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LESSON 36
ALCOHOLISM AND SUBSTANCE RELATED DISORDERS I
Personality refers to enduring patterns of thinking and behavior that define the person and distinguish him or her from other people. These enduring patterns are ways of expressing emotion as well as patterns of thinking about ourselves and other people. When enduring patterns of behavior and emotion bring the person into repeated conflict with others, and when they prevent the person from maintaining close relationships with others, an individual’s personality may be considered disordered.
The authors of DSM-IV-TR have organized ten specific forms of personality disorder into three clusters on the basis of broadly defined characteristics.
Classification of Personality Disorders 1-Paranoid personality disorder 2-Schizoid personality disorder 3-Schizotypal personality disorder 4-Antisocial personality disorder 5-Borderline personality disorder 6-Histrionic personality disorder 7-Narcissistic personality disorder 8-Avoidant personality disorder 9-dependent personality disorder 10-Obsessive–compulsive personality disorder
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Alcoholism and Substance Related Disorders
Examples
- We take aspirin to reduce headache.
- We take an antibiotic to fight an infection.
- We take tranquilizer to calm us after facing a trauma.
- We drink coffee or tea to get going in the morning.
- Smoke a cigarette to relax our nerves.
- We take valium to go to sleep.
There are many substances that are capable of harming the body or adversely affecting the behavior and mood. The misuse of drugs has become one of the most disabling problems of the society. Examples
- Sherlock Holmes fictional character who took drugs stimulants to alert him.
- Sportsmen take drugs to enhance their performance but in the long run their body develops drug dependence.
The term drug applies to any substance other than food that changes our bodily and mental functioning. Drug misuse may lead to a temporary mental syndrome such as intoxication but chronic excessive use of drugs can lead to a substance use disorder.
Substance use disorder can take two forms 1- Substance abuse 2- Substance dependence
1- Substance Abuse A pattern in which people rely heavily on a drug and they structure their lives around the drug.
2- Substance Dependence In which people show all symptoms of substance abuse plus physical dependence on the drug.
Drug Addiction
- Drug addiction is in which people show all symptoms of substance abuse plus physical dependence on the drug.
- But now we use the term substance dependence and not addiction.
Drug Tolerance
- People who need increased doses of drug in order to get its effect.
- Withdrawal symptoms emerge when individual suddenly stops taking drugs or reduces their dosage.
- These symptoms include muscle aches, pains and cramps, vomiting, nausea.
- It is believed that approximately 7 % of all adults in United States currently display some form of substance use disorder.
Poly Drug Use When an individual uses two or more drugs at the same time we label it as poly drug use.
Cross Tolerance
- When people take more than one drug at a time and the drugs interact with each other. Some time
the two drugs display cross tolerance docsity.com
The goals of treatment for substance use disorders are a matter of controversy. Some clinicians believe that the only acceptable goal is total absence from drinking or drug use. Others have argued that, for some people, a more reasonable goal is the moderate use of legal drugs.
Detoxification
- Alcoholism and related forms of drug abuse are chronic conditions.
- Treatment is typically accomplished in a sequence of stages, beginning with a brief period of detoxification —the removal of a drug on which a person has become dependent—for 3 to 6 weeks.
Medications
- Following the process of detoxification, treatment efforts are aimed at helping the person maintain a state of remission.
- Several forms of medication are used to help the person refrain from drinking.
Self-Help Groups: Alcoholics Anonymous
- Alcoholics Anonymous (AA) is maintained by alcohol abusers for the sole purpose of helping other people who abuse alcohol become and remain sober.
- AA is not officially associated with any other form of treatment or professional organization.
- The viewpoint espoused by AA is fundamentally spiritual in nature.
- DSM-IV-TR uses two terms to describe substance use disorders, and these terms reflect different levels of severity.
Substance Dependence, the more severe of the two forms, refers to a pattern of repeated self- administration that often results in tolerance, the need for increased amounts of the drug to achieve intoxication; withdrawal, unpleasant physical and psychological effects that the person experiences when he or she tries to stop taking the drug; and compulsive drug-taking behavior. Substance Abuse describes a more broadly conceived, less severe pattern of drug use that is defined in terms of interference with the person’s ability to fulfill major role obligations at work or at home, the recurrent use of a drug in dangerous situations, and repeated legal difficulties associated with drug use. Addiction is another, older term that is often used to describe problems such as alcoholism. The term has been replaced in official terminology by the term substance dependence, with which it is synonymous, but it is still used informally by many lay people.
A drug of abuse, sometimes called a psychoactive substance, is a chemical substance that alters a person’s mood, level of perception, or brain functioning.
People with a substance use disorder frequently abuse several types of drugs; this condition is known as poly-substance abuse.
Alcohol
- Alcohol affects virtually every organ and system in the body.
- After alcohol has been ingested, it is absorbed through membranes in the stomach, small intestine, and colon.
- The rate at which it is absorbed is influenced by many variables, including the concentration of alcohol in the beverage, the volume and rate of consumption, and the presence of food in the digestive system.
- After it is absorbed, alcohol is distributed to all the body’s organ systems.
- Almost all the alcohol that a person consumes is eventually broken down or metabolized in the liver.
- If the person’s consumption rate exceeds this metabolic limit, then blood alcohol levels will rise.
• Blood alcohol levels are measured in terms of the amount of alcohol per unit of blood. docsity.com
- According to DSM-IV-TR, the symptoms of alcohol intoxication include slurred speech, lack of coordination, an unsteady gait, nystagmus (involuntary to-and-fro movement of the eyeballs induced when the person looks upward or to the side), impaired attention or memory, and stupor or coma.
- The prolonged use and abuse of alcohol can have a devastating impact on many areas of a person’s life.
- 1-The disruption of relationships with family and friends can be especially painful.
- 2-Regular heavy use of alcohol is also likely to interfere with job performance.
- 3-Many heavy drinkers encounter problems with legal authorities.
- On a biological level, prolonged exposure to high levels of alcohol can disrupt the functions of several important organ systems, especially the liver, pancreas, gastrointestinal system, cardiovascular system, and endocrine system.
- In fact, over an extended period of time, alcohol dependence has more negative health consequences than abuse of any other drug, with the exception of nicotine. The misuse of alcohol leads to an enormous number of severe injuries and premature deaths in every region of the world.
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