This course is designed to give an overview of the care and management of the patient suffering from substance abuse. Focus will be placed on defining substance abuse and well as describing common psychoactive substances. The effects of substance abuse as well as assessing the “risks” associated with substance abuse will also be presented. Signs of intoxication from psychoactive drugs and indications of withdrawal will also be discussed. The general principles of treatment for substance abuse and the primary, secondary and tertiary prevention goals for substance abuse will be the final focus of this course.
Course Objectives
Upon completion of this course the student will be able to:
Define substance abuse
Describe commonly used psychoactive substances
Discuss the effects of substance abuse
List 3 risk factors for substance abuse
State 3 signs of intoxication from psychoactive substances
Explain the general principles of treatment for substance abuse
Discuss the goals of preventing substance abuse
Definition of Substance Abuse:
Substance abuse involves the inappropriate use of psychoactive substances (drugs or chemicals that alter the ordinary state of consciousness, mood, cognition or behavior). The following signs of dependence are usually present before a person is diagnosed with having a substance abuse problem:
Increasing amounts of substance used or extending usage over a longer period of time.
Persistent desire for substances.
One or more unsuccessful attempt to control substance use.
Increased amount of time spent obtaining, using or recovering from the effects of substances.
Frequent symptoms of intoxication or withdrawal.
Elimination or reduction of important occupational, recreational or social activities.
Continued use of substance despite recurrent problems with the substance.
Increased tolerance for the substance.
Increased substance use in order to decrease withdrawal symptoms.
Angel Dust, Acid, Microdot, Cubes, The Love Drug, Buttons, Magic Mushrooms.
Oral, injected, smoked or snorted
Altered perceptions, Mystical experience, Dream like state
Cannabis ( Hashish, Marijuana)
Herb, Grass, Hash, Weed, Dope, Reefer, Sticks, Gold, Mary Jane
Smoked or orally ingested
Relaxation, altered perception, Euphoria
Inhalants (Amyl nitrate, Nitrous Oxide)
Poopers, Laughing Gas, Rush
Inhaled
Relaxation, Euphoria and Intoxication
Nicotine
Cigarettes, Tobacco, Cancer Sticks
Smoked or chewed
Relaxation and mild stimulant effects
Effects of Substance Abuse:
Personal Effects:
Physical –The physical aspects of substance abuse include increased morbidity directly related to the substance and an increase risk of exposure to diseases such as HIV/AIDS and Hepatitis related to the use of a substance. Other physical effects include malnutrition, poor hygiene and the symptoms of withdrawal.
Family Effects – The effects of substance abuse on a family can be very severe. Families of substance abusers often endure frequent conflict, anger and violence as a mode to resolve conflict. Family members frequently become socially isolated in an attempt to cover up for the abuser, and if unable to cover for the abuser are often embarrassed to be with friends and neighbors. Co-dependency which is when a partner or child stays in the relationship with the abuser and often enables the abuser is also a very prevalent family effect of substance abuse.
Societal Effects – The societal effects of substance abuse include increased morbidity and mortality, increased economic costs and increased crime.
Mortality Effects – The mortality rate of a substance abuser is increased either directly (from overdose or withdrawal) or indirectly due to other conditions related to abuse and/or purchasing of some substances. Mortality related to alcohol is of great concern as alcohol can cause multi-system organ failure (especially kidney and liver) as well as increasing the risk of death due to motor vehicle driving while under the influence.
Cost Effects – The cost of substance abuse is enormous in society. Alcohol abuse for example is considered to be the most expensive health problem in America. Emergency room costs for alcohol related injuries is double that of normal visits. Unemployment secondary to substance abuse is also a major economic cost to society.
Crime Effects – On final social effect of substance abuse (excluding nicotine) is increased crime. Drugs are often at the root of many crimes (even those not directly related to purchasing the substance). Theft to pay for drugs, prostitution and even murder are all thought to be crimes either directly or indirectly related to substance abuse.
Assessing the “Risk” for Substance Abuse:
In most cases there are one or more “causative factors” that contribute to substance abuse. The following table list just a few of the questions that should be asked when attempting to determine if someone who is abusing substances is heading for serious trouble.
Risk Assessment Tips
Dimension
Risk Assessment
Biophysical Dimension
Are there existing physical problems contributing to substance abuse. Has the abuser developed long term effects from substance abuse?
Psychological Dimension
Does the abuser have a poor self-image or poor impulse control? Is there underlying psychopathology that is contributing to the problem?
Social Dimension
Does the abusers peer group support drug use or abuse? Is substance use a regular part of the abusers interactions with others?
Behavioral Dimension
Does the abuser use multiple substances and are these substances attached to leisure activities?
Health System Dimension
Is the client open to healthcare education about substance abuse? Does the client have financial access to substance abuse treatment?
Assessing for Signs of Intoxication:
Intoxication is a state of diminished physical and /or mental control that occurs as a result of current use of a psychoactive drug. Different substances cause different symptoms (hallucinations, hypervigilance or hyperactivity for example). The following table provides a detailed description of signs and symptoms of selected psychoactive substances.
Signs of Intoxication with Selected Psychoactive Drugs
Nursing CE Course
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