stage of change
Precontemplation - In this stage, people do not intend to take action in the foreseeable future (defined as within the next 6 months). People are often unaware that their behavior is problematic or produces negative consequences. People in this stage often underestimate the pros of changing behavior and place too much emphasis on the cons of changing behavior.
Contemplation - In this stage, people are intending to start the healthy behavior in the foreseeable future (defined as within the next 6 months). People recognize that their behavior may be problematic, and a more thoughtful and practical consideration of the pros and cons of changing the behavior takes place, with equal emphasis placed on both. Even with this recognition, people may still feel ambivalent toward changing their behavior.
Preparation (Determination) - In this stage, people are ready to take action within the next 30 days. People start to take small steps toward the behavior change, and they believe changing their behavior can lead to a healthier life.
Action - In this stage, people have recently changed their behavior (defined as within the last 6 months) and intend to keep moving forward with that behavior change. People may exhibit this by modifying their problem behavior or acquiring new healthy behaviors.
Maintenance - In this stage, people have sustained their behavior change for a while (defined as more than 6 months) and intend to maintain the behavior change going forward. People in this stage work to prevent relapse to earlier stages.
Termination - In this stage, people have no desire to return to their unhealthy behaviors and are sure they will not relapse. Since this is rarely reached, and people tend to stay in the maintenance stage, this stage is often not considered in health promotion programs.
Delirium tremens:
- 24-48 hours after alcohol cessation
- clouding of consciousness, auditory and visual hallucinations (persecutory type), and seizures.
- Mortality rate = 5-15%
Agitation, irritability.
Body tremors.
Changes in mental function.
Deep sleep that lasts for a day or longer.
Sudden, severe confusion (delirium)
Excitement or fear.
Fever.
Alcohol Withdrawal
Early signs: tremors, palpitations & sweating
Mild Withdrawal
Insomnia, Tremulousness, Mild anxiety, Gastrointestinal upset, anorexia, Headache, Diaphoresis, Palpitations
Naltrexone
- opioid antagonist used to treat alcohol use disorder + opioid dependence.
- Naltrexone blocks the effect of opioids and prevents opioid intoxication and physiologic dependence on opioid users
- blocks the euphoric and sedative effects of opioid
- binds to the endorphin receptors in the body, and blocks the effects and feelings of alcohol. Naltrexone reduces alcohol cravings and the amount of alcohol consumed.
- To avoid strong side effects such as nausea and vomiting, practitioners typically wait until after the alcohol detox process
Treatment for Alcohol withdrawal
- Benzodiazepines (for anxiety, seizures and DT’s)
- IV fluids/electrolytes – for dehydration
- Vitamins (B, thiamine, magnesium, folic acid)
What Cannabinoid Receptors
are the psychoactive effect
CB1
Dilaudid
hydromorphone
COWS
Clinical Opiate Withdrawal Scale
Resting Pulse Rate (over 120 rates a 4)
Sweating
Resltlesness
Pupil Size (pupils so dilated that only the rim of the iris is visible rates a 5)
Bone of Joint Aches
Runny nose or tearing
GI Upset
Tremor
Yawning
Anxiety or Irritability
Gooseflesh skin
Opiate Overdose
- Unresponsive to stimulus such as someone yelling their name, a light shake or a sternal rub
- Breathing is slow, erratic or not breathing at all
- Body is very limp
- Fingernails and lips are blue
- Skin is cold and/or clammy
- Pulse is slow, erratic, or not there at all
- Choking sounds or a snore-like gurgling noise
- Vomiting and/or Seizures
- Loss of consciousness
- Pupils are tiny
Naloxone (Narcan
- approximately 2 to 5 minutes
- Effects wear off within 30–60 minutes so critical to call 911
Opioid Withdrawal
Withdrawal symptoms typically last for approximately 1 week
Symptoms gradually decrease in intensity
Not physically life threatening
Dysphoric mood
Nausea or vomiting
Muscle aches
Lacrimation (teary eyes)
Rhinorrhea (running nose)
Pupils dilate
Piloerection (goosebumps)
Sweating
Sublocade
SC injection q month
To start you must have been on Suboxone for 7 days
(buprenorphine and naloxone)
Suboxone
- (buprenorphine and naloxone)
- synthetic opiate; taken orally; lower side effect profile than methadone; and decreased risk of overdose if mixed with other opiates.
- A client must be in active withdrawal to start on Suboxone.
- ‘ceiling effect’, which means that it may not offer enough therapeutic value for someone who has a very large tolerance to opiates.
- Put both meds together to lower the street value
- A wafer you put in your check or tongue
ORT Side Effects
Constipation
Dry mouth
Drowsiness
Loss of appetite
Decreased sex drive
Impotence, or difficulty having an orgasm
Sleep problems
Nausea
Anxiety
Restlessness
ORT Drug Interactions
Benzodiazepines
Alcohol
Antiretrovirals
Some antidepressants
Some antibiotics - CIPRO
Benzo, alcohol and opiate is Russian rullete where you don’t know which is going to stop your breathing
CIPRO can actually increase the dose (they’re taking 100mg but it feels like 150mg and can lead to overdose)
(LSD) D-lysergic acid diethylamide
- Trips are about 12 hrs
- Primary neurotransmitter involved: Serotonin (behavior, perception, mood, hunger, body temp. sexual behavior, muscle control & sensory perception
Benzodiazepines intoxication
Slurred speech
Incoordination
Unsteady gait
Nystagmus
Impaired coordination
Stupor
Coma
Benzodiazepines withdrawal
High blood pressure, pulse, temp
Tremor
Insomnia
Nausea and vomiting
Visual, tactile, or auditory hallucinations
Agitation
Anxiety
Grand mal seizures
If your gonna use on methadone
, use a couple hurs after the methadone and take ½ the dose you’d normally take
Nicotine
Nicotine imitates the action of a natural neurotransmitter called acetylcholine and binds to a particular type of acetylcholine receptor, known as the nicotinic receptor
Crack
smokable form of cocaine that is processed with ammonia or baking soda and water, and heated to remove the hydrochloride
Cocaine
- increases dopamine by preventing dopamine reuptake, leaving more dopamine in the synapse
- Get dopamine buildup and it floods the synaptic gap. Flood ends after about 30 min. and the person is left yearning to feel as he or she once did
- Cocaine use may cause such cardiac complications as coronary artery spasm, myocardial infarction, dilated cardiomyopathy, acute heart failure, endocarditis, and sudden death
Amphetamines
Mimic the effect of adrenaline on the body
Ritalin, Adderall
Campral
- AUD
- a medication which reduces alcoholism cravings.
- It is thought to stabilize chemical signaling in the brain that would otherwise be disrupted by alcohol withdrawal
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Values to know9
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Psych diagnostic criteria35
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Drugs12
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Med Nursing24
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Med Nursing 224
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Med Nursing 326
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Med Nursing 419
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Addictions26
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Disorders Psych24
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Disorder Psych 224
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Little Bits and Bobs 121
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Little Bits and Bobs 222
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Bits and Bobs 321
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Bits and Bobs 424
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Bits and bobs 620
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Bits and Bobs 510
