NU 665 C WEEK 4 Discussion

Often, people who suffer from stress, anxiety, and depression start using drugs in order to feel less conscious. Stress plays a significant role as individuals start and continue using these drugs, and eventually, they develop a substance use disorder. Some individuals also relapse. Furthermore, other people get pressured to improve their focus at work or school (Boland et al., 2021). For instance, athletes can feel pressure to improve their abilities in sports, and they can try to use drugs so as to increase focus. Similarly, people also abuse drugs due to peer pressure, especially teens, and this can eventually lead to substance abuse. This essay will delve into a detailed discussion of substance abuse in the United States today.

Question 1

Addiction has become a multifaceted issue in the United Nations as it contains a complex etiology that involves psychological, genetic, and environmental factors. Environmental factors include exposure to drugs at a tender age, availability of drugs, peer pressure, and socioeconomic status, among many others. On the other hand, genetics exposes individuals to substance abuse due to the hereditary component (American Psychiatric Association, 2022). Psychological factors like mental health disorders, stress, anxiety, and depression can further complicate the etiology of addiction.

Stressors that contribute to addiction are different and primarily interlinked. Factors like social isolation, economic hardships, increased levels of stress, and job insecurity can lead to substance abuse as a way to cope with the issues at hand (American Psychiatric Association, 2022). Furthermore, there are societal pressures and the stigmatization associated with mental health issues, which can lead to substance abuse. Here, individuals tend to self-medicate in order to manage their symptoms.

The challenges associated with substance abuse are extensive, as they negatively impact the communities, families, and individuals. It comes with health issues like chronic conditions, overdose, and infectious diseases, among many others (American Psychiatric Association, 2022). Social problems also arise due to addiction, for instance, child neglect, domestic violence, and strained relationships. Addiction leads to increased loss of productivity, law enforcement, and healthcare expenses.

Both physical and psychological dependence develop when the body adapts to the intake of substances, which leads to tolerance and symptoms of withdrawal. The reliance makes it difficult to quit and mostly requires therapy and counseling for successful recovery. Relapse is known as a significant challenge in the treatment of substance abuse and addiction. Factors like recurring mental health disorders, stress, depression, lack of social support, and increased exposure to drugs contribute to relapse (American Psychiatric Association, 2022). Strategies for effective relapse prevention include support groups, ongoing therapy, addressing underlying psychological issues, and medication-assisted treatments. Thus, understanding the components mentioned above is essential for developing practical approaches to substance abuse and addiction treatments and support in the United States.

Question 2

Various physical and mental findings can be realized when examining a client with substance use disorder; each is linked to the specific substance used and the extent of the current disorder. There are cardiovascular issues that are characterized by hypertension and increased heart rate; such symptoms are associated with stimulants like methamphetamine and cocaine as they contain stimulating effects on the body (Carlat, 2017))—substances like marijuana or tobacco cause respiratory problems like bronchitis and chronic cough. Gastrointestinal disturbances like vomiting and nausea are associated with alcohol abuse. Furthermore, there are neurological effects like seizures and tremors that are linked with chronic alcohol abuse due to nutritional deficiencies and neurotoxic deficiencies. Track marks and cellulitis are caused by skin and injection sites.

Mental findings like cognitive impairment include difficulty concentrating and memory loss often experienced with chronic cannabis and alcohol use. Mood disorders like irritability, anxiety, and depression are associated with substances like stimulants and opioids (Taylor & American Academy of Pediatrics2018). Psychotic symptoms like delusion, hallucinations, and paranoia are likely to be caused by abuse of methamphetamine—behavioral changes like social withdrawal, impulsivity, and increased risk-taking behaviors. The rationale for the above findings is based on how different substances interact with the body system, which leads to specific psychological and physiological changes. For example, stimulants increase the excretion of dopamine and norepinephrine, and this causes potential psychosis. On the other hand, depressants like alcohol are responsible for impairing cognitive functions.

