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We Tried Starbucks Secret Menu Drinks, and Reviewed Them!

Our Thoughts

We refrained from getting our typical Starbuck order, the caramel macchiato, and jumped out of our comfort zone. We order 6 Starbucks Secret Menu drinks that we found on Pinterest and TikTok.

Comment down below if you have tried any of these secret menu drinks before and if you liked them or not.

I gotta say some were really good and some were really really bad! Also comment down below your favourite Starbucks order! We love trying new things!

Starbucks Secret Menu Drink

Comment below which one looks like you will try.

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Schizophrenia Explained
Schizophrenia (shattered mind) it affects the way thinks, feels, perceives reality. It …
Mood Disorders: Mental Health
Moods occur from specific experiences in our lives that we relate to …
Community Health Nursing: Unit Two
Community Health Nursing Community health nursing is a huge umbrella term with …
Substance Abuse and Addictive Disorders
Individuals are addicted to drugs for many reasons mainly for pleasurable effects. …
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Schizophrenia Explained

person with schizophrenia holds blanket over face

Schizophrenia (shattered mind) it affects the way thinks, feels, perceives reality. It causes disturbances in thought process, perception, and affect. Skizo means split or divided and phren means mind.

In history, people thought individuals with schizophrenia were possessed by the devil due to lack of knowledge and were scared. Today stigma is huge and society is often unwilling to shoulder the costs of housing, treatment, and rehabilitation for people with mental disorders like schizophrenia.

Signs and Symptoms

Symptoms usually occurring late adolescence or early adulthood. Males eighteen to twenty-five and females twenty-six to forty-five. Twenty-five percent of people with schizophrenia experience complete remission after one or several psychotic episodes. People with schizophrenia experience complete remission after one or several psychotic episodes. Early interventions help increase the rate of recovery or decrease the severity of the disorder. Remission means they are not cured but symptoms are under control. It can be seen as anger, anxiety in the early years.

There are positive and negative symptoms of schizophrenia. Positive symptoms are ones that can be controlled by medications such as delusions, hallucinations, and illusions. These positive symptoms are ones that are added to the individual. Negative symptoms are ones that are taken away from the individual and often cannot be fixed with medicine. These include social withdrawal, blunt or flat affect, and lack of avolition (absence of will or drive). Negative symptoms include lack of pleasure in life and the absence of emotional content in-person expression or voice. it also includes the lack of ability to begin and sustain planned activities.

Other symptoms include laughing without reason, crying without a reason, poor memory, speech disorder, aggression, visual or auditory hallucinations, and lack of movement.

These symptoms negatively affect people’s jobs, empathy, relationships, self-care, schooling, and much more.

Delusions are a fixed false belief and are used in everyday language to describe a belief that is false, fanciful, or derived from deception. Delusions usually include pathological misperceptions. Hallucinations are perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception.

Behaviors

individual with schizophrenia looks out the blinds

Grandiose is feeling increased self-importance such as royalty and wealth. Persecutory is bad thoughts (someone is out to get me and when I fall sleep they break into my house and poison the food). Somatic is the feeling that something is wrong with your body. Nihilistic is thoughts that something bad is gonna happen (they are dead or the world is coming to an end). Hypervigilance is always waiting for something frightening or important to happen (watches out blinds all day). This is sustained attention to external stimuli. Preservation is persistent adherence to a thought or idea ( people on the radio can hear what I think) you can’t get them off that topic

Waxy Flexibility is a posture held in an odd or unusual fixed position for an extended period, usually in an awkward position. They will not move or get repositioned even with assistance. This may last from a few hours to a few days. Akathisia is when they rock in place.

Avolition is being so unmotivated that simple activities of daily living don’t get done such as showering. Ambivilou is being unable to make decisions and not really care either way. Anhedonia is not being able to enjoy things.

Speech Impairment and Unusual Patterns

Clang association is relating ideas based on sound and rhyme. Verbigeration is the repetition of words. Neologisms are invented words by the client. Word salad is jumbled words and phrases that are disconnected. Echolalia is imitation or repetition of what someone says.

