Substance Use Disorder Assessment and Treatment Quiz

Substance Use Disorder Assessment and Treatment in Healthcare Settings

• Screening tools include the Alcohol Use Disorder Identification Test (AUDIT) and the CAGE questionnaire
• The Transtheoretical model is used to assess readiness to change harmful behaviors
• Interactions leading into assessment should address the patient's emotional and physical state, substance use, and HIV/HCV status
• Interview approaches and attitudes should be nonjudgmental, prepared for defensiveness, and focused on obtaining accurate information
• Nonthreatening language should be used to discuss drinking and drug use problems
• Substance use disorder (SUD) assessment includes questions about frequency, route, and readiness to change
• The stages of change model helps to meet patients where they are in their recovery process
• Milieu management in healthcare settings includes safety, structure, confrontation with support, and environmental modification
• Treatment plans during and after hospitalization may include detox, medication-assisted treatment, inpatient or outpatient programs, and support groups
• The nurse-patient relationship should focus on trust-building, discussing natural consequences, creating a recovery plan, and providing physical and nutritional needs
• Discharge planning includes prevention of opioid overdose, educational materials, referrals for inpatient or outpatient treatment, and resources for recovery groups in the community
• Knowing how to use naloxone and keeping it within reach is essential for preventing opioid overdose, as recommended by the US Surgeon General Dr. Jerome Adams

Substance Use Disorder and Withdrawal Management

• 50% of people over 12yo used alcohol in the past month, with 44.4% classified as binge drinkers, highest among young adults (18-25yo).
• 3.4% of people over 12yo misused opioids, with 9.3 million from prescription pain relievers out of 9.5 million who misused.
• 14.5% of the population had a substance use disorder (SUD) in the past year, with alcohol use being the highest, followed by illicit drug use.
• Almost ten percent of the population had a co-occurring mental illness and substance use.
• When conducting a physical assessment, signs of trauma, abuse, chronic housing instability, and malnutrition should be considered.
• Alcohol Use Disorder is characterized by specific criteria such as taking alcohol in larger amounts than intended and giving up important activities due to alcohol use.
• Alcohol withdrawal symptoms include autonomic hyperactivity, hand tremor, insomnia, nausea, hallucinations, and seizures.
• Alcohol withdrawal can be assessed using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) and treated with benzodiazepines or phenobarbital.
• Opiate Use Disorder involves criteria such as taking opioids in larger amounts than intended and continued use despite knowledge of physical or psychological problems caused by use.
• Opioid withdrawal can be triggered by cessation of heavy and prolonged use and assessed using the Clinical Opiate Withdrawal Scale (COWS) or Clinical Institute Narcotic Assessment (CINA).
• First-line treatment for opioid withdrawal is buprenorphine, followed by methadone or clonidine, with the choice between tapering or maintenance.
• Cocaine use can lead to euphoria and psychomotor agitation, while cannabis withdrawal can cause irritability and anxiety, and lead to cannabis hyperemesis syndrome. Therapeutic language should be used to avoid stigmatization, e.g., "individual who uses substances" instead of "addict." Nursing assessment should follow the SBIRT method (Screening, Brief Intervention, Referral to Treatment).