Question 3

Compulsive substances use can be triggered by genetic predisposition whereby a family history of addiction increases the probability of one developing addictive behavior. Increased levels of stress and unresolved emotional issues may lead to individuals seeking relief from the use of drugs. Past traumatic experiences like neglect or neglect can lead to addiction as one may turn to substance abuse as a coping mechanism (Tusaie-BC & Fitzpatrick, 2022). Mental health disorders and peer pressure can trigger compulsive substance use. Exposure to substances at an early can also lead to compulsive substance use. Chronic pain and illness can make people turn to substance abuse for relief. Some individuals who lack proper coping mechanisms to deal with life challenges turn to substance abuse.

Question 4

Addictive behavior develops from complex interactions within the neurobiological framework that involve neural circuits, reward pathways, and neurotransmitters. The mesolimbic dopamine pathway is a crucial element in understanding addiction as the path is responsible for connecting the ventral tegmental area to the nucleus accumbent and prefrontal cortex. It plays a significant role in enforcing behaviors related to reward and pleasure (Tusaie-BC & Fitzpatrick, 2022). Dopamine is located at the core of addictive behavior and acts as a chemical messenger that facilitates communication between neurons. Thus, when an individual engages in drug consumption and gambling, dopamine levels in the brain’s reward intensify. Increased and repeated exposure to substance abuse leads to neuroadaptations, which alters the brain’s reward system. Chronic drug use introduces changes in dopamine receptor sensitivity, which results in tolerance; thus, a larger dose is required to achieve the same effect.

Question 5

Medication-assisted treatments and psychotherapeutic interventions play significant roles in managing opioid and alcohol disorders. The approaches mainly aim to lessen withdrawal symptoms, address the underlying psychological factors that contribute to substance use, and reduce cravings. For alcohol abuse, Medication-Assisted Treatments include disulfiram, naltrexone, and acamprosate (Carlat, 2017)). Disulfiram is responsible for creating vomiting and nausea as it creates unpleasant reactions when alcohol is consumed; it acts as a deterrent. Naltrexone is accountable for blocking opioid receptors, thus reducing the pleasurable effects of alcohol and cravings. Acamprosate is a medication that is responsible for restoring chemical balance in the brain, thus reducing the cravings and withdrawal symptoms. Psychotherapeutic interventions include Cognitive Behavioral Therapy, Motivational Enhancement Therapy, 12 Step Facilitation Therapy. Cognitive Behavioral Therapy (CBT) assists individuals in identifying and changing behaviors and maladaptive thought patterns related to alcohol use. Motivational Enhancement Therapy (MET) increases the motivation for change to commit to treatment through goal setting and personalized feedback. 12 Step Facilitation Therapy involves attending AA meetings and working through the 12 steps with a sponsor.

Medication Treatment for opioid abuse includes methadone, buprenorphine, and naltrexone. Methadone acts as a long-acting opioid agonist as it reduces withdrawal symptoms and cravings (Taylor & American Academy of Pediatrics2018). Buprenorphine is a partial opioid agonist, and naltrexone is responsible for blocking opioid receptors, thus preventing the extensive effects of opioids if used. Psychotherapeutic interventions include Contingency Management, Cognitive Behavioral Therapy, and Supportive Therapy.

In conclusion, a combination of psychotherapeutic interventions and Medication-Assisted Treatments is primarily effective for both alcohol and opioid abuse as it addresses both psychological and physiological aspects of addiction. The treatment should be tailored according to an individual’s personal needs and circumstances. Regular adjustments and monitoring should be made to ensure the effectiveness of the treatments and prevent relapse.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR.

Boland, R., Verdiun, M., & Ruiz, P. (2021). Kaplan & Sadock’s synopsis of psychiatry. Lippincott Williams & Wilkins.

Carlat, D. J. (2017). The psychiatric interview: A practical guide. Lippincott Williams & Wilkins.

Taylor, J. A., & American Academy of Pediatrics. (2018). Opioid addiction.

