It is the overindulgence in and dependence on a psychoactive

agents leading to effects that are detrimental to the individuals

physical health or mental health, or the welfare of others.
ALCOHOLISM
The consumption of, or preoccupation with, alcoholic
beverages to the extent that this behavior interferes with the
drinkers normal personal, family, social, or work life, and may
lead to physical and/or mental harm.
Terminologies:
1. Use refers to simple use of a substance; an individual
who drinks any alcoholic beverage is using alcohol

Terminologies (cont.):
2. Misuse / Heavy Use suggest consumption of alcohol to
the point where it causes physical, social, or mental harm
to the drinker
3. Abuse within the field of medicine, refers to use of a
prescribed medication in excess of the prescribed
dosage
(note: there are medications that contains alcohol in
some percentage)
Alcohol Abuse means you engage in excessive drinking that
results in health or social problems, but you are not
dependent on alcohol & havent fully lost control over the use
of alcohol.

Terminologies (cont.):
4. Dependence
Physical dependence the bodys physical adaptation
to the persistent presence of alcohol (ex. Taking alcohol
will relieve them from physical pain
Psychological dependence a persons mental reliance
upon alcohol to maintain their mental status quo (ex.
Taking alcohol will relieve them from stress, worry, or
anxiety
Addiction refers to any condition which results in the
continuation of behaviors demonstrated as harmful to
that person

Signs & Symptoms:

Most alcoholics deny that they have a drinking problems
Indications of alcoholism and alcohol abuse include the
following
Drinking alone or in secret
Being unable to limit the amount of alcohol you drink
Not remembering conversation or commitments,
sometimes referred to as blocking out
Making a ritual of having drinks before, with or after
dinner and becoming annoyed when this ritual is
disturbed or questioned
Losing interest in activities or hobbies that used to
bring pleasure
Feeling a need or compulsion to drink
Irritability when your usual drinking time nears,
especially if alcohol is not available

 Keeping alcohol in unlikely places at home, at work or

in the car
Gulping drinks, ordering doubles, becoming
intoxicated intentionally to feel good or drinking to feel
normal
Having legal problems or problems with relationships,
employment, or finances
Building a tolerance to alcohol so that you need an
increasing number of drinks to feel the alcohols
effects
Experiencing physical withdrawal symptoms such as
nausea, sweating, & shaking if you dont drink

Causes / Risk Factors:

Factors that can lead and/or contribute to the addiction problems
Alcohol alters the balance of some chemicals in the brain
1. Genetics certain genetic factors causes a person to be
vulnerable to alcoholism & other addictions
2. Emotional State high levels of stress, anxiety or
emotional pain can lead some people to drink alcohol to
block out the turmoil
3. Psychological factors having a low self-esteem or
depression
4. Social & cultural factors having friends who drinks
regularly; the glamorous way that alcohol drinking is
portrayed by media

Causes / Risk Factors (cont.):

5. Age people who begin drinking at an early age are at
the higher risk of becoming an alcoholic
6. Sex men are more likely to abuse alcohol than women
7. Family History risk is higher for people who have
parents who abuse alcohol
Complications:
Alcohol depresses your CNS. Initial reaction may be
stimulation. As you continue to drink, you become
sedated.
Alcohol lowers your inhibitions & affects your thoughts,
emotions & judgment.

Complications (cont.):
Alcohol in excessive amount affects speech & muscle
coordination
Too much alcohol can depress the vital centers of the
brain COMA
Excessive alcohol can cause fatigue & short-term
memory loss as well as weakness & paralysis of your
eye muscles

Other Complications (severe health effects):

Liver Disorders causes alcoholic hepatitis cirrhosis
GIT Problems causes gastritis which interfere with the
absorption of vitamin B (folic acid & thiamin) & other
nutrients; can cause damage to the pancreas which
produces the hormones that regulate metabolism of
fats, proteins & carbohydrates
CVS Problems can lead to high BP & damage the heart
muscle (cardiomyopathy) high risk of heart failure or
stroke
DM complications alcohol prevents the release of
glucose from the liver & can increase the risk of low
blood sugar (hypoglycemia); this is dangerous if you
have diabetes & are already taking insulin.

 Sexual function & menstruation can cause erectile

dysfunction in men & interrupts menstruation in women
Birth defects alcohol use during pregnancy may cause
fetal alcohol syndrome (small head, heart defects,
shortening of the eyelids & other abnormalities);
developmental disabilities are likely as well
Bone loss interfere with the production of new bone;
can lead to thinning of the bones fractures
Neurological complications cause numbness of hands
& feet; disordered thinking & dementia
Risk of Cancer chronic alcohol abuse has been linked
to a higher risk of cancer of the esophagus, larynx, liver
& colon

Other Complications:
Domestic abuse & divorce
Poor performance at work or school
Increased likelihood of motor vehicle fatalities and arrest
for drunken driving
Greater susceptibility to accidental injuries from other
causes
Higher incidence of suicide and murder

ALCOHOL WITHDRAWAL
Heavy consumption of alcohol results in the reduction of
GABA (neuro-inhibitor)
Abrupt stop results in inadequate quantities of GABA
No synaptic inhibition / uncontrolled firing of synapses
No inhibitory / depressant action from alcohol
Hallucination
Tremors
Convulsions
Possible heart failure

