Substance

Abuse
Karen Kate Galman, RN
Lecturer, Psychiatric Nursing
Substance Abuse
Using a drug in a way that is
inconsistent with medical
and social norms and
despite negative
consequences
Substance Dependence
An individual’s persistence
to use the substance
despite the problems it
may cause
Intoxication
Use of substance that
resulted in
maladaptive
behaviors
Withdrawal syndrome
 Refers to the negative
physical and
psychological reactions
that occur when use of a
substance ceases or
dramatically decreases
Detoxification
The process of safely
withdrawing from the
substance
Black out
 Episodes in which a person
continuous to function but has no
conscious awareness of his
behavior at the time or any later
memory of the behavior
Tolerance
 ENGE PA
PLEASE!!!
 A state in which
individual does not
respond to the
substance
Tolerance Break
AMP! HILO
AGAD!!
Very small amounts of
substance
intoxicates the
person
Spontaneous Remission
Individual who modify
or quit the use of
substances without a
treatment program
Dual Diagnosis
Son, you’re
an addict!
 Client with both
substance abuse and
psychiatric
conditions
 What are the
defense mechanism
used by substance
abusers ??
Defense Mechanisms used by
substance abusers

D.R.I.P.
Types of Abused Substances

D
U O
P W
S
N
P S
E
E
R
R
 Substance Abuse
SHIN

c Cocaine and caffeine

U
P H Hallucinogens
P S
E A Amphetamines

R
n Nicotine
D
Substance Abuse
O
W masandal hilo cO!!
S
N
E
M Marijuana
R A Alcohol

s Sedatives

A Anxiolytics
D
Substance Abuse
O
W masandal hilo cO!!
S
N
E
h Hypnotics
R i Inhalants

o Opiates

c Cannabis
 Cannabis
MARIJUANA
Upper leaves, tops,
hashish and flower
tops
 Medical use

• Dronabinol (Marinol)
• Nabilone (Casamet)
 Intoxication

REAL bad
R elaxation
E uphoria
A ppette increase
L oss of Inhibitions

B lood shot eyes

A ng BP ay mababa
D istorted perception and time and dry
mouth
Overdose for Cannabis

NONE
Withdrawal for Cannabis

A.M.A.T.S
A nxiety
M uscle ache
A nxiety ulit
T remors
S weating
Alcoholism
What is the first
letter of
ALCOHOL??
What letter
follows
A??
 B.A.L.

Blood Alcohol Level

b Blood extraction
a Alcohol evidence
l Level
 Screening Test
The CAGE questionnaire
Alcohol Intoxication

S.L.U.R.
Alcohol Intoxication
s Slurred speech

L loss of coordination

U Unsteady Gait

R Relaxation
 Alcohol Overdose
V omiting
H ypotension
R espiratory depression
U nconsciousness
D eath
Treatment for Overdose
Treatment for Overdose
• Lavage
• Dialysis
Alcohol Withdrawal
A nxiety
H allucinations
I ncrease V/S and Insomnia
T remors
S weating and seizures
Withdrawal symptoms

D.A.T

Is an
Alcoholic
 D.A.T
D elirium Tremens
A lcoholic Hallucinations
T hiamine Deficiency
Complications
• Wernicke’s
Encephalopathy
• Korsakoff’s
psychosis
Wernicke’s Encephalopathy

C onfusion
O pthalmoplegia
A taxia
T hiamine Deficiency
Korsakoff’s psychosis

R etrograde Amnesia
A nterograde Amnesia
C onfabulation
K orsakoff’s psychosis
Treatment for Withdrawal
V

L
What is the first
letter of
ALCOHOL??
 A stands for ….
A version Therapy
 Aversion Therapy

Antabuse (Disulfiram)
WARNING!
 NO TO…
M outh wash
O ver the counter cold remedies
F ood sauces with wine
F ruit flavor extracts
A ftershave lotions
V inegar
S kin products
 Other Medications
• Naltrexone (Revia)
• Acamprosate
(Campral)
Self help groups
Sedatives, Hypnotics and
Anxiolytics
They are the…
p apampam
B arbitals….
- Yellow jackets,
reds, blues, army,
rainbow
- Roofies, roche,
roaches
Examples of…
Barbitals
PhenoBARBITAL
AproBARBITAL
ButaBARBITAL
MephoBARBITAL
Examples of…
Barbitals
TalbuTAL
ThiopenTAL
MethohexiTAL
ThiamiLAL
 Intoxication
• Same as alcohol (SLUR)
•S tupor
•I mpaired attention
•C oma
Overdose
Benzodiazepines Barbiturates

Rarely fatal but Fatal

with lethargy and
confusion
 Treatment for
benzodiazepines
Activated charcoal and saline
cathartics
Treatment for B&B
Treatment for B&B

Dialysis
 Withdrawal
Same as alcohol (AHITS)
 Treatment
Lower the Tapering
dosage!!
 Hydrocarbons
(Aliphatic and Aromatic)
INHALANTS
 INCLUDES…

ANESTHETICS
NITRATES
ORGANIC SOLVENTS
 Effects
B rain & Liver damage
R espiratory depression
A pathy
I nability to function
N orexia
Opioids
White stuff, hard stuff
and junk
 Opioids
Morph
Meperid INE Heroin
Code
Hydromorph
Methad
ONE
Intoxication and overdose
Apathy

p Inpoint pupils
i Ncoordination impaired judgment

o verdose
Respi depression
d eath
 Treatment for Intoxication

Naloxone
(Narcan)
 Withdrawal
eroin
ikab (yawning)

H
atsing (rhinorrhea)
ulas (diaphoresis)
orror (piloerection)
indi tigas (impotebse)
ayok (craving)
indi mapakali (restlessness and
irritability)
 Treatment
Detoxification thru

METHADONE
 Treatment
Detoxification thru

Rapid reduction
(Morphine)
 Treatment
Detoxification thru

Cold turkey
(Phenothiazene)
Methadone withdrawal
• Less severe
• Same symptoms with heroin
• Treatment: clonidine and
tapering
 Substance Abuse
SHIN

c Cocaine and caffeine

U
P H Hallucinogens
P S
E A Amphetamines

R
n Nicotine
Cocaine, Amphetamines and
Methamphetamines
STIMULANTS
•Coke, crack, rock
•Speed, crystal,
crank, ice, shabu,
bato
Amphetamines
cocaine
methAmphetamines
 Intoxication
W eight loss
H yperactivity, grandiosity
I ncrease V.S./ Cns response
L oss of appetite
E uphoria
 Signs and symptoms
Perforated nasal septum
Withdrawal signs and symptoms

D epression
I rritability
P sychomotor
agitation
U npleasant dreams
 Cocaine Intoxication
H allucinations
D elusion
D angerous behaviors
 Cocaine Overdose
• Seizures
• Coma
Treatment
HALLUCINOGENS
• Psychedelics, psychomimetics

• Mescaline, psilocybin, lysergic

acid diethyl amide(LSD),
phencyclidine (PCP,angel dust),
ecstasy
 Intoxication
B lurred vision
L ack of coordination
I increase VS
S sweating
T remors