The Benefit of Behavior Support Plans in Psychiatric Inpatient Settings
Meidan Turel, Michael Siglag, Alexander Grinshpoon in Clinical Psychology in the Mental Health Inpatient Setting, 2019
To meet the need, the next challenge in the ERASE model is identifying the (A)ppropriate replacement behavior that is more adaptive for the patient to perform instead of the problem behavior. We will often use the example of nicotine replacement therapy (NRT) when teaching staff and patients about this stage. Quitting smoking is difficult enough but doing so “cold turkey” (without any aids) makes the experience quite unpleasant and often too difficult. NRTs will help address the physical cravings of nicotine, while therapy and counseling helps to address the behavioral components that are often paired with smoking (i.e., smoking with the morning coffee, smoking while driving, etc.). The behavior plan aims to substitute adaptive coping mechanisms to replace the maladaptive ones. Everyone works better when there is a safety net.
Deriving Addiction
Hanna Pickard, Serge H. Ahmed in The Routledge Handbook of Philosophy and Science of Addiction, 2019
Idioms emerge “spontaneously” as a function of experience. The idioms “kicking the habit” and “going cold turkey” refer to the fact that heroin addicts sometimes quit drugs all at once and on their own. Figures 2.1 and 2.2 provide mechanisms for such sudden shifts in symptoms. These idioms are now common parlance for all drug addictions but have not become part of the conversation in regard to other psychiatric disorders. This suggests that local and global bookkeeping, although part and parcel of all decision making, play more of a role in addiction than in other psychiatric disorders. In any case, the graphs help explain drug binging, remission, relapse, and the psychology and conversation that accompanies these fundamental features of addiction.
Psychiatric Emergencies in Substance Abuse
R. Thara, Lakshmi Vijayakumar in Emergencies in Psychiatry in Low- and Middle-Income Countries, 2017
In approximate order of appearance, the signs and symptoms of opioid withdrawal are: Anxiety, irritability and cravingDysphoric moodLacrimation and rhinorrheaInsomnia YawningIncreased sensitivity to painMuscle, bone and joint achesFever (usually low-grade) and hot and cold flushesPupillary dilation, piloerection (“cold turkey”) and sweatingNausea, vomiting, and diarrheaHyper-adrenergic stage: Increased blood pressure, pulse, and respiratory rateMuscle twitching and kicking (“kicking the habit”).
New Insights Regarding the Phenomenon of Quitting
Published in Issues in Mental Health Nursing, 2020
What was striking about the stories published in the newspaper was the absence of the above-described professional interventions. These were stories of people who quit something on their own—some even quitting “cold turkey.” The account of Lisa Wells, who recovered from smartphone addiction, was especially interesting in view of recent media publicity about this new form of addictive behavior. Wells admits being one of the people who “stroke their screens about 2,600 times a day” (2020, p. 9). Her decision to quit was prompted by the realization that she was having a hard time reading, writing, or listening to her husband because “my mind returned me to the small computer in my pocket, to an unanswered email, to a “like” or a retweet…I went away. In giving my attention to the device, I withheld it from the person I value most” (Wells, 2020, p. 8). She describes her struggle to reduce smartphone use by leaving the phone off at intervals, but she was uneasy, worried about missing “phantom emergencies.” Ultimately, she just quit—no smartphone! She reports that “it took about 72 hours to teach my body that we had gone back to the old ways [i.e., dumbphone, asking people for directions]…but when the device is gone there is nothing to resist. I can read a book for hours in a sitting, and when my loved ones speak I hear the story they’re telling” (Wells, 2020, p. 9).
Understanding why patients with substance use disorders leave the hospital against medical advice: A qualitative study
Published in Substance Abuse, 2020
Rachel Simon, Rachel Snow, Sarah Wakeman
Many patients reported that their withdrawal was not adequately treated when they were hospitalized. When discussing how his withdrawal was managed, one patient said, “There's some hospitals that won't give you anything that makes you go through it like cold turkey, which is like impossible.” A few patients specified that certain medications were given to help with withdrawal but this was not sufficient. One patient described, “They [health care staff] just tell you sorry…They’ll give you some clonidine and some bentyl and send you on your way. So that doesn't work.” A few patients, however, described that their withdrawal was well addressed. One patient reported, “They've given me Suboxone and that's helped a great deal. That's huge. If I didn't have that, I'd probably be going out of my mind right now.” Some patients also described that hospitals around the city treated withdrawal differently; some hospitals effectively treated withdrawal while others did not.
Spinal cord injury/dysfunction and medication management: a qualitative study exploring the experiences of community-dwelling adults in Ontario, Canada
Published in Disability and Rehabilitation, 2022
Lauren Cadel, Sander L. Hitzig, Tanya L. Packer, Tejal Patel, Aisha K. Lofters, Alison Thompson, Sara J. T. Guilcher
… there was another pill I was on a lot and it was for nerve pain. It’s a fairly common nerve pain pill. And I went off of it basically cold turkey because I didn’t know why I was on it. Sometimes when you’re on a pill for something like nerve pain, you don’t know exactly what it’s doing until you go off it. Do you not have nerve pain because the pill’s working, or do you not have nerve pain because there’s no pain there. Right. So, I went off of that nerve pain pill and I was fine… I kind of just weaned myself off all the pills one at a time (with clinical support). (Tyler, male, Traumatic SCI)
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