Dependence personality changes

When a patient does not have a painful terminal illness, drug dependence must be avoided. Signs of drug dependence include occurrence of withdrawal symptoms (acute abstinence syndrome) when tiie narcotic is discontinued, requests for tiie narcotic at frequent intervals around tiie clock, personality changes if the narcotic is not given immediately, and constant complaints of pain and failure of tiie narcotic to relieve pain. Although these behaviors can have other causes, the nurse should consider drug dependence and discuss the problem with tiie primary health care provider. Specific symptoms of tiie abstinence syndrome are listed in Display 19-3. 

Although benzodiazepines are well tolerated, the possibility of personality changes (nonchalance, paradoxical excitement) and the risk of physical dependence with chronic use must not be overlooked. Conceivably, benzodiazepine dependence results from a kind of habituation, the functional counterparts of which become manifest during abstinence as restlessness and anxiety even seizures may occur. These symptoms reinforce chronic ingestion of benzodiazepines. 

Tremeau F, Darreye A, Leroy B, Renckly V, Ertle S, Weibel H, Khidichian F Macher JP (2003). Personality changes in opioid-dependent subjects in a methadone maintenance treatment program. L Encephale, 29, 285-92... 

Other long-term effects of amyl nitrite use are unclear. Mood swings and personality changes have been reported but have not been studied. Tolerance to poppers develops on repeated exposure. Chemical dependence does not occur, and the drugs have a low potential for psychological dependence. 

Tolerance to the effects of phencyclidine develops in both animals and man. A slight physical dependence has been reported in man, characterized by a craving for the drug, persistent amnesia, slurred speech and difficulty in thinking, which may last up to 1 year after discontinuing the drug. Severe personality changes have also been reported. 

Alcoholism—A chronic, progressive, and potentially fatal biogenic and psychosocial disease characterized by tolerance and physical dependence and manifested by a total loss of control, as well as diverse personality changes and social consequences. 

To be successful, a team selected from different groups within the project team should participate in the preparation and review of these plans. In addition, a schedule of the review and approval process for these plans needs to be established, accepted by all reviewers, and distributed before release of the first draft. Reviewers should meet an established schedule for review and submission of comments. A distinction between review and approval authority should be determined. The review process determines if all of the required elements are identified. This review can take considerable time, depending on the complexity of the project. The approval process is important when all comments are incorporated. The key responsible persons associated with the project should accept and approve the changes to the document. 

This course of action is a possibility but will depend on how the message is delivered. Can be a way of showing you disapprove but care for the person s welfare. Remember that peer disapproval can be a very powerful force for change. 

Another way to conceptualize drug problems is to examine psychological versus physical dependence on a substance. Psychological dependence is defined by beliefs A person thinks he or she needs the substance in order to cope. Physical dependence, on the other hand, is defined by actual physical changes related to drug use that may result in withdrawal symptoms and tolerance. However, to confuse matters, recreational users also may experience tolerance and withdrawal, so it is important to be careful when using these distinctions to define whether a person has a drug problem. 

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