Many people do not understand why individuals become ...



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Drug and Alcohol Abuse

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Contents

Drug Addiction.........................................................................................3

Introduction………………………………………………………………3

Definitions………………………………………………………………..4

Causes of Drug Addiction, Abuse and Dependency……………………..4

Classification of drugs addiction………………………………………....5

Treatment…………………………………………………………..……10

Nursing management……………………………………………………11

Complication of drug addiction…………………………………………15

Alcoholism...............................................................................................16

Introduction………………………………………………………..……16

Definition…………………………………………………………….…17

Symptoms……………………………………………………………….17

Risk factors……………………………………………………………...18

Causes………………………………………………………………...…18

Complications…………………………………………..……………….19

Type of alcoholisms…………………………………………………….20

Alcohol Withdrawal………………………………………………….…20

Alcohol tolerance…………………………………………….……….…21

Physical dependence………………………………………….…………22

Psychological dependence………………………………………………22

Treatment……………………………………………………..…………23

Nursing care…………………………………………………………..…25

References……………………………………………………………....26

Drug Addiction (Drug Abuse)

Introduction

Many people do not understand why individuals become addicted to drugs or how drugs change the brain to foster compulsive drug abuse. They mistakenly view drug abuse and addiction as strictly a social problem and may characterize those who take drugs as morally weak. One very common belief is that drug abusers should be able to just stop taking drugs if they are only willing to change their behavior. What people often underestimate is the complexity of drug addiction—that it is a disease that impacts the brain and because of that, stopping drug abuse is not simply a matter of willpower. Through scientific advances we now know much more about how exactly drugs work in the brain, and we also know that drug addiction can be successfully treated help people stop abusing drugs and resume their productive lives.

Definitions

Definition of Drug Abuse

Drug abuse is using a drug excessively, or for purposes for which it was not medically intended.

Note: Drug abuse lead to drug dependence or addiction.

Definition of Physical Dependence

A physical dependence on a substance (needing the drug to function) is not always part of the definition of addiction. Some drugs (for example, some blood pressure medications) don't cause addiction but do cause physical dependence.

Definition of Psychological Dependence

Other drugs cause addiction without physical dependence, for example Morphine, Heroin and Cocaine.

Definition of Drug Addiction

A drug addiction is a person who takes excessive amount of drugs for prolonged periods and without medical indications, develops tolerance, and shows symptoms of withdrawal if he cannot get the drugs.

Most addicts have shown abnormal psychopathic traits before becoming addiction, and it is unusual for mentally normal person to become an addict, except possibly to barbiturates. Any drug with sedative, stimulating or hallucinogenic properties can become a drug of addiction.

Causes of Drug Addiction, Abuse and Dependency

Causes of drug addiction, abuse and dependency not unknown, but we can a list down them as factors:

1. peer pressure

2. Emotional distress

3. Anxiety

4. Depression

5. Environmental stress

Classification of drugs addiction

Upon this assignment, we can classify drugs addiction to: (look at the figure)

[pic]

1. Drugs that have a depressant effect

BARBITURATES

Street names: Amytal, Nembutal, Seconal, Phenobarbital; barbs, reds, red birds, phennies, tooies, yellows, yellow jackets.

Barbiturates are prescribe for sedative and hyponotic effect, also used to reduced pain. Addiction of Barbiturates usually mild. And tolerance developed when the patient can take it without becoming sleepy.

Features of dependence are :

• dizziness

• tremor

• nausea

• postural hypotension

• ataxia

• irritability

Withdrawals of Barbiturates are produced:

• anxiety

• sweating

• palpitation

• and insomnia

Sudden withdrawal: after large doses have been taken can produce a major epileptic fit.

MORPHINE

Streets Names: Roxanol, Duramorph; M, Miss Emma, monkey, white stuff.

Addiction to morphine is most likely in those who have access to it doctors, nurses and pharmacists. It is liable to produce:

• loss of efficiency

• neglect of appearance

• disregard of social conventions

• rambling remarks

• sudden changes of mood

• decline in physical health

• anaemia

• constipation

• low resistance to infection

Withdrawal features: include

• headache

• anxiety

• depression

• insomnia

• muscular cramps

• sneezing

• yawning

• and crying

HEROIN

Also called diamorphine hydrochloride .

