Alcohol use and its effects Problem drinking is now our third major health hazard, after heart disease and cancer. Continued alcohol misuse can lead to social, legal, domestic, job and financial problems. It may also cut a lifespan by 10-15 years and lead to overdosing, suicide, accidents and death from drink driving
Why people drink or take drugs “People think its all about misery and desperation and death and all that shite, which is not to be ignored, but, what they forget is the pleasure of it…otherwise we wouldn’t do it!” ‘Trainspotting’ by Irvine Welsh
HISTORICAL PERSPECTIVE OF ALCOHOL USE • Historical records of drunkenness exist from the 7th century • The church was particularly vocal on the issue of drunkenness, considering it a ‘sin against God’ • Many historical records show harsh punishments for drunkenness, with priests defrocked and laymen imprisoned • Alcohol has historically been used at celebrations (after battles/wars, social events) and large-scale drunkenness was not uncommon
HISTORICAL PERSPECTIVE OF ALCOHOL USE • In 1552 public drunkenness became an offence for the first time under civil law • In the middle-ages the drinking of gin became such a problem that Parliament was forced to heavily tax it with the introduction of the Gin Act in 1776 • The origin of the disease concept of alcoholism has been credited to Benjamin Rush 1745 in the USA and Thomas Trotter in the UK
HISTORICAL PERSPECTIVE OF ALCOHOL USE Rush argued that excessive use of spirits created an ‘imbalance’ in the nervous system and identified alcoholism as a ‘disease’ in which alcohol is the causal agent, loss of control over drinking behaviour the characteristic symptom, and total abstinence the only effective cure.
HISTORICAL PERSPECTIVE OF ALCOHOL USE • During the 19th century, many chronic alcoholics were incarcerated in lunatic asylums. This practice continued well into the 20th century. • In 1890 William Booth, founder of the Salvation Army, identified alcohol use as an escape mechanism from poverty. • The first world War of 1917 killed drunkenness as an issue of public concern in this county
HISTORICAL PERSPECTIVE OF ALCOHOL USE • However, consumption of alcohol became so critical in the USA that its use was prohibited by law in 1920. The Law was repealed in 1933 • The disease concept of alcoholism has evolved over the past 250 years due to advancement in medicine, public health and psychiatry. However, public attitudes to drunkenness have changed little over the centuries • Punitive measures continue to be regarded as the solution to alcoholic behaviour. The latest government thinking is of course…”stop their benefits”
Alcohol and its effects • Reward: to start with people drink for many different reasons; to feel good, confident, relaxed, to keep fear or shyness at bay and to increase a persons confidence or to keep bad feelings or memories at bay • All of these effects constitute a pay-off or reward for the user. The reward system is part of our survival kit, which has evolved to ensure the survival of the species, and makes essential activities such as eating, drinking, and sex pleasurable. The reward system releases opiods, (opiate-like substances), neurotransmitters which raise our dopamine levels and create a feeling of satisfaction. That feeling can become addictive
Alcohol and its effects • Tolerance; people drink for those rewards but always seem to fall short of them. This creates the need to drink larger amounts and for longer periods of time to produce the same effect and reward. They gradually fall short of the reward or pay off that they seek. • Dependence; at this stage the person needs to drink to function normally and satisfy the craving they experience. If they stop drinking they get the opposite effect of reward; depression, agitation, irritability, and then withdrawal. These effects are devastating to the person. Starting to drink again seems a better option than stopping.
Can lead to Addiction • Cycle of addiction; dependence is the need for continued use to avoid the physical and psychological withdrawal – tremors, sweating, cramps, diarrhoea, vomiting, cravings, depression etc. The cycle of addiction has begun
Symptoms of Alcoholism • Increase of tolerance, (needs more to get same effect) • Temporary loss of memory starts to occur, (blackouts) • Sneaking drinks or hiding the amount drunk • Preoccupation with drinking • Hurrying drinking, (effect needed not the social participation • Avoiding any reference to amount of drinking taking place or reductionism • Loss of control, (inability to predict the amount you will drink once you start) • Excuses, justification • Extravagant cost, (can’t really afford it; going without essentials to pay for it) • Aggression, (verbal or physical)
Symptoms of Alcoholism • Remorse, depression, guilt • Failed attempts to stop • Change in drinking patterns, and drinks • Loss of friendships, relationships • Resentments • Heightened self-centredness • Poor me, self pity • Stashing supply • Drinking first thing on a morning • Violating own moral standards
Symptoms of Alcoholism • Tolerance decreased, now need less to get drunk • Irrational fears • Irrational thinking, paranoia • Tremors, hand shaking • Inability to perform routine tasks without a drink • Confidence severely deteriorated without a drink • Knows needs help but finds excuses not to take up help