5-1AlcoholUseDisordersAS2000-5000SU2021.
5-1AlcoholUseDisordersAS2000-5000SU2021.
A depressant (also called a central nervous system depressant) is a chemical compound that manipulates neurotransmission levels, thereby reducing arousal or stimulation in various parts of the brain.
Depressants are also occasionally referred to as “downers” because they lower the level of arousal in the brain when taken.
Depressants
Alcohol
Barbiturates
Benzodiazepines
Barbiturates are a class of drugs that were used extensively in the 1960s and 1970s as a treatment for anxiety, insomnia, seizure disorders and as an anesthetic.
Apart from a few specific indications, they are not commonly prescribed these days, having been largely superseded by benzodiazepines.
Barbiturates
Side Affects
Confusion
Drowsiness
Irritability
Barbiturates are extremely dangerous and addictive
Overdose Symptoms:
Difficulty concentrating
Impaired judgment
Incoordination
Sluggishness
Speech disturbances
Staggering
Unusually slow and shallow breathing
Coma and death.
Street Names: Yellows, Barbs, Yellow Jackets, Phennies, Red Birds, Reds, Downers, Red Devils, Blue Birds, and Rainbows
Most Common: Mephobarbital, Phenobarbital, Butabarbital, Butalbital
Benzodiazepines (Benzos)
Prescribing Practices
Alcohol & Opiate Withdrawal
Anxiety & Depression
Bipolar Disorder
Borderline Personality Disorder
Epilepsy &Seizures
Insomnia & Night Terrors
Muscle Spasm
Nausea/Vomiting
They are some of the most commonly prescribed & abused medications in the United States.
Most Common
Xanax
Klonopin
Librium
Valium
Ativan
Restoril
Halcion
Although more than 2,000 different benzodiazepines have been produced, only about 15 are currently FDA-approved in the United States.
Intoxication Effects
Trouble breathing or inability to breathe.
Bluish fingernails and lips.
Confusion and disorientation.
Extreme dizziness.
Blurred vision or double vision.
Weakness.
Uncoordinated muscle movements.
Tremors.
Profoundly altered mental status.
Stupor.
Coma.
ALCOHOL
Types of alcohol Ethyl alcohol or ethanol – grain alcohol
Methyl – wood alcohol
Isopropyl – rubbing alcohol
By 1790, Americans consumed an average of 5.8 gallons of alcohol per person each year; by 1830, this figure peaked to 7.1 gallons (compared to 2.3 gallons today).
A brief History of Alcohol Production & Consumption
The Temperance Movement (early-mid 1800s) ?
In 1919, the 18th Amendment banned the manufacturing and selling of alcohol
In 1935, Bill Wilson (Bill W.) and Dr. Bob Smith (Dr. Bob) formed Alcoholics Anonymous (AA) and published Alcoholics Anonymous in 1939
In 1952, the American Medical Association first defined alcoholism.
In 1967, the AMA redefined alcoholism as a complex disease
The temperance movement spearheaded by female or religious groups; wanted to cease alcohol drinking; preceded the constitution
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Scope of the Problem
2.4 million people worldwide lose their lives to alcohol-related illness or injuries.
In the U.S. 90% of adults will consume alcohol at some point in their lives.
60+% of U.S. adults have drunk to the point of intoxication in the last year.
10 – 20% of adults who consume alcohol will meet criteria for an AUD
An individual’s pattern of alcohol use changes over time.
Some social drinkers become problem drinkers – while – some abusive drinkers can become abstinent or controlled.
AUD – Related Info
Most alcohol dependent people experience their first psychosocial or medical problem related to drinking in their 20s or 30s.
Most will seek treatment in their 40s.
Most are not like the “skid-row” vision of a daily drinker.
Debbie Hanselman, LMSW OCC MH1500 Winter 2019
Tolerance
As a person consumes alcohol on a regular basis the body adapts to the continued presence of alcohol.
This causes the person to drink more for the same effect – known as metabolic tolerance.
What were the 3 other types of tolerance
We discussed?
Behavioral Tolerance – Behavior of the individual indicates a lower dose despite having used much more of the chemical.
