Mental Health Evidence- Based Research Anxiety/ Cocaine Abuse ; {COCAINE & ANXIETY} NURSING MISC | GRADED A+

Mental Health Evidence- Based Research Anxiety/ Cocaine Abuse Prairie View A&M University College of Nursing Introduction to Cocaine as it Relates to Anxiety Cocaine is an addictive drug that is made from the leaves of Erythroxylon coca plant into a coca paste that is refined into many different forms (Boyd, 2018). These different forms of cocaine are known as cocaine hydrochloride (HCL), freebase, and crack. Cocaine HCL and freebase are powder forms of the drug that can be ingested or injected. Crack is a crystallized form that is smoked. Cocaine is a stimulant drug, which causes fast messaging to and from your mind, and it’s addictive, promoting desires for the substance. Cocaine results in a euphoric high and burst of energy in most cases. Sometimes, however, when somebody takes cocaine, they may rather encounter unfriendly impacts, for example, aggression, distrustfulness, or anxiety. At the point when individuals utilize cocaine, there is additionally the potential that they end up psychotic or experience extreme mental side effects. This paper will give a brief overview of cocaine abuse, elaborate on how anxiety is related to cocaine abuse, and discuss how cocaine abuse related to anxiety is incorporated into care on a mental health nursing unit. Anxiety is an uncomfortable feeling of apprehension or dread that occurs in response to internal or external stimuli; it can result in physical, emotional, cognitive, and behavioral symptoms (Boyd, 2018). Generally, when it comes to mental health and substance abuse, two primary theories can occur. The first assumption is that somebody who as of now has an issue with anxiety or other mental health problems may swing to drugs as an approach to self-cure. At the point when that occurs, the cocaine may not cause anxiety, but rather it might elevate the side effects of anxiety and exacerbate it. Secondly, there are likewise occasions in which somebody does not have anxiety, however subsequent to utilizing a substance like cocaine for an extended timeframe, they may create side effects of it. Furthermore, cocaine is an illicit drug, and getting it tends to be costly and unsafe, so this can cause anxiety or exacerbate it. Impact of Anxiety on Patients experiencing Cocaine Abuse Evidence Based Article Analysis Two factors of particular importance in understanding cocaine abuse and relapse are breakdowns in cognitive control to cocaine cues (DiGirolamo, Guevremont, & Smelson, 2015; Marks et al., 2014; Volkow, Wang, Tomasi, & Baler, 2013). In this article the various authors explored the idea that increased depression and anxiety symptoms harbored an impact on breakdowns in cognitive control in veterans due to cocaine abuse as well as exposure to cocaine. This study was conducted on veterans due to the fact that, cocaine use disorder is even further elevated in veterans, with a 2002–2013 survey of Veterans Affairs (VA) data (Department of Veteran Affairs, 2016) demonstrating that 19.18% of all substance use diagnoses were for cocaine use disorder (DiGirolamo, Guevremont, & Smelson, 2015; Marks et al., 2014; Volkow, Wang, Tomasi, & Baler, 2013). Results of this study indicated that members who were seriously reliant on cocaine became mildly depressed, impulsive, and highly anxious. These participants’ craving expanded significantly after being exposed to cocaine. Ultimately, evidence showed that cue-elicited craving doesn’t directly correlate with cognitive control breakdowns to cocaine use, but there was a significant increase in anxiety resulting in more errors toward cocaine cues (DiGirolamo, Guevremont, & Smelson, 2015; Marks et al., 2014; Volkow, Wang, Tomasi, & Baler, 2013). Meaning that when your brain is overly exposed to cocaine it turns out to be more troublesome for it to react to natural stimuli that you’d ordinarily find rewarding. Likewise, an investigation was directed on male rodents were who were allowed to self- regulate cocaine. The impact of anxiety on genetics were evaluated in the adult offspring (White et al., 2016). This shows that cocaine use in these rodents not only caused increased anxiety due to cocaine usage but it emphasized the correlation between the paternal cocaine abusers and male offspring. In which the male offspring show an increased baseline for anxiety in contrast to female offspring (White et al., 2016). Although this study was not conducted on the human population it is an example of the potentiating effects of cocaine in correlation to anxiety not only in the user but in it’s offspring. The increased stimulus caused by cocaine leaves a lasting effect for generations to come. As supported above, anxiety can cause an individual to risk their health