Street Names: Smack, H, ska, junk, and many others.

Heroin easily produces addiction. It may be preferred to morphine because of the intensity of the euphoria it produces and the absence of the vomiting and constipation likely to produced by morphine.

Symptoms of addiction

• headache

• anxiety

• depression

• insomnia

• muscular cramps

• sneezing

• yawning

• crying

• sever mental and physical deterioration

• And the addict is likely to die young of sepsis, pneumonia or pulmonary oedema

2. Drugs that have a stimulating effect

AMPHETAMINE

Street Names: Biphetamine, Dexedrine: bennies, black beauties, crosses, hearts, LA turnaround, speed, truck drivers, uppers.

Amphetamine drug produce an addiction , characterize by

• euphoria

• restlessness

• insomnia

• over activity

• psychotic reactions with delusions of persecution and hallucinations

• exhaustion

• aplastic anaemia

• excitement

COCAINE

Street Names: Coke, snow, flake, blow, and many others.

Cocaine is usually taken by injection, put it can be sniffad up the nose. It taken by morphine and heroin addicts to counteract the depressive effects of these drugs. It is likely to produce:

• elation

• over activity

• freedom from fatigue

• facile thought

• glibness

• restlessness

• short psychoses with confusion

• delusions

• and hallucination

Cocaine addict are often gross psychopaths, alcoholics, multiple drug takers, female or male prostitutes and treatment is usually unsuccessful.

3. Drugs liable to produce hallucinations

CANNABIS

Cannabis can produce acute or chronic reaction usually by dose related, but a novice may get one after smoking a single cigarette. Features are:

• ideas of depersonalization

• paranoid ideas

• delusions

• hallucinations

• confusion

• restlessness

• excitement

• sever panic

• delirium

• and disorientation

Chronic reactions are apathy, indifference to current affairs, decline in observance of social conventions and deterioration in behaviour. Also a short paranoid psychoses can occur.

LSD

Street Names: Acid, blotter, and many others.

LSD ( lysergic acid diethylamide) is a hallucinogenic drug more dangerous than cannabis. It produces:

• A dream like state

• Disorders or perception

• Hallucination

• Emotional disturbance

• Loss of control of behaviour leading to violence, murder and suicide

Chronic addiction causes apathy and mental deterioration.

Treatment   

Treatment for drug abuse or dependence begins with recognizing the problem. Though "denial" used to be considered a symptom of addiction, recent research has shown that people who are addicted have far less denial if they are treated with empathy and respect, rather than told what to do or "confronted."

Treatment of drug dependency involves weaning off the drug gradually (detoxification), support, and stopping the drug (abstinence). People with acute intoxication or drug overdose may need emergency treatment. Sometimes, the person loses consciousness and might need to be on a breathing machine (mechanical respirator) temporarily. The treatment depends on the drug being used.

Detoxification is the gradual withdrawal of an abused substance in a controlled environment. Sometimes a drug with a similar action is taken instead, to reduce the side effects and risks of withdrawal. Detoxification can be done on an inpatient or outpatient basis.

If the person also has depression or another mood disorder, it should be treated. Very often, people start abusing drugs in their effort to self-treat mental illness.

For narcotic dependence, some people are treated with methadone or similar drugs to prevent withdrawal and abuse. The goal is to enable the person to live as normal a life as possible.

Nursing Management

1. Addiction screening tools and clinical measures

Addiction screening tools are used to assist the addiction worker and the client during the initial assessment process.

Goal to use screening tools: The goal is to discover potential risk areas so the addiction worker selects tools that are designed to assess the risk that is being screening for. Screening tools are not designed to make clinical diagnosis; their role is to educate and identify potential risk.

To assess ours elf in screening and measures we can use (ADS) – 7©.

** The (ADS) – 7© is:

One of the new and exciting challenges of teaching addiction counseling in 2005 is that we no longer are just teaching our students how to assess and treat drug and alcohol concerns.

