Name: Dompor, Sharmaigne Rose G. Case: Alcoholism Definition: The term "alcoholism" refers to a disease known as alcohol dependence syndrome, the most severe stage of a group of drinking problems which begins with binge drinking and alcohol abuse. The Diagnostic and Statistical Manual of Mental Disorders, IV, defines alcohol abuse as drinking despite alcohol-related physical, social, psychological, or occupational problems, or drinking in dangerous situations, such as while driving. The World Health Organization's International Classification of Diseases refers to "harmful use" of alcohol, or drinking that causes either physical or mental damage in the absence of alcohol dependence. In other words, alcohol abuse is any harmful use of alcohol. Alcohol (ethanol) is a sedative anesthetics found in various proportions of liquor, wine, and beer. Alcohol produces a sedative effect by depressing the central nervous system (CNS). This effect causes the individual to experienced relaxed inhibitions, heightened emotions, mood swings that can range from bouts of gaiety to angry outburst, and cognitive impairments such as reduced concentration or attention span, and impaired judgment and memory. Depending on the amount of alcohol ingested, the effects can range from feelings of mild sedation and relaxation, to confusion and serious impairment of motor function and speech, to serve intoxication that can result into coma, respiratory failure and death. Signs and Symptoms
The intensity of CNS impairments depends on how much alcohol is consumed in a given period of time and how the body metabolizes it. Intoxication is determined by the level of alcohol in the blood, called blood alcohol level (BAL). The body metabolize 1 oz of liquor, a 5 oz of wine, or a 12-oz can of beer per hour without intoxication. Behavior and Blood Alcohol Levels Number of drinks
1-2
Blood alcohol levels (mg %) 0.05
5-6
0.10
10-12
0.20
15-20
0.30
20-24 25
0.40 0.50
Behavior
Impaired judgment, giddiness, mood changes Difficulty driving and coordinatin g movements Motor functions severely impaired, resulting in ataxia. There is emotional lability. Stupor, disorientation, and confusion Come Respiratory failure, death
Symptoms of Alcoholism For someone who is alcoholic or alcohol dependent, the symptoms include all of those associated with alcohol abuse (above). But alcoholics also continue to drink in spite of all the problems it has caused in their lives. When alcohol abuse reaches the alcohol dependence stage, the person also experiences at least three of seven other symptoms, including neglect of other activities, excessive use of alcohol, impaired control of alcohol consumption, persistence of alcohol use, large amounts of time spent in alcohol-related activities, withdrawal symptoms and tolerance of alcohol.
Symptoms of Alcohol Dependence •
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Neglect of other Activities : Important social, occupational, or recreational activities are given up or reduced because of alcohol use; Excessive Use: Alcohol is consumed in larger amounts over a longer period than intended; Impaired control : Ongoing, unsuccessful efforts to cut down or control alcohol consumption; Persistence of Use: Alcohol consumption is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely caused or exacerbated by alcohol; Large Amounts of Time Spent in Alcohol Related Activities: A great deal of time is spent in activities necessary to obtain, use or recover from the effects of alcohol; Withdrawal: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety when alcohol use is stopped after a period of heavy drinking; Tolerance : The need for increasing amounts of alcohol in order to feel its effects.
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Pathophysiology Rapid Alcohol intake ↓ Accumulation of acetaldehyde ↓ Acetaldehyde combines with the neurotransmitters dopamine and serotonin ↓ Tetrahydroisoquinolone and ß-cabolines ↓ More rapid metabolism of alcohol and decreased response to sedating, motor and demonstrates higher BAL ↓ Alcohol tolerance
Treatment of Alcoholism
Alcoholism is a treatable disease and many treatment programs and approaches are available to support alcoholics who have decided to get help, but no medical cure available. Regardless of how someone is diagnosed as alcohol dependent or how they came to realize they have a serious drinking problem, the first step to treatment is a sincere desire to get help. Alcoholics who are pressured into treatment by social pressure or forced to quit by circumstances rarely succeed in the long run. Even most alcoholics who seek help on their own volition have at least one relapse before they obtain long-term sobriety. Special medications Campral (acamprosate calcium) is the most recent medication approved for the treatment of alcohol dependence or alcoholism in the United States -- approved by the Food and Drug Administration in July 2004 -- but it has been used widely in Europe for many years.
Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid addiction. Naltrexone hydrochloride is sold as the brand name Revia and Depade. An extended-release form of Naltrexone is marketed in some countries under the trade name Vivitrol. Antabuse, or disulfiram as it is also known, was the first medicine approved for the treatment of alcohol abuse and alcohol dependence.
Nalmefene
Nalmefene, also known as Revex, is used in the medical treatment of alcoholism because it has been found to reduce craving for some alcohol dependent patients. Nalmefene May Reduce Relapse Researchers at the University of Miami have found that nalmefene significantly reduces replapse in alcoholics. Nalmefene Reduces Relapse Risk Nalmefene, an opioid antagonist that is not now commercially available in the oral form studied, is effective in preventing relapse to heavy drinking in alcohol dependent individuals.
Nalmefene Treatment Nalmefene is a newer opioid antagonist that, like naltrexone, has no agonist activity and no abuse potential. Additional advantages include a longer half-life, greater bioavailability and no dose-dependent liver toxicity. Naltrexone
Marketed as Revia, Naltrexone is a narcotic antagonist which has also been shown to reduce craving and consumption for some patients who are alcohol dependent. Once-A-Month Naltrexone Injection Successful Because of problems with adherence to a daily oral dose of naltrexone, the effectiveness found in treating alcohol dependence with a once-a-month injection of naltrexone could improve long-term treatment outcomes. Naltrexone Injections Show Promise for Alcoholism Findings from the first multi-site examination of the effectiveness of an inject-able, longacting formulation of naltrexone show significantly fewer drinking days and a greater likelihood of total abstinence during the three-month study period. Genetics May Determine Naltrexone's Effectiveness Researchers have found that genetics may play a role in why Naltrexone, a medication used to reduce cravings in people trying to quit drinking, works for some and not for others. Naltrexone Test Set for Schizophrenic Alcoholics The rate of alcoholism in people who have been diagnosed as schizophrenics is much higher than in the general population, and a New York psychiatrist plans research to see if Naltrexone is effective in treating the problem. Nursing interventions and treatment modalities
Several treatment modalities are used in most addiction treatment, including:
12-step-program-focused cognitive or psychoeducational behavioral group psychotherapy, and individual and family therapy.
Reaction: “Drink moderately” a very short ad but conveys a very long connotation. People may say that drinking alcoholic beverages is just there way of having fun, forgetting problems or relieving there stress and even helping them to go to sleep. “ my friends once told me that, there’s nothing wrong in drinking a glass of it, just to show respect to the person who invites you to drink.” And there right (haha), as long as your drinking in a moderate amount there’s nothing wrong. For many people, the facts about alcoholism are not clear. People must be aware of the term alcoholism, for them to realize that drinking to much is not just a simple habit or ways of having fun. Aside from the physical symptoms, which most people knows but just ignore it, the alcoholic’s personal lives may be affected. “I believe that we all have free will, we make decisions. There are bad decisions but deciding to prevent alcoholism is a very good decision to make.”
