Substance Related Disorders - Wilkins Chapter 64

Katelyn Crouch & Holli Schexnider

A _________________________ is a disorder of intoxication, dependence, abuse, and substance

withdrawal; caused by various substances, whether legal or illegal.
Drugs that have abuse potential:
Alcohol
Tobacco
Cocaine
Heroin
Marijuana
Prescription medications
Caffeine
Substance dependence vs substance abuse:
-Dependence: the user is ________________ on their drug of choice.
-Abuse: the user may _________________ alcohol, nicotine, recreational drugs, prescription drugs,
or any other substance that has the potential to alter how the mind and body works.
People who are dependent on alcohol are _________ likely than the general population to use other
drugs, and vice versa.
Substance use may vary from the occasional recreational use to addiction.
There is NO classic cultural, socioeconomic, or educational profile for a substance abuser.
Alcohol Use Wilkins Ch. 64
Alcohol used for consumption purposes is also known as __________________ or
_________________.
Alcohol use can range from social drinking to alcohol dependence, which is where the person abuses
alcohol daily and has a need for the drug.
_____________ is defined as a chronic, progressive behavioral disorder characterized by a strong
urge to consume ethanol and the inability to limit the amount, despite any consequences.
Signs of alcoholism:
Cravings
Loss of control

Dependence
Tolerance

Etiology for alcoholism:

Genetics GABRA2 or CHRM2
Biopsychosocial children of alcoholic parents
Environmental stress, family, friends, lifestyle, culture, etc.
Alcohol can be detected in the blood just ________ minutes after consumption, and is metabolized
in the _____________.
Legal limit = .08 mg/dL
Health complications due to alcohol abuse:
Liver and/or heart diseases
Diminished immune response and infection
Injury to the digestive system
Nutrient deficiencies
Increased cancer risks
Effects of alcohol abuse:
Behavior changes aggressiveness, mood swings, impaired judgement and more
Physical changes slurred speech, lack of coordination, unsteadiness
Accidents
Suicide
Oral implications:
Xerostomia
Glossitis
High caries risk
Poor home care
Alcohol breath
DH Considerations for the alcoholic patient:
Avoid alcohol containing mouth-rinses
Be aware of impaired wound healing
Use anesthetics without epinephrine
Use ultrasonic and air polishers with caution MUST use HVE suction.
Withdrawal symptoms may appear within ____________________ after alcohol cessation.

Tobacco Use Wilkins Ch. 33

______________ is the leading preventable cause of disease, disability, and premature death in the
United States.
Smoking has caused more preventable deaths in the US than AIDS, alcohol use, motor vehicle
accidents, homicides, drug overdoses, and suicides combined.
The CDC reports that cigarette smoking results in more than 480,000 premature death each year.
______________ is a poisonous, addictive stimulant that is found in tobacco.
Nicotine may be found in:
Cigars / cigarettes
Pipe tobacco
Snuff
Chewing tobacco
Nicotine is distributed into the bloodstream, which stimulates the adrenal glands to release
________________.
Nicotine increases the dopamine levels in the brain, which results in addiction.
Nicotine absorption occurs through the lungs, skin, and _________________ mucosa.
Smokeless tobacco (snuff) contains as much as 3-4 times the amount of nicotine as one cigarette.
Systemic effects of tobacco use:
Cardiovascular system
Pulmonary diseases
Cancer
Withdrawal symptoms:
Depressed mood
Anxiety
Anger
Decreased heart rate
Hunger
Cravings
Treatment for tobacco users: ______________ and ______________.
Oral Implications:
Bad breath; stained teeth

Increase in occurrence and severity of periodontal diseases

Increased risk of oral cancers
Bone and tooth loss
Delayed healing
Reduced inflammatory response

DH Care for the tobacco user:

Longer, more frequent appointments
Oral cancer screening information
Non-alcoholic rinses
Nutritional counseling
Recreational Drug Use Wilkins Ch. 64
_________________ are drugs that are taken for enjoyment or leisure, rather than true medical
purposes.
The most popular recreational drugs used are:
Alcohol
Tobacco
__________________
The most commonly used drugs among college students include:
Marijuana
___________________
Ecstasy
The recreational user can easily say no when drugs are offered. They do not depend on the drug to
function and can easily maintain healthy relationships with friends and family members.
The ___________________ experiences difficulty turning down drugs when offered; they will
choose drugs at all costs and this may cause issues with friends, family, and finances.
Oral Implications of recreational drug use:
Xerostomia
Glossitis; gingival inflammation
Poor oral hygiene
Caries; tooth loss
Perforated palate due to cocaine snorting
Attrition; erosion
DH Care:

The recreational user may require a pre med

Know potential drug interactions

Avoid alcohol containing products

NO local anesthetic for 24 hours after last meth use
Fluoride treatments
Ultrasonic and air polishers with caution must use HVE.

Drug addiction is a treatable disorder, but the user must be willing to acknowledge that their
addiction is a problem.
Medications used for drug treatment:

Methadone
L-A-A-M
Naltrexone
__________________

Behavior may be modified though counseling, support groups, and therapy.

Questions
1. Substance dependent individuals are at very low risk for developing a tolerance to their drug
of choice; they can safely use the lowest possible dose of a drug each time to maintain the
desired effect.
a. The first statement is true and the second is false
b. The first statement is false and the second is true
c. Both statements are true
d. Both statements are false
2. Tobacco use can lead to an increase in bone and tooth loss. Tobacco will also increase the
inflammation response, usually causing heavy bleeding.
a. Both statements are true
b. Both statements are false
c. The first statement is true and the second is false
d. The first statement is false and the second is true
3. The top 3 recreational drugs used on college campuses in the US include:
a. Alcohol, tobacco, cocaine
b. Tobacco, marijuana, cocaine
c. Marijuana, prescription pills, ecstasy
d. Alcohol, tobacco, and prescription pills