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Conducted by:Ass. Lect.Omneya Youssef

Neuropsychiatry Department

Faculty of Medicine

Substance misusefor 4th year

Faculty of Nursing

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Substance Abuse

Substance abuse:Is repeated use of alcohol or drugs leading

to functional problems.

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Substance Use Disorders

Substance Dependency:

The continued use of alcohol or drugs despitenegative consequences such as significant

problems in daily living.

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Substance Addiction

Addiction usually refers to a behavioral

pattern of alcohol or drugs abusecharacterized by overwhelming involvement

with the use of the drug and compulsion

in obtaining the drug. There is a high tendencyfor relapse after discontinuation.

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Substance Withdrawal

Withdrawaloccurs when there is a pattern of

use that escalates creating tolerance. When

the abused substance is removed there is a

physical response to the absence of the drug.

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Types of Drugs Abused

y Alcohol

y Cocaine

y Narcotics

y CNS depressantsy CNS stimulants

y Hallucinogens

y Inhalants

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ASSESSMENT FINDINGS

y History: Academic or job failures, marital failures,stealing to support habit, personality change, violentacting out

y Physical Examination:Malnutrition; abdominalcramps; diaphoresis, yawning, lacrimation, rhinorrhea 10hours after the last opiate injection; needle marks on armsalong path of a vein (wearing of long- sleeves); nasaldischarge with nasal septum perforation (cocaine)

y Social: Inability to maintainADL and fulfill roleresponsibilities and obligations

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Continued:

y High Risk for Violence: Directed toward self or others

related to feelings of suspicion or distrust; intake of

mind-altering substances; misinterpretation of stimuli

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Alcohol Abuse and Dependence

Alcohol is classified as a food product.

Alcohol is a CNSdepressant. It causes

behavioral changes as well as mood changes.

These changes are proportionally related to

the amount of alcohol consumed.Alcohol concentration is measured by a blood

alcohol level.

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Alcohol Abuse

Tolerance develops after prolonged heavy

drinking. Physical tolerance or tissue

adaptation means that cellular changes

occur in the central nervous system. So that

more of the drug is needed by the body to

provide the desired effect.

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CommonComplications withHistory of

Alcoholism

y 1. Liver Cirrhosis

y 2. Gastritisy 3. Pancreatitis

y 4.Tingling sensation/numbness of extremities

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GENERAL PRINCIPLES OFCARE:

DETOXIFIC

ATION/OVERDOSE

y Maintain airway: Intubation (keep airway on hand), suction

y Start IV line

y Monitoring: BP, respiration, pulse, temperature, LOC

y Prevent and control seizures; Keep in calm, quietenvironment

y Check for trauma, protect from injury

(If the pt shouts & walks back & forth, appropriatenursing intervention includes seclusion, staying with the

pt, and decreasing stimuli).y Administer ordered drugs; Detoxify / treat overdose

y Nutrition: High-calorie, high-protein, high-vitamin

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Alcohol Induced Disorders

Intoxication occurs after drinking excessiveamounts of alcohol and is evidenced by

maladaptive behaviors such as fighting,

impaired judgment and interference withsocial and work abilities.

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Factors InfluencingSubstance

Abuse

Psychosocial and Behavioral

BiologicalTheoretical

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Considerations

y Acute care

y Family needs/family support

y Prevention

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