The (ADS) – 7© is contain 49 questions , the lest below contain these questions.

1. Have family or peers expressed a concern about your drug use?

2. Have you tried to stop gambling and been unsuccessful?

3. Have you thought you have a problem with alcohol?

4. Have you worried about food and calories?

5. Have you not bought groceries or paid bills because of your

buying habits?

6. Have you lost interest in friends, hobbies, school, work, or other pursuits because of your drug use?

7. Have partners, peers, or family members expressed a concern about your sexual behavior?

8. Have you noticed a connection between your financial problems and gambling?

9. Have you purged food or used laxatives or diuretics as a strategy for maintaining body weight?

10. Have you noticed that during weekends you cannot relax unless you are working?

11. Have you missed work or family functions because of your sexual behaviors (e.g., people or cyber sex)?

12. Have you driven any kind of motor powered vehicle under the influence of alcohol?

13. Have family or friends suggested you have an eating disorder (anorexia or bulimia)?

14. Have you started the day drinking to avoid feeling sick?

15. Have you used sex (people or cyber sex) as a way to get away from the stress of the world?

16. Have any relationships failed as a result of work?

17. Have you felt depressed after a buying spree?

18. Have you acted on an internal drive to eat large amounts of food at one sitting?

19. Have you noticed that food seems to be a major source of pleasure for you?

20. Have you lost time (e.g., blackouts) during a drinking episode?

21. Have you lied about your sexual behaviors?

22. Have you ever committed a crime to obtain drugs (e.g., stealing)?

23. Have peers or family expressed a concern over the amount of time you work?

24. Have you used sex as a way to escape from the world?

25. Have you noticed you gamble to escape or as a means of excitement?

26. Have you noticed it takes more alcohol to feel good?

27. Have you lied about your eating habits?

28. Have you lied about your buying habits?

29. Have you chosen drugs over people or work?

30. Have you noticed that your sense of self-worth is directly related to your work?

31. Have peers personally or professionally expressed concern about your drinking?

32. Have you tried to control your sexual behavior (people or cyber sex) and failed?

33. Have you tried to stop drinking?

34. Have you lied about your gambling?

35. Have you felt regret, guilt, or remorse over your drug use?

36. Have noticed gambling is causing stress at home, but you continue to gamble?

37. Have you found yourself buying things knowing you cannot afford them?

38. Have your buying habits created money problems for you?

39. Have you experimented with different kinds of drugs to find a better high?

40. Have you noticed that you feel most in control when you are working?

41. Have you felt a deep sense of depression after sex (people or cyber sex)?

42. Have you attempted to keep your buying secretive?

43. Have you lied to family or peers to stay at work longer?

44. Have you used a system to increase your chances of winning when you gamble?

45. Have you lost money gambling and felt OK?

46. Have you spent the majority of a day obtaining drugs?

47. Have you made projects more complex and time consuming than they need to be?

48. Have you attempted to control your eating habits and failed?

49. Have you noticed buying helps you feel a sense of control?

Keys of (ADS) – 7© screening and measures

|Types of addictions |Questions screening |

|Drug dependency |1 |

| |6 |

| |22 |

| |29 |

| |35 |

| |39 |

| |46 |

|Alcohol dependency |3 |

| |12 |

| |14 |

| |20 |

| |26 |

| |31 |

| |33 |

|Compulsive Buying |5 |

| |17 |

| |28 |

| |37 |

| |38 |

| |42 |

| |49 |

|Compulsive Gambling |2 |

| |8 |

| |25 |

| |34 |

| |36 |

| |44 |

| |45 |

|Food Addictions |4 |

| |9 |

| |13 |

| |18 |

| |19 |

| |27 |

| |48 |

|Workaholism |10 |

| |16 |

| |23 |

| |30 |

| |40 |

| |43 |

| |47 |

|Sex Addiction |7 |

| |11 |

| |15 |

| |21 |

| |24 |

| |32 |

| |41 |

• Note: through screening we used dark keys in the table.

2. Rehabilitation of client

We can rehabilitation addicts client by isolation and privacy in the treatment.