Diagnosis

There is no lab test to determine Schizophrenia. Symptoms must be present for a significant period of one month, but with continuous signs of disturbances for at least six months, before a diagnosis can be done. Individuals must exhibit at least two of the specified symptoms (delusions, hallucinations, disorganized speech, grossly disorganized behavior, or negative symptoms). People with this disorder will experience a disturbance in their level of functioning.

The cause of schizophrenia is unknown. Some theories include familial patterns, dopamine hypothesis, reduction in brain metabolism, and thalamus.

It is thought that schizophrenia may be related to familial patterns. It may be caused by a genetic reason or a biological predisposition. First degree relatives of people with schizophrenia are ten times more likely to experience schizophrenia than the general population.

Another theory is the dopamine hypothesis. A schizophrenic brain shows that there is a high amount of dopamine in the brain. this level may be too much. Certain medications can block dopamine receptors in the brain.

The thalamus plays a major role in cognitive disturbances. It works as a gate or filter of information.

Risk Factors

Risk factors for schizophrenia include stress and infection during pregnancy that affects the baby. Schizophrenia is not caused by poor parenting, poor bond, or medication is taken during pregnancy.

Co-Morbidities include diabetes mellitus.

Interventions

Early interventions help increase the rate of recovery or decrease the severity of the disorder. Promoting safety is always number one when treating and intervening. It is encouraged that people with schizophrenia should participate in support groups.

Pharmacologic interventions are needed to control the symptoms of schizophrenia. Typical antipsychotic medications will control positive symptoms such as hallucinations, delusions, and illusions. Unfortunately, they do not help negative symptoms and sometimes will worsen them. Newer atypical antipsychotics have fewer neurological side effects and they are more effective at improving negative symptoms.

Side effects from medications range from mild discomfort to permanent movement disorders. Many side effects are frightening and upsetting to clients and they frequently cause non-compliance.

An individual may experience weight gain, sedation, dry mouth, blurred vision, hypotension, constipation, and urinary retention.

Extrapyramidal side effects such as akathisia, dystonia, and Tardive dyskinesia may occur. Akathisia is feet that are in constant motion. This causes restlessness, trouble standing, and pacing. Tardive dyskinesia is involuntary movements of the body and extremities as well as sucking or smacking of the lips. People may do a chewing motion or roll their tongue. Acute dystonia is facial grimacing such as involuntary eye movements and muscle spams which usually cause the trunk to arch forward.

Medication Emergencies

If an individual experiences medication emergencies administer anticholinergics, stop administration of offending meds, monitor vitals, reduce body temperature, and safety protect muscles.

Watch for an anticholinergic crisis. Anticholinergic medication is great for the treatment of extrapyramidal side effects but may cause anticholinergic crisis. This will show as confusion and hallucinations. This also presents as “red as a beet, mad as a hatter, blind as a bat, dry as a bone, and hot as a hare”.Physical signs are dilated pupils, blurred vision, difficulty swallowing, nausea, vomiting, seizures, decreased bowel should, tachycardia, and fever.

Neuroleptic malignant syndrome is another condition to watch out for. It is a life-threatening reaction that can occur in response to neuroleptic or antipsychotic medication. Symptoms include severe muscle rigidity, elevated temperature, changes in the level of consciousness, elevated liver enzymes, elevated creatine phosphokinase, and leukocytosis.

Clinical Course

There are four periods of the acute illness period, the stabilization period, the maintenance and recovery period, and the relapses period.

The acute illness period is bizarre or disruptive thoughts and behaviors that cannot be overlooked. This includes both negative and positive symptoms. The goal of this stage is suicide prevention, normalize sleep, and reduce substance abuse. There are three phases of the Acute illness period. Phase one is prodrome which introduces early symptoms to the client. Phase two is acute symptoms. Lastly, phase three is recovery.

The stabilization period introduces treatment which is fairly intense. Medication regime is established. Family and patient need to adjust to the new diagnosis and lifestyle. Symptoms are less acute but may be present.

Maintenance and recovery period occurs when the condition is stabilized. The goal is to regain the previous level of functioning and quality of life. For this stage to occur, medication compliance and family support are crucial. Education is key, monitor adverse effects.

