Professional Documents
Culture Documents
Disorders
Alcohol-Related
Disorders
the average alcohol-dependent person
decreases his or her life span by 10 to 15
years, and alcohol contributes to 22,000
deaths and 2 million nonfatal injuries each
year
at any time, two of three men are drinkers,
with a ratio of persisting alcohol intake of
approximately 1.3 men to 1.0 women, and
the highest prevalence of drinking is from
the middle or late teens to the mid-20s.
Comorbidity
Etiology
Psychological Theories
Psychodynamic Theories
some people may use this drug to
help them deal with self-punitive
harsh superegos and to decrease
unconscious stress levels
classic psychoanalytical theory
hypothesizes that at least some
alcoholic people may have become
fixated at the oral stage of
development and use alcohol to
relieve their frustrations by taking
the substance by mouth
Genetic Theories
Effects of Alcohol
Absorption
10 % of consumed alcohol is
absorbed from the stomach, the
remainder from the small intestine
peak blood concentration is
reached in 30-90 minutes
whether the alcohol was taken on
an empty stomach (which
enhances absorption) or with food
(which delays absorption)
Metabolism
90 % - metabolized through oxidation in the liver; the
remaining 10 percent is excreted unchanged by the
kidneys and lungs.
rate of oxidation by the liver is constant and the
body can metabolize about 15 mg/dL per hour, with a
range of 10 to 34 mg/dL per hour
the average person oxidizes three fourths of an ounce
of 40 percent (80 proof) alcohol in an hour
Behavioral Effects
0.05 % : thought, judgment, and restraint are loosened and
disrupted
0.1 % : voluntary motor actions usually become
perceptibly clumsy
0.1 - 0.15 % : legal intoxication
0.2 % :
the function of the entire motor area of the brain
is measurably depressed, and the parts of the brain that
control emotional behavior are also affected
0.3
% : confused or may become stuporous
0.4 - 0.5 % : coma
at higher levels, the primitive centers of the brain that
control breathing and heart rate are affected, and death
ensues
Liver
liver damage
Gastrointestinal System
esophagitis, gastritis, achlorhydria, and gastric
slurred speech
incoordination
unsteady gait
nystagmus
stupor or coma
D. The symptoms are not due to a general medical condition and are not
better accounted for by another mental disorder.
A. Cessation of (or reduction in) alcohol use that has been heavy and prolonged.
B. Two (or more) of the following, developing within several hours to a few days
after Criterion A:
insomnia
nausea or vomiting
psychomotor agitation
anxiety
Treatment
Benzodiazepines (orally or
parenterally) in tapering dosage
carbamazepine (Tegretol) in daily
doses of 800 mg
Alpha2-adrenergic receptor
antagonists ex. Clonidine (Catapres)
Treatment
best treatment is prevention
Benzodiazepine
25 to 50 mg of chlordiazepoxide every 2 to 4 hours until
they seem to be out of danger
once the delirium appears, 50 to 100 mg of
chlordiazepoxide should be given every 4 hours orally,
or lorazepam (Ativan) should be given intravenously (IV)
if oral medication is not possible
Fluids
Warm supportive psychotherapy
Alcohol-Induced Persisting
Amnestic Disorder
a disturbance in short-term memory
caused by prolonged heavy use of
alcohol
usually occurs in persons who have
been drinking heavily for many years
the disorder is rare in persons younger
than age 35
Wernicke-Korsakoff Syndrome
Wernicke's encephalopathy (a set of
acute symptoms) and Korsakoff's
syndrome (a chronic condition)
Wernicke's encephalopathy is
completely reversible with treatment,
only about 20 percent of patients with
Korsakoff's syndrome recover
thiamine deficiency, caused either by
poor nutritional habits or by
malabsorption problems
Treatment
Blackouts
Treatment and
Rehabilitation
Three general steps : intervention,
detoxification, and rehabilitation
The patient with alcohol abuse or dependence
must then be brought face-to-face with the
reality of the disorder (intervention), be
detoxified if needed, and begin rehabilitation
Intervention
Detoxification
The essential first step in
detoxification is a thorough
physical examination
The second step is to offer rest,
adequate nutrition, and multiple
vitamins, especially those
containing thiamine
Rehabilitation