Other Substance Use

This atom covers substance use disorders beyond alcohol and opioids — primarily stimulants (cocaine, amphetamines/methamphetamine), sedative-hypnotics (benzodiazepines, barbiturates), hallucinogens (PCP, LSD), cannabis, and inhalants. The critical clinical framework is stimulant versus depressant. Stimulant intoxication presents with sympathetic overdrive: hypertension, tachycardia, hyperthermia, dilated pupils, agitation, paranoia, and risk of seizures or cardiac arrest. Cocaine can cause MI even in young, healthy clients — chest pain in a cocaine user is a cardiac emergency. Methamphetamine causes severe dental destruction and formication (sensation of bugs crawling under the skin). Sedative-hypnotic withdrawal (benzodiazepines, barbiturates) mirrors alcohol withdrawal and carries seizure and death risk; it requires a gradual taper, never abrupt discontinuation. PCP intoxication produces unpredictable violence, nystagmus, and numbness; place the client in a low-stimulation environment with staff safety as the priority. Cannabis intoxication causes conjunctival injection, euphoria, and impaired coordination. Inhalant use in adolescents causes a characteristic chemical odor on breath and carries sudden cardiac death risk even on first use.