Which situations would the nurse characterize as indicating substance abuse rather than dependence?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The client reports that her boyfriend left her because she drinks so much.
2. The client reports being fired from three jobs this year due to tardiness after binge drinking.
3. The client reports needing more marijuana to feel "high."
4. The client has been arrested twice for purchasing methamphetamine.
5. The client has ruined three shirts due to overspraying paint while huffing.
1,2,5
Rationale 1: This is an example of substance abuse in that it has had consequences in the client's relationship. Neither of the hallmarks of substance dependence is noted.
Rationale 2: This is an example of substance abuse in that it has had a social consequence. Neither of the hallmarks of substance dependence is noted.
Rationale 3: This is an example of dependence. The hallmarks of substance dependence are tolerance (needing increased amounts of a substance to feel the desired effects) and withdrawal (the uncomfortable physiological and cognitive behavioral changes associated with lowered blood or tissue concentrations of the substance).
Rationale 4: This is an example of substance abuse in that a social consequence has occurred. There are no hallmarks of dependence noted.
Rationale 5: This is an example of substance abuse in that a social consequence has occurred. There are no hallmarks of dependence noted.
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