substance abuse ppt.pptx

SUBSTANCE ABUSE

1. SUBSTANCE ABUSE Submitted to : Ms. Seema rani Associate professor RCON, JH Submitted by: Ms. Arushi Negi M.Sc. Nursing RCON, JH

2. Introduction Excessive use of alcohol, psychoactive drugs and chemicals like volatile substances causes psychological disorder. In India 20 to 40% of subjects aged above 15 years are current users of alcohol and nearly 10% of them are regular or excessive user. Nearly 15 to 30% of patient are developing alcohol related problem and seeking admission in psychiatric hospitals.

3. Abuse It is a maladaptive pattern of substance use that impairs health.

4. Major types of dependence producing drugs are:

5. Factor Affecting Substance Abuse

6. Social Factor • Religious reason • Peer pressure • Urbanization • Extended period of education • Unemployment • Over crowding • Occupation: Chef, barmen, army personnel, actor, entertainer, etc. Easy Availability of Drug • Drug that can be obtained from elicit sources such as street drugs.

7. Psychiatric Disorder due to Substance Abuse

8. CONSEQUENCES OF SUBSTANCE ABUSE 

9. ALCOHOL DEPENDENCE SYNDROME Symptom GI: Gastritis, peptic ulcer, Ca. stomach, pancreatitis, malabsorption syndrome. CVS: HTN, cardiomyopathy CNS: Peripheral neuropathy, epilepsy, cerebral degeneration Damage to fetus: Fetal alcohol syndrome, LBW, still birth. Social: Marital disharmony, unemployment, financial problem, accident, criminality. Psychiatric Disorders Acute intoxication Withdrawal syndrome Alcohol induced amnestic disorder Alcohol induced psychiatric disorder.

10. OPIOD DISORDER The commonly used narcotics in India are heroin, pethidine, fortwin, etc. Acute intoxication:Bradycardia, apathy,hypotension, respiratory depression. Withdrawal syndrome: Watery eye, running nose, loss of appetite, irritability, tremor, sweating, cramps etc. Complications: Peripheral neuropathy, parkinsonism, criminality, AIDS Treatment: Detoxification, Antidote (naloxone). CANNABIS USE DISORDER It is derived from hemp plant (cannabis sativa). The dried leaves and flower is called as marijuana, Ganja. It is either smoked or taken in liquid form Acute intoxication: Impairment of consciousness and orientation, tachycardia, euphoria, dream-like state Withdrawal svndrome: Mostly found within 72-96 hr.Increased salivation, hyperthermia, insomnia, decreased appetite. Complications: Hypomania, paranoid psychosis. Treatment: Supportive and symptomatic.

11. COCAINE USE DISORDER The street name is crack'. It can be taken orally, smoking or parenterally. Acute intoxication: Pupillary dilatation, tachycardia, hypertension, sweating. Withdrawal syndrome: Agitation, depression, anorexia, fatigue and sleepiness. Complications: Acute anxiety reaction, seizure, respiratory depression, cardiac arrhythmia, etc. Treatment: Amyl nitrate is an antidote, Diazepam also be used. LSD USE DISORDER It is a powerful hallucinogen. It effects by acting on 5-HT levels in brain. Acute intoxication: It is characterized perceptual changes occurring in clear consciousness, illusion, paranoid ideation, automatic hyperactivity, marked anxiety, etc. Withdrawal syndrome: Flashback (brief experiences of the hallucinogenic). Complications:Anxiety, depression, visual hallucinosis. Treatment: Symptomatic treatment with antianxiety, antidepressant.

12. Prevention of Substance Abuse Provision of recreation and entertainment Proper channelization of energies of the adolescents into constructive activities Health education Inculcation of the dangers of drug abuse students, teacher and the family increasing awareness Provision of periodic psychiatric guidance Strict implementation of drug control measures Measures for deaddiction Effective prevention and intervention programs consider cultural context, social resistance skills, and developmental level of the child Skills training Teaching the problem solving and coping skills Development of proper social and problem solving skills Treatment of family problems Increased opportunities for prosocial activities with peers

13. PREVENTION OF SUBSTANCE USE DISORDER

14. Secondary Early detection and counseling. Brief Intervention in Primary Care (Simple Advices from Practitioner & Educational Leaflet).  Motivational Interviewing.  A Full Assessment which Includes, Appraisal of Current Medical, Psychological & Social Problems.  Detoxification with Benzodiazepines.

15. Treatment Modalities for Substance Related Disorders Alcoholics Anonymous Alcoholics Anonymous is a major self-help organization for the treatment of alcoholism. It is based on peer support—acceptance and understanding from others who have experienced the same problems in their lives. The only requirement for membership is a desire on the part of the alcoholic person to stop drinking. Each new member is assigned a support person from whom he or she may seek assistance when the temptation to drink occurs. Pharmacotherapy Disulfiram (Antabuse) is a drug that can be administered as a deterrent to drinking to individuals who abuse alcohol.

