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Alcohol Abuse and Addiction and Habituation
Alcohol Abuse and Addiction and Habituation
Problem and solution.
Abstract: Although there is no definition of "addiction" that is universally accepted, in general, addiction refers to a physiological and psychological dependence of a drug. Although some drugs of abuse induce physiological addiction, others do not. Moreover, some drugs are physiologically addictive usually not abused (Eg, caffeine). Tolerance to drug effects and withdrawal syndrome on abrupt cessation of consumption, which develop over time, are features physiological characteristic of addiction. "Habituation" is the term used to refer to psychological dependence on a drug. Some drugs of abuse are rewarding for their influence on the strengthening of the neurobiological processes, but not necessarily result in "tissue" related symptoms abstinence. Cessation of such drugs can bring everything to subjective craving due to previous drug conditioning (perhaps for some marijuana users) and desire may be more readily evoked or deeply conditioned among some people than others ("addictive personalities"). main evaluation methods of addiction and habituation are completed through clinical interviews or self-report surveys (eg, the American Psychiatric Association DSM-IV, Organization World Health ICD-10). treatment paradigms for the cessation of addiction begins with the initial detoxification or withdrawal, followed by inpatient or outpatient program participation (eg, 12-step programs, milieu, cognitive-behavioral or behavior). Pharmacological efforts (eg, methadone maintenance) can be used as harm reduction strategies among those who seem unable to stop using drugs.
It is estimated that approximately 15 percent of the world's adults have serious substance abuse problems (not including nicotine addiction), and this percentage has remained fairly constant in recent twenty-five. Of these substance abusers, about two thirds of alcohol abuse and third abuse other substances, mainly marijuana, amphetamines, cocaine and heroin. Approximately2.5 percent of the population abuse of marijuana, stimulants of abuse of 0.5 percent, 0.3 percent abuse cocaine or opiates (such as heroin), and up to 0.8 percent abuse other substances (eg inhalants, depressants, hallucinogens). Sites of drug production and manufacturing, and distribution routes, tend to identify regions at high risk of abuse.
Drug abuse causes significant health-related consequences and losses legitimate financial economies. The financial cost to society estimated at about 600 billion dollars per year worldwide. This does not include the cost of abuse of nicotine, which, through its influence on heart disease, lung cancer, chronic obstructive pulmonary disease, and numerous other consequences, is the number one murderer behavior of people in the world. Drug abuse also are associated with the production of psychotic symptoms (eg paranoid ideation) and injuries due to accidents and violence. Approximately 50 percent of traffic accidents involving drunk drivers with alcohol, and many motor vehicle accidents also involve chronic marijuana or amphetamine.
In addition, each drug class is associated with a single set their possible consequences. Some drugs can have fatal consequences (eg, opioids and antidepressants), and some have a high potential for addiction. Health effects may also vary with the drug. For example, depressants, PCP, stimulants, steroids, and cannabis are associated with cardiovascular disease. Stimulant use is linked to seizures, digestive problems and lung problems. documented consequences of marijuana use include lung damage and problems of short-term memory. Dementia, seizures, memory loss, impaired central and peripheral nervous systems, gastrointestinal diseases and cancers gastrointestinal tract are all consequences of alcohol consumption. Steroid use is associated with high blood pressure, potential heart attacks, liver tumors, temporary infertility, and degeneration of the tendon. Inhalants are well known causes of kidney, brain and liver damage.
The development and maintenance of the addictive process involves multiple pathways and levels of influence on the biological, psychological, sociological and domains. External influences the individual factors include environmental, cultural and social. The cultural and social norms, changes in drug use practices, and values and behaviors parents, siblings, friends, and role models may affect the experience of an individual drug. Processes that contribute to individual differences in substance use include physiological susceptibility, as measured in genetic studies, affective states, personality and cognition, including expectations and processes memory. Substance abuse in comparison with substance use is more strongly related to intra-personal processes (eg self-medication for anxiety emotional) social processes, although both are influential in the addiction process.
SUBSTANCE ABUSE AND DEPENDENCE
Substance use simply belongs for the use of a drug. Substance abuse involves the use of a drug for a purpose or a way that was not foreseen or prescribed. Substance abuse is characterized by an accumulation of negative consequences resulting from the use of drugs. Substance use leads to a decrease in the level of performance in the main roles life, or dangerous actions, legal problems or social problems, says the abuse. Substance dependence is a more severe form of drug abuse that includes tolerance (need for markedly increased amounts of the substance to achieve the desired effect of drug), withdrawal symptoms when stopping the drug use, the unpredictability of substance use, and an inability to control the use of a substance to the point it consumes daily life.
