Archive for the ‘Drug Abuse’ Category

Substance Abuse, comment

March 26, 2010

Substance abuse is out of control. We are quick to medicate for every unpleasant situation in our lives. Screening is very important but not realistic because of the very fine line of functional and abusive behavior. Who makes that decision? If I “popped“ 10 pills every morning just to make it through the day I would be comatose whereas others who don’t take their medication would not even be able to leave their houses.

Original Post
December 30, 2009
Title: Substance Abuse
Although there are mild cases, substance abuse can be a major problem that leads to other issues such as child abuse, elder abuse, or sexual assault. These issues are reasons that make substance abuse a serious problem. Substance abusers should put this under control as soon as possible. Alcohol treatment programs are designed to help those that want and need help be successful at this. As a nurse, assessment skills are imperative in diagnosing a substance abuse problem. Skills in the assessment of mental health cannot be forgotten, since they focus on emotional and psychological well being. A good mental health assessment could reveal the underlying problem(s) of substance abuse.

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Stress Management, comment

March 15, 2010

Stress is a very large part of our lives but as long as there are doctors on every street corner pushing "make you feel better pills" then why try to cope. We have become a pill-popper society because no one regulates or holds doctors accountable for their actions. I see this everyday as an ER nurse.

Original Post
March 1, 2010
Title: Stress Management
Everyone in today’s society has alot of stress. Is the stress today different than it was 50 years ago? We seem to be a society of people who are incapable of handling the stressors in our lives. We are seeing a higher use of medications to deal with life. I wonder if we are helping ourselves by taking medications instead learning ways to cope. Medications are necessary for some, but it seems that every patient I admit to the hospital is taking some form of medication to help them sleep, handle anxiety, or handle depression. I am worried that we are simply taking pills instead of learning coping mechanisms. We need to get away from being a society of pillpoppers and become a society that can handle what comes our way by maintaining a healthy body and mind.

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Stress Management, comment

March 4, 2010

While I agree with the author that we are seeing more usage of psychoactive medications in our patients, I do not agree that they are being substituted for coping skills. I see this as a very broad statement and an oversimplification of the underlying complexities that exist in our society today. Additionally, complex disease processes, consequences of chemically and genetically altered foods, and medication side effects all impact the human body and can potentiate the need for medication to manage symptoms; which might include sleep, mood, depression, pain and anxiety. Medications are manufactured to treat illness and improve quality of life. They also require a physician’s prescription in order to be obtained. There is a dual responsibility in a patient’s plan of care; in both the Physician and the patient. Physical illness has the ability to contribute to emotional and mental stressors; which in turn impacts the quality of life. If a pill helps someone facing a life limiting illness feel less anxious about their death or get a good night’s sleep because their sleep patterns are inadequate, in my mind’s eye this would seem to be good practice, not poor coping skills. While this would be only one group for whom the drugs would be prescribed, there are countless other patient populations for whom these medications might be beneficial. I can appreciate the author’s perspective from a professional viewpoint; however, time and again, we learn medicine is much more than black and white.

Original Post
March 1, 2010
Title: Stress Management
Everyone in today’s society has alot of stress. Is the stress today different than it was 50 years ago? We seem to be a society of people who are incapable of handling the stressors in our lives. We are seeing a higher use of medications to deal with life. I wonder if we are helping ourselves by taking medications instead learning ways to cope. Medications are necessary for some, but it seems that every patient I admit to the hospital is taking some form of medication to help them sleep, handle anxiety, or handle depression. I am worried that we are simply taking pills instead of learning coping mechanisms. We need to get away from being a society of pillpoppers and become a society that can handle what comes our way by maintaining a healthy body and mind.

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Stress Management

March 1, 2010

Everyone in today’s society has alot of stress. Is the stress today different than it was 50 years ago? We seem to be a society of people who are incapable of handling the stressors in our lives. We are seeing a higher use of medications to deal with life. I wonder if we are helping ourselves by taking medications instead learning ways to cope. Medications are necessary for some, but it seems that every patient I admit to the hospital is taking some form of medication to help them sleep, handle anxiety, or handle depression. I am worried that we are simply taking pills instead of learning coping mechanisms. We need to get away from being a society of pillpoppers and become a society that can handle what comes our way by maintaining a healthy body and mind.

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Legalization of Marijuana, comment

February 15, 2010

As a hospice nurse, I learn something new everyday. My patients are the most incredible teachers. The use of medications to manage the symptoms of the dying process can be very effective when administered in the appropriate dose dose at the appropriate interval. There are those time, however, when even extremely large doses of opiods and adjuvant analgesics seem to fail. It is disconcerting, to say the least, to witness a traumatic death. It leaves a scar on all who witness it, and brings to mind the ever unanswerable question, "WHY?". Legalization of medical marijuana is yet another mechanism and medication to be utilized to provide comfort to the dying. We are a culture that does not embrace death as part of living. We do not encourage open discussion of the dying process for it places us outside our comfort zone. Consequently, when faced with a difficult death, that is, a death where symptoms are difficult to manage, families of course want everything done to make their loved one’s passing a comfortable one. Morphine carries a stigma that is at times insurmountable to make patients and their families understand its efficacy. I daresay that "smoking a joint" to provide pain relief will be readily embraced by the general populace or on hospice units even as legalization of marijuana occurs. Marinol is already being utilized to stimulate appetite, and has gained acceptance within the medical community. However, I believe that unless an alternative formulation of marijuana is found, resistance will be met and, sadly, the drug will be underutilized; despite the fact that it has proven to be effective when other drugs have failed.

