📘 Important for Psychiatric Nursing, Substance Abuse Nursing & Staff Nurse Exams
🔰 What are Alcohol-Related Disorders?
These are a group of psychiatric and medical conditions caused by excessive or prolonged alcohol use, including dependence, withdrawal, intoxication, and organ damage.
✅ Classified under Substance Use Disorders in DSM-5.
🧭 Major Alcohol-Related Disorders:
🟩 1. Alcohol Intoxication
🔹 Caused by acute ingestion of alcohol 🔸 Symptoms:
Slurred speech
Unsteady gait
Impaired attention, memory
Aggression or inappropriate behavior
🟨 2. Alcohol Withdrawal
🔹 Occurs 6–24 hours after stopping heavy alcohol use 🔸 Symptoms:
Tremors (hands)
Anxiety, sweating
Nausea, vomiting
Seizures
Delirium Tremens (life-threatening)
🟧 3. Alcohol Dependence (Alcohol Use Disorder)
🔹 A chronic condition marked by:
Craving
Tolerance
Withdrawal symptoms
Continued use despite harm
🟥 4. Alcohol-Induced Psychotic Disorder
🔹 Hallucinations, delusions after alcohol use 🔸 Must be differentiated from primary psychosis
IV fluids, electrolyte balance 🔹 Provide supportive care and calm environment
🟧 3. Rehabilitation Phase
🔹 Support abstinence and motivation 🔹 Refer to de-addiction centers 🔹 Encourage participation in self-help groups (e.g., AA) 🔹 Educate about triggers and coping skills 🔹 Long-term drugs:
Disulfiram (aversion therapy)
Naltrexone (craving reducer)
Acamprosate (relapse prevention)
👩⚕️ Nurse’s Role in Alcohol Dependence:
Identify signs of use, abuse, withdrawal
Build trust, non-judgmental communication
Monitor for complications
Provide psychoeducation to patient and family
Promote rehabilitation and follow-up
📚 Golden One-Liners for Quick Revision:
🟨 Delirium Tremens = life-threatening alcohol withdrawal emergency 🟨 Korsakoff’s Syndrome = irreversible memory loss (B1 deficiency) 🟨 Disulfiram causes aversive reaction to alcohol 🟨 Benzodiazepines = drug of choice in withdrawal 🟨 Alcohol withdrawal seizures appear in 24–48 hours
✅ Top 5 MCQs for Practice:
Q1. Which vitamin deficiency leads to Korsakoff’s psychosis? 🅰️ Vitamin C 🅱️ Vitamin D ✅ 🅲️ Vitamin B1 🅳️ Vitamin K Answer: ✅ (c) Vitamin B1
Q2. The drug used to prevent alcohol withdrawal seizures is: 🅰️ Haloperidol ✅ 🅱️ Diazepam 🅲️ Disulfiram 🅳️ Naltrexone Answer: ✅ (b) Diazepam
Q3. Which of the following is a symptom of Delirium Tremens? 🅰️ High mood 🅱️ Increased appetite ✅ 🅲️ Confusion and hallucinations 🅳️ Bradycardia Answer: ✅ (c) Confusion and hallucinations
Q4. Which drug causes vomiting when alcohol is consumed? 🅰️ Acamprosate 🅱️ Diazepam ✅ 🅲️ Disulfiram 🅳️ Fluoxetine Answer: ✅ (c) Disulfiram
Q5. Which is a hallmark sign of alcohol dependence? 🅰️ Lack of appetite 🅱️ Weight gain ✅ 🅲️ Tolerance and withdrawal symptoms 🅳️ Cough Answer: ✅ (c) Tolerance and withdrawal symptoms
💊🧠 Opioid Use Disorders
📘 Important for Psychiatric Nursing, Substance Abuse, and Community Health Nursing
🔰 Definition:
Opioid Use Disorder (OUD) is a chronic, relapsing condition involving the compulsive use of opioids (natural or synthetic), leading to clinically significant impairment or distress.
✅ Includes dependence, withdrawal, overdose, and psychosocial impairment.
“A brain-based disorder driven by craving and loss of control over opioid use.”
🧪 Commonly Abused Opioids:
Natural: Morphine, Codeine
Semi-synthetic: Heroin, Oxycodone, Hydrocodone
Synthetic: Fentanyl, Methadone, Tramadol
Street name for heroin: Smack, Brown Sugar
🧭 Features of Opioid Use Disorder (DSM-5 Criteria):
(Need ≥2 criteria in 12 months)
Craving and strong urge to use
Loss of control over use
Withdrawal symptoms
Tolerance development
Continued use despite harm
Social, occupational neglect
🟩 Opioid Intoxication:
🔸 Occurs after recent opioid use 🔸 Signs/Symptoms:
🟨 Withdrawal causes flu-like symptoms with dilated pupils
🟨 Naloxone is the antidote for opioid overdose
🟨 Methadone and Buprenorphine are used for detox & maintenance
🟨 COWS scale = used to measure withdrawal severity
✅ Top 5 MCQs for Practice:
Q1. Which of the following is a sign of opioid overdose? 🅰️ Mydriasis, hypertension ✅ 🅱️ Miosis, respiratory depression 🅲️ Fever, hallucinations 🅳️ Muscle rigidity, delirium Answer: ✅ (b) Miosis, respiratory depression
Q2. Drug used to reverse opioid overdose is: 🅰️ Diazepam 🅱️ Disulfiram ✅ 🅲️ Naloxone 🅳️ Haloperidol Answer: ✅ (c) Naloxone
Q3. Common withdrawal symptom of opioid use is: 🅰️ Slow heart rate 🅱️ Sweating and diarrhea ✅ 🅲️ Both (b) 🅳️ None Answer: ✅ (c) Both (b)
Q4. Which drug is used in opioid maintenance therapy? 🅰️ Naltrexone ✅ 🅱️ Methadone 🅲️ Fluoxetine 🅳️ Risperidone Answer: ✅ (b) Methadone
📘 Important for Mental Health Nursing, Psychiatric Nursing, and Substance Abuse Modules
🔰 Definition:
Cannabis Use Disorder is a pattern of problematic cannabis use leading to significant impairment or distress, including dependence, tolerance, and withdrawal symptoms.
✅ Cannabis is the most commonly used illicit drug globally (also called marijuana, ganja, hashish, bhang, charas).
“Excessive cannabis use alters mood, cognition, and behavior, and can impair psychosocial functioning.”