3. Drug treatment centers “detoxification”

To management addicts client it is important connected of drug treatment to consulting about clients conditions.

4. Use Specific antidotes “for use in overdose”, e.g. Naltrexone in opiates overdoses.

5. Use Specific medications for withdrawal symptoms, e.g. Benzodiazepine and Methadone.

6. Harm minimization, e.g. clean needles, needle exchange

Complication of addiction

The complications of drug abuse and dependence include:

• Depression

• Relapse of drug abuse

• Drug overdose

• Bacterial endocarditis, hepatitis, thrombophlebitis, pulmonary emboli, malnutrition, or respiratory infections, caused by drug use through a vein (intravenous)

• Infection with HIV through shared needles

• Unsafe sexual practices, which may result in unwanted pregnancies, sexually transmitted diseases, HIV, or hepatitis.

• Problems with the law

• Increase in various cancer rates, for example, lung and pharynx cancer are linked to nicotine use, mouth and stomach cancer are associated with alcohol abuse and dependence

• Problems with memory and concentration, for example with hallucinogen use, including marijuana (THC).

Summary

1. drug abuse and addictions can caused mental disorders.

2. family and friends are important materials of treatment the addicts client.

Alcoholism (Alcohol Abuse)

Introduction

Alcoholism is a term with multiple and sometimes conflicting definitions. In common and historic usage, alcoholism refers to any condition that results in the continued consumption of alcoholic beverages despite the health problems and negative social consequences it causes. Medical definitions describe alcoholism as a disease which results in a persistent use of alcohol despite negative consequences. Alcoholism may also refer to a preoccupation with or compulsion toward the consumption of alcohol and/or an impaired ability to recognize the negative effects of excessive alcohol consumption. Although not all of these definitions specify current and on-going use of alcohol as a qualifier, some do, as well as remarking on the long-term effects of consistent, heavy alcohol use, include dependence and symptoms of withdrawal.

While the ingestion of alcohol is, by definition, necessary to develop alcoholism, the use of alcohol does not predict the development of alcoholism. The quantity, frequency and regularity of alcohol consumption required to develop alcoholism varies greatly from person to person. In addition, although the biological mechanisms underpinning alcoholism are uncertain, some risk factors, including social environment, emotional health and genetic predisposition, have been identified.

Alcoholism, or alcohol dependence, is the most severe form of alcohol abuse. It is a chronic disease characterized by the consumption of alcohol at a level that interferes with physical and mental health and with family and social responsibilities. An alcoholic will continue to drink despite serious health, family, or legal problems. Also you can say Alcohol abuse is described as any "harmful use" of alcohol (ethanol).

Definition of alcoholism:

The Journal of the American Medical Association defines alcoholism as a primary, chronic disease characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking.

The DSM-IV (the standard for diagnosis in psychiatry and psychology) defines alcohol abuse as repeated use despite recurrent adverse consequences. It further defines alcohol dependence as alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.

According to the APA Dictionary of Psychology, alcoholism is the popular term for alcohol dependence. Note that there is debate whether dependence in this use is physical (characterized by withdrawal), psychological (based on reinforcement), or both.

WHO (World Health Organization) is a chronic disease or a disorder characterized by excessive alcohol intake and interference in the individual’s health, interpersonal relationship and economic functioning.

Symptoms:

• Craving: A strong need, or compulsion, to drink.

• Loss of control: The inability to limit one's drinking on any given occasion.

• Physical dependence: Includes evidence of tolerance and withdrawal.

• Tolerance: The need to drink greater amounts of alcohol in order to get drunk.

• Withdrawal symptoms: Nausea, vomiting, sweating, shakiness, hallucinations (visual or auditory), anxiety, and even seizures. These symptoms can occur in individuals who have been heavy drinkers over a period of time.

Signs of use with ratio:

1% or 10 ml for every 1000 ml of blood

• 1-.2% - low coordination

• 2-.3% - presence of ataxia, tremors, irritability, stupor

• 3 and above – unconsciousness.

