There is a genetic factor in alcoholism.Children of...Read more
Ingested alcohol first gets into blood through oral mucus membrane...Read more
Psychological effect of alcohol Alcohol intoxication is characterized...Read more
Alcohol withdrawal is a condition that follows the cessation of or...Read more
There is a genetic factor in alcoholism. Children of alcoholics become alcoholic about 4 times more than children of Nonalcoholic's even when their biological parents do not raise them. Mono zygotic twins (twins born from same zygote) had about twice concordance rate for alcoholism as compared to dizygotic twins (twins from different zygotes). A childhood history of hyperactivity or conduct disorder increases a child's risk of becoming alcoholic particularly if there is alcoholism in family. A person with antisocial personality is predisposed to develop alcoholism. Many persons use alcohol to reduce anxiety. An alcoholic is shy, isolated, impatient, irritable anxious hypersensitive & sexually repressed. Some people, who have guilt feeling, self-punishing ideas turn to alcohol to diminish their unconscious stress. Some people take alcohol to relieve frustration. Alcoholics feel themselves inadequate hence turn to alcohol. Some cultures are prohibitive about alcohol. Islam prohibits alcohol consumption; hence percentage of alcoholics in Muslim population, especially in countries where Islamic laws are strictly applied,is very less as compared to others. The biological theory holds that addiction occurs at cellular level. Neuroadaptation makes the body dependent on alcohol.
Learning theory states that release of anxiety, fear & conflict arising from the first drink reinforces repeated alcohol consumption & leads to alcohol dependence.
Ingested alcohol first gets into blood through oral mucus membrane & lungs. After that it is absorbed from stomach & intestines. Then it is carried by blood to brain & other organs. The speed with which alcohol enters in blood stream depends on many factors like amount & type of food in stomach, alcohol content of drink, health of drinker. Immediately absorption metabolism of alcohol begins the kidneys & lugs excrete 10. /. Alcohol unchanged the rest undergoes oxidation alcohol & oxidation provides beat & work energy hence heavy drinkers neglect other food sources & ignore nutritional heeds are to which vitamin deficiency diseases & nutritional disorder May result. Alcohol is central nervous system (C N S) depressant. At level of 0.05% alcohol thought, judgment & restraint are disrupted .At revel 0.1 voluntary motor action become clumsy .At 0.2%, areas of brain controlling motor action & emotional behavior are affected. At 0.3% a person is confused. At 0.4% higher level centers of brain controlling respiration & heart rate are affected & it results in death. Alcohol consumption results in impaired consolidation of new information; hence events happening during influence of alcohol are not remembered. This is called alcoholic blackout. Liver is the main site of alcohol metabolism; hence it the most affected organ. Chronic heavy alcohol consumption results are irreversible fatty infiltration of liver. Acute intoxication may cause hypoglycemia leading to sudden death. Chronic heavy drinking for a long period causes gastritis, ulcer, pancreatitis etc. Heavy alcohol intake interferes with food digestion & absorption, which leads to vitamin deficiency. Alcohol consumption causes muscle weakness & cardiomyopathy.
Alcohol increases the effects of other CNS depressants like sedatives, (drugs reducing anxiety) & hypnotic (drug causing sleep). When these drugs are taken under influence of alcohol the combination my be fatal.
Psychological effect of alcohol Alcohol intoxication is characterized by maladaptive behavior. After recent consumption of alcohol. Signs Of intoxication is slurred speech, lack of co-ordination, unsteady gait, flushed face, irritability, impaired attention, excessive talk euphoric mood etc. Some people become withdrawn, some sleep after alcohol consumption, in some there is liability of mood with intermittent episodes of laughing & crying.
During intoxication the person may fall which results in brain hemorrhage & fractures some times fallen person is exposed to cold climate for hours which may result in cold bite. Alcohol consumption suppresses immune system, which predisposes the person to infection. Some times a person develops pathological intoxication characterized by sudden onset of marked behavioral change often consumption of small amount of alcohol is this condition the person is confused disassociated & may experience illusions e.g. mistaking rope for a snake, visual hallucinations seeing images of animals ghosts etc delusion (false suspicion about others) increased psychomotor activity etc. The person may become aggressive & may be dangerous to self & others. He may become depressed & may attempt suicide. This lasts for a few hours & terminates in prolonged period of sleep. Causes of this pathological intoxication are high levels of anxiety, brain damage (encephalitis, trauma) advancing age, sedative hypnotic drugs, fatigue etc. Person must be physically restrained from others to prevent him from harming self & others. Haloperidol in injection form is given for controlling aggression.
Alcohol withdrawal is a condition that follows the cessation of or reduction in prolonged or heavy drinking. Within hours signs & symptoms develop including tremors, quick reflexes, increased hart rate, increased blood pressure, fatigue, weakness, nausea, vomiting, fits, hallucination (hearing voices illusions night mares & disturbed sleep. Conditions that aggravate the symptoms are fatigue malnutrition physical illness & depression.