🧪 Common Cannabis Preparations:
Bhang – dried leaves, often consumed orally
Ganja – flowering tops (smoked)
Charas / Hashish – resin extract
Hash oil – concentrated liquid extract
Street names: Weed, Pot, Dope, Mary Jane
🧠 Key Features of Cannabis Use Disorder (DSM-5 Criteria):
(≥2 symptoms in 12 months)
Strong craving and repeated use
Tolerance to effects
Withdrawal symptoms
Impaired social, academic, or job performance
Continued use despite harm
Time spent acquiring/using/recovering
🟩 Cannabis Intoxication:
🔸 Psychological Effects:
Euphoria, relaxation, increased sociability
Altered perception of time
Impaired short-term memory and attention
Paranoia, hallucinations (high dose)
Panic, anxiety in some users
🔸 Physical Effects:
Red eyes (conjunctival injection)
Dry mouth, increased appetite (“munchies”)
Increased heart rate
Lack of coordination, slurred speech
🟨 Cannabis Withdrawal Symptoms:
(Begin within 1–2 days, peak in 3–7 days)
Irritability, anxiety, restlessness
Sleep difficulty, vivid dreams
Decreased appetite
Headaches, sweating
Depression and mood swings
🟥 Complications of Chronic Use:
Amotivational syndrome (apathy, lack of ambition)
Memory and attention deficits
Decreased academic/work performance
Exacerbation of schizophrenia and psychosis
Lung damage (if smoked long-term)
🩺 Management of Cannabis Use Disorder:
🔹 1. Acute Intoxication:
Calm, safe environment
Monitor for psychosis or panic reaction
Use benzodiazepines (e.g., lorazepam) if severe anxiety
Antipsychotics (e.g., risperidone) if hallucinations present
Monitor for hallucinations, anxiety, panic attacks
Provide non-judgmental counseling
Educate about risks (especially in adolescents)
Promote behavioral therapy and rehabilitation
📚 Golden One-Liners for Revision:
🟨 Cannabis = most abused illicit substance worldwide
🟨 Key sign of intoxication: red eyes + euphoria + slow reaction
🟨 Withdrawal includes irritability, sleep disturbance, anxiety
🟨 Chronic use may cause amotivational syndrome
🟨 No specific medication — CBT is the mainstay of treatment
✅ Top 5 MCQs for Practice:
Q1. Most common psychiatric complication of chronic cannabis use is: 🅰️ Mania ✅ 🅱️ Psychosis 🅲️ PTSD 🅳️ Bipolar disorder Answer: ✅ (b) Psychosis
Q2. A common physical sign of cannabis intoxication is: 🅰️ Pale skin 🅱️ Jaundice ✅ 🅲️ Conjunctival injection (red eyes) 🅳️ Drooling Answer: ✅ (c) Conjunctival injection (red eyes)
Q3. Cannabis withdrawal typically includes: 🅰️ Vomiting and fever ✅ 🅱️ Irritability and insomnia 🅲️ Tremors and seizures 🅳️ Bradycardia Answer: ✅ (b) Irritability and insomnia
Q4. Which term describes lack of motivation in long-term cannabis users? 🅰️ Psychosis 🅱️ Withdrawal syndrome ✅ 🅲️ Amotivational syndrome 🅳️ Korsakoff’s psychosis Answer: ✅ (c) Amotivational syndrome
Q5. Which therapy is most effective in long-term cannabis treatment? 🅰️ Surgery 🅱️ Electroconvulsive therapy ✅ 🅲️ Cognitive Behavioral Therapy 🅳️ Methadone replacement Answer: ✅ (c) Cognitive Behavioral Therapy
💊⚡ Amphetamine Use Disorder
📘 Important for Psychiatric Nursing, Substance Abuse, and Community Health Exams
🔰 Definition:
Amphetamine Use Disorder (AUD) is a pattern of stimulant (amphetamine-type substances) misuse that leads to clinically significant impairment, including psychological dependence, behavioral issues, and physical harm.
✅ Amphetamines are CNS stimulants that increase levels of dopamine, norepinephrine, and serotonin in the brain.
“Amphetamines stimulate the mind—then destroy it if misused.”
🧪 Examples of Amphetamines & Similar Stimulants:
Amphetamine sulfate
Methamphetamine (Crystal Meth, Ice, Glass)
MDMA / Ecstasy
Dextroamphetamine, Adderall
Prescription misuse for ADHD/weight loss
🧠 Effects of Amphetamine (Acute Use):
🟩 Psychological Effects:
Euphoria, increased energy, alertness
Talkativeness, decreased need for sleep
Increased confidence, restlessness
Hallucinations, paranoia, agitation (high dose)
Risky sexual or violent behavior
🟨 Physical Effects:
Dilated pupils (mydriasis)
Increased heart rate (tachycardia), BP
Dry mouth, sweating, tremors
Decreased appetite, insomnia
Risk of seizures or cardiac arrhythmia
🟧 Amphetamine Intoxication:
Occurs after excessive dose or repeated use
Severe anxiety, agitation, psychosis
Paranoid delusions, hallucinations
Hyperthermia
May result in stroke or sudden cardiac death
🟥 Amphetamine Withdrawal Symptoms:
(Begin within 24 hrs of last use)
Extreme fatigue, drowsiness
Depression, suicidal thoughts
Increased appetite
Sleep disturbances
Vivid dreams
Psychomotor retardation
⚠️ Unlike opioid withdrawal, amphetamine withdrawal is mostly psychological.