Cross Tolerance – When two chemicals target the same neuron receptor sites the receptors will become less sensitive to one of the chemicals (so they don’t work as well)
Reverse Tolerance – When lower doses of the chemical produces the same effect as higher doses taken before
Alcohol is metabolized by a healthy liver at the rate of – 1 oz eliminated every 3 hours
When too much alcohol is consumed the liver cannot metabolize it at the same rate.
This can cause alcohol overdose or alcohol poisoning – because alcohol depresses the CNS – it causes pass-out, respiratory and cardiac failure, coma and death can occur
Critical Signs for Alcohol Poisoning
Mental confusion, stupor, coma, or person cannot be roused.
Vomiting.
Seizures.
Slow breathing (fewer than eight breaths per minute).
Irregular breathing (10 seconds or more between breaths).
Hypothermia (low body temperature), bluish skin color, paleness.
Debbie Hanselman, LMSW OCC MH1500 Winter 2019
What Can Happen to Someone With Alcohol Poisoning That Goes Untreated?
Victim chokes on his or her own vomit.
Breathing slows, becomes irregular, or stops.
Heart beats irregularly or stops.
Hypothermia (low body temperature).
Hypoglycemia (too little blood sugar) leads to seizures.
Untreated severe dehydration from vomiting can cause seizures, permanent brain damage, or death.
ALCOHOL RELATED DISEASES
Alcoholic Hepatitis – Inflammation of Liver
Cirrhosis – Kills Liver Cells / Causes Scarring
Fatty Liver – Accumulation of Fatty Acids
Gastritis – Stomach Inflammation
Pancreatitis – Inflammation of The Pancreas
Cardiomyopathy – Enlarged Heart
Hypertension
Hyperglycemia / Hypoglycemia
Debbie Hanselman, LMSW OCC MH1500 Winter 2019
Alcohol related brain dysfunctions include:
Wernicke-Korsakoff’s Disease
Symptoms of Wernicke’s Encephalopathy
Ataxia – lack of muscle control or coordination of voluntary movements
Mental Status Changes – dementia and delirium as well as psychiatric illnesses
Nystagmus or ocular changes – involuntary eye movement
Korsakoff’s syndrome – Thiamine depletion induced brain damage.
Symptoms of Korsakoff’s syndrome
Memory loss
Inability to retain new information
Disconnection of the neural between neurons are destroyed
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Severe Alcohol Withdrawal Symptoms
Usually begins 8 – 12 hours after last drink
Includes all of the previously mentioned and
Perceptual Distortion
Hallucinations
Hyperthermia
Sepsis
Cardiac Arrhythmias
Seizure
Convulsions
Debbie Hanselman, LMSW OCC MH1500 Winter 2019
Fetal Alcohol Spectrum Disorder
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy.
These effects can include physical problems and problems with behavior and learning. Often, a person with an FASD has a mix of these problems.
It is 100% preventable!!!!
Debbie Hanselman, LMSW OCC MH1500 Winter 2019
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Slide 5-16
Fetal damage from alcohol is often not apparent at birth. Much of the damage is to the nervous system. ARND may not be recognizable for years. (pp. 223–225)
It is 100% preventable!!!!
There is no known safe amount of alcohol during pregnancy or when trying to get pregnant.
There is also no safe time to drink during pregnancy.
All types of alcohol are equally harmful, including all wines and beer.
THE FACE OF FETAL ALCOHOL SYNDROME
Debbie Hanselman, LMSW OCC MH1500 Winter 2019
References
Center for Disease Control. http://www.cdc.gov/ncbddd/fasd/facts.html
Creative Commons. Open Source Images. https://creativecommons.org/
Doweiko, H. (2015). Concepts of Chemical dependency. ninth edition. Cengage learning.
Gearing, R., McNeill, T., & Lozier, F. (2005). Father Involvement and Fetal Alcohol Spectrum Disorder: Developing Best Practices. Hospital for Sick Children, Department of Social Work, Toronto, Ontario. JFAS Int. 2005.
http://www.motherisk.org/JFAS_documents/JFAS%205003F_e14.pdf
Hanselman, D. & Dudek, D. (2017). Peer Recovery Coach: The Art of Mentoring. Marygrove College.
Inaba, D. (2016). Uppers, Downers, and All Arounders. CNS Productions.
Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/
Debbie Hanselman, LMSW OCC MH1500 Winter 2019