and develop unhealthy coping mechanisms. Unfortunately, cocaine abuse is a popular habit that people turn to. Gamma-aminobutyric acid (GABA) is the primary inhibitory neurotransmitter involved in the development of anxiety. The activation of GABA improves mood and eases the onset of stress and anxiety. Individuals that are seen with anxiety disorders have decreased GABA levels (Craige et al., 2015). Often when individuals are experiencing the onset of anxiety, they are tempted to turn to illegal substances to aid their disorder. Cocaine abuse is a common behavior among society. Comorbid psychiatric illnesses and cocaine abuse can be improved through education on substance use/abuse and strategies to support those experiencing these conditions. “Research indicates addictions/substance use and abuse are preventable, particularly by intervening with children and adolescents early before problems develop and before brains are altered (Bartlett et al., 2013). Application of the Concept of Cocaine abuse or Behavior in Clients on a Mental Health Unit In relations to the mental health unit, any client admitted with a history of cocaine use should be assessed for withdrawal symptoms. Nurses should screen clients on how long and how often they’ve used the substance so that way they can expect or anticipate certain behaviors that may be the result of cocaine use. In a situation that a client admitted to a mental health unit with a history of cocaine, a nurse can expect them to present with anxiety. The level of anxiety is usually increased when there is evidence of prolonged use leading to withdrawal symptoms. Clients must be monitored to avoid complications of injury or harm to themselves and in some cases, harm to others. Clients can often be withdrawn or depressed in the clinical setting and with the understanding that without the stimulating effects of cocaine, isolation and impaired social interaction can be a concern of the nurse. There are many effects on the body from cocaine use such as insomnia, irritability, and cravings, which then leads to increases anxiety. Managing these symptoms and effects can in turn aid in the reduction of anxiety. Interventions that can aid in managing symptoms include, detoxification, and maintenance treatments should be implemented to start the process of recovery from substance abuse. Medication interventions can also be useful in managing anxiety in clients who have a history of cocaine use with the use of Benzodiazepines drug class. Significance in Mental Health Nursing Evidence Based Article Analysis In conclusion, nurses can provide basic information about overdose prevention and interventions incase of an overdose. Providing these simple measures can make a serious impact. Lack of knowledge plays a big factor in people harming themselves as well as dying. Individuals that have addictions are some of the most immunocompromised individuals there are. Providing accurate information can save so many lives and break through the barrier of myths that stigmatize substance abuse. Patients that are struggling with cocaine addiction and anxiety need nonjudgmental care from health providers and must feel comfortable in order for them to receive full treatment compliance. A lot of individuals feel judged and that prevents them from seeking medical attention. Nurses have a lot of face to face interactions with patients, which is why their interaction is very crucial. At times these patients may react in an angry or hostile way because they feel stereotyped. A way to break this barrier is to encourage nurses to always provide compassion and care. Once nurses are properly trained and are fully aware of how anxiety and cocaine abuse are intertwined, efficient care will be provided. References: Boyd, M. A. (2018). Psychiatric Nursing: Contemporary Practice. Philadelphia: Wolters Kluwer. Bartlett, R., Brown, L., Shattell, M., Wright, T., & Lewallen, L. (2013). Harm reduction: compassionate care of persons with addictions. Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses, 22(6), 349-53, 358. Craige, C. P., Lewandowski, S., Kirby, L. G., & Unterwald, E. M. (2015). Dorsal raphe 5-HT(2C) receptor and GABA networks regulate anxiety produced by cocaine withdrawal. Neuropharmacology, 93, 41-51. Digirolamo, G. J., Gonzalez, G., Smelson, D., Guevremont, N., Andre, M. I., Patnaik, P. O., & Zaniewski, Z. R. (2017). Increased Depression and Anxiety Symptoms are Associated with More Breakdowns in Cognitive Control to Cocaine Cues in Veterans with Cocaine Use Disorder. Journal of Dual Diagnosis,13(4), 298-304. doi:10.1080/.2017. White, S. L., Vassoler, F. M., Schmidt, H. D., Pierce, R. C., & Wimmer, M. E. (2016). Enhanced anxiety in the male offspring of sires that self-administered cocaine. Addiction Biology, 21(4), 802–810.