🔄 Complications of Chronic Use:
Amphetamine-induced psychosis
Malnutrition and weight loss
Cognitive impairment
Violent or aggressive behavior
Stroke or heart failure
Dental decay (“meth mouth”)
🩺 Medical & Psychiatric Management:
🟩 1. Acute Intoxication:
Provide quiet, calm environment
Use benzodiazepines (for agitation, anxiety)
Antipsychotics (e.g., haloperidol) for severe psychosis
Manage hyperthermia and hypertension
Monitor ECG and vitals
🟨 2. Withdrawal Management:
Supportive care, nutrition, hydration
Antidepressants if depression is severe
Sleep aids may be used temporarily
Suicide precautions
🟧 3. Rehabilitation & Long-Term Care:
Cognitive Behavioral Therapy (CBT)
Motivational Interviewing (MI)
Group therapy / Narcotics Anonymous
No FDA-approved medications yet for amphetamine dependence
👩⚕️ Nursing Responsibilities:
Assess history, behavior, mental status
Monitor for aggression, hallucinations, suicide risk
Provide a non-stimulating, safe environment
Administer medications and monitor vitals
Educate about health risks and relapse prevention
Refer to rehabilitation services
📚 Golden One-Liners for Revision:
🟨 Amphetamines are CNS stimulants — cause energy, euphoria, and insomnia
🟨 No specific medication — CBT is primary treatment
🟨 Chronic use causes amphetamine psychosis & “meth mouth”
✅ Top 5 MCQs for Practice:
Q1. Which is a common physical sign of amphetamine intoxication? 🅰️ Bradycardia 🅱️ Constricted pupils ✅ 🅲️ Dilated pupils 🅳️ Jaundice Answer: ✅ (c) Dilated pupils
Q2. Amphetamine withdrawal usually presents with: 🅰️ Tremors and diarrhea 🅱️ Seizures ✅ 🅲️ Fatigue and depression 🅳️ Euphoria Answer: ✅ (c) Fatigue and depression
Q3. Which is a dangerous complication of long-term amphetamine use? 🅰️ Cirrhosis 🅱️ Hypoglycemia ✅ 🅲️ Psychosis and cardiac arrest 🅳️ Renal failure Answer: ✅ (c) Psychosis and cardiac arrest
Q4. “Meth mouth” is associated with which drug? 🅰️ Cocaine ✅ 🅱️ Methamphetamine 🅲️ Cannabis 🅳️ LSD Answer: ✅ (b) Methamphetamine
Q5. Which therapy is most effective for amphetamine addiction? 🅰️ Methadone 🅱️ Naloxone ✅ 🅲️ Cognitive Behavioral Therapy 🅳️ ECT Answer: ✅ (c) Cognitive Behavioral Therapy
🌈🧠 Hallucinogen Intoxication
📘 Important for Psychiatric Nursing, Substance Abuse, and Community Health Exams
🔰 Definition:
Hallucinogen Intoxication is a condition caused by recent use of psychedelic substances that lead to perceptual distortions, hallucinations, and altered mood and consciousness.
✅ It affects thought, perception, mood, and sensory experience, without necessarily causing physical dependence.
“Seeing, hearing, or feeling things that aren’t there — that’s the hallmark of a hallucinogen trip.”
Flashbacks (recurrence of trip weeks/months later)
Aggression and violence (especially with PCP)
🩺 Management of Hallucinogen Intoxication:
🟨 1. Acute Intoxication:
Provide calm, safe, low-stimulus environment
Offer reassurance — “talk down” method
Monitor vitals and behavior
Administer benzodiazepines (e.g., lorazepam) for anxiety or agitation
Use antipsychotics (e.g., haloperidol) only if severe psychosis occurs
Restraints may be needed if violent (especially PCP intoxication)
🟧 2. Long-Term Care:
Psychiatric evaluation for persistent symptoms
Psychoeducation about dangers of recurrence
Supportive counseling, relapse prevention, CBT
Refer to rehabilitation if abuse is regular
👩⚕️ Nursing Responsibilities:
Assess for substance history and current behavior
Ensure patient and environmental safety
Monitor for self-harm, aggression, psychosis
Provide non-judgmental support and reality orientation
Educate about risk of flashbacks and long-term damage
📚 Golden One-Liners for Quick Revision:
🟩 LSD and magic mushrooms cause visual hallucinations and perceptual distortions
🟩 Dilated pupils are typical in hallucinogen use
🟧 PCP intoxication may lead to violence and psychosis
🟧 Flashbacks = recurrence of trip without re-use
🟨 CBT and supportive therapy are key in long-term care
🟥 No specific withdrawal symptoms (psychological dependence only)
✅ Top 5 MCQs for Practice:
Q1. Which is a classic feature of hallucinogen intoxication? 🅰️ Miosis ✅ 🅱️ Visual hallucinations and perceptual distortion 🅲️ Excessive sleep 🅳️ High blood sugar Answer: ✅ (b)
Q3. Which of the following drugs is a hallucinogen? 🅰️ Diazepam 🅱️ Heroin ✅ 🅲️ Psilocybin 🅳️ Caffeine Answer: ✅ (c)
Q4. Which nursing action is priority during a “bad trip” on LSD? 🅰️ Apply restraints immediately 🅱️ Call police ✅ 🅲️ Calm environment and reassurance 🅳️ Give naloxone Answer: ✅ (c)
Q5. Hallucinogen intoxication usually leads to: 🅰️ Physical dependence 🅱️ Tremors and seizures ✅ 🅲️ Altered perception without withdrawal 🅳️ Bradycardia Answer: ✅ (c)
💥🧠 Cocaine Intoxication
📘 Important for Psychiatric Nursing, Substance Abuse, and Emergency Nursing Exams
🔰 Definition:
Cocaine intoxication is a condition caused by recent, excessive use of cocaine, a potent CNS stimulant, resulting in mental, cardiovascular, and behavioral disturbances.
✅ Cocaine blocks reuptake of dopamine, norepinephrine, and serotonin, leading to intense stimulation.
“Euphoria in minutes, danger in seconds — cocaine intoxication is a medical emergency.”
Q2. Which is the first-line drug for agitation in cocaine intoxication? 🅰️ Haloperidol ✅ 🅱️ Lorazepam 🅲️ Atropine 🅳️ Naloxone Answer: ✅ (b)
Q3. A major complication of cocaine use is: 🅰️ Liver failure 🅱️ Hypoglycemia ✅ 🅲️ Myocardial infarction 🅳️ Renal colic Answer: ✅ (c)
Q4. Cocaine withdrawal is usually associated with: 🅰️ Seizures 🅱️ Delirium tremens ✅ 🅲️ Fatigue and depression 🅳️ Severe diarrhea Answer: ✅ (c)
Q5. Which of the following should be avoided in cocaine intoxication? 🅰️ Benzodiazepines ✅ 🅱️ Pure beta-blockers 🅲️ Oxygen therapy 🅳️ Antipsychotics Answer: ✅ (b)
🧪🧠 Inhalant Use Disorder
📘 Important for Psychiatric Nursing, Substance Abuse, Pediatrics, and Community Health Exams
🔰 Definition:
Inhalant Use Disorder is a condition involving repeated, intentional inhalation of volatile chemical vapors to achieve euphoria or mind-altering effects, leading to addiction, physical harm, and behavioral changes.
✅ Common among children, adolescents, and low-income groups.
“Cheap, easy, and deadly — inhalants damage the brain with every sniff.”
