ASSESSING MENTAL STATUS AND

SUBSTANCE ABUSE

AILYN MAE C. TAÑAGRAS, RN, MAN

MENTAL HEALTH
 as a “state of well-being in which the individual realizes his or her
own abilities, can cope with the normal stresses of life, can work
productively and fruitfully, and is able to make a contribution to his
or her community”.

GOOD MENTAL HEALTH: (WHO)

1. Cope with the normal stresses of life
2. Work productively
3. Realize your potential
4. Contribute to the community
 GOOD MENTAL HEALTH CHECKLIST
You probably have good mental health if:
1. you are confident when faced with new situations or people
2. you feel optimistic
3. you do not always blame yourself
4. you set goals
5. you feel good about yourself
6. you have good self esteem
 TIPS TO MAINTAIN MENTAL HEATH
1. Building resilience
2. Build relationship
3. Exercise and stay healthy
4. Developed gratitude
5. Identify and use your strengths
6. Create flow
7. Share
8. Spirituality and religion
9. Seek help
MENTAL DISORDER
is characterized by a clinically significant disturbance in an
individual’s cognition, emotional regulation, or behaviour. It is
usually associated with distress or impairment in important areas of
functioning.

FACTOR AFFECTING MENTAL DISORDER

childhood abuse, trauma, or neglect
social isolation or loneliness
experiencing discrimination and stigma, including racism
social disadvantage, poverty or debt
bereavement (losing someone close to you)
severe or long-term stress
having a long-term physical health condition
unemployment or losing your job
homelessness or poor housing
being a long-term career for someone
drug and alcohol misuse
domestic violence, bullying or other abuse as an adult
significant trauma as an adult, such as military combat, being
involved in a serious incident in which you feared for your life, or
being the victim of a violent crime
physical causes – for example, a head injury or a neurological
condition such as epilepsy can have an impact on your behaviour
and mood. (It's important to rule out potential physical causes before
seeking further treatment for a mental health problem).
SIGNS AND SYMPTOMS OF MENTAL DISORDER
1. Feeling sad or down
2. Confused thinking or reduced ability to concentrate
3. Excessive fears or worries, or extreme feelings of guilt
4. Extreme mood changes of highs and lows
5. Withdrawal from friends and activities
6. Significant tiredness, low energy or problems sleeping
7. Detachment from reality (delusions), paranoia or hallucinations
8. Inability to cope with daily problems or stress
9. Trouble understanding and relating to situations and to people
10. Problems with alcohol or drug use
11. Major changes in eating habits
12. Sex drive changes
13. Excessive anger, hostility or violence
14. Suicidal thinking
SUBSTANCE ABUSE
SUBSTANCE ABUSE
Can be defined as using a drug in a way that is inconsistent with
medical or social norms and despite negative consequences

DETOXIFICATION
Is the process of safely withdrawing from a substance.

INTOXICATION
Is use of a substance that results in maladaptive behavior

WITHDRAWAL SYNDROME
Refers to the negative psychological and physical reactions that
occur when use of a substance ceases or dramatically decreases
BLACKOUT
It is an episode during which the person continues to function but
has no conscious awareness of his or her behavior a the time nor
any later memory of the behavior.

TOLERANCE
Is defined as the need for increasingly larger or more frequent
doses of a substance in order to obtain the desired effects originally
produced by a lower dose.

DEPENDENCE
A compulsive or chronic requirement. The need is so strong as to
generate distress (either physical or psychological) if left unfulfilled.
 SUBSTANCE CLASSES
Alcohol
Caffaine
Cannabis
Hallucinogen
Inhalants
Opioids
Sedatives, Hypnotics and Anxiolytics
Stimulant
Tobacco
Other
ETIOLOGY
1. Biological Factor
2. Social Factors
3. Psychological Factor
4. Psychiatric Disorders
5. Environmental factors
BIOLOGICAL FACTORS
1. Genetics
Children of alcoholics are three times more likely than other
children to become alcoholics.
Biological offspring of alcoholic parents have a significantly
greater incidence of alcoholism than offspring of nonalcoholic
parents.
Monozygotic twins have a higher rate for concordance of
alcoholism than dizygotic
2. BIOCHEMICAL FACTOR
Norepinephrine and dopamine have been implicated in opioid,
cocaine and ethanol dependence .
Abnormalities in alcohol dehydrogenase in alcohol dependence,