Alcohol abuse differs from alcohol dependence in that:

1. It does not include an extremely strong craving for alcohol

2. A person may experience some loss of control over drinking, which may lead to problems with work, home, school, relationships, or the law

3. It usually does not include signs of physical dependence.

Risk factors

• Age. People who begin drinking at an early age — by age 16 or earlier — are at a higher risk of alcohol dependence or abuse.

• Genetics. Your genetic makeup may increase your risk of alcohol dependency.

• Sex. Men are more likely to become dependent on or abuse alcohol than are women.

• Family history. The risk of alcoholism is higher for people who had a parent or parents who abused alcohol.

• Emotional disorders. Being severely depressed or having anxiety places you at a greater risk of abusing alcohol. Adults with attention-deficit/hyperactivity disorder also may be more likely to become dependent on alcohol.

Causes:

• Genetic. Alcoholism is thought to have a strong hereditary component.

• Biological. There may be a connection between alcoholism and certain neurotransmitters that form addictive substances in the brain when they combine with the products of alcohol metabolism.

• Social learning. Drinking alcohol may be learned early in the family of origin, thereby leading to a problem with drinking.

• Cultural. The incidences of alcohol abuse and dependence are higher in some cultures than others.

Complications:

Side effects

• Higher incidence of unemployment

• Higher incidence of domestic violence

• Legal problems

Health Hazards

• Increased incidence of cancer, particularly cancer of the larynx, esophagus, liver, and colon

• Alcoholic hepatitis, an acute syndrome reported by patients who have ingested about 100 grams of alcohol (about eight ounces of 100-proof whiskey, 30 ounces of wine, or eight 12-ounce cans of beer) daily for over one year. Symptoms can include fever, jaundice, and enlarged liver

• Acute and/or chronic pancreatitis —inflammatory disease of the pancreas

• Cirrhosis of the liver—alcohol abuse can cause alcoholic hepatitis, which then can lead to cirrhosis, or fibrotic changes in the liver

• Alcoholic neuropathy—or degenerative changes in the nervous system affecting nerves responsible for sensation and movement

• Alcoholic cardiomyopathy

• High blood pressure

• Nutritional deficiencies—vitamin B12, folate, and thiamine

• High blood pressure

• Erectile dysfunction

• Cessation of menses

• Fetal alcohol syndrome in the children of women who drink during pregnancy

• Depression

• Traffic fatalities

• Accidental deaths

• Increased risk of suicide

• Alcohol dementia

• Wernicke-Korsakoff syndrome or Wernicke's encephalopathy: a syndrome of central nervous system changes resulting from thiamine deficiency where an individual becomes confused, loses balance while walking, and shows loss of vision.

Types of alcoholism:

1. Social alcoholism: conforming to the group is often the basis of early drinking. Being when some need o feel with manhood. There is no different other form behavior acquired in the same way eg. Drug abuse, gambling, or delinquency.

2. Neurotic alcoholism: drinking is based mostly on unconscious motivation and serves as a means of maintaining psychodynamic equilibrium. In the life of neurotic alcohol, loss of control is a regular occurrence. Some of the common function of alcohol in these patients are the following: Build confidence, Relieve anxiety, Escape from responsibility, Substitute for hostility, Substitute for sex, and regress.

3. psychotic alcoholism: this type of alcoholism include 2 subtype: schizophrenic alcoholism and manic-depressive alcoholism. In either type, the morbidity and mortality rate are high.

• Schizophrenic alcoholism: is characterized by impulsive heavy drinking accompanied by signs of mental dissociation that greatly exceed those observed in ordinary alcoholic intoxication, eg, amnesia, fugue states, bizarre behavior, and sex orgies even to the extant of mayhem and murder.

• Manic-depressive alcoholism: is characterized by serious drinking bouts often less impulsive than schizophrenic alcoholism and often alternating with severe depression.

Alcohol Withdrawal

← Occurs when an individual abruptly stops drinking after alcohol has become a necessity of life to maintain functioning.

