NUR 211 Substance Abuse and Addiction
Nurse's role - ANS Prevention, education, treatment
What is addiction? - ANS psychological or physical, will risk negative consequences, alter mood
What is dependence? - ANS physiological need for drug, cannot control, withdrawal
What is codependency? - ANS cluster of maladaptive behaviors, using other people or things
for coping
Tolerance - ANS Needs more of drug to experience respiratory depression
How does genetics play a role in substance abuse? - ANS Alcoholism is hereditary, less
impulse control
Substance abuse amongst middle-aged adults - ANS higher rate of addiction (baby boomers),
substance abuse more prevalent
Substance abuse amongst elderly - ANS decreased liver and kidney function, drugs in system
longer, substance abuse not recognized as early
Substance abuse nursing observation - ANS Poor hygiene, watery/bloodshot eyes, rhinorrhea
or sniffing a lot, low weight, mood swings, paranoia, lethargic, poor balance and coordination
Recovery is a state of - ANS voluntary sobriety; patient must be ready
How does group therapy work? - ANS members help each other through process of change,
aided by group therapist, variety of settings, effective with children, adolescents
What is nicotine? - ANS highly addictive chemical found in tobacco
CNS Stimulant
Risk factors for nicotine addiction - ANS Emotions - stress, anxiety; Social pressure- smoking is
more acceptable in some groups, teenagers, out and about; Lack of education - not knowing the
harmful effects; Alcohol use - co-addiction; 25-64 Y.O.; Lower socioeconomic status - lack of
education
Nicotine withdrawal - ANS Craving; Nervousness; Restlessness; Irritability; Impatience;
Increased hostility; Insomnia b/c nicotine is a CNS stimulant; Weight gain- eat more if not
smoking
, Nicotine complications - ANS Vasoconstriction, decreased tissue oxygenation, atherosclerosis,
heart disease, hypertension, stroke, cancers (even w/ secondhand smoke), COPD, asthma,
macular degeneration, cataracts, PVD, chronic cough, SIDS, URIs, otitis media, low-birth-weight
babies
Nicotine addiction treatment - ANS Smoking cessation programs; Peer support; Group therapy;
Behavior modification therapy; Hypnotherapy; Acupuncture; Yoga; Massage
Nicotine replacement therapy - ANS Pharmaceutical substitute for nicotine in cigarettes or
chewing tobacco, doubles the success of smoking cessation; Relieves physiological effects of
withdrawal
Inhaler - ANS patients "puff" small doses of nicotine through prescription product that looks
similar to a cigarette, menthol for smoking sensation, use/taper over 2 to 3 months, avoid if
asthma
Nasal spray - ANS rapid rise of nicotine in blood, one spray in each nostril=1 cigarette, not for
clients with asthma, allergies, or respiratory issues
Lozenge - ANS OTC med, slowly dissolve in mouth (20 mins), max 20/day
Nicotine patch - ANS clean/dry skin, avoid using other nicotine products, stop if skin reaction,
remove prior to MRI, usually daily, change every 24 hours, shaved area, rotate sites
Nicotine gum - ANS not for longer than 6 months, chew slowly, avoid eating and drinking while
chewing
Bupropion (Wellbutrin) - ANS smoking cessation and antidepressant medication; help reduce
nicotine craving, irritability, restlessness, depression; may cause dry mouth, weight loss, GI
upset: N/C, avoid caffeine (insomnia), avoid if at increased risk for seizures; increase fluid intake
How does varenicline (Chantix) work? - ANS blocks some of the rewarding effects of nicotine
and stimulates the receptors in a way that reduces withdrawal (mimics nicotine)
Chantix side effects - ANS monitor for psychiatric changes, be aware of preexisting psychiatric
conditions, SI, insomnia, nightmares or strange dreams
Who would Chantix be contraindicated for? - ANS Psychiatric patients
Chantix nursing considerations - ANS Monitor BP, diabetes, titrate, take after meal
Overall effects of alcohol - ANS Alters judgment, increases risky behaviors