3. PSYCHOLOGICAL FACTORS
Loneliness
Unme Needs
Low self Esteem
Desire to escape from reality
Sense of adventure
Pleasure seeking
Sense of inferiority
Poor Impulse control
4. SOCIAL FACTORS
Religious Reasons
Peer Pressure
Urbanization
Extended period of education
Unemployment
Overcrowding
Poor Social Support
Effect of TV and other mass media
Occupation: Barmen, Executives, Salesmen, Actors, Entertainers,
Army, Personnel, Medical personnel.
5. PSYCHIATRIC DISORDERS
Depression
Anxiety Disorder
Schizophrenia
Personality Disorder

6. SOCIAL AND ENVIRONMENTAL FACTORS

Laws
Cost and Availability
 SUBSTANCE-RELATED DISORDERS
2 GROUPS:
Substance Use Disorders
Abuse or dependence
Substance-Induced Disorders
Intoxication, withdrawals, delirium, Dementia, Amnesia,
Psychosis, Mood Disorder, Anxiety Disorder, Sexual Dysfunction,
And sleep Disorders

COMORBIDITY
Up to 50%of addicts have comorbid psychiatric disorder
Antisocial PD
Depression
Suicide
DRUG ADDICTION SYMPTOMS OR BEHAVIORS
INCLUDE, AMONG OTHERS:
Feeling that you have to use the drug regularly — daily or even several
times a day
Having intense urges for the drug that block out any other thoughts
Over time, needing more of the drug to get the same effect
Taking larger amounts of the drug over a longer period of time than
you intended
Making certain that you maintain a supply of the drug
Spending money on the drug, even though you can't afford it
Not meeting obligations and work responsibilities, or cutting back on
social or recreational activities because of drug use
Continuing to use the drug, even though you know it's causing
problems in your life or causing you physical or psychological harm
DRUG ADDICTION SYMPTOMS OR BEHAVIORS
INCLUDE, AMONG OTHERS:
Doing things to get the drug that you normally wouldn't do, such as
stealing
Driving or doing other risky activities when you're under the influence
of the drug
Spending a good deal of time getting the drug, using the drug or
recovering from the effects of the drug
Failing in your attempts to stop using the drug
Experiencing withdrawal symptoms when you attempt to stop taking
the drug
 MARIJUANA, HASHISH AND OTHER CANNABIS-
CONTAINING SUBSTANCES
Signs and symptoms of recent use can include:
A sense of euphoria or feeling "high"
A heightened sense of visual, auditory and taste perception
Increased blood pressure and heart rate
Red eyes
Dry mouth
Decreased coordination
Difficulty concentrating or remembering
Slowed reaction time
Anxiety or paranoid thinking
Cannabis odor on clothes or yellow fingertips
 Major cravings for certain foods at unusual times

LONG-TERM USE IS OFTEN ASSOCIATED WITH:

Decreased mental sharpness

Poor performance at school or at work
Ongoing cough and frequent lung infections
 K2, SPICE AND BATH SALTS
Signs and symptoms of recent use can include:
 A sense of euphoria or feeling "high"
 Elevated mood
 An altered sense of visual, auditory and taste perception
 Extreme anxiety or agitation
 Paranoia
 Hallucinations
 Increased heart rate and blood pressure or heart attack
 Vomiting
 Confusion
 Violent behavior
Signs and symptoms of recent use can include:
 Feeling "high"
 Increased sociability
 Increased energy and agitation
 Increased sex drive
 Increased heart rate and blood pressure
 Problems thinking clearly
 Loss of muscle control
 Paranoia
 Panic attacks
 Hallucinations
 Delirium
 Psychotic and violent behavior
BARBITURATES, BENZODIAZEPINES AND HYPNOTICS
Signs and symptoms of recent use can include:

