Transcript Chapter 11 Alcohol, Tobacco and Caffeine Unacknowledged

Chapter 11
Alcohol, Tobacco and Caffeine
Unacknowledged Addictions
Alcohol
Alcohol a Dangerous Drug?
• Cocaine, heroin, marijuana,
LSD, PCP….and others!
• Alcohol isn’t considered
because it is socially
excepted
• Canadians consumed 7.1
liters
• comparable to US,
Australia, and less than
European countries
Alcohol a Dangerous Drug?
• Can have some
positive health
benefits
• moderate use can be
enjoyable
• However! Many
tragedies associated
with abuse……..
Alcohol and University Students
• Most popular drug
on University
campuses - 94.5%
• In Ontario - 1/3 had
more than 15 drinks
per week!
• Live in residence
• lower grades
• 17 and 22 years of
age
Alcohol and University Students
• Be aware of drinking
• campus culture and
tradition
• reduces tension
• celebrations
• social lubricant
• drinking games and
binge drinking
Drinking Alcohol and the
Risks!!!!!!
• Exacerbates risks of
suicide, automobile
crashes and falls
• peers / university
traditions encourage
dangerous practices
• participate in dangerous
behaviours……..
Physiological and Behavioural
Effects of Alcohol
• ethyl alcohol or ethanol
• Fermentation - a process to
produce ethanol - 14%
alcohol
• Distillation - increases
alcohol content
• Proof - % of alcohol
• Proof – gunpowder proof /
50% alcohol > 80 proof =
40% alcohol
Behavioural Effects
• NOTE: individual
variation in alcohol
tolerance
• alcohol is a depressant acts on CNS by decreasing
its activity
• depression is
progressive/continuous
Behaviours………...
Alcohol has different
effects on:
•
•
•
•
•
•
sight: visual acuity
hearing
speaking
smell-taste
pain reception
motor skills
Blood Alcohol Concentration (BAC):
ratio of alcohol to total blood volume
• at 0.02 % (2 parts of
alcohol for every 10,000
parts of blood) = relaxed
good mood
• at 0.05 % = impaired relaxation increases / some
motor impairment /
talkative
• at 0.08 % = impaired euphoria / more motor
impairment
Blood Alcohol Concentration
• at 0.10 % = intoxicated depression / further loss of
motor skills / loss of
judgement / drowsiness
• larger individuals lower
BAC - greater blood volume
• alcohol invades muscle
tissue to a greater extent
than fatty tissue
Learned Behavioural Tolerance
• Ability to modify
behaviour to appear
sober
• Acquired
physiological and
psychological
tolerance
• No skills or functions
enhanced by
drinking alcohol
Women and Alcohol
• Women have less
alcohol hydrogenase
• greater sensitivity to
the negative effects of
alcohol
• higher BAC (30%)
for same body weight
and alcohol
consumed as a man
Breathalyzer and Other Tests...
Breathalyzer
• determine BAC via exhaled
breath
Urinalysis - concentration of
unmetabolized alcohol in
urine
• both used to determine level
of intoxication
Blood tests are most accurate
The Morning After…...
NEXT DAY
• Congeners - forms of alcohol that
metabolize more slowly - produce
toxic by-products
• dehydration – fluids are in the
muscles and cerebral tissues
• hangover – mitochondrial
dehydration in CNS (loss of
cerebrospinal fluid) = headaches
• gastrointestinal irritation =
discomfort
….. The night before
• rest / solid food / pain
relievers (12 hours to
recover)
• alcohol is a drug,
therefore tolerance
and withdrawal
occur
Long Term Effects
Nervous System:
• reduction in brain size
and weight / left side =
language written &
spoken, mathematical
skill and logic
• reduced intellectual
ability
• binge drinking = most
damage
Cardiovascular Disease:
• effect on heart minimal
(small amounts of
alchol) may decrease
cholesterol levels
• increases blood pressure
• heart rate
• cardiac output
Hypertension and Stroke:
• moderate alcohol
consumption (red wine)
= increased HDL
• reduce hypertension
Alcohol consumption (large
quantity) causes:
• hypertension
• stroke
• negative effects / out-weight
good
• (moderate to heavy drinkers)
Liver Disease:
• cirrhosis = liver cells die / top ten
causes of deaths
• effects fat storage and transport
in the liver / cells stop functioning
• fibroses = damaged area develops
scar tissue / cells function
ineffectively
• alcoholic hepatitis = inflammation
of the liver / can lead to cirrhosis
Cancer
• esophagus, stomach, mouth, tongue
and liver
• breast cancer – women between 34 &
59 / 3 to 9 drinks/wk / 30%
• males – 12% increase for 1 drink per
day & 123% for 2 drinks per day
• facilitates absorption of carcinogenic
substances into sensitive tissues, i.e.
