Chronic Mental Health Issues hospitalization addictions (1).pdf

Chronic/Serious Mental Health Issues & addictions MTHL 9234  o Serious Mental Illness (SMI) o SMI & Depression/Suicide o SMI & Substance Abuse o Treatment Issues o Opioids o CNS Stimulants o CNS Depressants o Vid...

Chronic/Serious Mental Health Issues & addictions MTHL 9234  o Serious Mental Illness (SMI) o SMI & Depression/Suicide o SMI & Substance Abuse o Treatment Issues o Opioids o CNS Stimulants o CNS Depressants o Videos Agenda  Serious Mental Illness (SMI) SMI is a significant concern with prevalence of: Depression—4.8% Mania—1.0% Schizophrenia—0.9% Presents difficulties in multiple areas Chronic or recurrent Patients at risk for multiple physical, emotional, and social problems Difficulties in a wide range of functions Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved. 3  Older Adults with Before deinstitutionalization, SMI psychiatric hospitals were long-term residences Patients became dependent on services and structure and were unable to function independently Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved. 4  Limited experience with formal treatment Contribute to a cycle of treatment, brief recovery, Young and relapse Additional problems, Adults such as increased with SMI frequency of relapse, legal difficulties, homelessness, substance abuse, and unemployment Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved. 5  Establishing a Issues meaningful life Confronting Co-morbid Those With conditions: SMI Physical disorders Depression and suicide Substance abuse Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved. 6 Issues Confronting Those With SMI o Social problems o Stigma o Isolation and loneliness o Victimization o Economic challenges o Unemployment and poverty o Housing instability o Caregiver burden Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved. 7   Comprehensive community treatment  Community services and programs Resources for  Psychiatric or medical- Persons With somatic services Recurrent  Case management Persistent  Medication monitoring Mental Illness  Assertive community treatment (ACT)  Day programs  Crisis intervention services Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved. 8  SMI Depression & Suicide Loss can lead to acute or chronic grief. Chronic illness Persons with SMI may impacts daily life, can experience a profound contribute to despair, sense of loss. depression, and a lifetime risk for suicide of 5% for persons with schizophrenia. It is estimated that many more people with SMI engage in self-harming behaviours, which are strongly associated with substance use https://americanaddictioncenters.org/prescription-drugs  SMI Substance Abuse Higher risk Mental disorder and 2 X as likely to have for substance abuse a substance use disorder a substance use problem than people in the is said to have compared to the general general population. a concurrent disorder. population. Those Estimated that 20% of with substance use The rate may be as high people with a mental problems are 3 X as as 50% for people with illness have a concurrent likely to have a mental schizophrenia. disorder. illness as the general population. Estimated 15% of those with substance use disorders have a SMI. SMI Substance Abuse Substance abuse may be a form of self- medication, countering the dysphoria or other symptoms caused by illness or its treatment. Nicotine use has always been higher among those with SMI and is not declining as it has been in the general population. Substance abuse contributes to comorbid physical health problems, reduced quality of life, incarceration, relapse, and reduced effectiveness of medications.  SMI Substance Abuse Long-term abuse can lead to a variety of medical complications. For example: Alcohol use is associated with hepatic conditions. Marijuana use with lung disease. Cocaine use with cardiac toxicity. Ecstasy use with neurotoxicity. Patients with serious medical conditions often turn to alcohol or other substances to cope. Health care providers need to be diligent in their initial assessments and identify any coexisting or resulting psychological responses or disorders. What is Prescription Drug Addiction? https://americanaddictioncenters.org/prescription-drugs  Prescription Addiction Many become addicted, and that process happens slowly. Some people do not notice the shift from recreational abuse to intense addiction, but when an addiction takes hold, it can be serious. Prescription medications can mean the difference between a healthy and happy life or an upsetting and painful illness. But some people use prescription medications for reasons that have very little to do with illnesses. According to the National Institute on Drug Abuse (NIDA) about 52 m. Americans >12 have used prescription meds. for other