Withdrawal symptoms vary of a drug to drug. For example, abstinence from alcohol, sedatives or anxiety may involve autonomic reactivity, hand tremor, insomnia, nausea or vomiting, transient illusions or hallucinations, psychomotor agitation, anxiety, and grand mal seizures. Withdrawal of amphetamine or cocaine can include fatigue, unpleasant and vivid dreams, insomnia or hypersomnia, increased appetite and psychomotor retardation or agitation. For substance abusers, retirement is often a difficult process, with many symptoms, while abstaining from drug use can lead to recovery of physical and psychological problems and improving overall health.
DRUG ABUSE continuum
Conceptually, substance abuse can be seen as a continuum, with individuals at one extreme of being relatively Disease-free, "but engage in maladaptive behaviors over which they have some control. These people may use drugs repeatedly, and eventually be abused drugs. They choose to live a certain lifestyle in which their maladaptive behavior may or may not result in other disease states associated with the use (for example, cirrhosis of the liver). If these guys stop this negative cycle that can, perhaps on their own, learning alternative coping mechanisms and self-efficacy. Individuals at the other end of the continuum, however, apparently have no control over their use. Some individuals seem to lose control of the first time they use drugs. For these drug people is like a switch that is on or off. For them, total abstinence is the only alternative because they have a process control Once the switch is on. Can use until they die unless someone else can turn your off and stay that way. There is no logic to this behavior, no choice. Users of this type are usually ruin their own lives and the lives of those around them in their desire to use their drugs of choice. It seems that as one advances towards a more "at risk" end of the continuum there is less and less control over the use of substances.
It is unclear what causes the difference in loss control among people in different parts of the continuum. Researchers do not understand the process very well. They know that other factors may exacerbate the process, including differences biological metabolic processes different levels of susceptibility to the reinforcing effects of drugs, personality disorders or depression, and an inability to tolerate frustration or emotional distress. Some individual processes are in control, but many are not, and it seems that unless the individual has control over such process, the more likely he or she is to fall into substance abuse.
STAGES OF ALCOHOLISM AND DRUG ABUSE
During the early stages of abuse substances, alcohol or drug abuser experiences increase tolerance and use. Substance use at this stage is generally for purposes of self-medication. In recent stages of abuse, life becomes about the collection, use and recovery of drug use. The loss of control, ethical deterioration and obvious symptoms of withdrawal occur. It is not clear, however, if such progress is inevitable.
In an empirical review of 1991, the study of progression in alcoholism, Jill Littrell found that approximately 60 percent of adolescent problem drinkers refer to consumption levels not problematic when they reach age 20, and the 25 percent of young adults to refer to non-problematic drinking levels before reaching age 35. Studies examining the data in adults undergoing alcohol to a variety of treatments such as inpatient and outpatient follow-up periods of up to fifteen years provide a general outline of the results. Between 25 and 35 percent remain abstinent, whether or not to continue treatment. One percent additional 15 to 25 will be the withdrawal most of the time, with some periods effect. Approximately 6 to 9 percent will become problem drinkers or not controlled (especially those who were lighter drinkers and suffered fewer negative consequences while drinking). Another 20 to 33 percent of problem drinkers are stabilized, while 15 to 25 percent will die from causes related to alcohol.
It is unclear whether drug users follow a similar progression to that of alcoholics. There is probably some validity to the notion of progression for drug use in general but longitudinal studies are needed in this area. It is possible that such progress may simply express the accumulation of increasingly harsh consequences that one has the opportunity to drink or use drugs. Unlike the steps described above, a substance abuser can only incur more problems over time, along with increased tolerance for alcohol or other drugs of abuse.
Ethyl alcohol or ethanol, is the most commonly used drug in the world. Pharmacologically, alcohol is classified as a central nervous system depressant. Like other depressants, alcohol in small doses reduces heart rate and respiration, decreased coordination muscle and energy, dulls the senses, and lowers inhibitions, which results in feelings of relaxation and increased sociability. Large amounts of alcohol can cause depression of various body systems, resulting in coma or death. The immediate physical effects of alcohol depend on the amount and frequency of consumption, while the effects mental and emotional are influenced by the mood of the drinker and where drinking takes place.
