1. Substance Abuse:
Opioid
Shannon Hart
December 10, 2015

2. Addiction and Intoxication
 Addiction: a compulsive or chronic requirement. The
need is so strong as to generate distress (either
physical or psychological if left unfulfilled).
 Intoxication: the development of a reversible syndrome
of symptoms following excessive use of a substance.
The symptoms are drug-specific, and occur during or
shortly after the ingestion of the substance.

3. History of opioids
 The substance opium is obtained from the ripened pods of
opium poppy flowers.
 References to the use of opium are seen in Greek, Egyptian
and Arabian texts as early as 3000 BC.
 The rise in medicinal and recreational use of opium came in
the 16th and 17th century Europe, with the largest supply
arriving from China.
 Frederich Serturner isolated the active ingredient, morphine,
which then became used for pain relief and treatment of
diarrhea, eliminating the need for crude opium.

4. Pathways to Addiction
 There are two typical behaviors that lead to an opioid
addiction
 The first is through a physician for relief of a medical
problem. Addiction occurs when the patient increases the
amount and frequency of use, justifying the behavior as
symptom control
 The second is when the drug is obtained illegally for
recreational use. These drugs may be used alone or in
combination with others to enhance euphoria. Tolerance
develops, leading to addiction

5. Substance Abuse Statistics
 A government survey reported that in 2012, there were
6.8 million people 12 years and older, who used
prescription psychotherapeutic drugs non-medically.
 In the last 10 years, prescription drug abuse has seen a
drastic increase, becoming the second most common
type of illicit drug use
 In 2012, there was a reported 335,000 current heroin
users, aged 12 and older

6. Opium Substances
 Opioids are a group of compounds that include opium,
opium derivatives and synthetic substances.
 Natural origin opium includes Opium, Morphine and
Codeine
 Opioid derivatives include heroin, Hydromorphone,
Oxycodone, Hydrocodone
 Synthetic opiate-like drugs include Meperidine,
Methadone, Pentazocine, Fentanyl

7. Effects of Opioids
 The primary effects of opiates are on the CNS, the eyes and
the GI tract.
 CNS effects: euphoria, mood changes, mental cloudiness,
drowsiness, pain reduction, respiratory depression
 Eyes: stimulation of the oculomotor nerve results in pupillary
constriction
 GI effects: increased stomach and intestinal tone as well as
decreased peristaltic activity of the intestines. The combined
effects lead to decreased movement of food, leading to
constipation

8. Opioid Intoxication
 The behavioral and psychological effects of opioid
intoxication occur during or shortly after the use of opioid
substances.
 Initially a feeling of euphoria is felt, followed by apathy,
dysphoria, psychomotor agitation or retardation and
impaired judgment
 Physical symptoms include pupillary constriction (or dilation
in the case of an overdose), drowsiness, slurred speech,
memory and attention impairment.
 Severe opioid intoxication may result in respiratory
depression, coma and death

9. Opioid Withdrawal
 Symptoms of withdrawal occur from the reduction or cessation of
heavy and prolonged use of opioid substances.
• Symptoms include:
• dysphoric mood
• nausea and vomiting
• muscle aches
• lacrimation (tears) or rhinorrhea (runny nose)
• pupillary dilation
• piloerection (goose bumps)
• sweating
• diarrhea
• yawning
• fever
• insomnia

10. Opioid Addiction
 https://www.facebook.com/ajplusenglish/videos/654323
438042500/

11. Nursing diagnosis
 Ineffective denial- many patients with substance abuse deny
they have a problem. “I don’t have a problem with
(substance), I can quit anytime I want.”
 Ineffective coping- patients with substance abuse may have
destructive behavior towards others and self, have an
inability to meet their basic needs, are unable to meet role
expectations, and engage in risk-taking behaviors
 Risk for injury- clients withdrawing from CNS depressants
may be at risk for tremors, elevated blood pressure, N/V,
hallucinations, illusions, tachycardia, anxiety, and seizures

12. Tayler Ross Olson
May 1, 1985 - May 3, 2013

13. References
Townsend, M. C. (2015). Psychiatric Mental Health
Nursing: Concepts of Care in Evidence-Based
Practice (8th ed.). Philidelphia, PA: F.A. Davis
Company.