Substance Abuse As A Community Health Problem. Violence And Nursing Response.
Substance abuse as a community health problem.
Violence and nursing response.
Read chapters 26 and 27 of the class textbooks and review the attached PowerPoint presentations. Once done answer the following questions.
- Discuss the historical trends and current conceptions of the cause and treatment of substance abuse.
- Identify and discuss the issues related to substance abuse in various populations encountered in community health nursing practice.
- Describe and discuss the concepts of interpersonal and community violence.
- Describe and discuss the role of the nurse in primary, secondary, and tertiary prevention of violence
As stated in the syllabus, present your assignment in an APA format word document, APA required font attached to the forum in the discussion tab of the blackboard titled “Week 6 discussion questions” and the SafeAssign exercise in the assignment tab of the blackboard which is a mandatory requirement. A minimum of 2 evidence-based references (besides the class textbook) no older than five years must be used. You must post two replies on different dates to any of your peers sustained with the proper references no older than five years as well and make sure the references are quoted correctly in your assignment. The replies cannot be posted on the same day; I must see different dates in the replies. A minimum of 800 words are required and not exceeding 1,000 words (excluding the first and reference page). Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.
Please check your assignment after the week is due or after it is graded because I either made comments or ask for clarification in some replies or the assignment that required your response.
Chapter 26
Substance Abuse
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
More deaths, illnesses, and disabilities are attributed to substance abuse than to any other preventable health conditions in the United States.
– Substance Abuse and Mental Health
Services Administration (SAMSHA)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
2
Social Consequences of Substance Abuse
Crimes while under the influence of drugs, alcohol, or both
Need for money to buy substances
Specific theft of drugs
Almost 75% of inmates report prior drug use
All aggregates in society are potentially affected by substance abuse problems regardless of age or economic level
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
3
Etiology of Substance Abuse
Numerous theories try to explain it
Combination of many factors
Genetics within families
Individual (impulsivity and ease of disinhibition)
Environmental factors
Medical models
Biopsychosocial models
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
4
Historical Overview of Alcohol and Illicit Drug Use
Alcohol use has gained more social acceptance than other drug use.
Public attitudes and governmental policies have also influenced the history of illicit drug use.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Historical Overview of Alcohol and Illicit Drug Use (Cont.)
Consumption and laws affected by:
Alcohol-related deaths after lowered drinking age
Less tolerant national attitudes toward drinking
Increased societal and legal pressures and actions against drinking and driving
Increased health concerns among Americans
Knowledge of addictive properties
Counterculture acceptance of hallucinogens, cannabis, and heroin
The “War on Drugs”
Renewed interest in prevention/treatment efforts
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Laws Impacting Substance Abuse
Anti–Drug Abuse Acts of 1986 and 1988
Increased funding for treatment and rehabilitation
Created the Office of National Drug Control Policy (“drug czar”)
Worked on a public health approach to drug control
National Institute on Drug Abuse (NIDA)
Science on drug abuse and addiction
Prevention
Treatment
Decreasing the spread of HIV/AIDS
Other priority areas
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Laws Impacting Substance Abuse (Cont.)
Substance Abuse and Mental Health Services Administration (SAMHSA)
Builds and sustains programs, policies, information and data, contracts, and grants toward helping the nation act on the knowledge that promotes behavioral health treatment through all levels of prevention
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
8
Prevalence, Incidence, and Trends
Alcohol use by persons aged 12 or older:
Slightly more than half (52.8%) drink alcohol
Binge drinking at least once in prior 30 days— (22.6%)
Heavy drinking—6.2%
Young adults ages 18-25 had highest prevalence of binge and heavy drinking—39.8%
Drove under the influence of alcohol at least once in past year—11.1%
– SAMHSA (2011)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
9
Prevalence, Incidence, and Trends (Cont.)
Illicit drug use by persons aged 12 or older:
About 8.7% were current drug users, used an illicit drug during the past month
Illicit drugs used
Marijuana was the most commonly used drug
Others included cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics (pain relievers, tranquilizers, stimulants, and sedatives) used nonmedically
– SAMHSA (2011)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
10
Prevalence, Incidence, and Trends (Cont.)
Nonmedical use of prescription-type psychotherapeutics
There is a significant increase in the lifetime nonmedical use of pain relievers—specifically Percocet®, Percodan®, Vicodin®, Lortab®, Darvocet®, Darvon®, Tylenol® with Codeine, Propoxyphene, or Codeine Products, Oxycodone, and Hydrocodone
– NIDA (2010)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Prevalence, Incidence, and Trends (Cont.)
Hallucinogen, inhalant, and heroin use
LSD (d-lysergic acid diethylamide)
Peyote cactus
Psilocybin
PCP (phencyclidine)
Inhalants of choice are amyl nitrite, “poppers,” followed by glue, shoe polish, or toluene; correction fluid, degreaser, or cleaning fluid; gasoline or lighter fluid; and spray paints and other aerosols.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Prevalence, Incidence, and Trends (Cont.)
Gender difference
Males more likely to be current illicit drug users
Female illicit drug use (12 and older) increasing
Geographic trends
Highest in West > Midwest > Northeast > South
Racial/ethnic groups
Highest among American Indians or Alaska natives > African Americans> whites > Hispanics > Asians
– SAMHSA (2010)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Trends in Substance Abuse
May or may not relate to classically or clinically defined dependence or addiction.
Many are turning to recovery before they have developed physiological dependence.
Need to differentiate between use and misuse/abuse.
Use of harmful substances is indirectly and directly related to all of the leading health indicators targeted in Healthy People 2020.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Methamphetamine (MA)
Most widely produced controlled substance in the United States.
Illegal street names of the drug (crank, crystal, meth, ice, or glass).
Can be injected, inhaled, taken orally, or smoked.
Used predominantly by white young persons, with an overrepresentation of females.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Methamphetamine (MA) (Cont.)
Pleasurable effects are caused by the release of high levels of dopamine in the brain, leading to increased energy, a sense of euphoria, and increased productivity.
Short-term effects: increased heart rate, insomnia, excessive talking, excitation, and aggressive behavior
Prolonged use results in tolerance and physiological dependence
Negative consequences range from anxiety, convulsions, and paranoia, to brain damage.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Methamphetamine (MA) (Cont.)
The impact of MA abuse on communities, families, and social networks is considerable.
Young children of users are at risk for abuse and neglect.
Prenatal use puts children at risk for developmental problems, aggression, and attention disorders.
Exposure to combustible second-hand fumes.
Associated with increased incidence of violence (e.g., domestic abuse, homicide, and suicide)
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Steroids
Anabolic steroids are synthetic variants of male sex hormone testosterone
Build muscle and said to be androgenic
Most commonly used in athletes and other individuals willing to risk potential and irreversible health consequences to build muscle
Potentially fatal risks
Blood clots, liver damage, premature cardiovascular changes, increased cholesterol
Increased potential for suicide and aggressive and risky behaviors
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.
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Inhalants
Contain volatile components with psychoactive properties
Many products found in home or workplace (e.g., spray paints, markers, glues, and cleaning fluids)
Produce a rapid high that may resemble alcohol intoxications; may progress to loss of sensation and even unconsciousness
Irreversible effects:
Hearing loss, limb spasms, CNS or brain damage, or bone marrow damage; may result in death from heart failure or…
