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Copyright © 2008 Delmar. All rights reserved.
Chapter 28
Populations with Substance Abuse
Copyright © 2008 Delmar. All rights reserved.
2
Population with Substance Abuse
• Healthy People 2010 primary goal
• 19.4 million have a substance abuse disorder
Copyright © 2008 Delmar. All rights reserved.
3
Population with Substance Abuse
• Substance abuse– Marijuana, cocaine, inhalants, heroin– Steroids, ecstasy, methamphetamines
• Primary substances– Alcohol, marijuana, tobacco
Copyright © 2008 Delmar. All rights reserved.
4
Alcohol Use• Affects various organ systems
– Cardiovascular• Hypertension, arrhythmias, cardiomyopathy, stroke
– Liver• Hepatitis C• Cirrhosis, cancer
Copyright © 2008 Delmar. All rights reserved.
5
Increased Risk
• Cancers of mouth, pharynx, larynx, esophagus, breast
• Fetal alcohol syndrome
• Motor vehicle accidents
• Mental illness
• Depression, panic disorder, mania, hypomania, phobia, anxiety
Copyright © 2008 Delmar. All rights reserved.
6
Marijuana Use
• Most common illicit drug use
• Physiological effects– Impact brain, heart, lungs, respiratory and
immune system– Difficulties in learning, memory, problem-
solving, distorted perceptions, loss of coordination
Copyright © 2008 Delmar. All rights reserved.
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Marijuana Use
• Long-term effects– Change in stress response system – Activity of dopamine containing nerve cells– Myocardial infarction– Triple risk of developing cancer of head and
neck– Mental disorders
Copyright © 2008 Delmar. All rights reserved.
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Tobacco Use
• Number one preventable cause of heart disease
• Related to: – Cardiovascular disorders
• Atherosclerosis, CHF, AAA, MI
– Lung, mouth, pharynx, larynx, stomach, kidney, bladder, pancreas, cervical cancers
Copyright © 2008 Delmar. All rights reserved.
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Tobacco Use
• Periodontitis, gum disease, COPD, emphysema, bronchitis, pneumonia
• Asthma, airway obstruction, respiratory infection, peptic ulcers, cataracts
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Tobacco Use
• Ectopic pregnancy, premature rupture of membranes, preterm delivery, perinatal mortality, SIDS, growth retardation
Copyright © 2008 Delmar. All rights reserved.
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Tobacco Use
• Environmental Tobacco Smoke (ETS)
• Treating tobacco use and dependence
• Clinical practice guideline– Eight key findings – (See box 28-1)
Copyright © 2008 Delmar. All rights reserved.
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Tobacco Use
• Five-R’s model1. Relevance
2. Risk
3. Rewards
4. Roadblocks
5. Repetition
Copyright © 2008 Delmar. All rights reserved.
13
Populations at Risk
• Intergenerational transmission
• Hispanic youth
• Black youth
• American Indian
• Alaska Native women