A CASE STUDY OF A PATIENT SUFFERING FROM MENTAL AND
BEHAVIORAL DISORDER SECONDARY TO MULTIPLE PSYCHOACTIVE SUBSTANCE USE
TABLE
OF CONTENT
PRELIMINARY:-
1.
Title page
2.
Certification
3.
Dedication
4.
Acknowledgement
5.
Table of content
CHAPTER ONE:-
1.
Introduction
2.
Literature review
a.
Review of past work done
by others and general over view i.e incidence
b.
Definition
c.
Related anatomy and
physiology of the brain
d.
Etiology or causes
e.
Patho physiology
f.
Clinical features
g.
Management – Medical/ Nursing
h.
Prognosis / complications
CHAPTER TWO:-
1.
Patient particulars /
general data.
2.
Family history
3.
Personal history
4.
History of past illness.
5.
History of present illness
6.
Nurse’s observation on
admission
7.
Doctor’s examination-
physical / mental
8.
Laboratory investigations
and other tests
9.
Final / provisional
diagnosis
10.
Pharmacology of drugs
prescribed for patient.
CHAPTER THREE:-
1. Medical
management given to patients
a.
Physical e.g drugs, ECT,
surgery and other physical therapies.
b.
Psychotherapy, individual,
group, family etc
c.
Occupational therapy
prescribed
d.
Recreational therapy
prescribed e.g indoor, outdoor.
e.
Other therapies e.g
hydrotherapy etc.
2. Nursing
management according to nursing process.
a.
Client identified problem
b.
Special observations,
reviews and comments.
c.
General nursing care based
on physical, psychological and social identified needs of clients.
d.
Complications developed /
prognosis.
e.
Nursing care plan of at
least six identified problems, care of the client.
3. Conclusion
and recommendation.
4. Bibliography
and references
CHAPTER
ONE
1.0
Introduction
In
both cities and rural area, young people and adults can be seen who have
unsound minds. They wander about, sometimes begging for food or money. As they
talk to themselves or to others, it can be noticed that they are mentally ill.
In the neighbour hood where they live, those who now them well can trace their
problems back to excessive drinking of alcoholic beverages, smoking and or use
of drugs such as marijuana.
Unfortunately,
in spite of such evidence of the harmful effects of drugs, healthy people still
join in taking drugs. Drug abuse is not limited to any one country. All over
the world, the control of illegal trafficking in drugs is a hard task for
governments. Those who engage in illegal trade in drugs are determined to
continue because, they make big profit.
According
to Merck Manual of medical information (2003), substance abuse is the use of
mind- altering drugs without medical need, in an amount large enough or over a
period long enough to threaten the quality of life or
health and safety of the user or others.
Substances
such as alcohol, cannabis, amphetamines among others are now being taken
frequently and in large quantities by our youth. Teenagers and youths between
the age of 15 and 30 constitute the high risk groups with females also getting
involved. Other groups of abusers are divers, conductors, civil servants and artistes.
The
drugs or substances that are being taken can be illicit drugs such as cocaine,
heroin or legal substances such a prescription drugs like paracetamol,
chloroquine, cough syrup, e.t.c when used in excess or without medical
prescription.
According to APA
(2000) in DSM IV TR, substance abuse is a maladaptive pattern of
substance use manifested by recurrent and significant adverse consequences
related to the repeated use of substances that poses significant hazards to
health.
Individuals
who abuse substances may experience such harmful consequences of substance use
as repeated failure to fulfill roles for which they are responsible, legal
difficulties or social and interpersonal problems.
1.1
Literature
Review
American
Psychiatric Association (2000) defines drug abuse as continual use of
psychoactive substance despite knowledge of having a persistent or recurrent
social, occupational, psychological or physical problem that is caused by
deliberate use of this substance.
