SUBSTANCE ABUSE DISORDER. SUBSTANCE OF ABUSE. ALCOHOL MARIJUANA METHAMPHETAMINE OPIATES COCAINE BENZODIAZEPINES BARBITURATES KETAMINE. FACTS ABOUT ALCOHOLISM. Alcohol intoxication, dependence, and abuse are among the most prevalent mental disorders in the general populations
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SUBSTANCE OF ABUSE • ALCOHOL • MARIJUANA • METHAMPHETAMINE • OPIATES • COCAINE • BENZODIAZEPINES • BARBITURATES • KETAMINE
FACTS ABOUT ALCOHOLISM • Alcohol intoxication, dependence, and abuse are among the most prevalent mental disorders in the general populations • Alcoholism knows no racial barriers • It is the #1 drug of abuse in the USA • At least 15 million have serious alcohol-related problems • At least 4.6 million adolescents have serious alcohol related problems • Alcohol related cause is second to heart disease and cancer
Alcohol Intoxication • Is defined by the presence of important maladaptive behavioral or psychological changes due to alcohol ingestion; Inappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social, educational or occupational functioning.
Signs of alcohol intoxication • Slurred speech • Lack of coordination • Unsteady gait • Nystagmus • Impairment in attention and memory • Stupor or coma
Alcohol Withdrawal Syndrome • It developed after cessation of heavy and prolonged alcohol use. • Tremulousness • Insomnia • Nausea and vomiting • Autonomic hyperarousal • Transient visual, auditory and tactile hallucinations • Illusions • Psychomotor agitation • Grand mal seizures
Jellinek’s Type of Alcoholism • Alpha alcoholism: the earliest stage of the disease, manifesting the purely psychological continual dependence on the effects of alcohol to relieve bodily or emotional pain. This is the "problem drinker", whose drinking creates social and personal problems.
Jellinek’s Type of Alcoholism • Beta alcoholism: polyneuropathy, or cirrhosis of the liver from alcohol without physical or psychological dependence. These are the heavy drinkers that drink a lot, almost every day. They do not have physical addiction and do not suffer withdrawalsymptoms. This group do not have a "disease".
Jellinek’s Type of Alcoholism • Gamma alcoholism: acquired tissue tolerance, physical dependence, and loss of control. This is the AA alcoholic, who is very much out of control, and does, by Jellinek's classification, have a "disease". • Delta alcoholism: as in Gamma alcoholism, but with inability to abstain, instead of loss of control. • Epsilon alcoholism: the most advanced stage of the disease, manifesting as dipsomania, or periodic alcoholism.
Medications used to Control Alcoholism • Disulfiram (antabuse) • Acamprosate ( Aotal ) • Metronidazole ( Flagyl )
MEDICAL FINDINGS OF ALCOHOLISM • DEPRESSION • ANXIETY • PHOBIAS • SUICIDAL THINKING • DELUSIONS AND HALLUCINATIONS
MEDICAL COMPLICATIONS OF ALCOHOLISM • CARDIOVASCULAR • GASTROINTESTINAL • NUTRITIONAL • VITAMIN DEFICIENCY • ENDOCRINOLOGIC DEFECTS • NEUROLOGIC COMPLICATIONS • ONCOLOGY • INFECTIONS
CARDIOVASCULAR EFFECT OF ALCOHOLISM • HYPERTENSION • INCREASED PULSE RATE • ALCOHOLIC CARDIOMYOPATHY • EKG FINDINGS OF ATRIAL AND VENTRICULAR ARRYTHMIAS, INTRAVENTRICULA CONDUCTION ANOMALIES
GASTROINTESTINAL EFFECT OF ALCOHOLISM • Reflux esophagitis • Gastric and esophageal ulcer • Mallory Weiss syndrome • Erosive gastritis, atrophic gastritis, gastric hemorrhage • Chronic pancreatitis • Malabsorption and diarrhea • Fatty liver • Cirrhosis of the liver
Nutritional effect of alcoholism • Folic acid deficiency • Pyridoxine deficiency • Thiamine deficiency • Iron deficiency • Zinc deficiency • Vitamin A,D,K deficiency
Endocrinologic Effect of Alcoholism • Adrenocortical function • Adrenomedullary function • Thyroid function • Gonadal function • Pituitary function • Alcoholic hypoglycemia • Alcohol ketosis
Neurological Effect of Alcoholism • Wernicke’s - Korsakoff psychosis • Cerebral atrophy • Peripheral neuropathy • Alcohol myopathy
Oncological Effects of Alcoholism • Cancer of the mouth • Cancer of the tongue • Cancer of the oropharynx • CA of the hypopharynx • CA of the larynx • CA of the esophagus • CA of te liver
Infections and alcoholism • Pneumonia • Tuberculosis • Meningitis • Peritonitis • Ascending cholangitis • Pharyngitis