← Symptoms include:

▪ autonomic hyperactivity

▪ grand mal seizures

▪ psychomotor agitation and anxiety

▪ increased hand tremors

▪ sleep disturbances (insomnia and nightmares)

▪ illusions hallucinations

▪ hyperthermia

▪ tachycardia (impending delirium tremens)

Alcohol Withdrawal Delirium

← AKA delirium tremens

▪ experienced within 24 to 72 hours after the last intake:

o agitation

o elevated vital signs

o illusions and hallucinations

o restlessness

o hyperalertness

o incoherent speech

← serious medical complications may occur if the client is left untreated

Alcohol Tolerance

Alcohol consumption interferes with many bodily functions and affects behavior. However, after chronic alcohol consumption, the drinker often develops tolerance to at least some of alcohol's effects. Tolerance means that after continued drinking, consumption of a constant amount of alcohol produces a lesser effect or increasing amounts of alcohol are necessary to produce the same effect .

Type of alcohol tolerance:

Functional Tolerance Humans and animals develop tolerance when their brain functions adapt to compensate for the disruption caused by alcohol in both their behavior and their bodily functions. This adaptation is called functional tolerance. Chronic heavy drinkers display functional tolerance when they show few obvious signs of intoxication even at high blood alcohol concentrations (BAC's), which in others would be incapacitating or even fatal.

Acute tolerance. Although tolerance to most alcohol effects develops over time and over several drinking sessions, it also has been observed within a single drinking session. This phenomenon is called acute tolerance. It means that alcohol-induced impairment is greater when measured soon after beginning alcohol consumption than when measured later in the drinking session, even if the BAC is the same at both times.

Environment-dependent tolerance. The development of tolerance to alcohol's effects over several drinking sessions is accelerated if alcohol is always administered in the same environment or is accompanied by the same cues.

Learned tolerance. The development of tolerance also can be accelerated by practicing a task while under the influence of alcohol.

Environment-independent tolerance. Exposure to large quantities of alcohol can lead to the development of functional tolerance independent of environmental influences. This was demonstrated in rats that inhaled alcohol vapors. In another study,

Metabolic Tolerance .Tolerance that results from a more rapid elimination of alcohol from the body is called metabolic tolerance. It is associated with a specific group of liver enzymes that metabolize alcohol and that are activated after chronic drinking.

Physical dependence

Physical dependence results from the repeated, heavy use of alcohol. Heavy and continual use of alcohol can change the body chemistry so that if someone does not get a repeat dose they suffer physical withdrawal symptoms - the shakes, flu like effects, etc. They have to keep taking the drug just to stop themselves from feeling ill.

Psychological dependence

Psychological dependence is more common. In this case people get into the alcohol experience as a way of coping with the world or as a way of feeling OK. They feel they could not cope without alcohol and drugs even though they may not be physically dependent. In addition to physical dependence, we can develop psychological dependence. "Psychic need" is the perceived need to use a substance to cope with unpleasant feelings such as despondency, heartache, anxiety, stress, or depression. Relief from something unpleasant is a kind of reward called "negative reinforcement." That cycle is worsened by both the physical and psychological discomforts felt during abstinence. When we stop using the addictive drugs or alcohol that we've been using to cope with unpleasant feelings, those feelings return, as does the strong desire to return to the substances that enabled us to cope with them.

Treatment

Determining the level of dependence

The first step in treatment is to determine whether you're alcohol dependent. If you haven't lost control over your use of alcohol, treatment may involve reducing your drinking. If you're dependent on alcohol, simply cutting back is ineffective. Abstinence must be part of your treatment goal.

If you aren't dependent on alcohol but are experiencing the adverse effects of drinking, the goal of treatment is to reduce alcohol-related problems — often through counseling or a brief intervention, which usually involves alcohol-abuse specialists who can establish a specific treatment plan. Interventions may include goal setting, behavior modification techniques, use of self-help manuals, counseling and follow-up care at a treatment center.

Counseling may take many forms. With cognitive behavioral therapy, you and your therapist identify distorted thoughts and beliefs that trigger psychological stress. You learn new ways to view and cope with traumatic events. Emphasis is placed on developing a sense of mastery and control of your thoughts and feelings. .

