title: Heatwaves and their impact on people with alcohol, drug and mental health conditions: a discussion paper on clinical practice considerations.
abstract: OBJECTIVE
  This article discusses the clinical implications of adverse health outcomes derived during heatwaves for people with mental health disorders, substance misuse and those taking prescribed medications such as lithium, various neuroleptic and anticholinergic drugs.
  
  
  BACKGROUND
  With climate change it is predicted that the incidence of prolonged periods of extreme heat will increase. Specific adverse health outcomes associated with high environmental temperatures include heat stroke and heat exhaustion. Those at increased risk for heat-related mortality are those with chronic health conditions, including those with mental health disorders and substance misuse.
  
  
  METHODS
  Sources of evidence included and 'grey' literature published between 1985 and 2010, such as key texts, empirical research, public policies, training manuals and community information sheets on heat waves.
  
  
  CONCLUSIONS
  Current clinical practice and clinical impact of heatwaves on those people with comorbidity is explored. This includes the physiological components of heat stress, heat regulation, and the impact of alcohol and other drugs; and, ramifications and professional practice issues for those with mental health conditions and those requiring mental health medications.
  
  
  CONCLUSIONS
  Client education covering modification of the environment and the use of client heat safety action plans. Secure, accessible stores of prescribed medication are recommended and emergency substance withdrawal kits could be made available.
  
  
  CONCLUSIONS
  All nurses have a responsibility to increase the capability and resilience of their clients to manage their chronic health needs during a heatwave. At these times nurses need to give extra monitoring and assistance when clients lack the capacity or resources to protect themselves.
authors.affiliation: School of Nursing and Midwifery, Faculty of Health Science, Flinders University, Adelaide, South Australia, Australia. lynette.cusack@flinders.edu.au
authors.forename: Lynette
authors.initials: L
authors.lastname: Cusack
authors.forename: Charlotte
authors.initials: C
authors.lastname: de Crespigny
authors.forename: Peter
authors.initials: P
authors.lastname: Athanasos
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D001315:Australia / Q000453:epidemiology; D001833:Body Temperature Regulation / Q000187:drug effects / Q000502:physiology; D002908:Chronic Disease; D002985:Clinical Protocols; D015897:Comorbidity; D054597:Disaster Medicine; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D057232:Global Warming; D018882:Heat Stress Disorders / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000451:nursing; D024802:Nurse's Role; D010353:Patient Education as Topic; D011619:Psychotropic Drugs / Q000009:adverse effects; D012307:Risk Factors; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy / Q000209:etiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000451:nursing / Q000503:physiopathology
chemical_list: D011619:Psychotropic Drugs