Substance abuse: the designer drugs

Designer drugs, chemically altered compounds derived from federally controlled substances, have become a major cause of addiction and overdose deaths. These drugs include mescaline analogs, synthetic opioids, arylhexylamines, methaqualone derivatives and crack, a new form of cocaine. Sudden changes in mood, weight loss, depression, disturbed sleep patterns, deteriorating school or work performance, marital problems, and loss of interest in friends and social activities may be signs of drug addiction. Life-threatening complications of acute intoxication, such as hyperthermia, seizures, combative and psychotic behavior, and cardiorespiratory collapse, require prompt diagnosis and supportive intervention.     

Substance abuse: alcohol and drugs during adolescence

This paper reviews the problem of substance abuse during adolescence. By high school graduation, drugs and alcohol have become a part of the life-style of American youths. Although substance use may not cause problems for the majority, when there is abuse, it has a major impact on the adolescent's family as well as the adolescent himself. Nurses are in prime positions to identify the teenage substance abuser and provide treatment for him and his family.     

Substance abuse among sex offenders

A total of 461 male sex offenders were compared on their histories of alcohol and street drug use. The Drug Use Survey, Michigan Alcoholism Screening Test (MAST), and Drug Abuse Screening Test (DAST) were examined to provide measures of 1) type and frequency of substance use, 2) mood on alcohol and drugs, and 3) alcoholism and drug abuse. Most sex offenders had used alcohol and they had tried a wide range of street drugs. Over half of the sample had tried at least one street drug, including minor tranquilizers, amphetamines, barbiturates, cocaine, narcotics, phencyclidine, hallucinogens, and solvents. Marijuana was used most. Over one half of the sex offenders were alcoholics, based on the MAST. Results of the DAST suggested that less than a fifth of the sample had a drug abuse problem at the time of examination. Although the majority experienced positive affect in conjunction with alcohol and drug use, between one fifth and one half experienced depressed affect. Use of alcohol and amphetamines were most often associated with hostile feelings. Amphetamine and hallucinogen use were associated most with paranoia. Respondents felt most out of control with cocaine and hallucinogens. Results are discussed in terms of the role of substance abuse and violence in sex offences.     

Substance abuse among nurses--defining the issue

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THE PREVALENCE OF SUBSTANCE ABUSE in the nurse population is believed to parallel that in the general population (ie, approximately 10%).

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NURSES WITH SUBSTANCE ABUSE problems need help. They are in danger of harming patients, the facility's reputation, the nursing profession, and themselves. The consequences of not reporting concerns can be far worse than those of reporting the issue.

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PART ONE OF THIS TWO-PART SERIES discusses how society views addiction and the nursing profession, signs and symptoms of substance abuse, reasons nurses should report an impaired colleague, the code of silence that exists among nurses, and board of nursing jurisdiction. AORN J 82 (October 2005) 573-596.

     

Substance abuse among nurses--intercession and intervention

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IT IS NOT EASY to report a coworker who may have a substance abuse problem, so many nurses choose to remain silent about this issue.

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THIS ARTICLE PROVIDES suggestions for staff nurses about how to confront a peer, document inappropriate nursing behaviors related to substance abuse, and report these issues to a manager. The manager's role in counseling and intercession with a substance abusing employee also is detailed.

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REMEDIATION AND SUPPORT programs are addressed along with return-to-work issues and the need for education about this debilitating disease. AORN J 82 (November 2005) 777-799.

     

The prevalence of substance abuse among registered nurses

The purpose of this research was to estimate the prevalence of substance abuse and depression among a population-based sample of registered nurses. In addition, to estimate the degree to which substance abuse and depression were associated with nurses, a comparison was made between nurses and other employed individuals. Respondents were obtained from a probability sample of households that were part of the National Institute of Mental Health Epidemiologic Catchment Area Program (ECA). Of the adults interviewed as part of the ECA, 143 were under age 65 and currently working as registered nurses. These nurses were matched by neighborhood of residence (census tract) and gender to a comparison group of non-nurses from the ECA who were also employed at the time of interview. Estimates of the odds of substance use and depression among the nurses (n = 143) and non-nurses (n = 1410) were calculated. Nurses were no more likely to have engaged in illicit drug use or to have experienced depression than non-nurses. Nurses were also less likely to have experienced problems with alcohol abuse than non-nurses.     

Substance abuse education liaisons: a collaborative continuing education program for nurses in acute care settings

BACKGROUND: Alcohol, tobacco, and other drug abuse undermine physical and psychological well-being, contributing to the array of illnesses that necessitate admission to acute care settings. Addictive disorders often are undetected, underreported, or overshadowed by the primary illness. Nurses need continuing education to enhance competence in meeting this challenging problem. METHOD: Through a unique collaboration between university faculty and acute care nurses from seven hospitals, the nurses attended 18 monthly workshops designed to meet their learning needs related to substance abuse. RESULTS: The nurses acquired essential knowledge and skills regarding substance abusing clients. The publication of a substance abuse resource manual and the establishment of a continuing network of professionals committed to improving practice are additional positive outcomes of this endeavor. CONCLUSION: Project SAEL (Substance Abuse Education Liaisons) is a model that can be emulated by others.     

Identifying abuse among women: use of clinical guidelines by nurses and midwives

Title.  Identifying abuse among women: use of clinical guidelines by nurses and midwives.
Aim.  This aim of this study to identify the incidence of violence against women seeking healthcare services and evaluate the use of clinical guidelines to identify interpersonal violence.
Methods.  A cross-sectional survey was carried out. Data were collected over a period of 7 months in 2005 and 2006. The samples consisted of 14 nurses, 10 midwives and 208 women in Iceland (101 women visiting the Emergency Department and 107 receiving prenatal care at the High Risk Prenatal Care Clinic).
Results.  Twenty women (19·6%) who visited the Emergency Department and 21 women (19·8%) who came to the High Risk Prenatal Care Clinic had been sexually abused at some point in their lives by close family members. Within the preceding 12 months, 18 women at the Emergency Department (19·1%) and eight at the High Risk Prenatal Care Clinic (7·5%) reported physical abuse, and 22 women (22·2%) at the Emergency Department and 12 (11·5%) at the High Risk Prenatal Care Clinic reported emotional abuse. A majority of the nurses and midwives indicated that the guidelines were efficient for assessing/screening for gender violence in emergency and high risk clinical settings.
Conclusion.  Screening for abuse of women at emergency and high risk clinics is crucial, not only to offer the women the immediate interventions they might need, but also to ensure the future provision of appropriate healthcare services.     

Substance abuse: medical and slang terminology

Substance abuse is among one of the major problems plaguing our society. It has come to the attention of several healthcare professionals that a communication gap exists between themselves and substance abusers. Most of the time the substance abusers are only familiar with the slang terms of abused substances, a terminology that medical professionals are usually unaware of. This paper is an attempt to close that communication gap, allowing health care professionals to understand the slang terminology that their patients use, thus enabling them to make appropriate treatment decisions. In addition, the article presents some key features (including active ingredient, pharmacological classification, medical use, abuse form, usage method, combinations used, effects sought, long-term possible effects, and detectability in urine) of the most commonly abused substances.