🧪 Common Inhalants:
Category
Examples
Volatile solvents
Glue, paint thinner, correction fluid
Aerosols
Deodorants, spray paints
Gases
Butane, propane, nitrous oxide
Nitrites
Amyl nitrite (“poppers”)
Cleaning agents
Petrol, varnish, markers
🧠 Effects of Inhalants (Acute Intoxication):
🟩 Psychological Symptoms:
Euphoria, dizziness, excitement
Hallucinations, distorted perception
Slurred speech, poor coordination
Confusion, disinhibition
Aggression or violence
🟨 Physical Symptoms:
Red, watery eyes
Runny nose, chemical smell on breath
Nausea, vomiting
Muscle weakness
Headache
Staggering gait
🚨 Serious Complications:
Sudden sniffing death syndrome (cardiac arrest)
Hypoxia → brain damage
Liver, kidney, and bone marrow damage
Long-term cognitive impairment
Seizures, coma
Social withdrawal, academic failure
Risk of burn injuries (flammable substances)
🟧 Inhalant Withdrawal Symptoms:
⚠️ Mild but distressing:
Irritability, anxiety
Sleep disturbance
Headache
Depression
Craving for inhalants
🩺 Medical and Psychiatric Management:
🟨 1. Acute Intoxication:
Move to fresh air immediately
Ensure ABC (airway, breathing, circulation)
Oxygen therapy if hypoxic
Monitor vitals and consciousness level
Benzodiazepines for severe agitation or seizures
🟩 2. Long-Term Treatment:
Motivational interviewing & CBT
Family counseling (especially in adolescents)
School-based prevention programs
Referral to rehabilitation centers
No specific FDA-approved medications
👩⚕️ Nursing Responsibilities:
Identify chemical odor, stains on face/clothing
Monitor for cardiac and respiratory depression
Create safe environment (remove access to inhalants)
Provide emotional support & health education
Counsel on coping skills, peer pressure, risk awareness
Coordinate with parents, teachers, social workers
📚 Golden One-Liners for Quick Revision:
🟨 Inhalants = volatile substances inhaled for euphoria
🟨 Common in adolescents & low-income groups
🟥 Risk: Sudden sniffing death syndrome
🟥 Cause brain, liver, kidney, heart damage
🟧 No physical dependence, but psychological craving exists
🟦 CBT + family therapy = main treatment approach
✅ Top 5 MCQs for Practice:
Q1. Which of the following is a common sign of inhalant use? 🅰️ Miosis 🅱️ High blood sugar ✅ 🅲️ Red eyes and chemical odor 🅳️ Tinnitus Answer: ✅ (c)
Q2. Sudden sniffing death syndrome occurs due to: 🅰️ Seizures ✅ 🅱️ Cardiac arrhythmia 🅲️ Liver failure 🅳️ Renal obstruction Answer: ✅ (b)
Q3. Inhalant use is most common in: 🅰️ Geriatric population ✅ 🅱️ Adolescents 🅲️ Pregnant women 🅳️ Middle-aged executives Answer: ✅ (b)
Q4. Which therapy is most effective in long-term inhalant abuse? 🅰️ Electroconvulsive therapy ✅ 🅱️ Cognitive Behavioral Therapy 🅲️ Methadone 🅳️ Dialysis Answer: ✅ (b)
Q5. Which organ is most at risk in chronic inhalant abuse? 🅰️ Skin ✅ 🅱️ Brain 🅲️ Eyes 🅳️ Intestine Answer: ✅ (b)
💊😴 Sedative-Hypnotic Abuse
📘 Important for Psychiatric Nursing, Substance Abuse Nursing & Staff Nurse Exams
🔰 Definition:
Sedative-Hypnotic Abuse refers to the misuse and dependence on CNS depressants like benzodiazepines, barbiturates, and sleep medications, leading to tolerance, withdrawal, and functional impairment.
✅ These drugs are commonly used for anxiety, insomnia, seizures, but prolonged or high-dose use leads to addiction and overdose risk.
“Silent and deceptive—sedatives calm the mind but slowly capture it.”
🧪 Commonly Abused Sedatives & Hypnotics:
Drug Class
Examples
Benzodiazepines
Diazepam, Alprazolam, Lorazepam
Barbiturates
Phenobarbital, Secobarbital
Non-benzodiazepine sedatives
Zolpidem, Zopiclone (Z-drugs)
Others
Chloral hydrate, meprobamate
🟩 Effects of Sedative-Hypnotics (Acute Use):
🧠 Psychological Effects:
Drowsiness, calmness
Reduced anxiety
Relaxation and euphoria
Poor judgment, slowed reaction time
🩺 Physical Signs:
Slurred speech
Unsteady gait (ataxia)
Impaired coordination
Respiratory depression in overdose
Hypotension, bradycardia
🟥 Sedative-Hypnotic Intoxication:
CNS depression (ranging from mild sedation to coma)
Memory loss, confusion
Severe overdose → respiratory arrest, coma, death
Combined use with alcohol or opioids increases danger
🟨 Withdrawal Symptoms:
(Occurs within 6–12 hours of last dose; can last up to 1–2 weeks)
Anxiety, restlessness, agitation
Insomnia, tremors, irritability
Sweating, palpitations
Seizures
Nausea, vomiting
Risk of delirium or death (especially barbiturates)
⚠️ Withdrawal can be life-threatening — requires medical supervision.