Delirium tremens

Treatments:
i. Detoxification & withdrawal takes about 4-7 days; need
to take sedating medications to prevent delirium
tremens & other withdrawal seizures
ii. Medical assessment & treatment common medical
problems related to alcoholism are high BP, increase
blood sugar, liver & heart disease are addressed or
treated
iii. Psychological support & psychiatric treatment
counseling & therapy support recovery from the
psychological aspects of alcoholism; family support can
be an important part of the recovery process; involving
the spouse in the treatment process may increase the
chances of successful recovery

Treatments (cont):
iv. Emphasis on acceptance & abstinence effective
treatment is impossible unless you accept that youre
addicted & unable to control your drinking
v. Drug treatment an alcohol-sensitizing drug called
disulfiram (Antabuse) may be a strong deterrent if
taken with alcohol, produces severe physical reactions
flushing, nausea, vomiting & headaches; Naltrexone
(Revia), also reduces a recovering alcoholics urge to
drink; Acamprosate (Campral), an anti-craving
medication that may help you combat alcohol cravings
& remain abstinent from alcohol
vi. Continuing support aftercare programs helps
recovering alcoholics abstain from alcohol, manages
relapse & cope with necessary lifestyle changes

Prevention:
1) Knowing & recognizing a family history of alcoholism,
an important steps toward seeking treatment.
2) Early intervention is particularly important to prevent
alcohol dependence especially teenagers.
3) Recognizing that the likelihood of alcohol addiction
depends on the influence of parents, peers & other role
models, susceptibility to advertising, how early in life
they begin to use alcohol, the psychological need for
alcohol & genetic factors which predisposes them to
addiction.

Prevention (cont.):
4) To prevent teenage alcohol use, start be setting a good
example with your own alcohol use. Talk openly with
your child & spend quality time together but respects
your childs need for independence. Let your child know
what behavior you expect and what the consequences
will be if he or she doesnt follow the rules. Make sure
your child understands the legal & medical
consequences of drinking.

Slides

Cirrhotic Liver

Normal Heart

Enlarged Heart

Hepatocellular Carcinoma (Liver Cancer)

Gastritis

Cancer of the Larynx

Drug Addiction

DRUG ADDICTION
A compulsive use of psychoactive drugs to the point where the
user has no effective choice but to continue use.
Two (2) Components of Drug Addiction:
1. Physical Dependency
occurs when a drug has been used habitually and the
body has become accustomed to its effects
the person must then continue to use the drug in order
to feel normal, or its absence will trigger the symptoms of
withdrawal

2. Psychological Dependency
occurs when a drug has been used habitually & the
mind has become emotionally reliant on its effects, either
to elicit pleasure or relieve pain, and does not feel capable
of functioning without it
Characteristics of Drug Addiction:
1. An overpowering desire or need (compulsion) to continue
taking the drug & to obtain it by any means
2. A tendency to increase the dose
3. A Psychic (psychological) & generally a physical
dependence on the effects of the drug

Other TERMS:
Tolerance the bodys physical adaptation to a drug;
greater amounts of the drug are required over time to
achieve the initial effect as the body gets used to and
adapts to the intake
Example:
Some anesthesia medications are alcohol-based. If you
are an alcoholic, you may need more amounts of
anesthesia than the usual dose given to a non-alcoholic
person.
Same thing with narcotic analgesics. If you are a
narcotic drug addict (like using ketamine, morphine,
opium, cocaine), you need higher doses of medications
to relieve your pain.

 Pseudoaddiction used to describe patient behaviors that

may occur when pain is under treated; patients with
unrelieved pain may become focused on obtaining
medications
Scientific Basis for Drug Addiction:
Addictive drugs change the brains reward function
located in the mesolimbic dopamine system.
Addictive drugs flood this system with excessive amounts
of dopamine, creating a brief rush of euphoria commonly
called a high.
The brain associates the use of the drug with intense
pleasure & well-being & the association strengthens with
each subsequent intake or use.

 Over time, this intense pleasure will dominate normal

thoughts & desire.
Two Ways of Activating the Brains Reward System:
Depressants (alcohol, benzodiazepines, morphine)
are called downers
facilitate relaxation & pain relief
Stimulants (amphetamines, nicotine, cocaine)
are called uppers
heightens alertness & energy

Note:

Many prescription or over the counter drugs can

become addictive if abused
Alcohol
Cocaine
Caffeine
Ketamine
Meprobamate
Morphine
Opium
Paraldehyde

Analgesics
Codeine
Heroin
Laxatives
Amphetamines
Nicotine
Opiates
Phencyclidine

Barbiturates
Dextromethorphan
Hydrocodone
Meperidine
Methadone
Oxycodone
Benzodiazepines
Flunitrazepam

Therapy:
Psychological behavior modification methods
Replacement drugs to gradually wean the user
Residential treatment program (Rehabilitation Centers)
this is for seriously addicted individual in order to isolate
the patient from drugs & interactions with other users &
dealers

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