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ALCOHOLISM

PRESENTORS:

Bhumika Sabharwal

Vibhuti Sinha

SCOPE OF THE PRESENTATION

 Introduction to alcoholism  Theories of alcoholism  Signs & symptoms  Causes  Alcohol

Introduction to alcoholism Theories of alcoholism Signs & symptoms Causes Alcohol & medical problems Prevention Diagnosis Management Women & alcoholism Alcoholism on India Quiz bowl

 Introduction to alcoholism  Theories of alcoholism  Signs & symptoms  Causes  Alcohol
Alcoholism Alcoholism is a broad term for problems with alcohol, and is generally used to mean

Alcoholism

Alcoholism Alcoholism is a broad term for problems with alcohol, and is generally used to mean

Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the

detriment of the drinker's health, personal relationships, and social standing.

THEORIES

T H E O R I E S

Johnson Theory

Johnson (1980) explores the emotional

progression of the addict‟s response to

alcohol. He looks at this in four phases:

Learning the mood swing. Seeking the mood swing. Physical and social consequences. Risk for premature death ..

Milam Theory

Other theorists such as Milam & Ketcham

(1983) focus on the physical deterioration of alcohol. They describe the process in three stages:

Adaptive stage Dependent stage Deterioration stage

Milam Theory Other theorists such as Milam & Ketcham (1983) focus on the physical deterioration of

SIGNS

&

SYMPTOMS

  • Long-term misuse

Alcoholism is characterised by an increased tolerance of physical dependence on alcohol, affecting an individual's ability to control alcohol consumption safely. The onset of depression is a common symptom.

  • Physical Long-term alcohol abuse can cause a number of physical symptoms, including heart disease, nutritional deficiencies, peptic ulcers and sexual dysfunction. Damage to the central nervous system and peripheral nervous system can occur from sustained alcohol consumption.

  • Psychiatric

The social skills that are impaired by alcohol abuse include

impairments in perceiving facial emotions, theory of mind deficits;

the ability to understand humour is also impaired in alcohol abusers.

The most prevalent psychiatric symptoms are anxiety and depression disorders.

CAUSES

Genes Several childhood trauma Lack of peer and family support Stressful situations or a big life change

Peer pressure Relationship & social changes Emotional status Enjoying the “feeling”

Genetic Variation

Genetic differences exist between different

racial groups which affect the risk of

developing alcohol dependence. For example, there are differences between African, East Asian and Indo-racial groups in how they metabolize alcohol.

ALCOHOL

&

MEDICAL

PROBLEMS

Stomach the

entry point

  • Slows down functioning and interferes with digestion

  • Irritates the lining of the food pipe and stomach

  • Causes gastritis and ulcer

  • Increases incidence of cancer Liver

Stomach the entry point  Slows down functioning and interferes with digestion  Irritates the lining
  • Can lead to fatty liver (sluggishness due to accumulation of fat cells) and alcoholic hepatitis (jaundice- like symptoms)

  • Permanent damage cirrhosis Brain the control centre

  • Slows down the functioning

  • Causes loss of inhibitions and affects judgment and coordination

  • Leads to depression, poor memory and concentration - Triggers psychiatric problems - Damages brain cells permanently

Stomach the entry point  Slows down functioning and interferes with digestion  Irritates the lining

Heart the life line

  • Interferes with normal heart rhythm

  • Excessive alcohol use can -damage blood vessels -weaken heart muscles -cause enlargement

Other effects

Heart the life line  Interferes with normal heart rhythm  Excessive alcohol use can -damage
  • Neuritis tingling sensation, tremors in hands and feet

  • Pancreatitis painful inflammation of the pancreas

  • Degeneration of muscles due to protein loss

  • Malnutrition leading to many problems ranging from

tiredness onto poor memory

  • Sexual problems

PREVENTION

Targeting adolescents and young adults

Alcohol policies by government & various organizations

Restricting advertising of alcohol Educational campaigns Guidelines for parents

DIAGNOSIS

Urine and blood tests

Blood Alcohol content (BAC). These tests do not differentiate alcoholics from non-alcoholics.

Screening

T-ACE Test. The T-ACE test is a four-question test that asks the following questions:

Does it TAKE (T) more than three drinks to make you feel high? Have you ever been ANNOYED (A) by people's criticism of your drinking? Are you trying to CUT DOWN (C) on drinking? Have you ever used alcohol as an EYE OPENER (E) in the morning?

AUDIT Test. Alcohol Use Disorders Identification Test (AUDIT). It asks three questions about amount and frequency of drinking, three questions about alcohol dependence, and four questions about problems related to alcohol consumption.

CAGE questionnaire:

The questionnaire asks the following questions:

Have you ever felt you needed to Cut down on your drinking?

Have people Annoyed you by criticizing your drinking?

Have you ever felt Guilty about drinking?

Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

A single question : "When was the last time you had more than five drinks (for men) or four drinks (for women) in one day?" An answer

of "within 3 months" accurately identified about half of people who were problem drinkers.

Other Screening Tests: Michigan Alcoholism Screening Test (MAST) and the Alcohol Dependence Scale (ADS).

Social barriers

Attitudes and social stereotypes can create barriers to

the detection and treatment of alcohol abuse. This is

more of a barrier for women than men. Fear of stigmatization may lead women to deny that they are suffering from a medical condition, to hide their drinking, and to drink alone. This pattern, in turn, leads family, physicians, and others to be less likely to suspect that a woman they know is an alcoholic. In contrast, reduced fear of stigma may lead men to admit that they are suffering from a medical condition, to display their

drinking publicly, and to drink in groups. This pattern, in

turn, leads family, physicians, and others to be more likely to suspect that a man they know is an alcoholic.

MANAGEMENT

M A N A G E M E N T

Detoxification

Alcohol detoxification or „detox' for alcoholics is

an abrupt stop of alcohol drinking coupled with

the substitution of drugs, such as benzodiazepines, that have similar effects to prevent alcohol withdrawal.

Detoxification does not actually treat alcoholism, and it is necessary to follow-up detoxification with an appropriate treatment program for alcohol dependence or abuse in order to reduce the risk of relapse.

Psychological

  • Various forms of group therapy or psychotherapy can be

used to deal with underlying psychological issues that

are related to alcohol addiction.

  • The mutual-help group-counseling approach is one of the most common ways of helping alcoholics maintain sobriety.

  • Alcoholics Anonymous was one of the first organizations formed to provide mutual, nonprofessional counseling, and it is still the largest.

Medications

A variety of medications may be prescribed as

part of treatment for alcoholism:

Vitamin supplements Disulfiram Calcium carbimide Naltrexone Odansetron Acamprosate Benzodiazepines

Medications A variety of medications may be prescribed as part of treatment for alcoholism:  Vitamin

WOMEN

&

ALCOHOLISM

Women develop long-term complications of alcohol dependence more rapidly than do men.

Women have a higher mortality rate from alcoholism than men.

Heavy drinking over time has been found to have a negative effect on reproductive

functioning in women

ALCOHOLISM IN INDIA

ALCOHOL LAWS OF

INDIA

In India, consumption of alcohol is prohibited in the states of Gujarat, Manipur, Mizoram and Nagaland as well as the union territory of Lakshadweep.

Legal drinking age between 1825 years.

Advertising alcoholic beverages is banned in India as per the Cable Television Network (Regulation) Amendment Bill, which came into

effect on September 8, 2000.

National holidays such as Republic Day, Independence Day and Gandhi Jayanti are usually dry days throughout India.

ALCOHOL CONSUMPTION IN

INDIA

  • 62.5 million alcohol users estimated in India

  • Due to its large population, India has been identified as the potentially third largest market for alcoholic beverages in the world which has attracted the attention

of multi national liquor companies.

  • Sale of alcohol has been growing steadily at 6% and is estimated to grow at the rate of 8% per year.

  • About 80% of alcohol consumption is in the form of hard

liquor or distilled spirits showing that the majority drink

beverages with a high concentration of alcohol.

  • Branded liquor accounts for about 40% of alcohol consumption while the rest is in the form of country liquor.

  • Changing social norms, urbanization, increased availability, high intensity mass marketing and relaxation of overseas trade rules along with poor level of awareness related to alcohol has contributed to increased alcohol use.

  • Taxes generated from alcohol production and sale is the major source of revenue in most states (Rs.25,000 crores) and has been cited as a reason for permitting alcohol sale. Four states - Gujarat,

  • Mizoram, Manipur and Nagaland - have enforced prohibition.

 Changing social norms, urbanization, increased availability, high intensity mass marketing and relaxation of overseas trade

Indian Alcohol Policy Alliance (IAPA) is a registered non- governmental organization started in 2004 to prevent alcohol related

harm through policy intervention, advocacy and capacity building. IAPA is affiliated to Global Alcohol Policy Alliance and receives support from FORUT Campaign for Development and Solidarity.

IAPA provides a forum for advocacy to facilitate:

  • Development of alcohol policy that addresses issues related to alcohol taxation, restrictions on production, number of sales outlets and hours of operation as well as ensuring stricter implementation of rules on age restrictions, drinking and driving laws and advertising

  • Education and information dissemination to create a high degree of public awareness and generate support for activities that will dissuade harmful alcohol use practices

  • Research to highlight costs of alcohol use, monitor consumption trends and generate data for advocacy efforts to build political commitment and community support to reduce harmful impact of alcohol

QUIZ BOWL

Q U I Z B O W L

Legal drinking age in Delhi is ___.

Three stages according to the Milan Theory are-

______

,

______

& ______.

______

test is used for screening.

IAPA stands for ________.

IAPA started in the year _____.

Legal drinking age in India is _______.