NUR 3012 Care of Substance Abuse ~ used by people in almost all cultures since early times, ~ psychoactive substances alter the mind, the way reality is perceived, and the way a person feels = use for relief of negative emotional states such as depression, fear, and anxiety; for relief from fatigue or boredom; and as a break from daily routines because the drugs produce altered states of consciousness. Major Problems of Substance Abuse = Tolerance of the substance * Withdrawal symptoms = Substance dependence © Problems in cutting down or controlling use * Social and occupational activities reduced Meaning of Substance Abuse -_ taking different types of substances without the guidance or prescription of medical profession. = causing physical, mental, emotional and social harms. Types of Substance - Ref, to website of Narcotics Division, Security Bureau http://www.nd.gov.hkMHA THR tOAMMHOHELERR EAS Goeszne) Reparation of rap se RANATHERECUMNonELER RES AL Gate azide) Pepa gst by cy any of ge based RANA THAR ScAMME MEENA E AL (Calesmcr) Reported drag aburers by aot by common ype of drs abused cont SANARdare cA naenUEELRRRE AS ‘Spr dy surrsby symoneNARCOTICS ANALGESICS HALLUCINOGENS em Fairer | [ma fa <= Se or e one: [aie cel Sa a Stee | wma site rs == ep see STIMULANTS DEPRESSANTS = a Ee = = = = eeeTRANQUILLIZERS fe om — — Seeeereaea pace Sie ee ee OTHERS ; Definition of Terms eee Sees = Substance abuse -- continued use despite i related problems. * Substance dependence —a severe ee = condition, usually considered a disease; or +/- physical problems and serious disruptions eee es |e ee eres in the person’s work, family, and social life. learn peor = eee * Addiction — psychosocial behaviors related 5 sop pe to substance dependence; dependence and addiction are often used interchangeably.* Dual diagnosis --- the co-existence of substance abuse and one or more psychiatric disorders, Withdrawal symptoms -— result from a biological need that develops when the body becomes adapted to having the drug in the system, * Tolerance -- with continued use, more of the substance is needed to produce the same effect. Levelling of Psychoactive Substance Use Recreational Use Usually occurs in a social setting & tends to limited to infrequent social situations & involves small to moderate amounts of the particular substances use. Circumstantial Use Motivated by a desire to obtain a specific effect that is perceived as desirable within a certain context. £ = oe Intensified use Occurs when psychoactive substances are taken daily or almost daily, usually in low to moderate doses to relieve withdrawal. Compulsive use Individual uses high doses or a psychoactive substance daily or almost daily to obtain a desired physical and / or psychological effect (an important criteria for diagnosing DEPENDENCE).Method of Administration ‘There are EIGHT basic ways to consume a psychoactive substance: 1. Orally ~ consumed through the mouth (e.g smoking, oF pls) 2. Nasally ~ snorting or inhaling the psychoactive substance through the nose, which is longer acting. 6. Topical ~ applying the psychoactive substance onto the top layer of the skin (e.g. LSD blotter paper). 7. Sublingually dissolving the psychoactive substance under the tongue and absorbing it through the mouth tissue. 8, Rectally ~ inserting the psychoactive substance into the rectum so it can be absorbed through the rectal tissue. 3. Intramuscularly (IM) injecting the psychoactive substance into muscle, 4. Intravenously (IV) _~ injecting the psychoactive substance into a vein ~ is the most intense, rapid & efficient method of administration 5. Subcutaneous (SC) — injecting the psychoactive substance directly beneath the skin, ASSESSMENT ‘Screening for Substance Abuse AUDIT-C. The Alcohol Use Disorders Identification Test-C (AUDIT-C) is a 3-item screening tool used to identify individuals who are hazardous drinkers or have active alcohol use disorders B-DAST. The Brief Drug Abuse Screening Test (B- DAST) is the quickest drug abuse screening tool (p. 438-439)ASSESSMENT SBIRT. Screen, Brief Intervention, Refer to Treatment (seiRT) Breathalyzer. The simplest biological measure to ‘obtain is blood alcohol content (BAC) by use of a Breathalyzer Blood and Urine Screening. Blood and urine are the body fluids most often tested for drug content, although methods of analyzing saliva, hair, breath, ‘and sweat have been developed. (p. 438-439) Transtheoretical Model of Change ims oemen The. ponies Clee ACI NURSING ACTIONS 1. Pre-contemplation Nye cane te posit of clans slnegh the wae of 2. Contemplation so was desi 3, Determination] sei mo intended rng sh age: ve io 6. Relapse | Conia fin: ene: upon enrages ey Sy enact Canedton ane comeing eer | Import prevent rp ot and egesin, Sse ncn secon toe ees Re 5. Maintenance ssn he changes accomplish by revision & prevent le | rege iret st of kil nes nite chings and problem solving statis: epic rblons behaves wih ene Ife Motivational Interviewing (MI a 4. In Substance Abusers (SA), the counselor does Principles of Motivational Interviewing (MI) NOT assume an authoritarian role. Responsibility to change is left with the individual 5. Strategies of SA are more persuasive than coeteive; more supportive than argumentative. 6. When such an environment is created, itis the client who presents the arguments for change, rather than the therapist. 1. Help substance users to recognize and do something about their present / potential problems 2. It is particularly useful to who are reluctant to change & are ambivalent about changing. 3. Some are able to move onto change once unstuck.Four Processes of Motivational Interviewin; Service Scope in Hong Kons in 186 186 Engaging — e* 8 Focusing Reference List,