Alcoholism and Drug Abuse: Study Guide

Alcoholism and Drug Abuse: Study Notes

Alcoholism

• Alcoholics are individuals who drink to escape emotional distress.
• Alcoholism involves extreme dependence on excessive alcohol consumption.
• It is a chronic, progressive disease with compulsive alcohol intake leading to psychological, social, and physical decline.

Effects of Alcohol

• Affects the central nervous system, potentially leading to brain damage.
• Inhibits behavioral control in the cerebral cortex.
• Increases pulse rate.
• Causes vasodilation.
• Can result in liver cirrhosis and polyneuropathy, a degenerative nerve disease.

Progression of Alcoholism

Stage I

• Characterized by regular social drinking.
• Individuals seldom leave a party intoxicated.
• Alcohol tolerance increases gradually.
• The habit of having "quick ones" after work or before dinner develops.
• Occasional resort to alcohol occurs under pressure.

Stage II

• Occasional drinking begins at odd times of the day.
• Drinking increases under pressure.
• Food consumption is delayed to continue drinking.
• Feelings of guilt about drinking are absent.
• Memory blackouts start.
• Drinks are consumed more quickly and excessively compared to others.
• Individuals start blaming others for their drinking habits.

Stage III

• Psychological addiction has occurred.
• Incidents of speeding tickets and auto accidents (minor and major) occur.
• Attempts to stop drinking consistently fail.
• Acute resentment and anger towards friends and family develop.
• Social problems arise.
• Individuals keep problems to themself.
• Meals are taken sporadically.
• The person seeks out drinking buddies.
• Solitary drinking increases.
• Blackout incidents increase.

Stage IV

• A constant state of depression prevails.
• Job loss is likely to occur.
• Drinking is the person's sole interest.
• Family break-up is likely to occur.
• Alcohol tolerance increases further.
• Malnutrition can set in.
• Lack of concern for personal hygiene.
• Acute medical problems arises.
• Death may occur.

Types of Alcohol: Ethanol ("Grain Alcohol")

• Ethanol induces diuresis by inhibiting ADH (antidiuretic hormone).
• It is readily absorbed in the GIT and diffuses easily in tissues.
• Can lead to acidosis and increased blood osmolality.
• Accumulation of ketones and lactate occurs.
• It causes direct generation of hydrogen ions as alcohol is oxidized.
• Chronic consumption is defined as 50g of ethanol per day for approximately 10 years.

Types of Alcohol: Methanol ("Wood Alcohol")

• Methanol causes symptoms such as frank blindness (ocular toxicity) and metabolic acidosis.
• It is fatal in doses of 60-250 mL.
• A toxic blood level is > 50 mg/dL.

Isopropanol

• Isopropanol known as "rubbing alcohol."

Ethylene Glycol

• Is found in hydraulic brake fluid.
• Symptoms include metabolic acidosis, depressed reflexes, anuria, and necrosis.
• Treatment involves inhibiting alcohol dehydrogenase action.
• Calcium oxalate crystals (monohydrate) in the renal tubules indicate toxicity.
• Glycolic acid is a major metabolite causing acute toxicity and death.
• Fatal at 100 grams.

Laboratory Indicators of Alcohol Abuse

• Elevated Gamma-Glutamyl Transferase (GGT) levels
• Increased Aminoaspartate Transferase (AST) / Serum Glutamate-Oxaloacetate Transferase (SGOT)
• Elevated Aminoalanine Transferase (ALT) / Serum Glutamate-Pyruvate Transferase (SGPT)
• Elevated of High-Density Lipoprotein (HDL)
• Increased Mean Corpuscular Volume (MCV).

Drug Abuse

• Drug abuse involves use of medically useful drugs without prescription, or using dangerous chemicals.
• These substances change a person's mood and behavior.
• Drugs are useful medicines but can be harmful if abused.

Drug Dependence

• Drug dependent people uses drug continuously and cannot do without it

Drug Habituation

• Arises from repeated consumption of drugs

Characteristics of Drug Habituation

• It causes a desire to continue the intake to improve well-being
• There is little/no tendency to increase the dose
• There is a degree of psychic dependence on the drug
• It has detrimental effects

Drug Addiction

• A state of periodic or chronic intoxication produced by the repeated consumption of drugs

Characteristics of Drug Addiction

• There is an overwhelming need to take drugs, obtained by any means
• Develop tolerance, causes a need to increase the dose
• Can have psychic/physical dependence
• Detrimental effects on both individual and society

Prevention of Substance Use

Public Health Model Components

• Host: Focuses on individual's knowledge, attitudes about alcohol/drugs that influence abuse.
• Agent: Emphasizes the contents, distribution, and availability influencing abuse patterns.
• Environment: Addresses substance use setting and community mores influencing use.

Distribution of Consumption Model

• A direct relationship is said to exist between per capita consumption and prevalence of alcohol/drug use
• Increased opportunities to drink lead to increased drinking and drunkenness.

Socio-Cultural Model

• Emphasizes relationship between alcohol problems and patterns of alcohol use with society

Hallucinogens: Lysergic Acid Diethylamide (LSD)

• Street names include "Acid", "Blotter", "Cubes", "Boomers", "Microdots", "Yellow Sunshine", "Windowpane".
• LSD is a colorless, odorless, tasteless liquid/