By:

Aliño, Marla Francine A.

&
Liong, Henen Faith U.
BSOT-3
 Alcohol abuse is commonly called alcoholism.
 Symptoms of alcohol:
-violent behavior
-feelings of depression
-hallucinations and delusions(rare)
Long term:
-intense alcohol adaptation of the body that has
a withdrawal syndrome like:
*insomnia
*hyperactivity of the Autonomic N.S.
*anxiety
 Epidemiology:
* Race & Ethnicity
-Whites have the highest rate of alcohol use.
* Gender
-Men are much more likely than women to be
binge drinkers and heavy drinkers.
* Region and Urbanicity
-Alcohol use is highest in western states and
lowest in southern states.
* Education
-70% of adults w/ college degrees are current
drinkers compared w/ only 40% of those with less
than a high school education.
* Socioeconomic Class
-Alcohol-related disorders appear among persons
of all socioeconomic classes.
 Comorbidity:
-Psychiatric diagnoses are most commonly
associated w/ alcohol-related disorders.
• Psychiatric Diagnosis includes:
1.) Anti-Social Personality Disorder
-common in men w/ alcohol related disorders
and can precede the development of alcohol
related disorders.
2.) Mood Disorders
-common in women than in men
-occurs in patients w/ alcohol related disorders
who have a high daily consumption of alcohol
and family history of alcohol abuse
-they are the ones at risk of suicide
-bipolar 1 disorders are prone to be developing
alcohol related disorders due to they’re manic
episodes.
3.) Anxiety Disorders
-People use alcohol for it’s efficacy in alleviating
anxiety
 Etiology:
• Factors that are responsible for the development
of Alcohol-related disorders:
1.) Psychological theories
-Alcohol helps decrease feelings of nervousness
and helps in coping in day to day stresses of life.
*low doses of alcohol: enhanced feeling of well-
being.
* high doses of alcohol: nervousness and tension
increased.
2.) Psychodynamic Theories
-People uses alcohol because it helps them deal w/
self-punitive harsh superegos and to decrease
unconscious stress levels.
-Also it helps relieve frustrations.
3.) Behavioral Theories
-Alcohol may have rewarding effects after intake
w/c is called subsequent reinforcement that it
contributes to the decision to drink again and again
because it becomes an important aspect in alcoholic
rehabilitation.
4.) Socio-cultural Theories
-Alcohol is influenced by social groups that have
high and low rates of alcoholism
-less influence of ethnic groups, less prone to
alcoholism
-more influence of ethnic groups, more prone to
alcoholism
 ALCOHOL-RELATED DISORDERS:
• Alcohol Dependence and Alcohol Abuse
Diagnosis:
-In DSM-IV-TR, It is the need for daily use of
large amounts of alcohol for adequate
functioning, a regular pattern of heavy alcohol
intake.
-The drinking pattern is associated with certain
behaviors:
*inability to cut down or stop drinking
*continuation of drinking despite a serious
physical disorder
*persons w/ alcohol dependence and alcohol
abuse show impaired social or occupational
functioning because of alcohol use
 *Alcohol *Alcohol
Intoxication Withdrawal
- Evidence of ingestion - May include seizures
of ethanol. and autonomic
- Evidence of hyperactivity.
behavioral changes, a - Withdrawal symptoms
slowing in motor include fatigue,
performance and a malnutrition, physical
decrease in the ability illness and
to think clearly. depression.
• Delirium
Diagnosis:
- Patients with recognized alcohol withdrawal
symptoms should be carefully monitored to
prevent progression to alcohol withdrawal
delirium, the most severe form of the
withdrawal syndrome.
- Alcohol withdrawal delirium is a medical
emergency that can result in significant
morbidity and mortality.
- Patients with delirium are in danger to
themselves and to others because they may be
assaultive or suicidal.
- If untreated, it will result to medical illnesses
such as pneumonia, heart failure, etc.
• Alcohol-Induced Persisting Amnestic Disorder
Diagnosis:
- In DSM-IV-TR, it is a disturbance in short-term
memory caused by prolonged heavy use of alcohol,
usually occurs in persons who have been drinking
heavily for many years.
• Alcohol-Induced Psychotic Disorder