Tusaie-BC, K., & Fitzpatrick, J. J. (2022). Advanced practice psychiatric nursing: Integrating psychotherapy, psychopharmacology, and complementary and alternative approaches across the life span. Springer Publishing Company.

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NU 665 C WEEK 4 Discussion

Please complete the Discussion below in five references. Please number the questions in the discussion as you answer it. Please, my professor doesn’t want students to use Artificial Intelligence.

Value: 100 points

3-4 Pages

Due:  May 22, 2024 @ 5pm

Grading Category: Discussions

Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the following prompt.

Initial Post

For this discussion, address the following prompts:

• Elaborate on etiology, stressors, problems of addiction, dependence, and relapse in the United States today.
• Identify potential physical and mental findings when examining a client with a substance use disorder. Note your rationales.
• Describe possible triggers to compulsive substance use or behavioral addiction.
• Discuss the neurobiological mechanisms that underlie addictive behavior.
• What medication-assisted treatments (MATs) and psychotherapeutic interventions for monitoring (for alcohol and for opioid abuse) are available?

Use APA format with reference list (two to three books and/or articles).

The described expectations meet the passing level of 80%. You are directed to review the Discussion Grading Rubric for criteria which exceed expectations.

Week 4: Learning Materials

Readings

Required

• American Academy of Pediatrics. (2018). Opioid addiction.American Academy of Pediatrics.
  • Chapter 105: Medication-Assisted Treatment of Adolescents With Opioid Use Disorders.
• American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Text Revision (DSM-5-TR)(5th ed.). American Psychiatric Publishing, Inc. ISBN 978-0-89042-576
  • Substance Related Disorders: pp. 483–589
• Boland, R., Verduin, M., & Ruiz, P. (2021). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry(12th ed.). Wolters Kluwer.
  • Chapter 4: Substance Use and Addictive Disorders
  • Chapter Section 21.7: Drugs used to Treat Substance Use Disorders
• Carlat, D.J. (2017). The psychiatric interview(4th ed.). Wolters Kluwer.
  • Topic: Assessing alcohol use disorder
  • Topic: Mental Status Exam
• Fitzpatrick, J. J. (2022). Advanced practice psychiatric nursing(3rd ed.). Springer Publishing LLC.
  • Chapter 19: Integrative Management of Substance Use Disorders and Co-Occurring Mental Health Disorders
• Matthews, S., Dwyer, R. & Snoek, A. (2017). Stigma and self-stigma in addiction. Bioethical Inquiry 14,275–286.
• Office of Addiction Services and Supports. (n.d.) SBIRT for Healthcare Providers.New York State.
• (2019). First-episode psychosis and co-occurring substance use disorders (PDF).Publication No. PEP19-PL-Guide 3. National Mental Health and Substance Use Policy Laboratory.
• The Neurobiology of Addiction Full Video (21:11)
  • The Neurobiology of Addiction Video Transcript

Required Reading for the Week 6 Assignment

• Perry, B. D. & Winfrey, O. (2021). What Happened to You?

Recommended

• Rhoads, J. (Ed.). (2021). Clinical consult to psychiatric mental health. Springer Publishing.
  • Chapter 9: Substance Use Disorders
• R., (2020). The psychiatric-mental health nurse practitioner certification review manual.Springer Publishing.
  • Chapter 7: Substance Use Disorders

Videos

The Reward System (18:04 minutes)

The Reward System video transcript

Substance Use Disorder (25:16 minutes)

Substance Use Disorder Transcript

Additional Resources

• Providing Care for Addictions in the LGBTQIA Community (PDF). Note that you must scroll to locate this item on the website.
• Behavioral Interventions for SUD (PDF)
• Addressing Opioid Addiction and Other Substance Use Disorders in LGBTQ Populations (PDF)is a description of the course that must be found at the LBGT Health Education Center (https://www.lgbthealtheducation.org). Note that you will need to register in order to view the webinar; read the privacy policy first.