9.3 Alcohol Use Disorder

Question 1

Addiction

Answer 1

• Compulsive or chronic requirement. The need is so strong it can cause physical/psychological distress

Question 2

Substance Use Disorder

Answer 2

• Occurs when substances interfere with their ability to fulfill role obligations such as school, work, or home.
• Individuals often try to cut down, fail, and use of substances increases.

Issues that Arise
- Interpersonal relationships (they become isolated)
- Often participate in hazardous activities when impaired
- Tolerance develops and increase requirement to achieve desired effect.

Question 3

Intoxication

Answer 3

• Physical/mental state of exhilaration, emotional frenzy, lethargy, and stupor

Substance Intoxication
- Reversible syndromes following excessive use of a substance.
- Disruption in physical functioning
- Judgment is disturbed resulting in inappropriate and maladaptive behavior
- Social and occupational functioning impaired

Question 4

Withdrawal

Answer 4

• Physiological and mental readjustment that accompanies abrupt discontinuation of addictive substances.

Question 5

Predisposing Factors

Answer 5

• Genetics
• Reducing anxiety and increasing feeling of power
• Low self esteem
• Antisocial
• ADDITION INVOLVES IRRATIONAL THINKERS

Question 6

Alcohol Use Disorder

Answer 6

• Alcohol depresses the CNS

Pre-alcoholic Phase
- Drinking everyday to relieve stress

Early Alcoholic Phase
- Stops being a source of pleasure and begins with blackouts. Individual feels guilt and defensiveness with drinking

Crucial Phase
- Individual lost their ability to control their drinking. Commonly angry or aggressive. May experience loss of job, marriage, friends, family.

Chronic Phase
- Emotional and physical disintegration. Profound helplessness and self-pity.

Withdrawal
- Hallucinations, tremors, convulsions, severe agitation, panic.
- Depression
- Can be fatal for long time drinkers

Question 7

Low Dose Alcohol

Answer 7

Produces..

• Relaxation
• Loss of inhibitions
• Lack of concentration
• Drowsiness
• Slurred speech
• Sleep

Question 8

Chronic Alcohol Abuse Effects

Answer 8

Peripheral neuropathy
- Nerve damage that results in tingling or burning in the extremities. (Possibly due to deficiency in B-vitamin thiamine)

Alcoholic Myopathy
- Muscle pain, swelling weakness (generalized)
- Chronic includes gradual wasting and weakness of skeletal muscles

Alcoholic Cardiomyopathy
- Treatment is total abstinence from alcohol.

Wernicke’s Encephalopathy
- MOST SERIOUS FORM OF THIAMINE DEFICIENCY. Paralysis of ocular muscle, ataxia, diplopia, stupor. MUST HAVE THIAMINE REPLACEMENT THERAPY

Korsakoff Psychosis
- Syndrome of confusion, loss of memory, confabulation. Treated with thiamine replacement

Esophagitis - Inflammation of esophagus due to vomiting

Gastritis - Inflammation of stomach lining due to alcohol breaking down protective mucosal barrier.

Pancreatitis - Can be seen as abdominal distension and epigastric pain. Chronically you may see steatorrhea, malnutrition, weight loss, diabetes mellitus.

Alcoholic Hepatitis - Inflammation of liver which can cause ascites, elevated WBC, fever, jaundice

Cirrhosis - which can cause portal hypertension, ascites, esophageal varices, hepatic encephalopathy

Leukopenia - Impaired WBC’s which increases risk of infection

Thrombocytopenia - Low platelets

Sexual Dysfunction - Long term can include gynecomastia, sterility, impotence, decreased libido, issues with erections.

Question 9

Thiamine Deficiency

Answer 9

• MOST SERIOUS RISK IS WERNICKE’s ENCEPHALOPATHY (CAN CAUSE DEATH

Question 10

Fetal Alcohol Syndrome

Answer 10

Causes to the fetus
- Learning difficulties
- Speech/language delays
- Intellectual disability
- Poor reasoning skills
- Sleep/sucking problems
- Vision/hearing problems
- Problems with heart/kidney/bones
- Abnormal facial features
- Small head
- LBW
- Shorter than average height
- Poor coordination
- Hyperactive bowel sounds
- Difficulty paying attention
- Poor memory
- Difficulty in school

WOMEN WITH ALCOHOL RELATED DISORDERS HAVE A 35% RISK OF HAVING A CHILD WITH DEFECTS

Question 11

Alcohol Intoxication

Answer 11

• Disinhibition of sexual/aggressive impulses
• Mood liability
• Impaired judgment
• Impaired social/occupational functioning
• Slurred speech
• Unsteady gait
• Nystagmus
• Flushed face

Question 12

Alcohol Withdrawal

Answer 12

• Tremor of hands, tongue and eyelids
• N/V
• Tachycardia
• Diaphoresis
• Elevated BP
• Anxiety
• Depression/Irritability
• Transient Hallucinations
• Headache
• Insomnia

Question 13

Alcohol Withdrawal Delirium

Answer 13

• Other medical issues can increase risk of alcohol withdrawal progressing to alcohol withdrawal delirium.