Relapses may occur anytime during treatment and recovery. This is usually from noncompliance with medication.

This is a lifetime disorder, so it is vital to make sure that there are support systems in place and treatment is available to all. Education is necessary for people to understand schizophrenia so support safe and continued.

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Mood Disorders: Mental Health

plant and book

Moods occur from specific experiences in our lives that we relate to an emotion or feeling too. Alterations occur in our emotions that cause mood disorders. These alterations cause psychological effects manifested from either depression or mania. Moods can be elevated or depressive and can cycle between the two. Mood disorders often go undetected and therefore untreated.

Suicide is one of the leading causes of death for men and women. Teachers are noticing an 85% increase in anxiety disorder and a 73% increase in depressive disorder. This extreme increase in mood disorders is likely from a lack of social skills and a decreased sense of community. Children and teenagers are being exposed to technologies that take away from physical interactions. Technology allows these children to develop relationships with others all around the world. Although these technological interactions are positive they also pose a risk for them to develop less face to face interactions. Cyberbullying is one of the leading forms of bullying which as a huge impact on the development of mood disorders.

As humans we can be socially aware of other’s facial expressions, body language, and posture and wonder what that mood disorders that person may be suffering from. This way we can be more empathetic and understanding of others behaviors and attitudes.

Dopamine is an excitatory transmitter that strongly effects emotions and memory and auditory. Low levels are related to Parkinson’s and high levels are related to schizophrenia.

Etiology (Cause)

The cause of mood disorders is unknown but is related to hormones, family history, the immune system, substance use, developmental factors. It is also related to a deficiency of serotonin, dopamine, and norepinephrine.

Risk Factors

Women tend to have higher hormone levels and are therefore at a higher risk of developing a mood disorder than men. Children and teens are at high risk as well due to bullying, hormones, and stress. The elderly are at high risk because they are often isolated, lonely, and abused. The Elderly often don’t get many visitors, and their family and friends have passed away.

Some medications can lead to mental illness as an adverse effect. Individuals living with other illnesses (co-morbidities) are likely to develop the depressive disorder as well.

Other risk factors include; substance use, lack of social support, economic struggles, and stress.

Once an individual has a depressive episode they are at high risk for developing more episodes throughout their lifetime. Individuals who have family members with a history of mood disorders are at higher risk of becoming ill.

Unipolar Disorders

Unipolar disorder means one type of disorder. This can be either major depression or dysthymic disorder. Unipolar depression is solely focused on the lows or the negative emotions and symptoms experienced. This is characterized by severe and debilitating depressive episodes of clinical depressions or major depression.

There is a major distinction between a person who is going through a rough patch and is unhappy versus a person that is clinically depressed.

Major depressive disorder (depression) involves at least 2 weeks of a continuously sad mood. The individual must experience 4-7 symptoms of depression to be diagnosed.

Symptoms include; change in appetite, anhedonia (inability to enjoy), change in concentration, feelings of worthlessness, recurrent thoughts of death, disruption in sleep, and psychomotor agitation (restlessness).

Dysthymic disorder is a milder but more chronic form of depressive disorder. It is between a blue mood and major depressive disorder. The dysthymic disorder presents as a depressive mood mostly every day for at least 2 years.

Symptoms include; low energy, sadness, feeling of emptiness, low self-esteem, changes in concentration, feelings of hopelessness, guilt, and worries.

These individuals commonly suffer from self-care deficit and disturbed sleep patterns. Try developing routines and schedules. Reward self-care. Exercise, implement a healthy diet and try not to take naps during the day if you are having difficulty sleeping.

Interventions

woman takes notes with pen on notepad

The most effective treatment is psychotherapy (talking) and antidepressant medication.

Antidepressants may be administered which the goal of symptom reduction or remission. The objective is to choose the right medication and dosage for each patient. Never stop taking the medication abruptly! This can cause withdrawal and depressive symptoms.

Light therapy (phototherapy) can be used for people with seasonal depression. Light therapy is an artificial light source that is used 30 minutes a day. Should see effects 1-4days.

