JeanAnne Johnson Talbert – Substance Abuse Among Medical Patients: A Hidden Truth

Outline

Case Studies of Hidden Substance Use Disorders in Medical Patients: What Does it Look Like?

• In pregnant patients
• In general medical patients
• In surgical patients

Why is This Topic so Important? And so Challenging?

• Biostatistics
• Actual relevance in practice
• Morbidity and mortality – complications of substance use disorders

What Do These Substances Actually Do Within the Body?

• Pharmacokinetics and pharmacodynamics principles
• Reinforcement
• Tolerance and cross-tolerance
• Physical dependence
• Conditioning
• Sensitization
• Pregnancy-related complications

What Substances Are We Talking About?

• Alcohol
• Sedative/Hypnotics
• Opioids
• Stimulants
• Dissociatives
• Inhalants
• Cannabinoids
• Anabolic steroids
• Club drugs
• Nicotine

Street Drugs and Terminology

• Interpreting patient language
• What drugs are they talking about?

Neurobiology of Substance Abuse: You Mean it’s Not a Choice?

• Neurobiology and anatomy of the normal brain
• Substance abuse as a brain disease
• Genetic and environmental influences

Mental Illness and Substance Abuse “Dual Diagnosis”

• Co-occurring illnesses
• Traits and theories surrounding the two

Screening and Assessment Techniques

• Effective questionnaires to screen for substance use
• Techniques to promote open and honest communication from the patient
• Working with the pregnant patient who uses substances
• Assessing your own biases – and how to not let them interfere with your work

The Patient with an Underlying Substance Use Disorder: Withdrawal Symptoms & Emergency Treatments

• Anticipation/prevention of withdrawal symptoms
• Withdrawal protocols
• Medications to treat withdrawal symptoms
• Emergency treatments
• Treatment of the newborn following exposure to substances
• Safety for patients/family/staff
• Effective pain management
• Motivational interviewing – Assessing how to refer the patient following discharge from the hospital