Judith Wikel RN BSN MEd

MH 4.1

Chapter 28 Substance-Related DisordersAbused substances are those chemicals

that alter the individual’s perception by affecting the central nervous system.

Chapter 28 Substance-Related DisordersAddiction

When the dependence on a substance is physical, the term addiction is used.

Chapter 28 Substance-Related DisordersPregnancy 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.

Chapter 28 Substance-Related DisordersFatal Alcohol Syndrome (FAS)

Children with FAS are smaller at birth, have small heads (microcephaly), and fail to develop normally.

Chapter 28 Substance-Related DisordersChildren 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 inchildren and adolescence is very realand happens more often than werealize.

Chapter 28 Substance-Related DisordersSubstance 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.

Chapter 28 Substance-Related DisordersRelapse

The recurrence of substance-abusing behaviors after a significant period of abstinence.

Chapter 28 Substance-Related DisordersCaffeine

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.

Chapter 28 Substance-Related DisordersStages 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.

Chapter 28 Substance-Related DisordersPsychological 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.

Chapter 28 Substance-Related DisordersInhalants

Breathing in of volatile substances or chemical gases.

Chapter 28 Substance-Related DisordersInhalants

The breathing in of volatile substance or chemical gases.

Very popular with adolescents and young adults for several reasons: Easily availableRapid onset of effectsInexpensive

Complications: Sudden death by cardiac dysrhythmia or respiratory depression.

Chapter 28 Substance-Related DisordersCHARACTERISTICS OF SUBSTANCE USE

AND ABUSESome 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.

Chapter 28 Substance-Related DisordersTreatment

The first step to recovery is admitting you have a problem!

Chapter 28 Substance-Related DisordersDetoxification

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.

Chapter 28 Substance-Related DisordersDisulfiram (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.

Chapter 28 Substance-Related DisordersEffects of Alcohol on the Nervous

SystemPlease 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.

Chapter 28 Substance-Related DisordersCrack

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.

Chapter 28 Substance-Related DisordersHeroin

Signs and symptoms of Heroin Use, Overdose, and WithdrawalPlease refer to table 28-2 page 312

Q & AQuestion –

Cocaine that is processed and made into rocks is called:

A)SpeedB)CrackC)HighballD)Smack

Answer is B

Q & AQuestion - 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 dependentD) will go through withdrawal at work.

Answer is c

Q & AQuestion - 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) syphilisB)alcoholismC) spina bifidaD) fetal alcohol syndrome

Answer is D

Q & AQuestion - 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 ounceB) 1 ½ ouncesC) 2 ½ ouncesD) 3 ½ ounces

Answer is b

MH 4.1Study 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