ECT (electroconvulsive therapy) is used when medication is not working. It is used if experiencing schizophrenic activity. After this is complete the person needs to be reorientated to a person place and time. The person may experience confusion and memory loss. This is not done if the person has increased cranial pressure (trauma) to head.

Antidepressant Medication

antidepressant medication for mood disorders

MAOIs are antidepressants that are the last line of defense. They work by inactivating norepinephrine (plays a role in mood states and flight or fight response), serotonin, and dopamine (influences emotions, memory, and auditory), therefore increasing mood. Do not take with substances containing tyramine (aged cheese, beer, red wine, pickles, chocolate) because it causes a hypertensive crisis.

TCAs are the second line of treatment for antidepressant medications. Always check plasma blood levels due to the increased risk for toxicity from this medication. TCAS may cause suicidal thoughts, hypotension, arrhythmias, check vitals before administration. This medication should not be given to the elderly for these heart-related reasons.

SSRI is the first line of treatment in relation to antidepressants. It works by blocking the uptake of serotonin. serotonin is responsible for emotion, sleep, appetite, and sexual behavior.

Remember…

Antidepressants need to be taken consistently at the same time every day. It may take 3-4 months for the medication to be most effective. In 2-3 weeks individuals may notice a difference.

Anticholinergic side effects are blurred vision, urinary retention, dry mouth, and constipation.

Serotonin syndrome occurs when medications cause levels to get to high in your body. Signs and Symptoms include dilated pupils, shivering, twitching of muscles, rapid heart rate, high blood pressure, agitation, confusion, and diarrhea.

Bipolar Disorders

woman with mood disorder hold up a piece of cardboard in front of her face with a smile on it

Bipolar disorder means two disorders. This mood disorder switches between up and down moods. This mental health condition causes a quick shift from feeling high, full of energy to feeling sad, down, and hopeless. There are a high pole and a low pole in bipolar.

Mania is overactivity, an elevated or irritable mood. Manic is characterized by euphoria, a flight of ideas, and pressured speech.

Bipolar 1 is the most extreme causing impairment in social, occupational, and interpersonal functioning. This includes one or more manic episodes with a major depressive occurrence. Psychotic symptoms are present.

Bipolar 2 is less extreme which does not cause impairment in social, interpersonal, or occupational functioning. This includes one episode of hypomania accompanying major depression. No psychotic symptoms are present.

Men and women are equally effected and affects 1-3 % of the population. The mean age of onset is 21-30 years of age. Females are more prone to depression whereas males are prone to manic episodes.

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Community Health Nursing: Unit Two

community health nursing

Community Health Nursing

Community health nursing is a huge umbrella term with many different roles and specialties. Some specialties in community health include home health nursing, public health nursing, mental health nursing, occupational nursing, school nursing, and correctional nursing (works with inmates). Forensic nursing is a new category that works with emergency departments. Parish nurse works with the ministry, worshiping, and teaching. Telenurse provides nursing care through the use of a variety of technologies such as phone or skype.

Home Health Nursing

Home health nursing was created to provide care after being discharged from the hospital. The goals of home health nurses include health promotion, health maintenance, and health restoration. The main goal is rehabilitation and restoration to maximum health function. Nursing at home meets the basic needs of the client. These nurses work with family. The main focus is primary prevention, which is preventing disease and illness before they occur. Home health nursing connects the client and services to ensure continuity of care between the hospital and community. These community nurses prevent health problems from arising following discharge and prevent unnecessary hospital readmission.

The expansion of home health is due to numerous reasons. One reason is due to early discharges at hospitals. Hospitals try to get people back into the comfort of their own homes as quickly as possible. Some individuals actually prefer to be cared for at home. Technologies now allow for and make it easier for nursing to be done at home.

Elders are the most frequent users, but all ages can use this service. This way of nursing allows individuals to have control over and determine their own health needs.

There are direct and indirect functions of a nurse. Direct functions include physical care, supervision, assessing and teaching, and reporting to a physician. Indirect functions include consulting with others, advocating, documentation, and obtaining test results.