 Drowsiness
 Slurred speech
 Lack of coordination
 Irritability or changes in mood
 Problems concentrating or thinking clearly
 Memory problems
 Involuntary eye movements
 Lack of inhibition
 Slowed breathing and reduced blood pressure
 Falls or accidents
 Dizziness
METH, COCAINE AND OTHER STIMULANTS
Signs and symptoms of recent use can include:
 Feeling of happy excitement and too much confidence
 Increased alertness
 Increased energy and restlessness
 Behavior changes or aggression
 Rapid or rambling speech
 Larger than usual pupils, the black circles in the middle of the eyes
 Confusion, delusions and hallucinations
 Irritability, anxiety or paranoia
 Changes in heart rate, blood pressure and body temperature
 Nausea or vomiting with weight loss
 Poor judgment
 Nasal congestion and damage to the mucous membrane of the nose
(if snorting drugs)
 Mouth sores, gum disease and tooth decay from smoking drugs
("meth mouth")
 Insomnia
 Depression as the drug wears off
CLUB DRUGS
Signs and symptoms of use of club drugs can include:
 Hallucinations
 Paranoia
 Larger than usual pupils
 Chills and sweating
 Involuntary shaking (tremors)
 Behavior changes
 Muscle cramping and teeth clenching
 Muscle relaxation, poor coordination or problems moving
 Reduced inhibitions
 Heightened or altered sense of sight, sound and taste
 Poor judgment
 Memory problems or loss of memory
 Reduced consciousness
 Increased or decreased heart rate and blood pressure
Hallucinogens
LSD use may cause:
 Hallucinations
 Greatly reduced perception of reality, for example, interpreting
input from one of your senses as another, such as hearing colors
 Impulsive behavior
 Rapid shifts in emotions
 Permanent mental changes in perception
 Rapid heart rate and high blood pressure
 Tremors
 Flashbacks, a reexperience of the hallucinations — even years later
PCP USE MAY CAUSE:
 A feeling of being separated from your body and surroundings
 Hallucinations
 Problems with coordination and movement
 Aggressive, possibly violent behavior
 Involuntary eye movements
 Lack of pain sensation
 Increase in blood pressure and heart rate
 Problems with thinking and memory
 Problems speaking
 Poor judgment
 Intolerance to loud noise
 Sometimes seizures or coma
INHALANTS
Signs and symptoms of use can include:
 Possessing an inhalant substance without a reasonable explanation
 Brief happy excitement
 Behaving as if drunk
 Reduced ability to keep impulses under control
 Aggressive behavior or eagerness to fight
 Dizziness
 Nausea or vomiting
 Involuntary eye movements
 Appearing under the influence of drugs, with slurred speech, slow
movements and poor coordination
 Irregular heartbeats
 Tremors
 Lingering odor of inhalant material
 Rash around the nose and mouth
OPIOID PAINKILLERS
Signs and symptoms of narcotic use and dependence can include:
 A sense of feeling "high"
 Reduced sense of pain
 Agitation, drowsiness or sedation
 Slurred speech
 Problems with attention and memory
 Pupils that are smaller than usual
 Lack of awareness or inattention to surrounding people and things
 Problems with coordination
 Depression
 Confusion
 Constipation
 Runny nose or nose sores (if snorting drugs)
 Needle marks (if injecting drugs)
SYMPTOMS OF WITHDRAWAL
Common symptoms of withdrawal may include:
 Trembling and tremors
 Muscle pain or aches
 Hunger or loss of appetite
 Fatigue
 Sweating
 Irritability and agitation
 Depression
 Anxiety
 Nausea
 Vomiting
 Confusion
 Insomnia
 Paranoia
 Seizures
 Dilated pupils
ALCOHOLISM
Alcoholism refers to the use of alcoholic beverages to the point of
causing damage to the individual , society or both.
 PHYSIOLOGICAL EFFECTS OF LONG – TERM
ALCOHOL USE
Cardiomyopathy
Pancreatitis
Esophagitis
Hepatitis and Cirrhosis
Leukopenia and Thrombocytopenia
Protein malnutrition
Sexual Dysfunction
Fetal alcohol syndrome(low birth weight and inteligency)
Social, Financial and occupational problem
Criminality
Marital dishormony
ALCOHOL INTOXICATION STAGE AND SIGNS AND
SYMPTOMS
 BAC (blood
Intoxication Stage alcohol Symptoms
concentration)

mild impairments to speech and

memory
mild impairments to balance and
coordination
Mild 0.00% to 0.05%
mild impairments to attention
initial sleepiness
perceived beneficial effects, such
as relaxation
 increased impairments to speech and
attention
increased impairments to balance and
coordination
moderate memory impairments
Moderate 0.06% to 0.15% increased risk of aggression, in some people
increased risk of injury to self and others
significant impairments to skills necessary for
driving
increase in perceived beneficial effects of
alcohol, such as relaxation
 significant impairments to speech and
memory
significant impairments to coordination and
balance
significant impairments to judgment and
Severe 0.16% to 0.30% reaction time
dangerous impairments to skills necessary
for driving
Vomiting
blackouts (amnesia)
loss of consciousness
 loss of consciousness
danger of a life threatening alcohol
overdose
Life threatening 0.31% to 0.45%
suppression of vital functions,
leading to a significant risk of
death
 Alcohol withdrawal symptoms
anxiety or jumpiness
feeling low or depressed
shakiness or trembling
irritability
sweating
extreme tiredness (fatigue)
nausea and vomiting
loss of appetite
headaches
difficulty sleeping
FOR LISTENING