Overview of Substance Abuse Disorders

Oct 18, 2024

Lecture on Substance Abuse Disorders

Alcohol Use Disorder

Symptoms of Alcohol Withdrawal

  • Correct Symptoms:
    • Hallucinations and seizures
    • Elevated blood pressure and diaphoresis (correct answer)
    • Bradycardia and hypothermia
    • Decreased appetite and weight loss
  • Early Symptoms:
    • Autonomic hyperactivity
    • Increased blood pressure
    • Increased heart rate
    • Tremors
    • Diaphoresis

Important Notes on Alcohol

  • Alcohol is a depressant.
  • Withdrawal from alcohol is extremely dangerous and requires close monitoring.
  • Possible outcomes during withdrawal include cardiac dysrhythmias, hypertension, and tachycardia.

Prioritization During Alcohol Intoxication

  • Priority: Monitor vital signs closely due to risk of respiratory depression and eventual withdrawal symptoms.
  • Other options (less priority but important):
    • Urine toxicology screen
    • IV line and thiamine administration
    • Encouraging Alcoholics Anonymous attendance

Medications and Patient Understanding

Disulfiram (Antabuse)

  • Patient Understanding: Must avoid all alcohol-containing products, like cough syrups and mouthwash.
  • Disulfiram acts as a deterrent by causing severe illness upon alcohol consumption or absorption.

Barbiturates

Withdrawal Symptoms

  • Symptoms include anxiety, seizures, hallucinations, and delirium.

Patient Teaching on Phenobarbital

  • Avoid alcohol while taking this medication, as both are depressants.
  • Risks include seizures during withdrawal.

Reporting Concerns

  • Immediate Reports: Development of tolerance indicates potential dependency, which is dangerous.
  • Not Immediate: Occasional headaches, dizziness from standing, difficulty concentrating (these are less critical).

Stimulant Medications

Methylphenidate for ADHD

  • Common Side Effect: Insomnia (due to stimulant properties)
  • Incorrect Symptoms: Weight gain, bradycardia, constipation

Other Substance Information

True or False Questions

  • Speed and Crystal Meth: Not barbiturates; they are stimulants, leading to increased heart rate and potential for seizures.
  • LSD and PCP: True hallucinogens; risk of hallucinations, seizures, and mania.

Nursing Interventions for Hallucinogen Use

  • Ensure safety by monitoring vital signs and protecting the airway.
  • Reduce environmental stimuli to prevent exacerbating symptoms.

Narcotic Use

Important Nursing Interventions

  • Maintain patent airway.
  • Control seizures.
  • Assess level of consciousness and vital signs.
  • Have Naloxone (Narcan) readily available for overdose.
  • Be prepared with a defibrillator for potential cardiac dysrhythmias.

Common Narcotics

  • Examples include morphine, heroin, and dilaudid.

General Advice

  • Always prioritize interventions that keep the patient alive and minimize immediate dangers.
  • Consider physiological integrity as primary in Maslow's hierarchy of needs.

Thank you for following along with this lecture on substance abuse disorders. Remember the key points to ensure thorough understanding and patient safety.