⚠️ Complications of Long-Term Use:
Dependence and tolerance
Cognitive impairment
Accidental overdose
Falls and fractures (especially in elderly)
Depression, suicidal ideation
Social and occupational decline
🩺 Management of Sedative-Hypnotic Abuse:
🟩 1. Acute Intoxication:
Maintain airway, breathing, circulation
Flumazenil (benzodiazepine antidote – used with caution)
IV fluids, oxygen support
Monitor vitals, consciousness level, ECG
Avoid stimulation, ensure quiet surroundings
🟨 2. Withdrawal Management:
Gradual tapering (e.g., use long-acting benzodiazepine like diazepam)
Anticonvulsants if seizure risk
Clonidine or propranolol for autonomic symptoms
Thiamine supplementation (prevent Wernicke’s in alcohol users)
🟧 3. Long-Term Care:
Cognitive Behavioral Therapy (CBT)
Motivational Enhancement Therapy (MET)
Psychoeducation for patient and family
Refer to de-addiction & rehab centers
👩⚕️ Nursing Responsibilities:
Assess for signs of overdose, withdrawal, tolerance
Maintain seizure precautions during detox
Provide emotional support & calm environment
Monitor vitals, oxygen saturation, LOC
Educate patient & family about safe medication use
Encourage non-pharmacological sleep aids
📚 Golden One-Liners for Quick Revision:
🟨 Sedative-Hypnotics = CNS depressants → cause drowsiness, slowed CNS
🟧 Flumazenil = antidote for benzo overdose (use with caution)
🟩 Gradual tapering = safest withdrawal method
🟦 CBT + counseling = key to recovery
✅ Top 5 MCQs for Practice:
Q1. Which of the following is a sedative-hypnotic drug? 🅰️ Heroin 🅱️ Haloperidol ✅ 🅲️ Diazepam 🅳️ Fluoxetine Answer: ✅ (c) Diazepam
Q2. A life-threatening complication of sedative withdrawal is: 🅰️ Nausea 🅱️ Hallucinations ✅ 🅲️ Seizures 🅳️ Cough Answer: ✅ (c) Seizures
Q3. Which antidote is used for benzodiazepine overdose? 🅰️ Naloxone 🅱️ Atropine ✅ 🅲️ Flumazenil 🅳️ Naltrexone Answer: ✅ (c) Flumazenil
Q4. Long-term use of sedatives can lead to: 🅰️ Hyperactivity 🅱️ Increased intelligence ✅ 🅲️ Cognitive decline 🅳️ Weight loss Answer: ✅ (c) Cognitive decline
Q5. Best approach for sedative withdrawal is: 🅰️ Stop abruptly ✅ 🅱️ Gradual tapering 🅲️ High-dose replacement 🅳️ ECT Answer: ✅ (b) Gradual tapering
👩⚕️💊 Nursing Process in Substance Abuse
📘 Essential for Psychiatric Nursing, Community Health Nursing & Staff Nurse Exams
🔰 Definition:
The nursing process in substance abuse involves a systematic, patient-centered approach to assess, plan, implement, and evaluate care for individuals misusing alcohol, drugs, or other psychoactive substances.
✅ Focuses on detoxification, rehabilitation, relapse prevention, and holistic recovery.
🧭 Steps in Nursing Process:
🟩 1. Assessment
🔹 Subjective Data:
History of substance use (type, dose, duration, last use)
Administer medications as prescribed: 🔸 Benzodiazepines for alcohol withdrawal 🔸 Methadone or Buprenorphine for opioids
Maintain hydration, nutrition, and hygiene
Ensure seizure precautions
💬 Psychological Support:
Build therapeutic relationship
Encourage ventilation of feelings
Use motivational interviewing techniques
Involve family in care planning
📚 Health Teaching:
Explain long-term effects of substance abuse
Discuss relapse triggers and how to manage them
Educate on healthy lifestyle habits
Promote self-help group participation (e.g., AA, NA)
🛡️ Environmental Safety:
Remove harmful objects (during withdrawal)
Keep environment low-stimulus and calm
Monitor for suicide risk or aggression
🟦 5. Evaluation
🧾 Evaluate based on outcomes:
Has the patient stopped substance use?
Is the patient engaging in therapy or rehab?
Are withdrawal symptoms under control?
Has the patient reintegrated socially/family-wise?
Is there improvement in self-esteem and coping?
✅ Modify care plan based on response and progress.
👩⚕️ Nurse’s Role Summary:
Identify substance use early
Provide safe detox and withdrawal care
Offer psychosocial support and counseling
Educate client and family
Promote long-term rehabilitation and relapse prevention
📚 Golden One-Liners for Revision:
🟨 Assessment includes drug history + withdrawal monitoring
🟧 Top nursing diagnoses: Ineffective coping, Risk for injury, Disturbed thought process
🟥 Withdrawal care = medications + safety + support
🟦 Nurse uses CBT, MI, education, family involvement
🟩 Goal = abstinence + social and emotional rehab
✅ Top 5 MCQs for Practice:
Q1. Which nursing diagnosis is most common in substance abuse? 🅰️ Acute pain ✅ 🅱️ Ineffective coping 🅲️ Risk for constipation 🅳️ Powerlessness Answer: ✅ (b)
Q2. During alcohol detox, the nurse should: 🅰️ Isolate the patient 🅱️ Encourage caffeine intake ✅ 🅲️ Monitor for seizures and tremors 🅳️ Discontinue fluids Answer: ✅ (c)
Q4. The best short-term goal for a detoxing patient is: 🅰️ Return to job immediately ✅ 🅱️ Remain injury-free during withdrawal 🅲️ Gain 5 kg weight 🅳️ Join NA group tomorrow Answer: ✅ (b)
Q5. Which scale is used to assess opioid withdrawal? 🅰️ GCS 🅱️ MMSE ✅ 🅲️ COWS 🅳️ APGAR Answer: ✅ (c) COWS (Clinical Opiate Withdrawal Scale)
🎰🧠 Behavioral Addictions
📘 Essential for Psychiatric Nursing, Community Mental Health, and Staff Nurse Competitive Exams
🔰 Definition:
Behavioral addiction refers to a compulsive engagement in rewarding non-substance-related behaviors, despite negative consequences, similar to drug addiction in brain chemistry and behavior.
✅ Involves dopamine release, loss of control, craving, and withdrawal-like symptoms.
“It’s not about what you consume — it’s about what consumes you.”
🧪 Common Types of Behavioral Addictions:
Addiction Type
Examples
Gambling Addiction
Lottery, casinos, online betting
Internet Addiction
Excessive browsing, YouTube, web surfing
Gaming Addiction
Online or video gaming (e.g., PUBG, COD)
Social Media Addiction
Facebook, Instagram, TikTok obsession
Shopping Addiction
Uncontrolled online/offline buying
Sexual Addiction
Pornography, risky sexual behavior
Work Addiction
Compulsive overworking (workaholism)
Food Addiction
Binge eating, compulsive snacking
🧠 Clinical Features of Behavioral Addiction:
🟩 Psychological:
Craving and urge to perform the behavior
Loss of control over frequency/duration
Mood changes: guilt, anxiety, depression
Lying, hiding behavior from others
Impaired academic, social, or work function
🟨 Physical/Functional:
Neglect of health, hygiene, and responsibilities
Poor sleep, fatigue (esp. in gaming/internet addiction)
Relationship breakdowns
Financial debt (gambling/shopping)
🟥 Diagnostic Criteria (DSM-5 reference):
Currently, only Gambling Disorder is officially recognized in DSM-5 under “Substance-Related and Addictive Disorders.”
