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Substance Abuse : Nursing Issues

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Ecstasy. Cont. Most associated drugs. Ketamine. GHB (Gamma-hydroxybutyrate) A. Ethanol ... E. Ecstasy 'X', 'E', 'Adam' Effects. Overdose. Interactions. F. ... – PowerPoint PPT presentation

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Title: Substance Abuse : Nursing Issues


1
Substance Abuse Nursing Issues
  • German Molina, M.D.
  • Assistant Professor of Clinical Psychiatry
  • University of Miami

2
I. Introduction
  • Substance abuse vs. use
  • Epidemiology
  • DSM Criteria

3
A. DSM IV Criteria
  • Dx Substance Abuse
  • Dx Substance Dependence
  • Dx Polysubstance Dependence

4
II. Risk Factors
  • Some risks are unique to the substance
  • Commonly associated drugs
  • Consequences of the use
  • Psychiatric symptoms
  • Axis I
  • Axis II

5
III. Most commonly associated drugs
  • Ethanol
  • Marijuana
  • Methamphetamine
  • Cocaine
  • Ecstasy

6
Cont. Most associated drugs
  • Ketamine
  • GHB (Gamma-hydroxybutyrate)

7
A. Ethanol
  • Effects
  • Overdose
  • Interactions

8
B. Marijuana
  • Grass, weed, pot, ganja
  • Effects
  • Overdose
  • Interactions

9
C. Methamphetamine
  • Speed, crystal, meth, crystalmeth
  • Effects
  • Overdose
  • Interactions

10
D. Cocaine
  • coke, Snow, crack
  • Effects
  • Overdose
  • Interactions

11
E. Ecstasy
  • X, E, Adam
  • Effects
  • Overdose
  • Interactions

12
F. Ketamine
  • K, Special K, KitKat
  • Effects
  • Overdose
  • Interactions

13
G. GHB
  • Liquid X, Scoop, Organic Quaalude
  • Effects
  • Overdose
  • Interactions

14
IV. Issues relevant to IDU
  • HIV disease stage
  • Fragmentation of continuity of services
  • Adherence
  • Physical complications

15
V. Medical Care
  • On-site medical care vs. referral
  • Med/Psych available in methadone clinic
  • Intensive case management
  • Pain management

16
VI. Psychopathology
  • In MMT
  • Antisocial Personality D/o
  • Secondary psychiatric symptoms

17
VII. Medical evaluation
  • Physical assessment
  • Short/long term use of substance
  • Withdrawls
  • Neurotoxicities of medications prescribed

18
Cont. Medical
  • Head trauma
  • Metabolic encephalopathies
  • Neurosyphilis
  • Cva
  • Seizures

19
Cont. Medical
  • Opportunistic infections
  • Minor Cognitive Motor Disorder
  • HIV-associated Dementia

20
VIII. Treatment Considerations
  • Settings
  • Medication treatment efficacy, safety, abuse
    liability, adherence
  • Risk reduction intervention
  • To be individualized
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