Treatment is symptomatic with bed rest & hydration. Benzodiazepines (e.g. Librium) are used for controlling over activity; other drug like propranolol (ciplar) & carbamezapine (tegratal) are also useful. Some times patients of alcohol withdrawal progress into Delirium Tremens (DT). This develop within a week after person stops drinking or reduces intake, in this condition patient is disoriented (i.e. does not know about time, place, person, or self) his consciousness is disturbed, there are fluctuating levels of psycho motor activity ranging from hyper excitability to lethargy. The patient is dangerous to self & to others. Untreated delirium tremens has mortality rate of 20%. This is a seen in middle aged physically ill patient who consumes heavy drinks for more than five years. The best way to treat delirium tremens is to prevent it.
Patients withdrawing from alcohol that exhibit withdrawal symptoms are given 20 mg of chlordiazopoxide Hydrochloride (Librium) every two hours until symptoms are over. Once delirium appears 100 mg every four-hour should be given. Pt is given high caloric high carbohydrate diet supplemented with vitamins. Patient is kept in a secluded room, dehydration is corrected with fluids, and patients are also given warm supportive psychotherapy. Alcohol induced hallucinosis (seeing images or hearing voices) begins within 48 hours after cessation of drinking & persists after the person has recovered from symptoms of alcohol withdrawal. This may continue for weeks or may be permanent. The patient is given benzodiazipine (e.g. Librium) adequate nutrition, fluids anti-psychotics (e.g. seranace).
Alcohol amnestic disorder is a disturbance of short term memory (hours, days) due to prolonged heavy use of alcohol, other associated features are unsteady gait disturbed co-ordination tingling sensation allover body (peripheral neuropathy) liver cirrhosis. This disorder is seen in persons above age of 35 years.
Alcoholic encephalopathy is a neurological disease characterized by unsteady gait weakness of movements of eyes, inability to fix the eyes at one place (nystagmus) & confusion. This may clear spontaneously in a few days or weeks if the patient is given thiamin injection. Some patients develop alcoholic induced dementia characterized by disturbed memory, impairment in social & occupational activities, inability to receive, process store & recall information. In severe cases patient requires constant care. New born of an alcoholic mother develops Fetal Alcohol Syndrome .These symptoms of syndrome are mental retardation, defective heart & delayed motor development. The risk of alcoholic mother's newborn developing FAS is about 35%. The damage to the body of fetus developing in alcoholic mother's womb is the result of exposure to ethanol or its metabolites. Alcohol may also cause hormone imbalance that increases the risk of abnormalities.
Most alcoholics come to treatment as a result of pressure of wife employer or fear of death. Patients persuaded & supported by wife & children have better outcome. Those who realize that they are alcoholic & need help get the best results. The alcoholic is hospitalized & given treatment. Once patient is admitted & stops taking alcohol he develops alcohol withdrawal syndrome (described earlier) for which he is given antianxiety medicine e.g. cholorodiazepoxide, these medicines may be given for weeks or months after withdrawal period is over. The mental status examination of patient is done to find whether patient has any psychological illness. Anti depressant (e.g. fluoxetine) is used for persons suffering from depression (i.e. sadness of mood). Lithium has also been used with some success. Once patient is out of alcohol withdrawal syndrome & if he is not having any psychological illness then patient is put on disulfiram (Antabuse) 250 mg daily. His consent is taken in writing. In body alcohol is converted into acetaldehyde which in turn is quickly converted into water & carbon dioxide. Acetaldehyde is a toxic substance. Disulfiram prevents conversion of acetaldehyde in to water & carbon dioxide. Hence when a person on this medicine takes alcohol he develops the effects of acetaldehyde. The symptoms are flushing, feeling of heat on face, eyes, limbs & chest. The person develops paleness hypertension (low BP) nausea air hugger & numbness. Patient has to be hospitalized & treated symptomatically with IV fluids, La six, Vitamin C, Avil & medicines, which raise BP. This state remains for 30 to 60 minutes & may prolong. The patient on this medicine should avoid substances containing even minute quantities of alcohol e.g. sauces vinegar. Patient is also given psychotherapy in which causes of drinking are searched e.g. frustration, anxiety etc & patient is taught how to deal with them. Patient is also taught about the possible consequences of continued alcohol drinking. Behavior therapist teaches the alcoholic the way to reduce anxiety e.g. relaxation, assertiveness training, self-control, skills & strategies to master environment.
Alcoholic Anonymous (AA) is a supportive fellowship of alcoholic's worldwide. An alcoholic is referred to AA as part of multiple treatment approach. An alcoholic derives much of benefit from the organization & becomes enthusiastic participant. Its members make public admission of their alcoholism & remain away from alcohol
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