Original Post
November 6, 2009
Title: Legalization of Marijuana, comment
The debate over the legalization of marijuana has been a heated one for decades. Most recently a ski town in Colorado – Breckenridge – voted to legalize marijuana by a greater than 72% majority rule. The ruling will allow adults 21 years and older to have in their possession up to one ounce of marijuana. While this is a symbolic triumph for advocates of legalized marijuana – possession of pot in the state of Colorado remains a crime for individuals without medical clearance. Although there are many credible resources, outlining the scientific research detailing the pro’s of medical cannabis – I think there has to remain stringent government regulations allowing it’s use. It may not be as addicting as alcohol – but as I think back about 20 years to a college dorm room…can we really argue that someone under the influence of such a substance would make a good school bus driver, medical practitioner, teacher, truck driver? Medical use is one aspect – recreational use is quite another.

Original Post
November 2, 2009
Title: Legalization of marijuana
I was reading my local paper today and there was an article about the legalization of marijuana written by a former police officer. He was fully supportive of such an endeavor. He made great points about how difficult it is to close down an illegal drug dealer but how much easier it would be if we made them legal dealers and had some control over their operations. The government could make billions off of legalization of marijuana. If we take the power of money away from the illegal dealers it will not hold the same draw for them. Alcohol, which is legal and a billion dollar industry, causes many problems for those who use it. Marijuana is not physically addicting like alcohol but it is still illegal. I used to be surprised at the extensive use of marijuana in our society. If we know it is not physically addicting and no worse than alcohol why is it taking our society so long to decide that it is helping a lot of people.

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PRN Medication Administration Within Correctional Facilities

February 15, 2010

PRN medication administration presents a unique set of challenges in Correctional Facilities. Working within the confines of the Department of Corrections regulations, (hereafter known as DOC), the limitations set by the physical environment, subjectivity, manipulation, the prison culture in general, all of these obstacles create an environment that can be difficult in providing symptom management to Inmates. Of particular concern, is the management of pain. Chronic health conditions, acute illness, or surgical procedures, all predispose the Inmate to pain. Since medication administration times are strictly scheduled, obtaining medication for "breakthrough" pain is difficult. Opiod analgesics, such as codeine, are frequently utilized. While the abuse liability is high, the maximal pain relief is low; additionally, without the ability to administer the drug on a prn basis, Inmate’s symptoms are poorly controlled. Stronger opioids were not stocked in medical units. There is a delay in procurement of Class II narcotics which in turn, creates an environment where pain is uncontrolled, subsequently taking twice as much time and repeated doses of medication to manage a symptom that could have easily been managed had the medication been administered within the appropriate time frame. What I frequently found were the medications that the inmates were permitted to "Keep on Person" (hereafter known as KOP) were abused in an attempt to control unrelieved pain. Those medications, usually Acetaminophen, Ibuprofen, Ultram, even Diphenhydramine, were utilized in excess since the pain medication was not being administered within the suggested time frame. This in turn created issues with disciplinary action to the Inmate for abusing KOP privileges, loss of ability for the Inmate to manage even his/her minor pain, creating an atmosphere on non-compliance directed toward the Inmate, and perpetuated a negative feedback cycle with no possible resolution. And in the end, pain was unrelieved. If we as Clinicians are to effectively treat pain, proper administration of medication is mandatory.

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Sleep

February 2, 2010

Review of Health Assessment for Nursing Practice by Susan F. Wilson and Jean Foret Giddens.

I liked the chapter on Sleep. It was a good review and update. I liked that is was short and direct. The interactive exercises were lacking in drug interventions. There are so many drugs for sleep ranging from Benadryl to, dare I say, Propofol! Although, I am familiar with the common drugs of Ambien, Lunesta, or Soma. I think I would be much better served to know the drug/drug/alcohol/OTC interactions are. Well, we hope our patients aren’t deviating from their prescribed course of treatment, but we should be highly aware of the risk for potential knowledge deficit and abuse. Somnolently Yours.

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Substance Abuse

December 30, 2009

Although there are mild cases, substance abuse can be a major problem that leads to other issues such as child abuse, elder abuse, or sexual assault. These issues are reasons that make substance abuse a serious problem. Substance abusers should put this under control as soon as possible. Alcohol treatment programs are designed to help those that want and need help be successful at this. As a nurse, assessment skills are imperative in diagnosing a substance abuse problem. Skills in the assessment of mental health cannot be forgotten, since they focus on emotional and psychological well being. A good mental health assessment could reveal the underlying problem(s) of substance abuse.

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Physical dependence vs addiction

December 24, 2009

Interesting in this unit is the difference between physical dependence and addiction. addiction: A disease process characterized by continued use of a specific psychoactive substance despite physical, psychological or social harm. physical dependence: Defined as a state in which an abstinence syndrome will occur if drug use is discontinued. Physical dependence is the result of neuroadaptive processes that take place in response to prolonged drug exposure. I would find it easy to pass judgement in a clinical setting having never been in that situation myself. Pain management and psychosis must be areas of great concern for physicians and nurses alike. In these circumstances, the whole picture must be realized and perhaps this is where psychological counseling should be a part of the treatment plan. I believe the health care field as a whole is beginning to realize the importance of not just treatment with drugs, but by more holistic approaches.

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Narcotic Drug Diverson by Nurses

November 10, 2009

Nursing staff have enormous access to potent narcotics, Diversion of these drugs is not a complicated process. Controls are not tight and often the diversion goes unnoticed for quite a while. Many times the diversion is not for the nurse but rather a significant other or sometimes even to sell for additional income. I believe the advent of computerized Pixus etc may help to decrease the diversion because of improved tracking.

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