NCM 116 – Care of Clients with Maladaptive SEM 02
Patterns of Behavior, Acute and Chronic FINALS
Lecturer: Dr. Cefer S. Sales, RN, MD, MHM, CHA
UNIT 4 – CHAPTER 19: ADDICTION
TOPIC OUTLINE only at certain times or drinking only beer. This period
I. Substance Abuse of temporarily controlled drinking soon leads to an
II. Types of Substance escalation of alcohol intake, more problems, and a
III. Application of the Nursing Process subsequent crisis. The cycle repeats continuously.
→ Reports exist that some people with alcohol-related
problems can modify or quit drinking on their own
SUBSTANCE ABUSE
without a treatment program; this is called
• Substance use disorders and related disorders are a spontaneous remission or natural recovery.
national health problem. More than 16.6 million adult
Americans and 697,000 adolescents aged 12 to 17
RELATED DISORDERS
years have an alcohol use disorder. Of adults (age 18
• Gambling Disorder - is a non-substance related
years or older), 14% report binge drinking in the past
diagnosis. It is characterized by problem gambling,
month. Other statistics include the following: nearly
spending money one cannot afford to lose, lying about
88,000 people die from alcohol-related causes each
gambling, getting money from others, and an inability
year; alcohol related death is the third leading
to refrain from gambling for any specific time. Attempts
preventable cause of death in the United States; and
to quit or cut down result in restless, anxious, and
30% of driving fatalities are alcohol related (National
irritable behavior.
Institute on Alcohol Abuse and Alcoholism [NIAAA],
• Caffeine and Tobacco or Nicotine - are substances
2015).
that are addictive and are included in the DSM-5, but
are not considered mental health problems per se.
TYPES OF SUBSTANCE ABUSE
o Substances can induce symptoms that are similar
• Polysubstance Abuse - abuse of more than one to other mental illness diagnoses, such as
substance anxiety, psychosis, or mood disorders. They are
• Drug and alcohol can lead to legal problems. called substance-induced anxiety, substance-
Categories of drugs include: induced psychosis, and so forth. The symptoms
→ Alcohol may subside once the substance is eliminated
→ Sedatives, hypnotics, and anxiolytics from the body, though this is not always the case.
→ Stimulants
→ Cannabis ETIOLOGY
→ Opioids The exact causes of drug use, dependence, and
→ Hallucinogens addiction are not known, but various factors are thought
→ Inhalants to contribute to the development of substance-related
• Intoxication - is a use of a substance that results in disorders. Much of the research on biologic and genetic
maladaptive behavior factors has been done on alcohol abuse, but
• Withdrawal Syndrome - refers to the negative psychological, social, and environmental studies have
psychological and physical reactions that occur when examined other drugs as well.
use of a substance ceases or dramatically decreases
CULTURAL CONSIDERATIONS
ONSET AND CLINICAL COURSE • Attitudes toward substance use, patterns of use, and
→ A pattern of more severe difficulties for people with physiological differences to substances vary in
alcoholism begins to emerge in the mid-20s to the different cultures. Muslims do not drink alcohol, but
mid-30s; these difficulties can be the alcohol-related wine is an integral part of Jewish religious rites.
• Some Native American tribes use peyote, a
breakup of a significant relationship, an arrest for
public intoxication or driving while intoxicated, hallucinogen, in religious ceremonies.
• Certain ethnic groups have genetic traits that either
evidence of alcohol withdrawal, early alcohol-related
health problems, or significant interference with predispose them to or protect them from developing
functioning at work or school. alcoholism. For instance, flushing, a reddening of the
→ During this time, the person experiences his or her
face and neck as a result of increased blood flow, has
first blackout, which is an episode during which the been linked to variants of genes for enzymes involved
person continues to function but has no conscious in alcohol metabolism. The flushing reaction is
awareness of his or her behavior at the time or any highest among people of Asian ancestry (Aoki,
later memory of the behavior. Wehage, & Talalay, 2017).
→ As the person continues to drink, he or she often
develops a tolerance for alcohol; that is, he or she TYPES OF SUBSTANCES AND TREATMENT
needs more alcohol to produce the same effect. After 1. Alcohol - is a central nervous system depressant that
continued heavy drinking, the person experiences a is absorbed rapidly into the bloodstream. Initially, the
tolerance break, which means that very small effects are relaxation and loss of inhibitions.
amounts of alcohol intoxicate the person. → Intoxication: there is slurred speech, unsteady
→ The later course of alcoholism, when the person’s gait, lack of coordination, and impaired attention,
functioning is definitely affected, is often concentration, memory, and judgment. Some
characterized by periods of abstinence or temporarily people become aggressive or display
inappropriate sexual behavior when intoxicated.
