RNSG 2213 (M.H.) - Exam 3, Modlule 8: Substance Related &
Addictive DX|Substance Use Disorders Assessment and Management:
Addiction, Dependence, Tolerance, Cross-Tolerance, Craving, Intoxication,
Withdrawal, Detoxification, Codependency, Dual Diagnosis, Neurobiology,
Dopamine Pathways, Genetics, Psychological Factors, Sociocultural
Influences, CNS Depressants, Alcohol Use Disorder, Opioids, Stimulants,
Benzodiazepines, Barbiturates, Cocaine, Methamphetamine, Marijuana,
Hallucinogens, Inhalants, Prescription Drug Abuse, Screening Tools, CIWA-
Ar, AUDIT, CAGE, Relapse Prevention, Therapeutic Interventions,
Medications for Maintenance and Detoxification Exam Questions Verified
and Provided with Complete A+ Graded Rationales Latest Updated 2026
Substance use disorder
disorder characterized by continued substance craving and use despite significant life disruption and/or
physical risk
Addiction
is a chronic, relapsing disorder characterized by compulsive drug seeking and use, despite harmful
consequences. It involves changes in the brain's structure and function, leading to a loss of control over
substance use and a preoccupation with obtaining and using the substance.
dependance
body develops a need for the drug; if drug is removed person becomes physically ill (withdrawal)
Codependency
is a behavioral condition where one person prioritizes the needs and well-being of another, often at the
expense of their own. In the context of addiction, codependence often occurs when a partner, family
member, or friend becomes overly involved in managing or enabling the addict's behavior, leading to
unhealthy dynamics and emotional distress.
,intoxication
refers to the acute effects of a substance on the body and mind, resulting in changes in mood, behavior,
and cognitive function. These effects can vary depending on the substance used and may include
euphoria, impaired judgment, motor dysfunction, and altered perception.
Withdrawal
is a set of physical and psychological symptoms that occur when an individual reduces or stops the use
of a substance they are dependent on. Symptoms can vary widely based on the substance but may
include anxiety, nausea, tremors, sweating, and, in severe cases, seizures or delirium.
craving
overwhelming desire to use
Tolerance and Cross-Tolerance
Tolerance is a phenomenon where an individual requires increasing amounts of a substance to achieve
the same effects that were previously experienced with lower doses. Cross-tolerance occurs when
tolerance to one substance leads to a reduced response to another substance that has similar effects,
due to shared mechanisms of action in the body.
Detoxification
is the process of allowing the body to eliminate a substance while managing withdrawal symptoms. It
often occurs in a controlled setting and may involve medical supervision, particularly for substances that
,can cause severe withdrawal symptoms, such as alcohol or opioids. The goal of detoxification is to
stabilize the individual physically and prepare them for further treatment and recovery.
Epidemiology of substance abuse
Scope
Age of first use = < 14 yrs start using = higher prevalence of developing a dx
Male/female = males have more prevalence, but females become addicted/intoxicated more quickly
Ethnic groups = Native Americans & Alaska Natives hv 20% inc
Comorbidity: psychiatric and medical
Suicide = 10% from sub. use dx, 15% from alcohol use dx
Etiology of substance abuse
Neurobiology of addiction: brainstem, limbic (reward) system, cerebral cortex
Release of dopamine
Genetic vulnerabilities = 40-60%
Psychological factors = 4 or > adverse childhood exp. = 7x more likely to develop alcohol use dx
Sociocultural factors
, Substance Use in Pregnancy: some effects
Alcohol: miscarriage, preterm birth and stillbirth, fetal alcohol syndrome = most common cause of
mental retardation
Nicotine: lower birth weight, developmental issues, SIDS, cerebral palsy
Opioids: addiction at birth, withdrawal symptoms, fetal demise & still births
Stimulants: preterm delivery, low Apgar, neonatal mortality
fetal alcohol syndrome (FAS)
-mental retardation
-delayed development
-distinct facial abnormalities
Screening and Assessment
Need for screening - intervene early and provide treatment
AUDIT, B-DAST, SBIRT, CAGE are standardized tools
Urine/blood other drug screens: objective, measurable tests
Levels of Care - some examples
Detoxification: medically managed programs
Addictive DX|Substance Use Disorders Assessment and Management:
Addiction, Dependence, Tolerance, Cross-Tolerance, Craving, Intoxication,
Withdrawal, Detoxification, Codependency, Dual Diagnosis, Neurobiology,
Dopamine Pathways, Genetics, Psychological Factors, Sociocultural
Influences, CNS Depressants, Alcohol Use Disorder, Opioids, Stimulants,
Benzodiazepines, Barbiturates, Cocaine, Methamphetamine, Marijuana,
Hallucinogens, Inhalants, Prescription Drug Abuse, Screening Tools, CIWA-
Ar, AUDIT, CAGE, Relapse Prevention, Therapeutic Interventions,
Medications for Maintenance and Detoxification Exam Questions Verified
and Provided with Complete A+ Graded Rationales Latest Updated 2026
Substance use disorder
disorder characterized by continued substance craving and use despite significant life disruption and/or
physical risk
Addiction
is a chronic, relapsing disorder characterized by compulsive drug seeking and use, despite harmful
consequences. It involves changes in the brain's structure and function, leading to a loss of control over
substance use and a preoccupation with obtaining and using the substance.
