ADDICTION

Concept 33
Goals for This Concept Presentation

1. Define and describe the concept.

2. Notice risk factors for addiction.
3. Recognize when an individual has an
addiction.
4. Provide appropriate nursing and
collaborative interventions to minimize the
impact of addiction.
DEFINE AND DESCRIBE THE
CONCEPT OF ADDICTION
 Definition
Addiction is a compulsive and maladaptive
dependence on a substance (e.g., alcohol,
cocaine, opiates, or tobacco) or a behavior
(e.g., gambling, Internet, pornography); the
dependence typically produces adverse
psychologic, physical, economic, social, or
legal ramifications.

Taber's cyclopedic medical dictionary. 2009, FA Davis, Philadelphia.

 Key Terms
Define the following terms:
– Substance abuse
– Substance dependence
– Tolerance
– Withdrawal
How do the terms relate to the concept of
addiction?
Categories of Addiction
 Physiologic Process of Addiction
• Neurochemical interactions within reward centers of brain
• Addictive substances link to this reward center
• Neurotransmitters involved in the reward system
– Dopamine
– -aminobutyric acid (GABA)
– Glutamate
– Acetylcholine
– Norepinephrine
– Serotonin
 Consequences of Addiction
• Consequences are dependent on the
individual and the type of addiction
• Consequences include
– Habituation
– Adaptation
– Tolerance
– Withdrawal
NOTICE RISK FACTORS FOR ADDICTION
RECOGNIZE WHEN AN INDIVIDUAL HAS
AN ADDICTION
 Identifying Addiction: History
• Problems in areas of life function: legal,
financial, social, marital, occupational
• Reported leisure activities involve alcohol or
other drugs
• Frequent reference to substance, indicating
preoccupation
• Driving while intoxicated
• Reported injury associated with falls, fights,
automobile crashes, and so on
• Substance abusers often are hesitant to
disclose information about addiction
 Common Addiction Symptoms
• Fatigue
• Insomnia
• Headaches
• Anorexia
• Reported sexual dysfunction
• Reported change in mood
• Reported weight loss
• Vague physical complaints
 Identifying Addiction: Examination
Findings
• Physical manifestations of withdrawal
• Appearance older than stated age
• Undernourished
• Failure of standard doses of sedatives to
have a therapeutic effect
 Diagnostic Tests
Various tests may be ordered to detect
addiction-related disorders. Discuss tests and
how they link to the diagnosis.
PROVIDE APPROPRIATE NURSING AND
COLLABORATIVE INTERVENTIONS TO
DECREASE SYMPTOMS AND IMPACT OF
ADDICTION
 Collaborative Care
Always consider the interdisciplinary team as
applicable. Examples include
– Physician and nurse provider(s)
– Nurse
– Social worker
– Counselor or psychologist
 Clinical Management:
Primary Prevention
• National Institute on Drug Abuse (NIDA)
recommends identification of specific drug
problems in the community, and then
building on resources
• Successful models promote healthy families
and healthy communities
• Promotion of individual positive coping
strategies
Clinical Management: Screening
Many different screening tools for behavioral
and/or substance abuse addictions.
Examples include:
– NIAAA quantity and frequency questions
– CAGE questionnaire
 Clinical Management:
Collaborative Interventions
Emergency Management
• Goal is to prevent life-threatening
complications
• Treatment is substance and complication
specific
– Dosage of substance, substance combinations
Clinical Management: Collaborative
Interventions (cont’d)
Recovery
• Goal is to help patient to get the help
needed to achieve and maintain sobriety
• Collaborative care is used to facilitate;
success in recovery includes motivational
interviewing
• Relapses are common
Collaborative Care: Pharmacotherapy

1. For which specific target symptoms are

antipsychotics prescribed?
2. What are the desired patient outcomes?
 Clinical Management:
Collaborative Interventions (cont’d)
Varies depending on cause of psychosis
• Family intervention
• Family therapy
• Cognitive and behavioral therapy
• Group therapy
• Peer support
• Psychosocial rehabilitation
• Vocational rehabilitation
Interrelated Concepts