Patterns of Behavior, Acute and Chronic FINALS
Lecturer: Dr. Cefer S. Sales, RN, MD, MHM, CHA
UNIT 4 – CHAPTER 19: ADDICTION
TOPIC OUTLINE only at certain times or drinking only beer. This period
I. Substance Abuse of temporarily controlled drinking soon leads to an
II. Types of Substance escalation of alcohol intake, more problems, and a
III. Application of the Nursing Process subsequent crisis. The cycle repeats continuously.
→ Reports exist that some people with alcohol-related
problems can modify or quit drinking on their own
SUBSTANCE ABUSE
without a treatment program; this is called
• Substance use disorders and related disorders are a spontaneous remission or natural recovery.
national health problem. More than 16.6 million adult
Americans and 697,000 adolescents aged 12 to 17
RELATED DISORDERS
years have an alcohol use disorder. Of adults (age 18
• Gambling Disorder - is a non-substance related
years or older), 14% report binge drinking in the past
diagnosis. It is characterized by problem gambling,
month. Other statistics include the following: nearly
spending money one cannot afford to lose, lying about
88,000 people die from alcohol-related causes each
gambling, getting money from others, and an inability
year; alcohol related death is the third leading
to refrain from gambling for any specific time. Attempts
preventable cause of death in the United States; and
to quit or cut down result in restless, anxious, and
30% of driving fatalities are alcohol related (National
irritable behavior.
Institute on Alcohol Abuse and Alcoholism [NIAAA],
• Caffeine and Tobacco or Nicotine - are substances
2015).
that are addictive and are included in the DSM-5, but
are not considered mental health problems per se.
TYPES OF SUBSTANCE ABUSE
o Substances can induce symptoms that are similar
• Polysubstance Abuse - abuse of more than one to other mental illness diagnoses, such as
substance anxiety, psychosis, or mood disorders. They are
• Drug and alcohol can lead to legal problems. called substance-induced anxiety, substance-
Categories of drugs include: induced psychosis, and so forth. The symptoms
→ Alcohol may subside once the substance is eliminated
→ Sedatives, hypnotics, and anxiolytics from the body, though this is not always the case.
→ Stimulants
→ Cannabis ETIOLOGY
→ Opioids The exact causes of drug use, dependence, and
→ Hallucinogens addiction are not known, but various factors are thought
→ Inhalants to contribute to the development of substance-related
• Intoxication - is a use of a substance that results in disorders. Much of the research on biologic and genetic
maladaptive behavior factors has been done on alcohol abuse, but
• Withdrawal Syndrome - refers to the negative psychological, social, and environmental studies have
psychological and physical reactions that occur when examined other drugs as well.
use of a substance ceases or dramatically decreases
CULTURAL CONSIDERATIONS
ONSET AND CLINICAL COURSE • Attitudes toward substance use, patterns of use, and
→ A pattern of more severe difficulties for people with physiological differences to substances vary in
alcoholism begins to emerge in the mid-20s to the different cultures. Muslims do not drink alcohol, but
mid-30s; these difficulties can be the alcohol-related wine is an integral part of Jewish religious rites.
• Some Native American tribes use peyote, a
breakup of a significant relationship, an arrest for
public intoxication or driving while intoxicated, hallucinogen, in religious ceremonies.
• Certain ethnic groups have genetic traits that either
evidence of alcohol withdrawal, early alcohol-related
health problems, or significant interference with predispose them to or protect them from developing
functioning at work or school. alcoholism. For instance, flushing, a reddening of the
→ During this time, the person experiences his or her
face and neck as a result of increased blood flow, has
first blackout, which is an episode during which the been linked to variants of genes for enzymes involved
person continues to function but has no conscious in alcohol metabolism. The flushing reaction is
awareness of his or her behavior at the time or any highest among people of Asian ancestry (Aoki,
later memory of the behavior. Wehage, & Talalay, 2017).
→ As the person continues to drink, he or she often
develops a tolerance for alcohol; that is, he or she TYPES OF SUBSTANCES AND TREATMENT
needs more alcohol to produce the same effect. After 1. Alcohol - is a central nervous system depressant that
continued heavy drinking, the person experiences a is absorbed rapidly into the bloodstream. Initially, the
tolerance break, which means that very small effects are relaxation and loss of inhibitions.
amounts of alcohol intoxicate the person. → Intoxication: there is slurred speech, unsteady
→ The later course of alcoholism, when the person’s gait, lack of coordination, and impaired attention,
functioning is definitely affected, is often concentration, memory, and judgment. Some
characterized by periods of abstinence or temporarily people become aggressive or display
inappropriate sexual behavior when intoxicated.
