Transcript Lesson 25 Sub Misuse and Abuse FINAL4-29-11

Lesson 25: Substance Misuse and Abuse
You Are the
Emergency Medical Responder
Your emergency medical services (EMS) unit is
summoned to a residence on a report of an unconscious
person. When you arrive and size-up the scene, you
discover an older couple. The wife is distraught and
says that her husband had been drinking alcoholic
beverages heavily earlier in the day. Shortly after taking
his prescribed Valium®, she says he became drowsy and
incoherent, and then collapsed. Unable to get him to
respond, she called 9-1-1. On assessing the patient, you
find that he is unresponsive, his breathing is shallow
and slow, his heart rate is slow and his pulse is weak.
Emergency Medical Response
Substance Abuse and
Substance Misuse
 Abuse: The deliberate, persistent and excessive use
of a substance without regard to health concerns or
accepted medical practices.
 Misuse: The use of a substance for unintended
purposes or for appropriate purposes but in
improper amounts or doses.
 Includes use of illegal (or illicit or controlled)
substances and legal substances, such as nicotine,
alcohol and over-the-counter (OTC) medications,
such as sleeping pills and diet pills.
Emergency Medical Response
Substance Abuse Terms
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Dependency
Addiction
Withdrawal
Tolerance
Overdose
Emergency Medical Response
Categories of Abused Substances
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Stimulants
Hallucinogens
Depressants
Narcotics
Inhalants
Cannabis products
Emergency Medical Response
Stimulants
 Effects on the body:
• Increased physical
and mental activity
• Temporary feelings
of alertness
• Appetite suppression
• Energy bursts
 Examples:
• Amphetamine,
dextroamphetamine,
methamphetamine
• Cocaine
• Crack cocaine
Emergency Medical Response
Hallucinogens
 Effects on the body:
 Examples:
• Changes in mood,
• Lysergic acid
sensation, thought,
diethylamide (LSD)
emotion and self• Psilocybin
awareness
• Phencyclidine (PCP)
• Altered perception of
• Mescaline (angel
time and space
dust)
• Visual, auditory and
tactile delusions
Emergency Medical Response
Depressants
 Effects on the body:
• Decreased physical
and mental activity
• Altered level of
consciousness (LOC)
• Depressed
respirations
• Impaired
coordination and
judgment
 Examples:
• Barbiturates
• Benzodiazepines
• Ketamine
• Rohypnol
• GammaHydroxybutyrate
(GHB)
• Alcohol
Emergency Medical Response
Narcotics
 Effects on the body:
• Depression
• Pain relief
 Examples:
• Morphine
• Codeine
• Heroin
• Oxycodone
Emergency Medical Response
Inhalants
 Effects on the body:
• Mood altering
• Depression of central
nervous system
• Erratic blood
pressure and pulse
 Examples:
• Amyl nitrate
• Nitrous oxide
• Solvents
Emergency Medical Response
Cannabis Products
 Effects on the body:
• Feelings of elation
• Distorted
perceptions of time
and space
• Impaired judgment
and motor
coordination
 Examples:
• Marijuana
• Hashish
Emergency Medical Response
Other Substances
 Designer drugs
• MDMA (“ecstasy”)
• Anabolic steroids
• OTC medications, such as aspirin, nasal sprays,
laxatives and emetics
Emergency Medical Response
Stimulant Overdose
Signs and Symptoms
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Moist or flushed skin
Sweating, chills
Nausea or vomiting
Fever
Headache
Dizziness
Rapid pulse
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Rapid breathing
High blood pressure
Chest pain
Possible respiratory
distress
 Excitability, restlessness,
talkativeness or
irritability
 Possible sudden loss of
consciousness
Emergency Medical Response
Hallucinogen Abuse
Signs and Symptoms
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Sudden mood changes
Flushed face
Claims of seeing or hearing something not present
Anxiety or fear
Emergency Medical Response
Depressant Abuse
Signs and Symptoms
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Drowsiness
Confusion
Slurred speech
Slow heart and breathing rates
Poor coordination
Emergency Medical Response
Alcohol Withdrawal
Signs and Symptoms
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Confusion and restlessness
Trembling
Hallucinations
Seizures
Emergency Medical Response
Signs of Cannabis and Inhalant Use
 Cannabis: red, bloodshot eyes
 Inhalants: drunken or disoriented appearance
(similar to hallucinogen abuse)
Emergency Medical Response
General Principles of Care
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Size-up the scene
Perform a primary assessment
Summon more advanced medical personnel
Perform a physical exam
Take a SAMPLE history to try to find out what
substance was taken, how much was taken and
when it was taken
Calm and reassure the patient
Keep the patient from getting chilled or overheated
Keep the patient’s airway clear
If the patient has difficulty breathing, administer
emergency oxygen, if available
Emergency Medical Response
Factors Contributing to
Substance Abuse
 Lack of parental supervision
 Breakdown of traditional family structure
 Wish to escape unpleasant surroundings and
stressful situations
 Widespread availability of substances
 Peer pressure and the basic need to belong
 Low self-esteem, including feelings of guilt or shame
 Media glamorization promoting the idea that using
substances enhances fun and popularity
 History of substance abuse in the home or
community environments
Emergency Medical Response
Prevention Guidelines and Unintentional
Misuse or Overdose
 Read the product information; use only as directed
 Ask a doctor or pharmacist about intended use and
side effects; if taking more than one medication,
check for possible interaction effects
 Never use another person’s prescribed medications
 Always keep medications in their original, marked
containers
 Discard all out-of-date medications
 Keep medications out of reach of children
Emergency Medical Response
You Are the
Emergency Medical Responder
Based on your findings, you suspect that the patient
ingested a combination of drugs and alcohol.
Emergency Medical Response