16. Counseling Counseling on a one-to-one basis is often used to help the client who abuses substances. The relationship is goal-directed, and the length of the counseling may vary from weeks to years. The focus is on current reality, development of a working treatment relationship, and strengthening ego assets. The counselor must be warm, kind, and nonjudgmental, yet able to set limits firmly. Group Therapy Group therapy with substance abusers has long been regarded as a powerful agent of change. In groups, individuals are able to share their experiences with others who are going through similar problems. They are able to “see themselves in others,” and confront their defenses about giving up the substance. They may confront similar attitudes and defenses in others. Groups also give individuals the capacity for communicating needs and feelings directly.

17. Psychopharmacology for Substance Intoxication and Substance Withdrawal Alcohol Benzodiazepines are the most widely used group of drugs for substitution therapy in alcohol withdrawal. Chlordiazepoxide (Librium), oxazepam (Serax), lorazepam (Ativan), and diazepam (Valium) are the most commonly used agents. Opioids Examples of drugs in the opioid classification include opium, morphine, codeine, heroin, hydromorphone, oxycodone, and hydrocodone. Depressants Substitution therapy for CNS depressant withdrawal (particularly barbiturates) is most commonly with the long-acting barbiturate phenobarbital (Luminal). Stimulants Treatment of stimulant intoxication usually begins with minor tranquilizers such as chlordiazepoxide and progresses to major tranquilizers such as haloperidol (Haldol). Hallucinogens and Cannabinols Substitution therapy is not required with these drugs. When adverse reactions, such as anxiety or panic, occur, benzodiazepines (e.g., diazepam or chlordiazepoxide) may be prescribed to prevent harm to the client or others.

18. TERITARY PREVENTION  Alcohol Deterrent Therapy  Other Therapies include Assertive Training, Teaching Coping Skills, Behavior Counseling, Supportive & Individual Psychotherapy.  Agencies concerned with Alcohol – Related Problems (Alcoholic Anonymous, Al – Anon, Al – Teen, etc).  Motivation Enhancement including Education about Health consequences of Alcohol use. Identifying High Risk Situations & Developing Strategies to Deal with them (Eg: Craving Management).  Drink Refusal Skills ( Assertiveness Training )  Dealing with Faulty Cognitions. Handling Negative mood States.  Time Management.  Anger Control.  Financial Management.  Developing the Work Habit.  Stress management.  Sleep hygiene.  Recreation & Spirituality.  Family Counseling – To Reduce Interpersonal Conflicts, Which may Otherwise Trigger RELAPSE.

19. REHABILITATION

20. ROLE OF COMMUNITY HEALTH NURSE Community mental health nursing is the application of specialized knowledge to populations and communities to promote and maintain mental health and to rehabilitate population at risk that continue to have residual effects of mental illness. Community mental health nursing is differing from hospital set-up. The community settings requires that the psychiatric nurse possess knowledge about a broad array of community resources and be flexible in approaching problems related to individual psychiatric symptoms, family and support symptoms and basic living needs such as housing and financial support.

21. Attributes

22. Carr et al (1984) have identified the following roles for nurses working in community mental health services: Consultative role: This means giving advice to other professionals in the community about the type and level of nursing care required for a group. Clinician role: Providing direct nursing care to the patients in the community. Therapeutic role: Employing psychotherapeutic and behavioral methods for management of patients. Assessor: The nurse may assess the care given to the client/group and may also asess the outcome of ongoing care process. Educator: Creating awareness in the community about mental health and mental illness with special focus on vulnerable groups. Trainer: Training of paraprofessionals, community leaders, school teachers,and other care giving professionals in the community. Manager/administrator: Management of resources planning and coordination. Domiciliary care: Services are provided to the client by visiting their homes. Services like administration of medication, assessment of level of the functioning, monitoring side effect of medication, counseling of patient and their family member, etc. Liaison role: Community mental health nurse be liasoning reduces the gap between patient and hospital, client and employers, etc. Preventive role: The preventive role are primary, secondary and tertiary.

23. Other areas of community health psychiatric nursing are:

24. Summary Through this assignment i learned about substance abuse, factors affecting it, its prevention, psychiatric disorder , its treatment and role of nurse.

25. Conclusion Excessive use of alcohol, psychoactive drugs and chemicals like volatile substances causes psychological disorder. In India 20 to 40% of subjects aged above 15 years are current users of alcohol and nearly 10% of them are regular or excessive user. Nearly 15 to 30% of patient are developing alcohol related problem and seeking admission in psychiatric hospitals.

26. BIBLIOGRAPHY Dash B. A comprehensive textbook of community health nurrsing.The health sciences publishers.2017 Townsend M. C. Essentials of psychiatric mental health nursing. Sixth edition. F.A Davis company publishers. 2014. PRESENTATION TITLE

27. Thank you