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Chapter: 11th 12th std standard Class Nursing Health Care Hospital Hygiene Higher secondary school College Notes

Alcoholic addiction and drug abuse

During the last decade, there is a marked increase in the use of psychoactive or mind altering drugs in our society. Concurrence with their resistance has come their misuse. The misuse of drug may take a form of dependence or abuse.

Alcoholic addiction and drug abuse:


During the last decade, there is a marked increase in the use of psychoactive or mind altering drugs in our society. Concurrence with their resistance has come their misuse. The misuse of drug may take a form of dependence or abuse.


In traditional usage dependence signified psychological reliance on a particular drug, while addiction was resend for psychological dependence as indicated by withdrawal symptoms, if the drug were to be discontinued. The most commonly used problem drugs are alcohol, barbiturates, amphetamines, heroin and marijuana.


Adults can purchase some of these drugs such as alcohol legally and other drugs such as barbiturates can be used legally under medical supervision. Still other drugs such as heroin are illegal.


The physical signs of abuse or addiction can be very much depending on the person and the drug. For example, some one who abuses marijuana may have a chronic cough or worsening of asthmatic conditions. The chemical in marijuana responsible for producing its effects is associated with weakening.

The immune system makes the user more vulnerable to infections such as pneumonia. Each drug has short term and long-term physical effects. Stimulants like cocaine increase heart rate and blood pressure whereas, opiods like heroin may slow the heart rate and reduce respiration. Withdrawal is the variety of symptoms that occur after use of some addictive drugs is reduced or stopped.


Length of withdrawal and symptoms vary with the type of drug. For example, withdrawal symptoms of heroin may include restlessness, muscle and bone pain, insomnia, diarrhoea, vomiting and cold flashes. These physical symptoms may last for several hours, but the general depression that often accompanies heroin withdrawal may last for weeks.


In many cases withdrawal can be easily treated with medications to ease the symptom but treating withdrawal is not the same as treating addiction.


Consumption of excessive alcohol leads to the person' s impairment of reasoning and volition temporarily that destroys the brain center that controls behaviour. The mental functioning stops its work. Thereby a person' s voice becomes loud and squeaky, his thinking uncontrolled and disassociated. When the quantity of alcohol in the blood increases, the individual tends to become irritable, obstinate and boastful. When walking he is in need of support, gradually he sinks into sleep caused by alcoholic stupor.


Kinds of alcoholic mental disorder: Pathological intoxication:

In this the person' s mental activities lose their organisation and system for periods extending from a few minutes to few hours. Sometimes the patient exhibits a tendency towards crime, murder or suicide. Motor co-ordination is retained but the person cannot speak clearly. When he or she recovers from pathological intoxication, he retains no traces of memory concerning his condition during it.


This kind of intoxication can be seen occasionally even when very small quantity of alcohol has been consumed. Normally it occurs only when more alcohol has been absorbed. Basically it occurs only in people who posses characteristics of schizophrenia, epilepsy or hysteria or in people whose mind has suffered from injury. This disorder is sometimes seen when the amount of glucose in blood falls below normal level.


Delirium tremens:


This form of alcoholic mental disorder is seen in persons continuing drinking for many years. It also occurs temporarily when drinking is stopped suddenly. Immediately the disease begins, the patient shows signs of insomnia, anxiety, restlessness and lack of appetite. Following this there is an attack of fever, the tongue is coated and he suffers from constipation with the result that sometimes he finds difficult to take food.


Gradually the pulse rate begins to fall, the hands and feet shiver, the tongue shrubs over words and the other abnormalities occur. In order to cure the patient he should be made to be in a dark and a quiet room. Liquid diet and vitamin B should be administered. In order to control cure anxiety, warm bath, anxiolytic drugs and cathartic medicines can be administered.


Kornakoff spychosis:


This form of mental disorder is seen in men who have been drinking alcoholic stimulants over a long period. This group constitutes 10%. The symptoms of this disease resemble those of delirium tremens. The patient is incapable of making new acquisitions besides which he does not remember any thing. He fails to recognise even his own family members. Whatever he reads is immediately forgotten.


Because of this disease certain nerves are rendered weak with the result that a patient experiences pain in arms and legs and their extremities tend to bend.


The main cause for this physical symptom is lack of vitamin B in the body. In order to cure the patient of the disease, alcoholic stimulants must be completely forbidden, the patient should be given rest and food rich in vitaminB complex. Certain benefits results from the use of galvanic impulse followed by massage and exercise, while the use of vitamin B can clear away many physiological shortcomings.

There is a high rate of mortality among patient suffering from this disease.


Acute alcoholic hallucinosis:


Some 20 to 25 % of alcoholics, suffering from this mental disease falls into this category. Most of the patients exhibit schizoid characteristics, which becomes aggravated due to the use of alcohol. In acute alcoholic hallucinosis, as in delirium tremens the patient suffers from anxiety, insomnia, extreme emotionality and various kinds of hallucination.


In a state of delirium, many of the hallucination tend to be of visual nature. While in the case of acute alcoholic hallucinosis, they are of auditory origin. The patient professes to hearing a variety of voices that threaten him, abuse him and scold him, responsible for many kinds of immoral activity. Often such voice address the patient as if he were a separate individual. Some patients become so obsessed with these voices that they seek the protection of police or even commit suicide.


Most of the people suffering from this disease become introverts and those suffering from delirium tremens become extroverts, because these patients are a source of danger to others and themselves. It is necessary to have definite control over them.


The first step in curing them is to stop them from drinking alcoholic stimulants, because the patient has to be cured in relatively shorter time. But if the patient again falls into his old ways it does not take a long time for the disease to come back and in occasional cases it can even lead to schizophrenia.


Alcoholic deterioration:


When a person continues to consume alcohol in abnormally large quantities over a number of years, his personality becomes disintegrated. About 25% of the alcoholics are suffering from alcoholic deterioration.


The symptoms of alcoholic deterioration are irritability, cruelty, loss of memory, suspicious nature, deficiency of ambition and volition and indifference or hatred towards the family, indifference to personal appearance and apparel. This mental disease also causes the following physical symptoms such as reddening of throat and nose, swelling of the face, nervous tension and deficiency of physical energy, heart disease and lack of resistance to disease.


Treatment of alcoholic disorder.


The chief cure consists in avoiding alcohol enhanced by the counselling of the patient and family members by the nurse. Treatment can be effected in hospitalisation and as well as in the home. The decision concerning this can be left to the discretion of the doctor who takes into consideration the patients circumstances.


Main methods of cure are


Complete abstinence from alcohol Punishment such as heavy fine, imprisonment Using medicines


Destroying the craving for use of stimulating drugs/alcohol Meeting of alcoholic anonym


Psychotherapy - includes Suggestion


Moral encouragement Advice


Hypnotism etc


In psychotherapy, the main stress is on removing the fundamental causes that encourage it. The object of curing a person of alcoholism is to make his personality so strong by manifesting the concealed conflicts and putting an end to these actual causes that he can solve his own problems more rationally and permanently. With this end in view the alcoholic is encouraged to understand his problems and at the same time he is induced to take the necessary steps that will help him to get rid of this toxin latent.


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