H.

SUBSTANCE RELATED DISORDERS

I. DEFINITION
Any substance that affects the pleasure centers of the brain producing
pleasurable changes in mental or emotional states leading to potential for
abuse.

Related Terms
1. Substance Abuse
Continued use of substance despite related problems due to its
pleasure given to the person.
2. Substance Dependence
Indicates a severe condition associated with addiction, such as
tolerance, withdrawal and unsuccessful attempt to stop using
the substance. The person cannot, think, work or function
without using the substance.

H. SUBSTANCE RELATED DISORDERS

I. DEFINITION

Related Terms
3. Dual Diagnosis
Is the co-existence of substance abuse and psychiatric
disorders within the same person.
4. Withdrawal Symptoms
Refers to the negative physical reactions that occur when use of
a substance ceases or dramatically ceases.
5. Tolerance
The need for increased amount of a substance to produce the
same effect.

H. SUBSTANCE RELATED DISORDERS

CONTINUUM OF CHEMICALLY MEDIATED COPING RESPONSES

Adaptive Response

Natural High
Physical activity
Meditation

Occasional use of
tobacco, alcohol,
prescription of
drugs

Maladaptive Response

Frequent use of
tobacco, alcohol,
prescription of
drugs, use of illicit
drugs

Dependence
on tobacco
and alcohol
Abuse or
dependence
on illicit drugs

H. SUBSTANCE RELATED DISORDERS

II. DYNAMICS OF SUBSTANCE ABUSE

1. Use of these substances may progress from acute to

chronic use (social drinking, curiosity, peer pressure or
pakikisama, temporary relief of pain or tension)
2. Reliance on use of substances as a means of dealing with
personal tension and discomfort.
3. Vicious cycle of behavior includes:
lowered self-esteem

substance use

guilt and anxiety

H. SUBSTANCE RELATED DISORDERS

III. TEN MOST COMMON SUBSTANCES ABUSED
Based on the Diagnostic and Statistical Manual of Mental Disorder, 4th
edition, Text Revision (DSM-IV-TR)

1. Caffeine
2. Alcohol
3. Inhalants
4. Nicotine
5. CNS Depressants or sedative-hypnotics their main purpose
is to reduce anxiety, induce sleep, sedate. Downers
Barbiturates
Benzodiazepine
6. CNS Stimulants their main purpose is relief from fatigue,
added energy, added alertness. Uppers
Amphetamines
Cocaine

H. SUBSTANCE RELATED DISORDERS

III. TEN MOST COMMON SUBSTANCES ABUSED

7. Opiates are commonly use to relieve moderate to severe

pain.
Heroin
Codeine
Morphine
Opium
Meperidine
Methadone
8. Marijuana although not a CNS depressant,, it produces
feeling of relaxation and mild euphoria. The active ingredient
in marijuana is tetrahydrocannabinol (THC)
9. Hallucinogens
10. Phencyclidine

H. SUBSTANCE RELATED DISORDERS

IV. DSM-IV-TR DIAGNOSTIC CRITERIA: SYMPTOMS OF SUBSTANCE ABUSE

Denial of problems
Miinimizes use of substance
Rationalization
Blaming others for problems
Anxiety
Irritability
Impulsivity
Feelings of guilt and sadness or anger and resentment
Poor judgment
Limited insight
Low self-esteem
Ineffective coping strategies
Difficulty expressing genuine feelings
Impaired role performance
Strained interpersonal relationship
Physical problems such as sleep disturbances and inadequate nutrition

H. SUBSTANCE RELATED DISORDERS

V. WITHDRAWAL SYNDROME

Tremors
Anxiety
Agitation and irritability
Tachycardia
Hypertension
Diaphoresis
Hallucinations
Grand mal seizure
Delirium tremens

H. SUBSTANCE RELATED DISORDERS

VI. SCREENING FOR SUBSTANCE ABUSE

1. CAGE Questionnaire
a. Cut-down
b. Annoyance
c. Guilt
d. Eye-opener
2. B-DAST (Brief Drug Abuse Screening Test)
3. Breathanalyzer
4. Blood and Urine screening
5. Hair Test and Oral Fluid Test
6. Sweat Test

H. SUBSTANCE RELATED DISORDERS

Predisposing Factors
Sociocultural
Psychological
Precipitating Factors
Neurobiology
Withdrawal syndrome
Appraisal of Stressors
Curiosity
Desire to be grown up
Desire to rebel against
authority
Peer pressure
Desire to ease the pain
Desire to feel good
Coping Resources
Motivation to change
Social support
Health status
Social skills

Coping Mechanism
Minimization
Projection
Rationalization
Denial
Nursing Diagnosis
Disturbed Sensory Perception
Acute Confusion
Ineffective Coping Mechanism
Dysfunctional Family processes
Nursing Interventions
Convey an attitude of acceptance to the patient
Family Therapy Confrontation Strategies
Attitude Therapy
Refer to Self-help group (AA)
Individual Counseling
Pharmacotherapy