And drug use

Roger Baccus, age 23 years, is prescribed Demerol for postoperative pain. You discover in his health history on the chart that he has a history of alcohol and drug use. Determine what further assessments you would need to make Explain how Roger s answers would influence the actions that you as a nurse would take. 

A comprehensive assessment of the stimulant-dependent patients psychological, medical, forensic, and drug use history may be difficult, because information may be incomplete or unreliable. In recognition of this deficiency, it is important that the patient receives a thorough physical examination, as well... 

To provide accurate information about drugs and drug use, alcohol use, smoking and other risky behaviour. 

Outpatient group members were very similar to the inpatient PCP abusers in most sociodemographic and drug-use characteristics. Their mean age was 29 years, educational level 12.6 years, and number of prior arrests 1.5. The majority of outpatients were black (83 percent), unmarried (67 percent), and unemployed (67 percent). Their mean duration of PCP use was almost 8 years, with, usually, no prior or recent substance abuse treatment. Thirty-seven percent used PCP at least daily, always by smoking. Like the inpatient PCP abusers, outpatients frequently (87 percent) reported abuse of other drugs alcohol (46 percent), marijuana (46 percent), and cocaine (37 percent). Several outpatients for whom cocaine was the preferred drug of abuse used PCP as a "cheaper high" when cocaine was not affordable. 

UK national statistics on smoking, drinking and drug use www.doh.gov.uk/public/statspntables.htm... 

DoH (2001). Smoking, Drinking and Drug Use among Young People in England in 2000. Department of Health/HMSO, London. Also available at www.doh.gov.uk/public/ statspntables.htm... 

Webb E, Ashton CH, Kelly P and Kamali F (1996). Alcohol and drug use in UK university students. Lancet, 348, 922-925. 

HIV-infected persons, even those with viral loads below detectable limits, should be considered infectious and should be counseled to avoid sexual and drug-use behaviors that are associated with transmission or acquisition of HIV and other infectious pathogens. 

Some clinicians and researchers have noted that drug problems seem inextricably linked to problems with emotions. Certainly, many studies have found evidence for links between emotions, especially extreme emotional experiences, and drug abuse, and such links are frequently described in the personal stories told by drug users. However, the relationship between emotions and drug use is... 

Another way that professionals assess for psychiatric disorders is to use an inventory that assesses for personality characteristics. The most famous of these inventories is the Minnesota Multiphasic Personality Inventory (MMPI), which is now in its second edition as an instrument. Although the MMPI is actually a personality inventory, as it names suggests, many professionals will use it to spot suspected psychiatric disorders, such as depression, Bipolar Disorder, Schizophrenia, and Anxiety Disorder. The MMPI has several scales to assess common personality traits, such as depression, mania, psychopathic deviance, and even alcohol and drug use (Weed, Butcher, McKenna, Ben-Porath, 1992). 

Brown, S. A., Myers, M. G., Lippke, L., Tapert, S. F., Stewart, D. G., Vik, P. W. (1998). Psychometric evaluation of the Customary Drinking and Drug Use Record (CDDR) A measure of adolescent alcohol and drug involvement. Journal of Studies on Alcohol, 59, 427M38. 

Many chronic diseases can cause hypotension. Heart conditions (and drugs used for its treatment) can lead to bradycardia, thyroid dysfunction (either under- or over activity), diabetes mellitus, Parkinson s disease and neuropathies. Also, all acute conditions with the risk of dehydration, such as fever, vomiting, diarrhoea and bleeding, can cause hypotension. 

Baker GB, Prior TI, Coutts RT. 2002. Chirality and drugs used to treat psychiatric disorders. J Psychiatry Neurosci 27 401. 

Elliott, D.S., Huizinga, P., and Ageton, S.S. (1985) Explaining Delinquency and Drug Use. Thousand Oaks, CA Sage. 

Martino S, Carroll KM, Nich C Rounsaville BJ (2006). A randomised controlled pilot study of motivational interviewing for patients with psychotic and drug use disorders. Addiction, 101, 1479-92... 

Coutts RT, Urichuk LJ. Polymorphic cytochromes P450 and drugs used in psychiatry. Cell Mol Neurobiot 1999 19 325-354. 

Drake RE, Xie H, McHugo GJ, et al. The effects of clozapine on alcohol and drug use disorders among patients with schizophrenia. Schizophr Bui, 2000 26 441-449. 

Wille, R. (1983) Processes of recovery from heroin dependence relationship to treatment, social changes and drug use , Journal of Drug Issues, 13 333-42. 

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