Diagnosis:
- Includes delusions and hallucinations

- The most common hallucinations are auditory,

usually voices, but are often unstructured.
- Hallucinations after alcohol withdrawal are
considered rare and the syndrome is distinct from
alcohol withdrawal delirium, usually appear in
persons abusing alcohol for a long time.
• Alcohol-Induced Anxiety Disorder
Diagnosis:
- Symptoms includes anxiety, panic attacks,
obsessive-compulsive symptoms or phobic
symptoms; can either be during intoxication or
during withdrawal.
• Fetal Alcohol Syndrome
Diagnosis:
- Indicates that women who are pregnant or are
breast-feeding should not drink alcohol.
- The leading cause of mental retardation in US,
occurs when mothers drinking alcohol expose
fetuses to alcohol in utero, the alcohol inhibits
intrauterine growth and postnatal development.
- Microcephaly, craniofacial malformations, and
limb and heart defects are commonin affected
infants; development of maladaptive behaviors.
- It may also cause hormone imbalances that
increase the risk of abnormalities
 Prognosis:
- Between 10 to 40% of alcoholic persons enter
some kind of formal treatment program during
the course of their alcohol problems.
- First, is the absence of preexisting antisocial
personality disorder
- Second, evidence of general life stability with a
job, continuing family contacts and the absence
of severe legal problems.
- Third, if the patient stays for the full course of the
initial rehabilitation (2 to 4 weeks).
 Treatment and Rehabilitation:
- 3 steps:
• Intervention

- the goal of the intervention step is called

confrontation, is to break through feelings of denial
and help the patient recognize the consequences
likely to occur if disorder is not treated.
- also a process aimed at maximizing the motivation
for treatment.
• Detoxification

- 1st step: is through physical examination; absence of

serious medical disorder, severe alcohol withdrawal
is unlikely.
- 2nd step: is to offer rest, adequate nutrition and
multiple vitamins.
• Rehabilitation
- 3 major components:
• Continued efforts to increase and maintain high
levels of motivation for abstinence.
• Work to help the patient readjust to a lifestyle
free of alcohol.
• Relapse prevention.
 Medications:
- Benzodiazephines- primary medication to control
alcohol withdrawal symptoms such as seizure
activity, delirium, anxiety, and tremor
associated with alcohol withdrawal.
 Preparations:
- major amphetamines that are currently used in
the US are dextroamphetamine,
methamphetamine, a mixed destroamphetamine-
amphetamine salt and the amphetamine-like
compound methylphenidate; these drugs have
street names such as ice, crystal meth and speed.
- In general class, amphetamines are referred as
analeptics, stimulants and psychostimulants used
to increase performance and to induce a euphoric
feeling such as: students studying for exams,
athletes in competition, etc.
- Amphetamine-like substances are ephedrine,
pseudophedrine and phenylpropanolamine; these
drugs are very dangerous and can cause death.
 Epidemiology:
* Race and Ethnicity
-increasing among white professionals.
* Age
-highest rates of use were among 18-25 year olds
followed by 12-17 year olds.
* Socio-economic Class
-Amphetamine-related disorders appear among
persons of all socioeconomic classes.
 Neuropharmacology:
- Amphetamines may be taken orally or inhaled
(“snorting”).
- Designer amphetamines causes release of
dopamine and norepinephrine and serotoni, the
neurotransmitter implicated as the major
neurochemical pathway for hallucinogens.
 Disorders:
Amphetamine Dependence and Amphetamine
•
Abuse
Diagnosis:
- In the DSM-IV-TR, it can result in a rapid
downward spiral of a person’s abilities to cope
with work and family related obligations and
stresses.
 *Amphetamine *Amphetamine
intoxication withdrawal

- Intoxication of - Crash occurs with

cocaine and symptoms of anxiety,
amphetamines are dysphoric mood,
similar because it has fatigue, etc.
been strongly - Most serious
influenced by withdrawal symptom
cocaine. is depression which is
- Amphetamine associated with
specifies perceptual suicidal ideation.
disturbances.
 • Amphetamine Intoxication Delirium
Diagnosis:
- Delirium associated with amphetamine use
generally results from high doses of amphetamine
and so sleep deprivation affects the clinical
presentation.
- The use of amphetamines by a person with
preexisting brain damage can also cause
development of delirium.
• Amphetamine-Induced Psychotic Disorder
Diagnosis:
- Presence of paranoia.
- Visual hallucinations and evidence of disordered
thinking
- Treatment of choice is the short-term use of an
antipsychotic medication such as Haldol.
• Amphetamine-Induced Mood Disorder
Diagnosis:
- intoxication is associated with manic or mixed
mood features, whereas withdrawal is associated
with depressive mood features.

