Substance-Related and Addictive Disorders

Substance abuse and addiction affects persons in all walks of life, from every cultural and economic group. In your practice as a PMHNP, you will encounter patients with substance abuse and dependence. Some of the people who present for treatment are at a low point in their lives and want to turn things around. They may present for other conditions, such as depression or bipolar disorder, anxiety, PTSD, or personality disorders. One of the most common ways of self-medicating a mental disorder is with alcohol and illicit drugs. Marijuana is a common substance patients use to treat various symptoms. To effectively treat patients with addictive disorders and substance use disorders, the provider needs to examine their own values and thoughts about the use of substances.

This week, as you review the Learning Resources on substance-related and addictive disorders, try to note the effectiveness of therapeutic approaches for patients diagnosed with these disorders. No Assignment is due this week. Use this quiet week to work on your practicum assignment if you are taking both courses concurrently.

American Psychiatric Association. (2010). Practice guideline for the treatment of patients with substance use disorders. https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/substanceuse.pdfAmerican Society of Addiction Medicine. (2020). ASAM criteria. https://www.asam.org/asam-criteria/aboutAmerican Society of Addiction Medicine. (2020). ASAM clinical practice guideline on alcohol withdrawal management. https://www.asam.org/docs/default-source/quality-science/awg-3-20-20.pdfAmerican Society of Addiction Medicine. (2020). The ASAM national practice guideline for the treatment of opioid use disorder – 2020 focused update. https://www.asam.org/docs/default-source/quality-science/npg-jam-supplement.pdf?sfvrsn=a00a52c2_2American Society of Addiction Medicine. (2020). Supporting access to telehealth for addiction services: Regulatory overview and general practice considerations. https://www.asam.org/Quality-Science/covid-19-coronavirus/supporting-access-to-telehealth-for-addiction-services

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)

  • Chapter 20, “Substance Use and Addictive Disorders”

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.  

  • Chapter 66, “Substance-Related and Addictive Disorders”

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

  • Chapter 7, “Substance Use Disorders”

Required Media (click to expand/reduce)UW-Department of Family Medicine and Community Health. (2020, January 27). Substance misuse & disorders in older adults [Video]. YouTube. https://www.youtube.com/watch?v=lSFY79061tA

Medication Review

Review the FDA-approved use of the following medicines related to treating substance-related and addictive disorders:

Alcohol abstinenceAlcohol dependenceAlcohol withdrawalNicotine addictionOpioid dependenceReversal of benzodiazepine effects
acamprosate
disulfiram
nalmefene
naltrexone
chlordiazepoxide
clonidine
clorazepate
diazepam
lorazepam
oxazepam
bupropin
varenicline
buprenorphine
naltrexone
flumazenil
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