Types of Drugs Commonly Abused In Nigeria
According
to NDLEA and NDICP (2014),
·
Sedatives, example,
barbiturates, mild tranquillizers
·
Cannabis, example,
marijuana, hashish.
·
Hallucinogens, example,
Lysergic Acid diethylamide (LSD), dertrover.
·
Narcotics, example, heroin,
methadone.
·
Stimulants, example,
cocaine, amphetamine
Sedatives
These
are group of drugs used to relax the nervous system and induce sleep. When
taken in small doses, they can reduce day time tension and anxiety.
Barbiturates are the largest sub-group of sedatives. Some of the barbiturates
are short acting and fast starting, while some are low- starting and long
acting. These slow- starting and long- acting sedatives are the most abused.
Cannabis
This
is a plant that has been grown for thousands of years as a source of fibre and
of seeds rich in oil. The leaves and greenish flowers are a source of a
powerful nercotic substance. The leaves and flowers are prepared and taken in
various forms, they may be eaten, drunk, inhaled or smoked. It’s not used
medicinally. The drug is known by various names in different parts of the world
such as marijuana and hashish. The strongest form of the drug is obtained from
a compound that forms the flowers of the female plants. Often the leaves are
simply dried, powered, and mixed with tobacco in cigarette or smoked alone.
Hallucinogens
These
are drugs capable of provoking changes of sensations, thinking, distorted
perceptions, self awareness and emotions. They alter the user’s ability to
separate fact from fantasy. The degree to which the users suffers from hallucinations
depends on the dose of the drug taken.
Nercotics
These
are drugs that often blunt the senses. They also make people sleep and relieve
pain. Nercotics which usually refer to opium and it’s derivatives in large
doses may cause a complete loss of the senses. Nercotics acts as depressants to
certain areas of the brain and part of the nervous system. They can also reduce
hunger, thirst, sex drive in addition to pain.
Stimulants
These
are group of drugs that excite the nervous system. They include caffeine
(present in coffee, tea and some soft drinks). The effects of caffeine are
mild. Strong stimulants are amphetamine and cocaine.
1.2
Incidence
The
illicit use of alcohol and other drugs (substance abuse) is on the increase
particularly among adolescents and young adults. This is reflected on the
number of admissions recorded at various psychiatric health institutions.
Merck
(2003) pointed out that, many drugs, some legal and some not, alter the mind. Some
mind- altering drugs affect brain function each time they are used, regardless
of how much is used. Other mind – altering drugs affect brain function only if
a large amount is used or of it is used continually.
Some
individuals such as those with sickle call anaemia, may become addicted to the
drug they are being treated with, such as injection pentazocine.
Theories
concepts related to substance abuse includes the following:
§ Peer Group Theory:
This theory indicates
that, adolescents take substances in order to be accepted by their peers.
§ The Drugs Personality
Theory:
This states that, drug
risers were nonconformist while those that are conformist do not take drugs.
This is based on the longitudinal study.
§ Parental Influence Theory:
This stated that, poor
parent – child relationship seems to be contributing to the development of
substance use. Drug taking behaviour is learned especially alcohol taking
behaviour.
§ Deviance Theory:
Stated
that, taking substance is attached to the fact that, because a culture or sub-cultural
group is stigmatized or punished, it’s members adopt value to survive in such
environment.
1.3
Definitions
Drug: Any
chemical substance used in the treatment, cure, prevention or diagnosis of
disease or used to other wise enhance physical or mental well being.
Drug Abuse: Illicit
use of drugs outside medical prescription that poses danger to the health and
interferes with physical, psychological, social and occupational functions.
Drug Dependence: This
is a compelling need to continue taking a mind – altering drug to induce
pleasure or to relieve anxiety and tension and avoid discomfort.
Tolerance: The
need to use progressively larger amounts of the drug to reproduce the effects
originally achieved with the starting amount.
Withdrawal Syndrome: This
is the collection of symptoms that manifest, following cessation or reduction
in the intake of substance.