Substance - Alcohol

Taken by ingestion

Effects on body: CNS depression, multisystem impairments w/ chronic use

Intoxification: aggressiveness, impaired judgement, depression, slurred speech etc.

Withdrawal Characteristics: w/in 4-12h of cessation or reduction (in heavy/prolonged use)

tremors, N,V, malaise, weekness, tachy, sweating, ^BP, anxiety, h/a, hallucinations

Can progress to Delirium Tremens: (1-7d after last drink): tremors, hallucinations, disoriented, ^temp, dilated pupils, tachy, agitation, ^RR, delirium, grand mal seizures, death

Manage with: Librium, Ativan, Serax, Multivitamins (thiamin)

Substance - Sedative-Hypnotics

Non barbituate Hypnotics:

Quaalude, Halcion, Dalmane, Placidyl, Restoril

Barbituates:

Nembutal, Seconal, Amytal, Tuinal, Phenobarbital

Antianxiety Agents: Benzodiazapines

Ativan, Xanax, Serax, Valium

Librium

Ingestion or Injection

Effects on body: generalized depressant to brain, nerves, muscles, heart, & metabolic rate

mild sedation to death depending on dosage & potency of drug

Intoxication: disinhibition, modd lability, impaired judgement, slurred speech, unsteady gait

confusion, impaired memory

Withdrawal Characteristics: sweating, Pulse>100, ortho hypo, ^hand tremor, insomnia, malaise, weakness, N,V, hallucinations, anxiety, seizures

Manage with: long acting barbituates (phenobarbital-Luminal) & benzodiazapines

Substance - CNS stimulants

Amphetamines:

Benzedrine, Dexedrine (by injection or ingestion)

Cocaine: (by inhalation, smoke, inject, or topical)

Caffeine

Nicotine

Effects on body: CNS excitement, Cardio/Pulm (^BP, ^P, dysrhythmia) cocaine=MI, VF, sudden death, inhaled cocaine=pulm hemmorrhage, chronic bronchiolitis, pneumonia, rhinitis, GI/GU(constip, dsyuria, anorexia), Sexual (^urge)

Intoxication: anger, grandiosity, tachy, ^BP, persperation, chills, N,V,CP, seizures, coma

Withdrawal Characteristics: dsyphoria, fatigue, vivid unpleasant dreams, insomnia, ^appetite

Manage with: Librium & antidepressants

Susbstance - Opioids

Morphine

Codeine

Demerol-meperidine

Heroin

Dialandia

Percodan

Methadone

Darvon

Talwin

Oxycontin

effects on body: CNS (euphoria, mood changes, mental clouding, drowsy, decr pain) constricted pupils, resp depression, depressed cough, N,V GI (decr peristalsis, constip, impaction) Cardio (hypotension) Sexual (decr libido, impotence)

Intoxication: initial euphoria, apathy, dsyphoria, drowsy coma, death, resp depress., impaired judgement

Treat intoxication with : Narcan

Withdrawal Characteristics: craving, dsyphoria, N,V, abd cramps, fever, diarrhea

Heroin w/drl s/s: onset 6-24h after last dose, peak 1-3d, subside 5-7d

Dextoxification: methadone substitute, cold turkey w/ or w/o sedation, nutrition, rest

Substance - Hallucinogens

Lysergic Acid diethylamide - LSD

Phencyclidine - PCP

Ecstasy

Volatile Solvents - inhalants

Effects on body: unpredicatable, Physiologic - A, N, V, chills, ^BP, ^P, ^temp, Psychologic - ^response to color,texture & sounds, distorted vision, sense o slowing, paranoia, panic

Toxic reaction: Panic & Flashbacks

Intoxication: marked anxiety, depression, paranoia, perceptual changes

tachy, palpitations, tremors

PCP Intoxication: belligerence, impulsive, nystagmus, HTN, tachy, seizures, coma, death

Withdrawal Characteristics: manage adverse reactions w/ benzodiazepines & antipsychotics (Haldol)

Substance - Cannabis

Marijuana

Effects on Body: Cardio (tachy, ortho hypo, decr O2 to heart) Resp (initial broncholdilation, COPD, laryngitis, bronchitis, cough, hoarseness Reprod( decr testost levels, sperm abnormalities, ^ risk spont ab CNS (high, relaxed, disoriented, depersonalization, impaired judgement & memory, tremors

Intoxication: impaired coordination, euphoria, anxiety, ^ appetite, dry mouth, tachy

Withdrawal: restless, irritable, insomnia, anorexia

Substance abuse

the use of a drug in an unintended manner despite the potential negative consequences

Alcohol

is the most widely used illicit substance in the US

dual diagnosis

an individual who is addicted to heroin and is diagnosed with bipolar disorder is said to have a dual diagnosis

Blackout

an episode during which the individual will continue to function but does not have a conscious awareness of or will not be able to remember the events that occur during this time

CNS stimulant

cocaine (a cns stimulant) is a highly addictive drug that produces an intense and immediate feeling of euphoria

Opioid Overdose

Respiratory depression, papillary constriction, coma, and death are possible results of opioid overdose

Thiamin (Vit B1)

Individuals with an addiction to alcohol are administered thiamin vit b1to prevent neurologic conditions such as Wernicke's syndrome