weeks, in the blood and urine it can be detected any time around 3 days to 4 weeks and up to 90 days in the hair. 5. Opioids Opioids are a CNS depressant and a popular drug due to desensitizing (lower sensitivity) in the function and mental pain. Opioid compounds include both potent prescription analgesics such as morphine, meperidine (Demerol), codeine, hydromorphone, oxycodone, methadone, oxymorphone, hydrocodone, and propoxyphene as well as illegal substances such as heroin, illicitly produced fentanyl, and normethadone. Fentanyl (Duragesic, Actiq) is a synthetic opioid used in clinical settings for anesthesia. It is 50 to 100 times more potent than morphine Intoxication and overdose is a euphoric feeling, impaired judgement, agitation, drowsiness, slurred speech, impaired attention and memory. Severe intoxication can lead to coma and respitory depression, pupil restriction, death and unconciousiness. Narcan is the treatmeant of overdose because it can reverse the symptoms of opioid toxicity, this is given ebery couple of hours until the opioite level drop. HEROIN HAS A HIGHER ABUSE POTENTIOAL BEAUSE IT CROSSES THE BLOOD BRAIN BARRIER. Withdrawl and detoxificatiom symptoms of ‘withdrawl began when the drug starts to decrease initial symptoms are anxiety, aching pains oif the back and legs, Yawning, dilated pupils, goose flesh, comiting, diarrhaea, runny noses and eyes, sleepiness, elevated BP and heart rate. Tapering with methadone or other tapering opioids. Methadone is whats given for heroin. Heroin is a short acting drug that produce withdraw in 6-24 hours and peak in 2-3 days. and subside in 5-7 days. A DEVICE CALLED NSS-2 BRIDGE . 6. Hallucinogens Take away the perception of reality and replace them psychosis, which include hallucinations(Usually visually) with hallucinogens the HR goes up, Ataxia(lack of coordination), euphoric, vomiting, salivation(excess siliva production), hostile, blank stare, bizarre behavior and agitation. Intoxication and Overdose when these people become intoxicated they feel anxiety, depression, paranoid, fear of losing there mind, blurred vision, unsteady gait ect. PCP consumption can lead to unpredictable behavior, this person may become aggressive. And this can last 6-8 hours. They have a increased B/P and HR Ataxia(lack of coordination), euphoric, vomiting, salivation(excess siliva production. They can be managed by isolation from external stimuli and physical restraints. PCP TOXICITY include seizure and respitory depression. Cooling blanket (for high temp)and mechanical devices (breathing device) are used to assist with the symptoms pcp. Withdrawl and detox no withdrawl may be presenct just craving for this drug. Although these people may experience flashbacks and this can last up to 5 years. 7. Inhalants Are drugs that are inhaled most of the inhalant is spray paint, glue, lighter fluid, propellant gas. These inha;ants can cause severe brain damage, peripherial nervous system damage and liver disease. Intoxication and overdose involves dizziness, nystagmus, lack of coordination, slurred speech, unsteady gait, tremor, muscle weakness, and blurred vision. Stupor (near unconcious) and coma can happen. Withdrawl and detox there is no withdrawl symptoms only the craving for more of the drug, later in life these people can suffer from dementia, psychosis and anxiety or mood disorders, when a person experiences these they only treat they symptom. TREATMENT AND PROGNOSIS 12 STEP PROGRAM – based off total abstinence is is essential.
