harkness2e chap17 ppt

Copyright © 2016 Wolters Kluwer • All Rights Reserved

Chapter 17Substance Use

2Copyright © 2016 Wolters Kluwer • All Rights Reserved

Chapter Highlights• Factors affecting prevalence rates of substance

use: age, gender, race, socioeconomic level, urban or rural settings

• Population-based interventions to decrease substance use

• Evidence-based treatment protocols for substance abuse that should be incorporated by community health nurses in all practice settings

• Self-help groups: a highly effective community-based treatment with proven efficacy in sustaining recovery


Question

Is the following statement true or false?Addiction is a term, along with habituation, which the WHO recommends be substituted with substance use.


Answer

FalseRationale: Addiction is a term, along with habituation, which the WHO recommends be substituted with substance dependence. However, clients and practitioners commonly use addiction.


International Aspects of Substance Abuse

• Scope of substance abuse• Public health policies to minimize

harms from substance use• National scope of substance use

• Alcohol• Cannabis• Tobacco• Illicit drugs


Substance Abuse

A person is diagnosed as having substance abuse when they exhibit the following behaviors associated with substance use:• Problems at work, home, and school• Problems with family or friends• Physical danger• Trouble with the law


Substance Use (cont.)• The use of alcohol, illicit drugs, and

nonmedical use of prescription medications

• Illicit drugs include cannabis, cocaine, heroin, hallucinogens, inhalants, and methamphetamine.

• Nonmedical use of prescription medications includes pain relievers, tranquilizers, stimulants, and sedatives.


Question

Is the following statement true or false?With no use of illicit substances or alcohol in the preceding 9 months, a person is considered “abstinent.”


Answer

FalseRationale: A person is considered “abstinent” with no use of illicit substances or alcohol in the preceding 12 months.


AddictionA term, along with habituation, which the WHO recommends be substituted with substance dependenceClients and practitioners commonly use addiction.


Substance Dependence• Health and emotional problems associated

with substance use• Unsuccessful efforts to cut down on use• Symptoms of tolerance or withdrawal• Reducing other activities to use the

substance• Spending time in activities related to

substance use• Using the substance in greater quantities or

for a longer period of time than intended


AbstinenceIf there is no use of illicit substances or alcohol in the preceding 12 months, a person is considered “abstinent.”


Question

Is the following statement true or false?The United States leads the world in rates of substance use.


Answer

TrueRationale: The United States leads the world in rates of substance use. Patterns of substance dependence vary by age, gender, race, ethnicity, and geographic location.


Health Profiles and Interventions for High-Risk Populations

• Pregnant women• Substance use at an early age• College students and binge drinking• Older adults• Injection drug users• Methamphetamine users


Question

Is the following statement true or false?Studies of disadvantaged adolescents in impoverished areas or homeless youth have found that youth follow a stepwise progression of substance use.


AnswerFalseRationale: There is debate in the literature about the “gateway effect” theory of substance abuse, which proposes that substance abuse is progressive and begins with tobacco, then moves sequentially to alcohol or cannabis, and ultimately to other illicit substances. Studies of disadvantaged adolescents in impoverished areas or homeless youth have not found that these youth follow such a stepwise progression of substance use.


Environmental Factors• Poverty• Lack of access to health services• Capacity of law enforcement to

constrain supply• Contribute to a disproportionate

burden of harm among• Native Americans• Alaskan Natives• African Americans


Biopsychosocial Risk Factors• Genetic history• Family history• History of trauma• Early initiation• High comorbidity with major mental

illness and increased risk for chronic health conditions


Pharmacologic Treatments for Alcohol-Dependent Disorders

• Naltrexone• Acamprosate• Disulfiram


Pharmacologic Treatments for Opioid Use Disorders

• Methadone• Buprenorphine• Naloxone


Question

Is the following statement true or false?Screening for substance use is the second step in assessing if a person has substance use disorder.


Answer

FalseRationale: Screening for substance use is the first step in assessing if a person has substance use disorder. The efficacy of screening instruments is highly dependent on the candor of client responses.


Multimodal Approach• Motivational interviewing• Opioid substitution programs• Family therapy• Couples therapy• 12-step self-help groups


Impact on the Community• Public health models for populations at

risk• Screening• Maladaptive behaviors• Social contexts

harkness2e chap17 ppt

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