purposes. While people who abuse prescription medications might think that their habits are harmless, those pills can deliver serious consequences. https://americanaddictioncenters.org/prescription-drugs  Treatment issues Medication Nonadherence Anosognosia adverse effects Relapse, Treatment Residual chronicity, and inadequacy symptoms loss Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved. 15 https://americanaddictioncenters.org/prescription-drugs  Opioids Instead, these drugs Opioids only treat pain, tend to “trick” people in but they don’t reduce pain into ignoring their inflammation, combat symptoms of infection. discomfort. Their illnesses are very Opioids perform that much in place, but trick by tinkering with they’re just a touch chemical levels inside easier to overlook. the brain. A person taking the Typically, brain cells drug might feel happy, release a boost of a at ease, or rewarded, specific chemical, even though something dopamine.. very painful is happening. https://americanaddictioncenters.org/prescription-drugs  Opioids That boost of reward can be very addictive and people that take these drugs need more of them to feel that same level of boost. As a result, opioids are terribly dangerous. Addicted people tend to take too much, and when they do, they suppress the urge to breathe. People can die due to this habit. Specific Opiates: Fentanyl Oxycontin Oxycodone Codeine Morphine Hydrocodone Percocet Vicodin etc https://americanaddictioncenters.org/prescription-drugs  Drugs in this class tend to CNS Stimulants boost or stimulate the brain. This works by the release of, or a blocking of reuptake of, specific brain chemicals that have to do with reward, attention, or focus. It can be assumed that these drugs would make anyone feel jittery, people with mental health conditions that impede focus tend to have an unusual response to the effects these medications https://americanaddictioncenters.org/prescription-drugs can deliver.  CNS Stimulants For these people that require CNS stimulants, most days are filled with twitching, nervousness, and worry. When they take CNS stimulants, they feel much more focused and attentive. They can get things done that they just never had the ability to finish in the past. For people with mental health conditions that benefit from CNS stimulants, abuse is rarely a problem. People with these conditions can sometimes be persuaded to sell them or make them available to others. Those other people can become intensely addicted to the boost in energy these drugs can bring. Specific Prescription Stimulants: Ritalin Adderall Concerta Dexedrine https://americanaddictioncenters.org/prescription-drugs CNS Depressants Designed to slow down the operation of the brain. Work by adjusting the brain neurotransmitter gamma-amniobutyric acid (GABA). Mental health conditions like anxiety or panic disorder can benefit from this slowing. When people with these conditions feel an attack coming on, they can take a medication that eases brain function, and that can help them to maintain a mental equilibrium, rather than spinning off into anxiety. Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved.  Some people can feel sedated or experience euphoria at the same time. It can lead some people to taking these drugs recreationally. CNS depressants are sometimes with other drugs like cocaine or alcohol, which can lead to respiratory depression. People who attempt to stop taking these medications can be profoundly ill as they recover. They might even experience seizures. CNS Depressants https://americanaddictioncenters.org/prescription-drugs Some CNS Depressants: VICODIN OXYCONTIN FENTANYL MORPHINE VALIUM XANAX ATIVAN https://americanaddictioncenters.org/prescription-drugs  Tolerance: People with this issue must take more and more of a drug in order to feel effects that once came with smaller doses. Withdrawal: When people attempt to stop taking the drug, they feel physically or mentally ill. Loss of control: An inability to control when the use happens or how much a person takes characterizes a loss of control. Inability to stop use: As much as a person like this might want to quit or cut back, it’s impossible to do so. Continued use despite negative consequences: Arrests, medical crises, or other terrible life events can’t deter the use. Intense focus: For someone like this, nothing is as important as the drug. Family, friends, pets, careers, and hobbies all pale in importance https://americanaddictioncenters.org/prescription-drugs Dependence  https://youtu.be/QOQ3KPcFwfk Drug abuse among medical professionals rarely detected (5 min) Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved.  https://youtu.be/fi2k80vEQUU Insight: Prescription Drug Abuse (14 min) Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. All rights reserved.