Substance abuse
Bob started drinking last month, drinks five days a week, drinks while he is driving, and gets arrested twice. Does he meet criteria for alcohol use disorder.
NO- S/S must be present over a 12-month period.
•Neurotoxicity & Psychosis
•Cracked teeth, skin infections, lung/ kidney/ liver damage
Withdrawal symptoms....
•Panic
•muscle aches
•nausea/vomiting
•lacrimation or rhinorrhea
•pupillary dilation
•chills
Symptoms of opioid withdrawal.
Hallucinogen induced disorder treatment.
•Low stimuli… minimal light, sound, activity
•Attempt to “talk down” patient
•Stay with the patient
•Speak slowly and clearly in low voice
•Give Diazepam for anxiety
Chronic alcohol abuse can lead to this...identify the symptoms
1. Alcoholic hepatitis (enlarged, tender liver; nausea and vomiting; lethargy; anorexia; elevated white blood cell count; fever; and jaundice),
2. cirrhosis- end-stage liver disease
3. pancreatitis (constant/ severe epigastric pain; nausea and vomiting; and abdominal distention)
4. Leukopenia/ Thrombocytopenia
Molly craves alcohol, experiences shaking hands, GI problems, sweating and pains in her stomach.
Withdrawal.
Symptoms of intoxication...
•euphoria, apathy, dysphoria, psychomotor agitation or retardation, impaired judgment, Constricted pupils, ↓ respirations, ↓ BP, Slurred speech
•Severe intoxication...
•respiratory depression, coma, and death.
What is opioid intoxication
Treatment for an opioid overdose.
Administer naloxone, maintain airway, IV fluids, monitor VS
At high doses opioids induce this....
Hypotension and respiratory depression
Henry does not feel any of the effects of alcohol, even in high amounts. What is this called?
Tolerance
•Slurred speech
•Incoordination
•Drowsiness
•Decreased B/P
Alcohol Intoxication
Name 2 drugs to reduce or eliminate cravings for alcohol.
Naltrexone and Acamprosate.
Minimum BAC for intoxication...
What is 0.08%
What are 2 questions you can ask to assess someone's substance use?
1. In the last year, have you ever drunk or used drugs more than you meant to?
2. Have you felt you wanted or needed to cut down on your drinking or drug use in the last year?
Impaired motor coordination
euphoria
anxiety
sensation of slowed time
impaired judgment
Cannabis Intoxication
Disulfram is used for this. What happens if mixed with a substance?
Treatment of alcohol use disorder.
When mixed with alcohol symptoms include: hypotension, N/V, facial flushing, pounding in chest
S/S of delirium tremons
Hallucinations, delusions, agitation, fever, tachycardia, HTN, agitation, fluctuating levels of consciousness
When do delirium tremons peak & how long do they last?
Peak 2-3 days after cessation
Lasts 1-5 days
Dysphoria
Fatigue
Sleep disturbances
Cravings
Suicidal ideation
Amphetamine & cocaine withdrawal.
Identify 3 drugs for long term management for opioid use disorder. What do they do?
Methadone- blocks cravings
Buprenorphine- blocks signs and symptoms of withdrawal
Naltrexone- blocks euphoric effects of opioids