Substance Abuse Genetically linked

 Usually varies from time to time or from culture to Increased risk among monozygotic twins
culture Relationship of dopamine stimulation in the limbic
 Causes maladaptive behaviors secondary to system producing pleasant feelings.
mood-altering substances  Psychological
 Wide spread concern with broad social  To lift underlying depression or to reduce tension,
ramifications and personal consequences frustration and emotional pain
 May lead to addiction  Deals with the importance of family dynamics
 Children of alcoholics are 4x likely to develop
Classification of Commonly Abused Substances
alcoholism
1. CNS Depressant  Inconsistent preventing behavior, poor role
 Alcohol modeling, and lack of nurturing will pave the way
 Barbiturates for the child to adopt similar maladaptive lifestyle.
 Non-barbiturate sedative hypnotics  Socio-cultural
 Anxiolytics  Effect of the society or other people on
 Inhalants substance abuse such as adolescent peer
 Opioids (narcotic analgesics) pressure, laws, culture, social attitudes, and
 Synthetics availability
 Behavioral cognitive theory
Intoxication: depressed CNS  Associated with certain cues or changes in the
Withdrawal: stimulated CNS personality with the ingestion of the substance.

2. CNS stimulants
 Amphetamine
 Non-amphetamine DSM IV Criteria for substance related d/o
 Nicotine A. Substance Dependence
 Caffeine - a maladaptive pattern of substance use as
 Hallucinogen manifested by 3 or more of the ff:
 Cannabinoids  Tolerance
 Withdrawal
Alcohol abuse is considered as the leading abused  A need for more of the substance than was
substance intended
- about 2/3 of theAmerian adults consume alcohol  Inability to stop using even when wanting to
do so
- 1/3 of all the hospital admissions are somewhat related to
 Great deal of time is spent in acquiring
alcohol abuse
substance
- 1/3 of all traffic events are alcohol-related  Causes social, occupational, or recreational
problems
- about 14% of the adults population meet the criteria for an
 Continued use of the substance despite
alcohol-related disorder
knowing the side effects
- about 6.2% of adults meet the criteria for a substance-
With clinically significant impairment or distress as
related disorders
manifested by one or more of the ff:
- the actual prevalence of substances abuse is difficult to
 Failure to fulfill obligations at work, school,
determine precisely because many people will not seek
or home
treatment and data may not be accurate.
 Recurrent use in hazardous situation
Theoretical perspective  Law violations
 Biological theory B. Substance intoxication
 - development of group of symptoms due to An overdose or excessive alcohol intake in a short
recent use of a substance period of time can result to: (ABCD)
- significant change in the behavior or personality
due to the effect of the subs to the CNS Altered level of consciousness
- Not related to any medical conditions and other Breathing is depressed; vomiting
mental conditions
C. Substance withdrawal Coma
- development of a group of clinical Decreased BP and death
manifestations due to sudden cessation or
Alcohol metabolism
reduction in the intake of a substance
- Symptoms may cause clinically significant Facts
distress or impairment
 10% - stomach
- Not related to any medical diagnosis or mental
 90% - small intestine
health problem.
Empty stomach – can reach bloodstream within 20 minutes
after ingestion
Alcohol abuse
Slow absorption:
 Alcohol is a CNS depressant that is rapidly absorbed  Beer (4%)
into the bloodstream  Wine (12%)
 Alcoholism is considered to be present when there is  Liquor (40-50%)
0.1% or 10ml for every 1000mL of blood. Fool also slows alcohol absorption
 Alcohol is dissolved in body’s water and distributed to all
Blood alcohol concentration
body tissues.
Blood alcohol level Behaviors  The body can metabolize 10 ml of alcohol (1 ounce of
Up to 0.1% Anxiety euphoria, loud, loss whiskey or 1 glass of beer) in 90 minutes.
of inhibition  Hot coffee or “sweating it out” does not increase the
0.10-0.15% Slurred speech, motor metabolism of alcohol.
incoordination  Late stage alcoholism: decrease in tolerance
0.2-0.3% Irritability, block-out,  Acetaldehyde – toxic
tremors, ataxia, stupor  CNS stimulant
0.3% and up Unconsciousness
 Can cause liver cell loss and liver cirrhosis
 Decreases vitamins activation
Effects of alcohol intake  Reacts with brain neurotransmitter =
tetrahydroisoquinolone (addiction) and beta-
1. Relaxation carboniline (severe anxiety)
2. Loss of inhibition
Physiologic effects of long term alcohol abuse
3. Slurred speech
4. Unsteady gait  Wernicke-korsakof’s syndrome
5. Lack of coordination  Characterized by amnesia, clouding of
6. Impaired attention consciousness, confabulation (falsification of
7. Impaired concentration memory), memory loss, and peripheral
8. Impaired memory neuropathy
9. Impaired judgment  Results from poor nutrition of the alcoholic
10. Aggressive display of inappropriate sexual particularly inadequate amounts of thiamine and
behaviors niacin, and neurotoxic nature of alcohol.
11. Black-outs  Common behavioral problems
 o denial, dependency, destructive
domineering
Treatment
 Symptoms of withdrawal usually begin 4-12 hours
after cessation or marked reduction of alcohol intake
Manifestations:
 Hand tremors
 Sweating
 Elevated pulse and BP
 Insomnia
 Anxiety
 Nausea and vomiting
 Transient hallucinations and delusions
 Seizures
 Delirium (delirium tremens)
 Alcohol withdrawal can be life threatening, so
detoxification needs to be accomplished under
medical supervision
 Treatment of alcohol overdose is similar to that of any
CNS depressants;
 Gastric lavage
 Dialysis
 Respiratory support
 Cardiovascular support
 Safe withdrawal is usually accomplishes by
benzodiazipines (diazepam and lorazepam)
Disulfiram (Antabuse)
 Inhibits the breakdown of acetylcholine by an enzyme
(aldehyde dehydrogenase)
 Acetyldehyde is toxic to our body
The person who drinks alcohol while taking disulfiram will
become ill:
 Sweating
 Flushing of the neck and face
 Tachycardia
 Hypotension
 Throbbing headache
 Nausea and vomiting
 Palpitations
 Dyspnea
 Tremors
 Weakness
*should have NO intake of alcohol for 24-48 hours.
*disulfiram reaction will then result to aversion to alcohol