Others are under research (Internet, Gaming).
⚠️ Complications:
Depression and anxiety disorders
Social withdrawal and isolation
Academic/work failure
Financial problems and debt
Suicidal thoughts (esp. in gambling/internet addiction)
Risk of dual diagnosis with substance abuse
🩺 Management of Behavioral Addictions:
🟩 1. Psychological Therapy:
Cognitive Behavioral Therapy (CBT) → gold standard
Motivational Enhancement Therapy (MET)
Behavioral contracts and goal setting
Psychoeducation for patient and family
Relapse prevention strategies
🟨 2. Pharmacological (for comorbidities):
SSRIs (e.g., fluoxetine, sertraline) for anxiety/depression
Mood stabilizers (e.g., lithium) in select cases
Naltrexone – studied for gambling and internet gaming
🟧 3. Social & Environmental Measures:
Limit device usage, screen time, parental controls
Join self-help groups (e.g., Gamblers Anonymous)
Encourage offline hobbies, exercise, social interaction
School/workplace support systems
👩⚕️ Nursing Responsibilities:
Assess behavioral patterns, screen for addiction signs
Build trust and non-judgmental environment
Educate on risks and coping skills
Collaborate with psychologists, counselors, family
Reinforce healthy routines and goal tracking
Promote family therapy and tech-free bonding time
📚 Golden One-Liners for Revision:
🟩 Gambling Disorder = only DSM-5-recognized behavioral addiction
🟨 Behavioral addiction ≠ substance but triggers dopamine-based reward
🟥 CBT is most effective therapy
🟥 Common feature = loss of control despite harm
🟦 Watch for depression, isolation, poor performance
🟧 Family support + routine = key to recovery
✅ Top 5 MCQs for Practice:
Q1. Which behavioral addiction is officially recognized in DSM-5? 🅰️ Gaming disorder 🅱️ Internet addiction ✅ 🅲️ Gambling disorder 🅳️ Shopping addiction Answer: ✅ (c)
Q2. Best psychological therapy for behavioral addiction is: 🅰️ Hypnotherapy ✅ 🅱️ Cognitive Behavioral Therapy (CBT) 🅲️ Electroconvulsive Therapy 🅳️ Psychoanalysis Answer: ✅ (b)
Q3. A key feature of behavioral addiction is: 🅰️ Increased immunity 🅱️ Physical withdrawal only ✅ 🅲️ Craving and compulsive behavior 🅳️ Increased socialization Answer: ✅ (c)
Q4. A student addicted to online gaming is likely to have: 🅰️ Enhanced study performance 🅱️ Better sleep ✅ 🅲️ Sleep disturbance and poor grades 🅳️ Increased appetite Answer: ✅ (c)
Q5. Which medication is studied for behavioral addiction management? 🅰️ Diazepam ✅ 🅱️ Naltrexone 🅲️ Haloperidol 🅳️ Penicillin Answer: ✅ (b)
🧑🎓💊 Substance Abuse in Adolescents
📘 Essential for Psychiatric Nursing, Child & Adolescent Health, Community Nursing & Staff Nurse Exams
🔰 Definition:
Adolescent substance abuse is the use of psychoactive substances (alcohol, tobacco, drugs, inhalants) by individuals aged 10–19 years, leading to physical, emotional, social, and academic problems.
✅ It is a growing public health issue, often beginning with experimentation and progressing to dependence.
“Teenage brains crave risk — and substances exploit that vulnerability.”
🧭 Common Substances Abused by Adolescents:
Substance
Examples
Tobacco
Cigarettes, bidis, e-cigarettes
Alcohol
Beer, whisky, wine
Cannabis
Ganja, hashish, bhang
Inhalants
Glue, whiteners, petrol, paint
Prescription drugs
Cough syrup (codeine), painkillers, sedatives
Illicit drugs
Cocaine, heroin, LSD (less common)
🧠 Causes / Risk Factors:
🟩 Individual Factors:
Curiosity and thrill-seeking
Low self-esteem
Peer pressure
Poor impulse control
🟨 Family Factors:
Parental neglect or addiction
Domestic violence
Lack of communication and supervision
🟧 Social/Environmental Factors:
Easy availability
Media glorification
Urbanization and stress
Academic failure or school drop-out
🩺 Signs and Symptoms of Substance Use in Adolescents:
🟥 Behavioral Changes:
Sudden aggression or withdrawal
Loss of interest in studies, hobbies
Skipping school, falling grades
Secretive or lying behavior
🟦 Physical Changes:
Red or watery eyes
Slurred speech, tremors
Unusual body odors
Poor hygiene, fatigue
🟪 Psychological Changes:
Mood swings
Anxiety, depression
Sleep problems
Poor concentration
⚠️ Complications:
Accidents and injuries
Addiction and tolerance
Mental health disorders: depression, psychosis
Unsafe sex, teenage pregnancy
HIV/AIDS (IV drug use)
Academic failure
Criminal behavior
🩺 Nursing Management and Interventions:
🟩 1. Assessment:
Substance history: type, frequency, duration
Physical, emotional, and social assessment
Use screening tools: CRAFFT, ASSIST
🟨 2. Health Education:
Dangers of drug use
Refusal skills and assertiveness training
Promote self-esteem and coping skills
🟧 3. Family Involvement:
Educate parents about warning signs
Encourage open communication
Support positive parenting practices
🟥 4. Counseling and Rehabilitation:
Motivational Interviewing (MI)
Cognitive Behavioral Therapy (CBT)
Refer to de-addiction centers for youth
Group therapy, school-based support programs
👩⚕️ Nurse’s Role:
Early identification and screening
Establish trust with adolescents
Educate in schools and communities
Coordinate with family, school, social worker
Promote drug-free campaigns and awareness
Refer to child psychiatrist if needed
📚 Golden One-Liners for Quick Revision:
🟨 Adolescents use substances due to peer pressure and curiosity
🟨 Most common: tobacco, alcohol, inhalants
🟩 Nurse uses CRAFFT tool for screening
🟧 Best approach = education, family support, CBT
🟥 Substance abuse in teens may lead to addiction, crime, mental illness
✅ Top 5 MCQs for Practice:
Q1. Most commonly abused substance by adolescents is: 🅰️ Cocaine ✅ 🅱️ Tobacco 🅲️ LSD 🅳️ Morphine Answer: ✅ (b)
Q3. A major psychosocial reason for adolescent drug use is: 🅰️ Old age 🅱️ Family success ✅ 🅲️ Peer pressure 🅳️ Good schooling Answer: ✅ (c)
Q4. Important nursing action in adolescent drug abuse is: 🅰️ Punish the child ✅ 🅱️ Build trust and provide counseling 🅲️ Ignore the issue 🅳️ Refer to jail Answer: ✅ (b)
Q5. Which therapy is best for adolescent substance users? 🅰️ ECT 🅱️ Surgery ✅ 🅲️ Cognitive Behavioral Therapy 🅳️ Psychoanalysis Answer: ✅ (c)
🚬🧠 Tobacco Use Disorder
📘 Important for Psychiatric Nursing, Community Health, Public Health, and Staff Nurse Exams
🔰 Definition:
Tobacco Use Disorder (TUD) is a chronic and relapsing condition characterized by the compulsive use of tobacco products (smoking or smokeless), tolerance, withdrawal, and inability to quit despite harmful consequences.
