Nicotine-related Disorders lan why

***********************************APA 7th edition****************************
Respond to your colleagues. Compare the differential diagnostic features of opioid-related disorders to the diagnostic features of Nicotine-related Disorders. What are their similarities and differences? How might you differentiate the two diagnoses?

Nicotine-related Disorders

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Many research articles have identified tobacco use as the most preventable cause of disease and death in the United States. DISCLAIMER: This post is not meant to be offensive to anyone who uses tobacco; this is only a post of information that can be beneficial in practice.

In reference to nicotine-related disorders, researches have suggested that smoking is associated with personality traits such as extraversion, impulsivity, risk-taking, modernistic enthusiasm, avoiding monotony, and antisocial personality (Baniasadi et al, 2015). I want to make a clear distinction that you do not have to suffer mental illness to have a nicotine use disorder; antisocial personality disorder is one of the disorders that have been associated with nicotine use disorder. There are many people who use tobacco out of habit or even in response to Persons with personality disorders may struggle with the dependency nicotine provides leading to misuse of nicotine products.

The population we serve suffer from mental illness and may also have nicotine-related disorder. We want to guide them through psychotherapy and provide psychopharmacologic agents when needed. As practitioners, we understand that smoking tobacco products can lead to an increase in cardiovascular disease, stroke, and death. Education on smoking cessation is important for our clients so they can make informed decisions.

Psychotherapy for Nicotine-related Disorders

A viable technique to help begin to stop tobacco use, CBT aides beating these social marks of disgrace related to tobacco‑use inception and backslide counteractive action in the long haul (Goyal et al, 2020). Cognitive Behavioral Therapy (CBT) is one of the most popular forms of psychotherapy that has been proven to be effective for smoking cessation. Please keep in mind that the client has to be ready to initiate smoking cessation or CBT will not be effective.

Psychopharmacology for Nicotine-related Disorders

Nicotine replacement therapy (NRT) in the form of gum and patch was the only smoking cessation medication approved by the US Food and Drug Administration (FDA) (Prochaska & Benowitz, 2016). This is one of the most popular medications that are used for smoking cessation. As for psychopharmacology, Bupropion is an atypical antidepressant, which also acts as a nicotinic receptor antagonist, with similar efficacy to nicotine replacement therapy (NRT) (Zhong et al, 2019). As mentioned in the previous sentence, Bupropion works by blocking the nicotine receptors in the brain so the client will not receive the same satisfaction from consuming the tobacco. I would suggest using CBT in combination with NRT for optimal efficacy.

Clinical Features with DSM 5 Criteria:

A problematic pattern of tobacco use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1. Tobacco is often taken in larger amounts or over a longer period than was intended.

2. There is a persistent desire or unsuccessful efforts to cut down or control tobacco use.

3. A great deal of time is spent in activities necessary to obtain or use tobacco.

4. Craving, or a strong desire or urge to use tobacco.

5. Recurrent tobacco use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., interference with work).

6. Continued tobacco use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of tobacco (e.g., arguments with others about tobacco use).

7. Important social, occupational, or recreational activities are given up or reduced because of tobacco use.

8. Recurrent tobacco use in situations in which it is physically hazardous (e.g., smoking in bed).

9. Tobacco use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by tobacco.

10. Tolerance, as defined by either of the following: a. A need for markedly increased amounts of tobacco to achieve the desired effect. b. A markedly diminished effect with continued use of the same amount of tobacco.

11. Withdrawal, as manifested by either of the following: a. The characteristic withdrawal syndrome for tobacco (refer to Criteria A and B of the criteria set for tobacco withdrawal). b. Tobacco (or a closely related substance, such as nicotine) is taken to relieve or avoid withdrawal symptoms (APA, 2013).

The level of severity is based on the number of symptoms the client presents with. Mild has 2-3 symptoms, moderate has 4-5, and severe has 6 or more of the above listed symptoms.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Fifth Edition.

Baniasadi, T.; Javanmard, Z.; Zivari-Rahman, M.; Shokouhi-Moqhaddam, S.; Adhami, M. (2015). Investigating the Relationship between Personality Traits and Self-Control and Nicotine Dependence Symptoms in Male Prisoners in Kerman, Iran. Addiction & Health. 7(1-2), 82-86.

Goyal, J.; Menon, I.; Goyal, T.; Passi, D.; Gupta, U.; Gupta, R. (2020). Effectiveness of cognitive behavioral therapy and basic health education for tobacco cessation among adult tobacco users attending a private tobacco cessation center. Journal of Family Medicine & Primary Care. 9(2), 830-833.

Prochaska, J. J.; Benowitz, N. L. (2016). The Past, Present, and Future of Nicotine Addiction Therapy. Annual Review of Medicine. 67(8), 467-486.

Zhong, Z.; Zhao, S.; Zhao, Y.; Xia, S. (2019). Combination therapy of varenicline and bupropion in smoking cessation: A meta-analysis of the randomized controlled trials. Comprehensive Psychiatry. 95(11), 1-6.

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