These nurses must be flexible, self-directed, adaptable, and great critical thinkers. When the nurse is unable to direct the client’s issue they direct the client through a referral process which will give the client another source of assistance.

Public Health Nurse

nurse gives patient an IV in hand

Public health nurses take a population approach to protect and promote health and prevent disease. This involves coordinating care, planning services or programs, and collaboration. The client may be the population, the community, a group, the family, or the individual. These nurses must have great communication skills. These nurses have many roles that depend on the needs and resources of the community. These roles include advocating for a required service, management, school health and safety, emergency nursing, and controlling communicable diseases.

Rural Nursing

Community Health Care Nursing is working in a rural setting. Rural is generally in terms of geographic location and population density or the distance from/time to commute to an urban center. Rural health care providers usually live and practice in a particular community for decades. There are a limited number of community nurses. CHN needs to have an accurate understanding of rural clients to design community health programs that are available accessible and appropriate.

People in rural areas may experience increased health risks such as obesity, higher smoke rates, higher prevalence of heart disease, higher mental illness rates, higher rates of hypertension, and arthritis.

There are many barriers to rural settings. Accessibility (lack of existing health care services and lack of the necessary personnel to provide those services). Affordability, services may not come at a reasonable cost, or family may have insufficient resources to purchase them when needed. Driving cost or low income, coverage for health care. Acceptability and service may be inappropriate or may not be offered in a manner that corresponds with the values of the target population, things will be done in the “hospital way”.

There are many challenges for nurses in rule settings. In small towns, everyone often knows everyone but yet boundaries must be kept. Information cannot be shared and must remain confidential. As a nurse in a small town, people may think you know a little about a lot. These nurses often have heavy workloads. Nurses must put parameters on work, prevent getting burnt out.

Practical Nurse

community nurse draws up medication into needle

Practical nurses have countless roles. They must perform skills as set up by the agency, document care given, observing and report client changes to a supervisor, and call appropriate persons in emergency situations. They must also validate and evaluate services. Practical nurses assist with activities of daily living (ADLs), assist with transfers and bathing, provide nutritional counseling, exercise and mobility encouragement, as well as stress management. Skills of a practical nurse include ostomy care, dressing changes, medication administration, catheter insertion, pressure ulcer treatment, and much more.

Evidence-Informed Practice

The evidence-Informed practice provides guidance to nurses to help them make the most relevant and individualized nursing care decisions in their practice

Evidence-informed practice is combining the best evidence derived from research with clinical practice knowledge and expertise and unique client expectations preferences or choices when making clinical decisions. the application of the best available evidence to improve practice.

Community health care nurses use the evidence-informed practice to develop a hypothesis, make clinical observations, look at various sources for information, and develop clinical questions.

Clinical practice guidelines are developed by a team of experts who find and appraise the evidence draw conclusion and make recommendations about best practice.

When applying the evidence-informed practice to client community nurses must recognize the importance of assisting the client with decision making. They must ensure that the evidence is at an appropriate literacy level for each client. These nurses must advise the client of the benefits and risks of intervention and must always consider client preferences and values in practice decisions.

Ethics

Ethics is a branch of philosophy that includes a body of knowledge about the moral life and a process of reflection for determining what persons ought to do or be regarding this life. Culture will affect ethics. Community nurses’ ethical principles are doing good and preventing harm. An ethical dilemma is a puzzling moral issue in which a person takes or chooses not to take a course of action. Ethical decision making is the process of how ethical decisions are made. Ethical issues are moral challenges facing our profession.

Morals are shared generational societal norms about what constitutes right and wrong. Values are beliefs about shared worth or importance of what is desired or esteemed within society.

The code of ethics is a framework nurses use to guide their professional obligation and actions within the profession. The code of ethics includes safe, competent care, health and wellbeing, respect and autonomy, the dignity of all persons, justice and fairness to all, accountability, confidentiality, and qualitative practice.

