Drug Abuse, Alcohol Abuse and De-Addiction

Drug Abuse, Alcohol Abuse and De-Addiction

1.  Drug Abuse

Drugs are a pervasive part of our society. Certain mood altering substances are quite socially acceptable and are used moderately. They include alcohol, caffeine, and nicotine. A wide variety of substances are produced for medicinal Purposes. On the other hand, the dangerous effects of other illegal substances have been well documented.

“At the bottom of every person’s dependency, there is always pain. Discovering the pain and healing is an essential step in ending dependency”.

Definition for Abuse: To use wrongfully or in a harmful way. (APA-2000)

Types

·  Alcohol

·  Amphetamines and related substances

·  Caffeine

·  Cannabis

·  Cocaine

·  Hallucinogens

·  Inhalants

·  Nicotine

·  Opioids

·  Phencyclidine (PCP) and related substances

·  Sedatives, hypnotics, or anxiolytics

Causes

·  Genetic Factors

·  Biochemical Factors: Alterations in neurotransmitters

·  Psychological: curiosity, escape from reality, personality, life style and self-medication

·  Social: peer pressure, easy availability, Culture, media, and popularity of drugs

Management of drug abuse

Care for a substance using patient starts with an assessment during the phase of drug intoxication and detoxification

·  Vital signs

·  Intra Venous Fluid (IVF)

·  Medication

·  Rehabilitation

2. Alcohol Abuse

Alcohol abuse can steal the best years of your life. Alcohol does not kill the addict. It kills the family, kids and people who tried to help. Alcohol abuse is temporary fun with permanent consequences.

The word “alcoholism” was first coined by “Magnus Huss”. It was derived from Arabic word ‘alkuhl’, means ‘essence’.

Definition

“Alcoholism is defined as a chronic diseases manifested by repeated drinking that produces injuries to the drinker’s health or to his social or economic functioning” - S. Nambi

Epidemiology

The World Health Organization estimates about 140 million people throughout world

Incidence                               - 2% in India

Above 15 years                    - 20 – 40 %

Regular or excessive users                - 10%

Process of Development

Experimental - person start drinking alcohol due to peer pressure and curiosity

·  Recreational - functions like marriages, hostel days or college day, parties, conference

·  Relaxation – whenever they want relaxation, on holidays and Sunday, they start enjoying their drink and continue to do so.

·  Compulsive – some people who started drinking occasionally, start drinking almost daily or drinking heavily for a period of time for pleasure or to avoid the discomfort of withdrawal symptoms.

Diagnostic Evaluation

·  Blood Alcohol level

·  Serum electrolyte

·  Urine toxicology

·  Liver function test

·  ECG

·  CAGE Questionnaire: (Cut down, Annoyed, Guilt, Eye-opener)

·  AUDIT - Alcohol Use Disorders Identification Test

·  DAST - Drug Abuse Screening Tool

Management

The management includes outpatient and Inpatient modalities

·  Informed consent

·  Medications

·  Vitamin and nutritional supplementary to correct nutrition deficiencies

·  IV fluids and electrolyte balance

·  Symptomatic treatment

·  Alcohol Deterrent therapy

Rehabilitation of Alcoholic Dependence

·  Alcoholics Anonymous (self-help groups)

·  Aversion therapy

·  Psychological method

·  Counseling

·  Individual and group psychotherapy

·  Marital and family therapy

·  Behavioral modification (aversion therapy)

·  Relapse prevention therapy

Patient Education and Health Maintenance

·  Instruct patient and family about adverse physiologic and psychological effects of substance use.

·  Discuss health maintenance practices to minimize potential effects of substance use (e.g., vitamin use, proper diet).

Explain the potential for injury from risk-taking behaviours. Reinforce the need for 1aftercare groups and activities.