Alcohol Eng

7/29/2019 Alcohol Eng

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Mental Health Primary Care

MHPC


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Bidi, Cigarettes ,Tobacco Charas, bhang, ganja Alcohol Opium, brown sugar, heroin


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Alcohol affects brain

For getting pleasure

To reduce pain, anxiety, tension In continued drinking, tolerance Cutting down or Abstinence causes withdrawal

symptoms

Withdrawal symptoms go away with drinking. Toreduce withdrawal symptoms person feelscompelled to drink


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Anxiety disorder

Depression

PsychosisSigns and

Symptoms

, .

Self Medication Hypothesis


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MHPC


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Dependence: can not stop drinking, feelscompelled to drink

Work, occupation, relationship problems

Medical disorder or accident

Mental disorder,e.g.Depression Legal problems, e.g.violence


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Physical Dependence Psychological Dependence

Withdrawal effects Craving


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LikingCravin

g

Non-problematic

use Abuse Dep


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Tremors

Excessive perspiration, tachycardia

Sleep disturbance

Nausea and vomiting Anxiety, irritability Agitation

Illusions and hallucinations: visual, Tectile,auditory Convulsions

Delirium


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Death: Annually

World: 18 lakh

India: 2 lakh Of the drinkers

10% menand

3% women have AUD

AUD: A Major Public Health Problem


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1 Unit = 12 Gram Alcohol 1 Unit Alcohol raises blood alcohol level by

15-20mgm/100ml

Body takes I hour to lower blood level 15-20

mgm/100ml


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Age:18 - 25 years Male> Female

Uneducated> Educated

Easy availability Social acceptance Certain occupations


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First degree relatives: 4 times greater risk both modeling as well as heredity


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1Unit Alcohol= 720ml Beer 1Unitalcohol=240ml wine 1Unit Alcohol= 90ml spirit


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Causes of death: Suicide Cancer Heart Disease Liver disease

Alcohol use disorder shortens life by 10years

Alcohol is associatedwith :

50% vehicular

Accidents 50% Murders 25% Suicides


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1. Tolerance*

2. Withdrawal*

3. Larger amounts/longer period than intended

4. Inability to, or persistent desire to, cut downor control

5. A great deal of time spent obtaining, using, or

recovering

6. Important activities given up or reduced

7. Use despite problems caused or exacerbated by use

*Dx: with Physiological Dependence39


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Alcohol affects all body organs

Heart:high blood pressure, arrythemia,Heart

failure

Brain: amnesia,Confusion,auditoryhallucinations,convulsion,ataxia

Liver:hepatitis,cirrhosis,Cancer

Muscles:weakness

Pancreas:pancreatitis, hemorrhage


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Lungs:infections Stomach and intestines:ulcer, bleeding Reproductive system:impotence, testicular

atrophy, harm to baby in prenatal period Skin:excess perspiration, non-healing

wounds CNS:Accidents, vehicular and with moving

machinery- peripheral neuritis


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Methyl alcohol instead of ethyl alcohol Methyl alcohol is toxic : Heart, kidney, liver,

brain Blindness

Death if not treated early

Hooch: Laththo


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Anxiety disorder, Depression X 4 Psychotic disorders x 6

Person with psychiatric disorder should cutdown drinking

Alcohol use may reduce some anxiety inbeginning but later worsens

Increases risk of suicide and attemptedsuicide


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Male: 14 Units /weel Female: 7Units/ week

spread over the week

Daily drinking increases risk of Alcoholdependence: Keep periods of not drinking

Safe drinking?


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1. Cut Down

2. Annoyance

3. Guilt

4. Eye opener

If 1 yes, Alcohol use disorder probable

If 2 or more yes, AUD Certain


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MHPC

InAlcohol Use Disorders


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1. Reduce Risk of suicide or harm2. Listening non-judgmentally3. Giving information and reassurance4. Encourage professional help5. Encourage self help

MHPC : Alcohol Use Disorders


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Abuse:

Reduce quantity

Total Abstinence

Dependence:

Total Abstinence


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Psychoeducation Detoxification Treatment of medical and psychiatric

comorbid disorders Alcohol deterrent drug like disulfiram Working with family to improve relationships

Self help groups


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1. Precontemplation.The person sees no need to change.2. Contemplation. The person has thought of the pros and

cons of their substance use but is not sure about changing.3. Preparation. The person is ready to take action to change.

4. Action. The person is attempting to change and avoidingsituations which might trigger their substance use.

5. Maintenance. The person has changed and is working toprevent themselves from relapsing back to substancemisuse.

6. Relapse.In any permanent changes, relapses can happen atfirst.


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Withdrawal effects: 1week after quittingalcohol are treated. No need for continuingalcohol use

With physical exam and lab investigation canassess physical harm due to alcohol

Diagnoses and treats comorbid psychiatric

disorders

Psychiatrist


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Alcohol disulfiram reaction Nausea Headache

Vomiting Perspiration Flushing Thirst

Palpitations Pain in chest Dizziness Convulsion


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Without knowledge of patient


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Ahmedabad, Vadodara, Rajkot,Surat, Vapi has AA

Groups Abstinent people help others who wish to quit

alcohol


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Thank You!

Alcohol Eng

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