dependance
body develops a need for the drug; if drug is removed person becomes physically ill (withdrawal)
Codependency
is a behavioral condition where one person prioritizes the needs and well-being of another, often at the
expense of their own. In the context of addiction, codependence often occurs when a partner, family
member, or friend becomes overly involved in managing or enabling the addict's behavior, leading to
unhealthy dynamics and emotional distress.
,intoxication
refers to the acute effects of a substance on the body and mind, resulting in changes in mood, behavior,
and cognitive function. These effects can vary depending on the substance used and may include
euphoria, impaired judgment, motor dysfunction, and altered perception.
Withdrawal
is a set of physical and psychological symptoms that occur when an individual reduces or stops the use
of a substance they are dependent on. Symptoms can vary widely based on the substance but may
include anxiety, nausea, tremors, sweating, and, in severe cases, seizures or delirium.
craving
overwhelming desire to use
Tolerance and Cross-Tolerance
Tolerance is a phenomenon where an individual requires increasing amounts of a substance to achieve
the same effects that were previously experienced with lower doses. Cross-tolerance occurs when
tolerance to one substance leads to a reduced response to another substance that has similar effects,
due to shared mechanisms of action in the body.
Detoxification
is the process of allowing the body to eliminate a substance while managing withdrawal symptoms. It
often occurs in a controlled setting and may involve medical supervision, particularly for substances that
,can cause severe withdrawal symptoms, such as alcohol or opioids. The goal of detoxification is to
stabilize the individual physically and prepare them for further treatment and recovery.
Epidemiology of substance abuse
Scope
Age of first use = < 14 yrs start using = higher prevalence of developing a dx
Male/female = males have more prevalence, but females become addicted/intoxicated more quickly
Ethnic groups = Native Americans & Alaska Natives hv 20% inc
Comorbidity: psychiatric and medical
Suicide = 10% from sub. use dx, 15% from alcohol use dx
Etiology of substance abuse
Neurobiology of addiction: brainstem, limbic (reward) system, cerebral cortex
Release of dopamine
Genetic vulnerabilities = 40-60%
Psychological factors = 4 or > adverse childhood exp. = 7x more likely to develop alcohol use dx
Sociocultural factors
, Substance Use in Pregnancy: some effects
Alcohol: miscarriage, preterm birth and stillbirth, fetal alcohol syndrome = most common cause of
mental retardation
Nicotine: lower birth weight, developmental issues, SIDS, cerebral palsy
Opioids: addiction at birth, withdrawal symptoms, fetal demise & still births
Stimulants: preterm delivery, low Apgar, neonatal mortality
fetal alcohol syndrome (FAS)
-mental retardation
-delayed development
-distinct facial abnormalities
Screening and Assessment
Need for screening - intervene early and provide treatment
AUDIT, B-DAST, SBIRT, CAGE are standardized tools
Urine/blood other drug screens: objective, measurable tests
Levels of Care - some examples
Detoxification: medically managed programs