tobacco
• alcohol-induced immunologic
suppression
• synergistic effect with tobacco
• alcohol-induced outcomes, such as
malnutrition, anemia
Other Effects
• causes indigestion
and heart burn
• damages mucous
membranes =
stomach and
intestinal irritation,
absorption and
chronic diarrhea
Alcohol and Pregnancy
Excessive Drinking during Pregnancy / Rate of
Developmental Disabilities
alcohol passes directly into the infant's blood stream
• BAC much greater than mother
• FAS - leading cause of
development delays in Canada /
North America
• during 1st trimester - organ
development
• last trimester - CNS development
Foetal Alcohol Syndrome (FAS)
Physical and Foetal Behaviour Difficulties:
• sleeping / hyperactive
• learning disabilities
• dyslexic
• greater incidence of :
• congenital heart disease
• spina bifida
• hip dislocation
• skeletal development
Foetal Alcohol Effects (FSE) Infants Exposed to Prenatal Alcohol
• No FAS - symptoms
• effects 3/1000
children
• low birth weight
• irritability
• possible permanent
mental impairment
Alcoholism – Alcohol Abuse
• Interferes with work, school or social
and family relationships
• violation / law i.e., drunk driving
• approx. 2 in 10 Canadians / drinking
problem resulting in physical health
problems, financial, relationships
• 50% of Canadians – problems with
others people who drink
• loud, insulting, humiliation,
argumentative, violent
Social impact of alcohol:
• motor vehicle accidents
• Pedestrian accidents
• Occupational accidents
• Home and recreational accidents
• Homicide
• Rape
• Marital problems
• Family violence/abuse
• Suicide
Overall – family patterns
important
• Genetic link not
found to date
• however - alcoholism
4 to 5 times greater
in alcoholic homes
• Two Types Types of
Alcoholics have been
identified
Type 1: Had at least One
Parent Who was an Alcoholic
• drinking at home was
normal and encouraged
• avoids novelty/harmful
situations
• concerned about the
thoughts and feeling of
others
Type 2:
males only / biological sons of alcoholic
fathers
• experiences both violence and
drug abuse
• don't seek social approval /
lack inhibition
• One alcoholic Parent = 52%
chance of developing a problem
• Two alcoholic Parents = 71%
chance of developing a problem
Social and Cultural Factors and
Alcoholism:
• Social and Cultural Factors and
Alcoholism:
• part of traditions and cultural
interactions
• may predispose people more than
genetic potential
• Medication – temporally escape!
• Stress – disappointment –
unfulfilled expectations –
relationships – depression
Effects on the Family:
Children have no idea of what normal family
life is like!!!!
• (dysfunctional)
• Victims of violence, abuse, neglect or
incest
• low self-esteem and depression
• Adopt one of the following roles
• Family Hero – too good to be true
Effects on the Family:
Children have no idea of what normal
family life is like!!!!
• Scapegoat - Draws
attention through
poor behaviours
• Lost Child – passive
and withdrawn in
upsetting situations
• Mascot – comic relief
Recovery
#1 Assume Responsibility for Actions
Intervention – planned confrontation
• ( Family and trained therapist)
Treatment Programs:
• Symptoms: + delirium tremens (DT’s)
• Long-term addicts – medical treatment –
detoxification ( 7 to 21 days) physiological
addiction
• psychological treatment starts ( 3 to 6 weeks)
• may require more time / repeated intervention!
Family Therapy, Individual Therapy,
and Group Therapy
• determine underlying
reasons for problem
• develop coping mechanisms
• Other types of treatment
• Drug – Disulfiram
(Antabuse) – causes
extremely unpleasant side
effects when coupled with
alcohol
Alcoholic’s Anonymous (AA)
• private, nonprofit, self-help
organization founded in 1935
• group support – over 1 million
members world wide
• lifetime problem
• AA ( Al-non) has other groups to
help spouses, partners, children
and friends
• Alateen – help teens deal with
alcoholic parents
Relapse
• Success varies from
Individual to
Individual
• some recover other
never recover others
partially recover
• approx. 60% relapse
• pattern has to be
broken – promote selfesteem and personal
growth