✅ Nicotine is the primary addictive component.
“Tobacco kills more people than alcohol, drugs, and violence combined — slowly and silently.”
🧪 Forms of Tobacco:
Type
Examples
Smoking forms
Cigarettes, bidis, cigars, hookah
Smokeless forms
Gutkha, pan masala, khaini, zarda, snuff
🧠 Nicotine Effects:
Stimulates dopamine release → reward & addiction
Increases alertness, temporarily reduces anxiety
Causes increased BP, heart rate
Highly addictive → within days of use
🟩 Symptoms of Tobacco Use Disorder (DSM-5 Criteria):
(≥2 criteria within 12 months)
Strong craving and urge to use tobacco
Tolerance (needs more to get effect)
Withdrawal symptoms when stopped
Unsuccessful attempts to quit
Continued use despite physical or mental harm
Neglect of responsibilities
Social or recreational activities reduced
🟥 Tobacco Withdrawal Symptoms:
Irritability, anxiety, restlessness
Headache, fatigue
Increased appetite, weight gain
Craving for tobacco
Difficulty concentrating
Depressed mood
Peak within 2–3 days; can last weeks
⚠️ Health Complications of Tobacco Use:
🩺 Smoking-related:
Lung cancer, COPD, asthma
Cardiovascular diseases (MI, stroke)
Oral and throat cancer
Low birth weight in newborns
Premature aging and infertility
🦷 Smokeless tobacco-related:
Oral cancer (tongue, cheek, lips)
Tooth loss, gum disease
Foul breath, stained teeth
Esophageal or pancreatic cancers
🩺 Management of Tobacco Use Disorder:
🟨 1. Behavioral Therapies:
Brief intervention and motivational interviewing (5 A’s): 🔹 Ask – about tobacco use 🔹 Advise – to quit 🔹 Assess – readiness 🔹 Assist – with plan 🔹 Arrange – follow-up
Non-nicotine medications: 🔸 Bupropion (Zyban) – antidepressant that reduces craving 🔸 Varenicline (Chantix) – reduces nicotine effects on brain
👩⚕️ Nursing Responsibilities:
Assess tobacco history (age started, frequency, form)
Use screening tools: Fagerström Test for Nicotine Dependence
Educate about health hazards and quitting benefits
Support NRT administration and monitoring
Encourage family support
Refer to tobacco cessation clinics or helplines
📚 Golden One-Liners for Quick Revision:
🟩 Nicotine = main addictive substance in tobacco
🟧 Tolerance and withdrawal = key signs of tobacco addiction
🟨 CBT + NRT = most effective combination
🟥 Smokeless tobacco → oral cancers
🟦 5 A’s = Ask, Advise, Assess, Assist, Arrange
🟧 Varenicline and Bupropion = prescription quit-smoking aids
✅ Top 5 MCQs for Practice:
Q1. Which chemical causes addiction in tobacco? 🅰️ Carbon monoxide ✅ 🅱️ Nicotine 🅲️ Tar 🅳️ Lead Answer: ✅ (b)
Q2. A common withdrawal symptom of tobacco is: 🅰️ Hypotension 🅱️ Diarrhea ✅ 🅲️ Irritability and craving 🅳️ Rash Answer: ✅ (c)
Q3. Which therapy helps reduce craving for tobacco? 🅰️ Haloperidol 🅱️ Fluoxetine ✅ 🅲️ Bupropion 🅳️ Naloxone Answer: ✅ (c)
Q4. Which tool assesses nicotine dependence? 🅰️ CAGE 🅱️ MMSE ✅ 🅲️ Fagerström Test 🅳️ PHQ-9 Answer: ✅ (c)
Q5. Oral cancer is most associated with which form of tobacco? 🅰️ E-cigarettes 🅱️ Cigars ✅ 🅲️ Smokeless tobacco 🅳️ Hookah Answer: ✅ (c)
🧪💨 Inhalant Use Disorder
📘 Essential for Psychiatric Nursing, Pediatric Nursing, Community Health & Staff Nurse Exams
🔰 Definition:
Inhalant Use Disorder is a condition characterized by the compulsive use of volatile chemical substances (inhalants) through sniffing or huffing, which produce mind-altering effects, despite negative physical, psychological, and social consequences.
✅ Most common among children and adolescents due to low cost and easy availability.
“It’s not what you inject, but what you inhale — and it can kill instantly.”
