Professional Documents
Culture Documents
Substance Abuse
Substance Abuse
Caffeine
Cannabis
Cocaine
Hallucinogens
Inhalants
Nicotine
Opioids
Withdrawal Syndrome
Refers to the negative psychological and physical
reactions that occur when use of a substance ceases or
dramatically decreases.
Detoxification
is the process of safely withdrawing from a substance.
ONSET AND CLINICAL COURSE
The early course of alcoholism typically begins with the
first episode of intoxication between the 15 and 17 years
of age.
A pattern of more severe difficulties for people with
alcoholism begins to emerge in the middle 20s to the
middle 30s; these difficulties can be the alcohol related:
Breakup of a significant relationship
An arrest for public intoxication or driving while intoxicated
Evidence of alcohol withdrawal
Early alcohol-related health problems
Significant interference with functioning at work or school.
Blackout
Which is an episode during which the person continues
to function but has no conscious awareness of his or her
behavior at the time nor any later memory of the
behavior.
Tolerance
He/she needs more alcohol to produce the same effect.
Tolerance Break
Very small amounts of alcohol will intoxicate the person.
Initial Effects
Relaxation
Loss of inhibition
Intoxication Symptoms
Slurred speech
Unsteady gait
Lack of coordination
Impaired attention
Concentration
Memory
Judgment
Some people become aggressive or display
inappropriate sexual behavior when intoxicated.
The person who is intoxicated may experience a
blackout.
Overdose
Vomiting
Unconscious
Respiratory depression
Treatment
Gastric lavage or dialysis to remove drug
Sweating
Insomnia
Anxiety
Korsakoff’s psychosis
Pancreatitis
Esophagitis
Hepatitis
Cirrhosis
Leukopenia
Thrombocytopenia
Ascites
SEDATIVES, HYPNOTIC AND
ANXIOLYTICS
INTOXICATION AND OVERDOSE
Intoxication Symptoms
Slurred speech
Lack of coordination
Unsteady gait
Labile mood
Treatment
Includegastric lavage followed by ingestion of active
charcoal and a saline cathartics dialysis can be used if
symptoms are severe.
WITHDRAWAL AND DETOXIFICATION
Lorazepam – action typically last about 10 hours produce
essential with barbiturates to prevent coma and death that will occur
if the drug is stopped abruptly.
STIMULANTS (AMPHETAMINES,
COCAINE, OTHER)
Amphetamines – are drugs that stimulate or
excite the CNS; used by people who wanted to
lose-weight or to stay awake.
Cocaine – highly addictive and a popular
recreational drugs because of the intense and
immediate feeling of euphoria it produces.
Methamphetamine – it is particularly dangerous.
It is highly addictive and causes psychotic
behavior.
INTOXICATION AND OVERDOSE
Intoxification Effects
Euphoric feeling
Hyperactivity
Hyper vigilance
Talkativeness
Anxiety
Grandiosity
Hallucination
Anger
Fighting
Impaired judgment
Physiologic Effects
Elevated Blood Pressure
Tachycardia
Dilated pupils
Perspiration/ chills
Nausea
Chest pain
Confusion
Cardiac Dysrrhythmias
Fatigue
Vivid
Unpleasant dreams
Insomnia/ Hypersomnia
Increase appetite
Symptoms of Intoxication
Impaired motor coordination
Inappropriate laughter
Impaired judgment
Short term-memory
Distortion of time and perception
Anxiety
Dysphoria
Social withdrawal
Physiologic Effects
Increased appetite
Conjunctival injection (Bloodshot Eyes)
Dry mouth
Hypotension
Tachycardia
• Oxymorphone
• Hydrocodone
• Heroin
• Normethadone
INTOXICATION AND OVERDOSE
It may develops soon after the initial euphoria
feeling; symptoms includes:
Apathy
Lethargy
List lessens
Impaired judgment
Constricted pupils
Drowsiness
Slurred speech
Respiratory depression
Papillary constriction
Unconsciousness
Death
Administration of NALOXONE
(Narcan ) opioid antagonist is the
treatment of choice because it reverses
all signs of opioid toxicity.
WITHDRAWAL AND DETOXIFICATION
Initial Symptoms
Anxiety
Restlessness
Vomiting
Dysphoria
Lacrimation
Rhinorrhea
Sweating
Diarrhea
Yawning
Fever
Insomnia
Short-acting drugs such as heroin produce
withdrawal symptoms in 6-24 hrs. symptoms
peak in 2-3days and gradually subside in 5-
7days.
Longer- acting substances such as methadone
may not produce significant withdrawal
symptoms for 2-4days and the symptoms may
take 2weeks to subside
Methadone – used as replacement for the opioid
and the dosage is decreased aver 2weeks.
HALLUCINOGENS
Substances that distort the user’s perception of
reality and produce symptoms similar to
psychosis including hallucinations (usually
visual) and depersonalization.
It Causes:
Increased pulse
Blood pressure
Temperature
Dilated pupils
Hyperreflexia
INTOXICATION
Marked by several maladaptive behavioral
Psychological Changes:
Anxiety
Depression
Paranoid ideation
Ideas of reference
Physiologic symptoms
Sweating
Tachycardia
Palpation
Blurred vision
Tremors
Lack of coordination
Glue
Paint thinner
Spray paint
It can cause:
Brain damage
Liver disease
INTOXICATION AND OVERDOSE
Inhalants intoxication involves:
Dizziness
Nystagmus
Lack of coordination
Slurred speech
Unsteady gait
Tremor
Muscle weakness
Blurred vision
Behavioral symptoms:
Belligerence
Aggression
Apathy
Impaired judgment
Inability to function
Respiratory depression
Vagal stimulation
Dysrrhythmias
Treatment:
Consist of supporting respiratory and cardiac
functioning until the substance is removed
from the body.
WITHDRAWAL AND DETOXIFICATION
People who abuse inhalants may suffer from
persistent dementia or inhalant-induced
disorder such as psychosis, anxiety or mood
disorder even if the inhalant abuse ceases.
TREATMENT AND PROGNOSIS
Until 1970’s, organized treatment programs and clinics for
substance abuse was scarce.
The user was advised to “pull yourself together” and “get
control of your problem.”
Founded in 1949, the Hazelden Clinic in Minnesota is the
noted exception; because of its success, many programs
are based on Hazelden model of treatment.
Alcoholic Anonymous was founded in the 1930’s by
alcoholics. This self help group developed the 12-step
program model for recovery which is based on the
philosophy that total abstinence is essential and alcoholics
need the help and support of others to maintain sobriety.
Twelve Steps of Alcoholics Anonymous
We admitted we were powerless over alcohol - that our lives had become
unmanageable.
Came to believe that a Power greater than ourselves could restore us to sanity.
Made a decision to turn our will and our lives over to the care of God as we
understood Him.
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves and to another human being the exact nature of our
wrongs.
Were entirely ready to have God remove all these defects of character.
Made a list of all persons we had harmed, and became willing to make amends to
them all.
Made direct amends to such people wherever possible, except when to do so would
injure them or others.
Continued to take personal inventory and when we were wrong promptly admitted it.
Sought through prayer and meditation to improve our conscious contact with God as
we understood Him, praying only for knowledge of His will for us and the power to
carry that out.
Having had a spiritual awakening as the result of these steps, we tried to carry this
message to alcoholics and to practice these principles in all our affairs.
PHARMACOLOGIC TREATMENT
Have two main purposes:
To permit safe withdrawal from alcohol, sedative/hypnotics, and
benzodiazepines
To prevent relapse.