Residential treatment programs

Many residential alcoholism treatment programs in the United States include abstinence, individual and group therapy, participation in alcoholism support groups, such as Alcoholics Anonymous (AA), educational lectures, family involvement, work assignments, activity therapy, and the use of counselors and professional staff experienced in treating alcoholism.

Here's what you might expect from a typical residential treatment program:

• Detoxification and withdrawal. Treatment for alcoholism may begin with a program of detoxification, usually taking about four to seven days. You may need to take sedating medications to prevent delirium tremens or other withdrawal seizures.

• Medical assessment and treatment. Common medical problems related to alcoholism are high blood pressure, increased blood sugar, and liver and heart disease.

• Psychological support and psychiatric treatment. Group and individual counseling and therapy support recovery from the psychological aspects of alcoholism. Many treatment programs also offer couples and family therapy because family support can be an important part of the recovery process. In fact, involving a spouse in the treatment process may increase the chances of successful recovery.

• Emphasis on acceptance and abstinence. Effective treatment is impossible unless you accept that you're addicted and currently unable to control your drinking.

• Drug treatments. An alcohol-sensitizing drug called disulfiram (Antabuse) may be a deterrent. Disulfiram won't cure alcoholism, nor can it remove the compulsion to drink. But if you drink alcohol, the drug produces a severe physical reaction that includes flushing, nausea, vomiting and headaches. Naltrexone (ReVia), a drug long known to block the narcotic high, also reduces the urge to drink. Acamprosate (Campral) is an anti-craving medication that may help you combat alcohol cravings and remain abstinent from alcohol. Unlike disulfiram, naltrexone and acamprosate don't make you feel sick soon after taking a drink.

In June 2006, the Food and Drug Administration (FDA) approved the first injectable drug to treat alcohol dependence. Vivitrol, a version of the drug naltrexone, is injected in the buttocks once a month by a health care professional. It may reduce the urge to drink by blocking neurotransmitters in the brain thought to be associated with alcohol dependence. Vivitrol doesn't affect alcohol withdrawal symptoms. It's intended for people with alcoholism who are receiving counseling and who haven't had a drink for at least a week. Although similar medication can be taken in pill form, the injectable version of the drug may be easier for people recovering from alcohol dependence to use consistently.

• Continuing support. Aftercare programs and support groups help people recovering from alcoholism or alcohol abuse abstain from drinking, manage relapses and cope with necessary lifestyle changes.

Nursing care:

Nursing Diagnosis: Ineffective individual coping

Principles of Nursing Care:

• Well lighted room

• Diet as tolerated

• Monitor vital signs

• Administration of glucose

• Vitamins

Client assessment data base

Data depend on the duration/extent of alcohol use, concurrent use of other drugs, degree of organ involvement, and presence of other psychiatric conditions.

Nursing priority

1. Maintain physiological stability during withdrawal phase.

2. Promote client safety.

3. Provide appropriate referral and follow-up.

4. Encourage/support SO involvement in Intervention (confrontation) process.

Discharge goals

1. Homeostasis achieved.

2. Complications prevented/resolved.

3. Sobriety being maintained on a day-to-day basis.

4. Ongoing participation in a rehabilitation program/attendance at group therapy (e.g., Alcoholics Anonymous).

5. Plan in place to meet needs after discharge.

References:

• Psychiatry for nurses . John Gibson ( Fourth edition).

• Handbook of Psychiatry. Philip Solomon/ Vernon D. patch. 3rd edition.

• Basic Psychiatric Concepts in Nursing. Joan kyes/ charles k. hofling. 3rd edition.

• Essentials of Psychiatry. Jerald Kay / Allan Tasman. 2006 John Wiley & Sons, Ltd.

• Substance Abuse Lecture . DR. Majed Al-Mounem

• Wikipedia

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Drugs addiction classification

Drugs that have a depressant

Drugs that have a stimulant effect

Drugs liable to produce hallucination

We talk about:

Cannabis

LSD

We talk about:

Amphetamine

Cocaine

We talk about:

Barbiturates

Morphine

Heroin

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