Veracity is telling the truth, this promotes trust in a therapeutic relationship. There may be exceptions where telling the truth may bring about more harm than good. Ethical judgment chooses the best ethical resolution of the issue. The choice of action feels right for the resolution of an ethical issue. Consequentialism is when the action is the one that produces the greatest amount of good or the least amount of evil in a given situation. Utilitarianism maximizes the good and minimizes the harm for the greatest number of people. Deontology is when the action is right or wrong in itself regardless of the good that might come from it.

Virtue ethics are to enable persons to flourish as human beings for example compassion, trustworthiness, and integrity. Ethics of care is a belief in the morality of responsibility in relationships that emphasize connection and caring.

Advocacy

Advocacy is a nurse’s responsibility. It minimizes unnecessary or unwanted procedures that may increase suffering, protects the communities’ privacy, helps individuals gain access to appropriate health services, and ensures fairness in health.

Advocacy is an ethical concept in community nursing that we can differentiate between community health and public health. In terms of community health, the focus is on the individual and looks at the quality of life of the individual in the community. Public health advocacy deals with the group and looks at the quality of life for populations.

There are three stages for the framework of advocacy. The information stage gathers information. The strategy stage decides on a goal and how you will reach it. The action stage focuses on implementing the strategies.

To ensure client advocacy a nurse must maintain confidentiality, keep the client informed, act in accordance with the client’s wishes and instructions and always act in the client (individual, or groups) best interest.

Principles of Community Nurses

Respect for autonomy, dignity and respect for individuals, non-maleficence (do no harm), beneficence (do good), and fair distribution of benefits.

There are three theories of distributive rights egalitarianism, libertarianism, and liberal democratism. Egalitarian means that everyone is entitled to equal rights and equal treatment in society. Libertarian means we have the right to private property. Liberal democracy is a theory that values both liberty and equality.

Learn more about Community Nursing Click Here for Unit 1

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Substance Abuse and Addictive Disorders

Pills from addiction and substance abuse

Individuals are addicted to drugs for many reasons mainly for pleasurable effects. Substances alter mental status, improve performance, relieve boredom, and to self medicate a mental disorder.

Addiction is a chronic relapsing and treatable medical condition. It is most prevalent in all mental conditions. Addiction is a disease of the brain and not a judgment on character.

It is often neglected and undertreated in Canadian society because it is often legal and by choice. Unfortunately, there is stigma and judgment in regards to addiction and substance abuse. This can lead to individuals not seeking the help and support they need.

Neurobiology of Addiction

Addiction is when an addictive substance is taken in excess. It causes direct activation of the brain reward pathway. Increased levels of dopamine release a high. The brain requires higher levels to gain normal function and the same dopamine-related effects.

Some people are born with certain temperaments causing them to be more susceptible to addiction. In other words, they have a more addictive personality. These temperaments are not the cause of addiction. There are also many social and environmental predisposing factors in people early lives that may make a person more vulnerable to addiction. Children whose mothers experienced stress during pregnancy may contribute to vulnerability to addiction.

Goals of Treatment

Treatment for addiction and substance use

There are three goals for treatment for addiction. To stabilize the person’s condition, to alter the course of the disorder, and to alter the persons overall functioning.

It is vital to build a bond between health care providers and individuals based on mutual respect, trust, and empathy. Therapeutic alliance between the two is necessary.

Substance Use Disorder

Substance use disorder is substance-specific involving many different addictive substances such as; alcohol, sugar, gambling, drugs, medications, and many more. This causes impaired control and social impairment which affects school and work. This involves risky use which is when they know it can impair them they still do it. It also pharmacologic pattern, they have increased tolerance so they need more to achieve the same effect. This is measured on a continuum. If they score greater than a six, they are considered to have substance use disorder.

Adolescents constitute the greatest vulnerability because their bodies are still changing and growing. The substances will affect their body and minds more than an adult. Substance users often have mood or anxiety disorders. Substance use is strongly associated with other mental health disorders.

Some more classes of substances include hallucinogens, inhalants, opioids, hypnotics, sedatives, and tobacco.

Substance-Induced Disorder

Substance-induced disorder of intoxication is reversible behavioral changes due to the effect of the substance on the Central Nervous System. This results in maladaptive behavior. Withdrawl creates a negative psychological and physical reactions when the substance is reduced or removed such as hangover.