🧪 Commonly Abused Inhalants:
Category
Examples
Volatile solvents
Glue, paint thinner, nail polish remover
Aerosols
Deodorants, spray paints
Gases
Butane, propane, nitrous oxide (laughing gas)
Nitrites
Amyl nitrite, “poppers”
Cleaning agents
Petrol, varnish, correction fluid
🧠 Acute Effects of Inhalants (Intoxication):
🟩 Psychological Signs:
Euphoria, excitement
Disorientation, hallucinations
Dizziness, confusion
Poor judgment, loss of inhibition
Aggression or paranoia (in some cases)
🟨 Physical Signs:
Slurred speech
Red or watery eyes
Runny nose, chemical odor on breath or clothes
Unsteady gait (ataxia)
Nausea, vomiting
Hyporeflexia
Drowsiness, headache
🟥 Complications of Inhalant Use:
Sudden Sniffing Death Syndrome (cardiac arrest)
Hypoxia → irreversible brain damage
Liver and kidney damage
Peripheral neuropathy
Hearing loss
Seizures, coma
Social withdrawal, school failure
Burns and accidents (flammable substances)
🚨 Withdrawal Symptoms:(Not as severe as alcohol/opioids)
Irritability, anxiety
Sleep disturbance
Headaches
Nausea
Craving to sniff again
Depression
🩺 Management of Inhalant Use Disorder:
🟩 1. Acute Intoxication:
Move patient to well-ventilated area
Administer oxygen if hypoxic
Monitor vital signs and mental status
Benzodiazepines for severe agitation or seizures
Keep patient calm and safe
🟨 2. Long-Term Management:
Cognitive Behavioral Therapy (CBT)
Motivational Interviewing (MI)
Group and family counseling
School-based awareness programs
Social skill training and relapse prevention
🟧 3. Rehabilitation and Follow-Up:
Refer to de-addiction centers (especially for adolescents)
Build life skills and hobbies
Monitor for dual diagnosis (e.g., depression + inhalant use)
👩⚕️ Nursing Responsibilities:
Assess for signs: stains, odors, behavioral change
Provide non-judgmental, empathetic care
Educate adolescent and family about dangers
Collaborate with school, social worker, counselor
Reinforce health education, coping skills, peer resistance
Monitor for relapse and self-harm behavior
📚 Golden One-Liners for Revision:
🟨 Inhalant abuse is common in adolescents
🟥 Sudden sniffing death = fatal arrhythmia from inhalant use
🟩 Most abused inhalants: glue, petrol, correction fluid
🟧 No specific detox meds → CBT is mainstay
🟦 Signs: red eyes, chemical smell, poor school performance
🟥 Complications include brain, heart, liver damage
✅ Top 5 MCQs for Practice:
Q1. Which group is most vulnerable to inhalant abuse? 🅰️ Elderly men ✅ 🅱️ Adolescents 🅲️ Pregnant women 🅳️ Cardiac patients Answer: ✅ (b)
Q2. A common physical sign of inhalant use is: 🅰️ Miosis 🅱️ Jaundice ✅ 🅲️ Red eyes with chemical odor 🅳️ Petechiae Answer: ✅ (c)
Q3. Which life-threatening complication is linked to inhalant use? 🅰️ Liver cirrhosis ✅ 🅱️ Sudden sniffing death syndrome 🅲️ Anemia 🅳️ Seizure aura Answer: ✅ (b)
Q4. Most effective therapy for long-term recovery is: 🅰️ Electroconvulsive therapy ✅ 🅱️ Cognitive Behavioral Therapy (CBT) 🅲️ Chemotherapy 🅳️ Radiation Answer: ✅ (b)
Q5. Inhalant withdrawal is best described as: 🅰️ Physically dangerous ✅ 🅱️ Mild but includes craving and irritability 🅲️ Life-threatening 🅳️ Painless and invisible Answer: ✅ (b)
🏫📚 School-Based Drug Education Programs
📘 Essential for Community Health Nursing, Adolescent Health, and Staff Nurse Exams
🔰 Definition:
School-Based Drug Education Programs are structured interventions conducted in schools to educate children and adolescents about the risks of substance abuse, promote healthy behavior, and develop life skills to prevent drug use.
✅ These programs aim at early prevention, behavioral development, and community awareness.
“Teach prevention before addiction takes root.”
🎯 Objectives:
Raise awareness about harmful effects of drugs
Promote positive decision-making and refusal skills
Delay or prevent onset of substance use
Improve emotional intelligence and self-control
Reduce peer pressure and risky behaviors
Strengthen protective factors like family and school support
🧭 Key Components of School Drug Education:
🟩 1. Knowledge-Based:
Basic facts on types of drugs (tobacco, alcohol, inhalants, etc.)
Short- and long-term health effects
Legal implications of drug use
Impact on mental health and social life
🟨 2. Skill-Based:
Decision-making and problem-solving
Refusal skills to say no to drugs
Coping with peer pressure
Goal setting and self-confidence building
🟧 3. Value-Based:
Respect for body and health
Building self-esteem and responsibility
Encouraging drug-free lifestyle choices
🏥 Models Used in Drug Education Programs:
Model Type
Focus Area
Information Model
Facts about drugs and effects
Affective Model
Feelings, attitudes, self-awareness
Social Influence Model
Peer pressure, assertiveness training
Life Skills Model
Resilience, emotional regulation
Harm Reduction Model
Minimize harm if use occurs
🇮🇳 Notable Indian Programs & Guidelines:
🟥 1. NCERT Curriculum on Substance Abuse (Classes VI–XII)
Integrated into science, health, and social studies
🟦 2. Nasha Mukt Bharat Abhiyan
Govt. campaign to create drug-free campuses
Awareness rallies, poster-making, pledges
🟩 3. NGOs & School Collaborations
PRAKASH Foundation, NIMHANS modules
Student Health Clubs and Youth Forums
👩⚕️ Role of Nurse in School Drug Education:
Organize awareness sessions and group discussions
Use visual aids, posters, storytelling, role-plays
Early identification of at-risk students
Referral to counselors or de-addiction centers
Coordinate with teachers and parents
Encourage peer-led education programs
Participate in national campaigns like Nasha Mukt Bharat
📚 Golden One-Liners for Quick Revision:
🟨 School drug education = early prevention of addiction
🟧 Life skills model = best for adolescent empowerment
🟩 Nurse conducts sessions using visuals, peer-led talks, role plays
🟥 Refusal skills training = key to resist peer pressure
🟦 Indian programs include NCERT, Nasha Mukt Bharat Abhiyan
✅ Top 5 MCQs for Practice:
Q1. Main goal of school-based drug education is to: 🅰️ Punish users 🅱️ Promote drug use ✅ 🅲️ Prevent initiation of substance abuse 🅳️ Expel addicted students Answer: ✅ (c)
Q2. Which skill is emphasized to help students say “NO” to drugs? 🅰️ Cooking skill 🅱️ Singing skill ✅ 🅲️ Refusal skill 🅳️ Painting skill Answer: ✅ (c)
Q3. “Nasha Mukt Bharat Abhiyan” is launched by: 🅰️ UNICEF 🅱️ WHO ✅ 🅲️ Government of India 🅳️ Red Cross Answer: ✅ (c)
Q4. Best teaching method in adolescent drug education is: 🅰️ Lecture only ✅ 🅱️ Role-play and group discussion 🅲️ Dictation 🅳️ Written test Answer: ✅ (b)
Q5. Life skills in drug prevention include: 🅰️ Gambling skills ✅ 🅱️ Decision-making and coping skills 🅲️ Story writing 🅳️ Gymnastics Answer: ✅ (b)