Two physical effects resulting from prolonged consumption include excessive alcohol tolerance and withdrawal. Alcohol tolerance refers to the need for increasing amounts of alcohol to achieve the same level of intoxication. For example, five or six drinks may be necessary to achieve the same effects produced by one or two drinks when the individual began drinking. Alcohol withdrawal, in contrast, refers to a series of physical and psychological reactions when an individual experiences a significant reduction or cessation of prolonged heavy drinking. Symptoms withdrawal include nausea, vomiting, anxiety and hand tremors.
An interaction of biological, psychological and environmental problems come into play in the development of drinking behavior and problems. For example, some people may be genetically predisposed to alcohol problems, but regardless of that alcohol actually experience negative consequences also depend on their immediate social and physical, such as the drinking habits of the family and the availability of alcohol, and their consumption habits.
Alcohol use and misuse
Most people who drink alcohol do so without negative consequences. Others may really get a health benefit from its use. Some, however, the beverage so as to put other people at risk of experiencing alcohol-related problems. Although without a pattern of alcohol consumption is riskless, certain patterns of consumption may help reduce the risk significantly.
The Dietary Guidelines for Americans, published jointly by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services define moderate drinking as no more two standard drinks per day for men, and no more than one per day for women and sixty-five years of age and older. A standard drink is 0.5 ounces of alcohol, equivalent to 12 ounces of beer, 5 ounces of wine or 1.5 ounces of distilled spirits of 80 degrees. These guidelines suggest that moderate alcohol use is related or low with a lower risk for the occurrence of negative consequences of alcohol. For others, however, refrain from alcohol is the safest thing to do. Groups should avoid all alcohol consumption are pregnant women, children and adolescents, plans to drive or engage in other activities that require alertness, people unable to maintain moderate alcohol consumption, and those who are using prescription medicines or prescription that interact with alcohol.
Another way to understand problem drinking is to examine the definitions of alcohol abuse. The World Health Organization (WHO) defines alcohol abuse as alcohol consumption that puts people at risk of problems, including "the use at risk," "clinical alcohol abuse" and "dependency." alcohol consumption risk is the consumption of alcohol in a way that is incompatible with the legal or medical guidelines, and is likely to pose any acute health problems social or chronic user or others. Some examples are underage drinkers, drinking by individuals with a family history of alcoholism or problems with alcohol, or drink if you have a medical condition that could be worsened by drinking, such as a stomach ulcer or liver disease. Alcohol abuse is a clinical most serious type of abuse that results in one or more recurrent adverse consequences, such as breach of important duties or the repeated use of alcohol in situations of physical danger. Alcohol dependence is the most serious type of alcohol abuse is a chronic disorder that is characterized by three or more symptoms within twelve months. These symptoms include alcohol tolerance, withdrawal, loss of control, and continued use despite knowledge of having physical or psychological.
The negative consequences of alcohol consumption is estimated to affect more than 10 percent of the U.S. population, with many of these individuals are not detected. A series of brief screening tools are available to help detect potential problems with alcohol. One of the most used among these is the CAGE questionnaire four themes, which derives its name from self-administered the following four questions:
1. Have you ever felt you should Cut down on your drinking?
2. Do people who criticize Annoyed by your drinking?
3. Have you ever felt bad or guilty about your drinking?
4. Have Any ever had a drink in the morning to steady your nerves or get rid of a hangover (opens eyes)?
If you answer yes to just one or two items on the CAGE questionnaire may indicate a drinking problem.
PREVALENCE
In the United States, 44 percent of adults eighteen years of age and older are current drinkers, consuming at least twelve drinks in the past year. Meanwhile, 7.4 percent, or approximately 14 million Americans abuse experience alcohol or alcohol dependence. Heavy episodic or binge has remained at the same approximate level of 16 percent for all adults since 1988, with the highest rate, 32 percent, among young adults eighteen to twenty-five. More than half of adults report having a close relative who has experienced alcoholism.
Only 5 percent of the heaviest drinkers consume as much as 42 percent of alcohol drunk in the United States, and 20 percent of drinkers account for nearly 90 percent of alcohol consumed. Most of the alcohol drunk in the United States, therefore, is consumed by a relatively small population of very heavy drinkers.