Epidemiology

Greater than 80% of the Canadian population consume alcohol. Canadians consume a rate more than 50% above the world average. 47% of men and 24% of women do heavy drinking. Women are more likely to do drugs and men are more likely to abuse drugs and alcohol.

Alcohol

Alcohol is a central nervous system depressant that is absorbed through the stomach, colon, and small intestine. It can cross the placenta. Physiological effects depend on the amount taken, the level of tolerance, gender, body mass, and metabolic rate. Years of alcohol abuse causes cerebellar degeneration from increased levels of acetaldehyde (a toxic byproduct of alcohol metabolism) It causes impaired coordination, unsteady gait, and fine tremors.

First alcohol affects the forebrain, motor coordination, and decision making. Then alcohol knocks out the midbrain, you lose control over emotions and increases chances of a blackout. Finally alcohol batters the brainstem and affects heart rate, body temperature, appetite, and consciousness, a dangerous and potentially fatal condition.

Warnick’s Syndrome is an alcohol-induced cognitive disorder result of thiamine deficiency. It causes oculomotor dysfunction, ataxia, and confusion.

C.A.G.E. questionnaire is used to assess alcohol abuse. C- Have you ever cut down on your drinking or drug use? A-Have you ever been angry about being confronted about drugs or alcohol. G- do you or have you felt guilty about drinking or drug use? E-eye opener.

Alcohol withdrawal occurs when alcohol is reduced or when abstaining. There are three stages of withdrawal. Minor withdrawal appears 6-12 hours after the last drink, it causes tachycardia, hypertension, and anxiety. Intermediate withdrawal appears 12-72 hours after the last drink, and can cause seizures, hallucinations, and dysthymia. Major withdrawal is the most severe. It can cause hypertension, hallucinations, fever, changes in alertness and consciousness, and even sudden death may occur. It also causes agitation and delirium tremors which is vomiting, sweating, shaking, increase temperature and increase BP. People who want to get help and treatment from alcohol should be hospitalized or go to rehab for these reasons.

Opioids

Opioids are used for severe pain. It causes CNS depression, sleep/stupor, and analgesia. May cause tolerance and physical dependence. Common physical effects include sweating, nausea, constipation, pain relief, fatigue, confusion, and respiration depression. It causes pleasurable rewards which makes it addicting.

Cocaine

Cocaine is a Central Nervous System stimulant that has a high potential for abuse. Initially causes a sense of euphoria and a cocaine rush (energy and alertness). Its followed by an intense depressive phase called the cocaine crash (powerful cravings). Long term use depletes norepinephrine. Withdrawal occurs in a few hours to a few days and may become depressive with suicidal ideation.

Intervention And Interviewing

Interventions require a safe environment. A quite low stimulating environment. Plenty of water, rest, food is needed along with lots of support.

Motivational interviewing principles include avoid arguing, express empathy, develop discrepancy, roll with resistance, and support self-efficiency.

Stages of Change

Quitting is not a single event. It is a back and forth process. The five stages of change include Precontemplation, contemplation, preparation, action, and maintenance.

Precontemplation considers the benefits and the risks of no intent on quitting. Contemplation is where the individual is aware of a problem that exists but has not made a plan to stop. Preparation is where they have a plan on how to quit in the next thirty days. Action they see how they are doing, they have quit in the last 6 months. Maintenance is a follow up after 6 months about temptations. A person may float through these stages until eventually, they are successful.

Therapy and Reduction

hospital setting with machinery

Cognitive Behavioural therapy addresses the interaction between how we think, feel,  and behave. It helps identify cognitive patterns and emotions that are linked to these behaviors.

Harm Reduction reduces the risk of adverse consequences arising from substance use while recognizing that abstinence is ideal. Harm reduction works well with people who have no intention of reducing use ex.) food in a bar helps absorb some of the alcohol.

Alcoholics or Gamblers Anonymous has a 12 step program. Its a peer self-help group. Each member is assigned to a support person who has obtained sobriety. The focus is on abstinence and loss of control over the ability to drink or gamble. This is a life long commitment.

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