• Amphetamine-Induced Anxiety Disorder

Diagnosis:
- Amphetamine, like cocaine, can induce
symptoms similar to those seen in obsessive-
compulsive disorder, panic disorder and phobic
disorders.
• Other Agents:
- “CLUB DRUGS”- use in clubs, bars, parties;
includes GHB, ketamine, ecstasy, rohypnol (date
rape drugs), etc. that produces disorienting and
sedating effects and often users cannot recall
what occurred during all or part of an episode
under the influence of the drug.
 Treatment and Rehabilitation:
- An inpatient setting and the use of multiple
therapeutic methods are usually necessary to
achieve lasting abstinence.
- Treatment with specific drugs may be needed on
short-term basis and antipsychotics may also be
prescribed for a few days but physicians must also
establish a therapeutic alliance with patients to
deal with underlying depression.
 Preparations:
- Cannabis are obtained from the Indian hemp
plant, Cannabis sativa and is the most commonly
used illicit drug in the US.
- Cannabis plant is usually cut, dried, chopped and
rolled into cigarettes and which are then
smoked.
- Common names of Cannabis includes: marijuana,
grass, pot, weed, tea and Mary Jane.
 Epidemiology:
*Race and Ethnicity
- whites had higher rates of lifetime and past-
year marijuana use than blacks.
*Age
- aged 18 years or older had used marijuana at
least once in their life-time.
- adolescents in school indicates recent increases
in lifetime, annual, current and daily use of
marijuana by 8th and 10th graders.
*Gender
- current marijuana use in males was almost
twice the rate for females overall among those
aged 26 and older.
 Neuropharmacology:
- When cannabis is smoked, the euphoric effects
appear within minutes, peak in about 30 mins. And
last 2-4 hours.
- It may be taken orally when it is prepared with
food, such as brownies and cakes.
- Cannabis must be taken orally or may also be
taken by inhaling its smoke.
 Disorders:
• Cannabis Dependence and Cannabis Abuse
Diagnosis:
- Psychological dependence on cannabis use does
develop in long-term users.
*Cannabis Intoxication
- Heightens users’ sensitivities to external stimuli.
- For 8 to 12 hours after using cannabis, users’
impaired motor skills interfere with the
operation of motor vehicles and other heavy
machinery.
• Cannabis Intoxication Delirium
Diagnosis:
- Is characterized by marked impairment on
cognition and performance task.
- Modest doses impair memory, reaction time,
perception, motor coordination and attention
but high doses also impair users’ level of
consciousness.
• Cannabis-Induced Anxiety Disorder
Diagnosis:
- Short-lived anxiety states often provoked by
paranoid thoughts.
- Panic attacks may be induced, based on ill-
defined and disorganized fears.
• Cannabis-Induced Psychotic Disorder
Diagnosis:
- It is rare; transient paranoid ideation is more
common.
- Psychotic episodes are sometimes referred to as
“hemp insanity”.
• Cannabis-Related Disorder
Diagnosis:
*flashbacks-persons who have experienced
sensations related to cannabis intoxication after
the short-term effects of the substance have
disappeared.
*cognitive impairment-longer periods of heavy
cannabis use, the more pronounced the cognitive
impairment.
*amotivational syndrome-associated with long-
term heavy use and has been characterized by a
person’s unwillingness to persist in a task be it at
school, work, or in any setting that requires
prolonged attention or tenacity.
 Treatment and Rehabilitation:
Principles:
1.) Abstinence- can be achieved through direct
interventions such as hospitalization.
2.) Support- can be achieved through the use of
individual, family and group psychotherapies.
 Medical use of Marijuana:
- Marijuana has been used as a medicinal herb for
centuries.
- Used to treat various disorders such as multiple
sclerosis(MS), chronic pain, AIDS, epilepsy and
glaucoma.