Alcohol also is the drug most frequently used by children and adolescents. In 1999, more than half (52%) of eighth graders (14-years old) and 80 percent of twelfth graders (18-years old) reported having consumed alcohol at least once. more problematic drinking occurs in 15 percent of eighth graders and 31 percent of twelfth graders who reported binge drinking (consuming five or more drinks in a row) within two weeks above. Of American teenagers of high school, more than half (51%) of alcohol in the drink now. In 1999, one in three high school students presented heavy drinking episodes of five or more drinks at least once during the last thirty days. The prevalence of excessive alcohol consumption increases the frequency until adolescence to early adulthood.
HEALTH FINDINGS
Alcohol consumption has health and social consequences to drinkers, for whom the around, and the nation as a whole. About 100,000 deaths each year are attributed to alcohol, making it the third leading cause of preventable mortality in the United States. Worldwide, 750,000 deaths are attributed to alcohol consumption each year. alcohol related deaths from cancer, liver cirrhosis, pancreatitis, car accidents, falls, drowning, suicide and homicide. Alcohol affects almost all body systems, and contributes to a number of medical problems, including the functioning of immune system disorders, bone diseases, hypertension, stroke, cardiovascular disease, impaired cognitive function fetal disorders, traumatic injury, depression, gastrointestinal disorders, and cancers of the neck, head, stomach, pancreas, colon, breast and prostate. Alcohol also produces significant social problems, including domestic violence, child abuse, marriage and family breakdown, violent crime, motor vehicle accidents, lost work productivity, absenteeism and low school performance. The estimated cost of alcohol abuse in the United States in 1998 was approximately $ 185 million.
Young people are particularly vulnerable to the effects of acute alcohol because of its low tolerance to alcohol, lack experience with drinking, and consumption patterns that often include episodic heavy drinking in high-risk situations, such as when driving and sexual encounters. Leading causes of mortality and morbidity among young people include motor vehicle injuries related to alcohol, homicide and suicide. Consumption of alcohol among young people is associated with decreased school performance, increased crime, and the development of psychiatric problems later in life. Alcohol has also been found to precede other illicit drugs, thereby serving as a gateway "to the use of other drugs, including marijuana and cocaine.
Women and the elderly are also at greater risk of experiencing alcohol-related harm, due to lower water levels in the body, which means that small amounts of alcohol result in higher levels of intoxication that in younger men. Drinking during pregnancy has been associated with increased rates of miscarriage, fetal death and premature births, and fetal alcohol syndrome-a set of birth defects caused by maternal alcohol consumption during pregnancy. For older people, drinking even moderate amounts of alcohol can cause considerable problems due to chronic illness, interactions with drugs and pain and loneliness of death loved ones.
At the same time, moderate to low levels of alcohol consumption have been associated with a lower risk of heart disease and stroke. These effects appear to be confined mainly positive, however, individuals of middle age and older in industrialized countries with high rates of cardiovascular disease. The individuals and populations should weigh the risks and benefits of drinking themselves and others, including factors such as the situations in which drinking will take place and the amount likely to be consumed, to determine the net result of drinking.
SOLUTIONS
The burden of alcohol abuse is measured in a number of ways, including the prevalence and incidence of deaths, injuries and diseases attributed to alcohol, hospitalization rates, potential years of life lost due to alcohol abuse, and indicators quality of life. Great resources are spent each year in the United States to address health and social problems resulting from alcohol abuse. Because a single solution can reduce all alcohol-related harm to individuals and populations, a comprehensive approach with a series of strategies that address the multiple causes and dimensions of the problems alcohol is necessary. These strategies should include educational approaches, such as public health education and awareness programs, including school, and family-based prevention programs in the community, environmental approaches, such as controls on the price and availability of alcohol, the minimum age for buying alcohol, legislative measures to curb driving under the influence of alcohol, and restrictions on the promotion, marketing and advertising of alcohol, and efforts health care, such as the detection of primary health care, counseling by health professionals, preventive services, and effective psychological treatment and
pharmacological approaches.
Dr.Kedar B. Karki
New Hope Rehabilitation Center Satdobato Lalitpur
drkarki_kedar@yahoo.com
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About the Author
Dr.Kedar B. Karki
New Hope Rehabilitation Center Satdobato Lalitpur
Craft Beer Distributor of the Year – GABF