Name: Dompor, Sharmaigne Rose G.

Case: Alcoholism
Definition: The term "alcoholism" refers to a disease known as alcohol dependence
syndrome, the most severe stage of a group of drinking problems which begins with
binge drinking and alcohol abuse.
The Diagnostic and Statistical Manual of Mental Disorders, IV, defines alcohol abuse as
drinking despite alcohol-related physical, social, psychological, or occupational
problems, or drinking in dangerous situations, such as while driving. The World Health
Organization's International Classification of Diseases refers to "harmful use" of alcohol,
or drinking that causes either physical or mental damage in the absence of alcohol
dependence. In other words, alcohol abuse is any harmful use of alcohol.

Alcohol (ethanol) is a sedative anesthetics found in various proportions of liquor, wine,

and beer. Alcohol produces a sedative effect by depressing the central nervous system
(CNS). This effect causes the individual to experienced relaxed inhibitions, heightened
emotions, mood swings that can range from bouts of gaiety to angry outburst, and
cognitive impairments such as reduced concentration or attention span, and impaired
judgment and memory. Depending on the amount of alcohol ingested, the effects can
range from feelings of mild sedation and relaxation, to confusion and serious
impairment of motor function and speech, to serve intoxication that can result into
coma, respiratory failure and death.

Signs and Symptoms

The intensity of CNS impairments depends on how much alcohol is consumed in a given
period of time and how the body metabolizes it. Intoxication is determined by the level
of alcohol in the blood, called blood alcohol level (BAL). The body metabolize 1 oz of
liquor, a 5 oz of wine, or a 12-oz can of beer per hour without intoxication.

Behavior and Blood Alcohol Levels

Number of drinks Blood alcohol levels Behavior

(mg %)
1-2 0.05 Impaired judgment,
giddiness, mood changes
5-6 0.10 Difficulty driving and
coordinating movements
10-12 0.20 Motor functions severely
impaired, resulting in
ataxia. There is emotional
lability.
15-20 0.30 Stupor, disorientation, and
confusion
20-24 0.40 Come
25 0.50 Respiratory failure, death
Symptoms of Alcoholism

For someone who is alcoholic or alcohol dependent, the symptoms include all of those
associated with alcohol abuse (above). But alcoholics also continue to drink in spite of all
the problems it has caused in their lives.

When alcohol abuse reaches the alcohol dependence stage, the person also experiences at
least three of seven other symptoms, including neglect of other activities, excessive use
of alcohol, impaired control of alcohol consumption, persistence of alcohol use, large
amounts of time spent in alcohol-related activities, withdrawal symptoms and tolerance
of alcohol.

Symptoms of Alcohol Dependence

• Neglect of other Activities: Important social, occupational, or recreational

activities are given up or reduced because of alcohol use;
• Excessive Use: Alcohol is consumed in larger amounts over a longer period than
intended;
• Impaired control: Ongoing, unsuccessful efforts to cut down or control alcohol
consumption;
• Persistence of Use: Alcohol consumption is continued despite knowledge of
having a persistent or recurrent physical or psychological problem that is likely
caused or exacerbated by alcohol;
• Large Amounts of Time Spent in Alcohol Related Activities: A great deal of
time is spent in activities necessary to obtain, use or recover from the effects of
alcohol;
• Withdrawal: Withdrawal symptoms, such as nausea, sweating, shakiness, and
anxiety when alcohol use is stopped after a period of heavy drinking;
• Tolerance: The need for increasing amounts of alcohol in order to feel its effects.
•

Pathophysiology

Rapid Alcohol intake

↓
Accumulation of acetaldehyde
↓
Acetaldehyde combines with the neurotransmitters dopamine and serotonin
↓
Tetrahydroisoquinolone and ß-cabolines
↓
More rapid metabolism of alcohol and decreased response to sedating, motor and
demonstrates higher BAL
↓
Alcohol tolerance
Treatment of Alcoholism

Alcoholism is a treatable disease and many treatment programs and approaches are
available to support alcoholics who have decided to get help, but no medical cure
available.

Regardless of how someone is diagnosed as alcohol dependent or how they came to

realize they have a serious drinking problem, the first step to treatment is a sincere desire
to get help. Alcoholics who are pressured into treatment by social pressure or forced to
quit by circumstances rarely succeed in the long run.

Even most alcoholics who seek help on their own volition have at least one relapse before
they obtain long-term sobriety.

Special medications

 Campral (acamprosate calcium) is the most recent medication approved for the
treatment of alcohol dependence or alcoholism in the United States -- approved by
the Food and Drug Administration in July 2004 -- but it has been used widely in
Europe for many years.
 Naltrexone is an opioid receptor antagonist used primarily in the management of
alcohol dependence and opioid addiction. Naltrexone hydrochloride is sold as the
brand name Revia and Depade. An extended-release form of Naltrexone is
marketed in some countries under the trade name Vivitrol.
 Antabuse, or disulfiram as it is also known, was the first medicine approved for
the treatment of alcohol abuse and alcohol dependence.

Nalmefene

Nalmefene, also known as Revex, is used in the medical treatment of alcoholism because
it has been found to reduce craving for some alcohol dependent patients.

Nalmefene May Reduce Relapse

Researchers at the University of Miami have found that nalmefene significantly reduces
replapse in alcoholics.

Nalmefene Reduces Relapse Risk

Nalmefene, an opioid antagonist that is not now commercially available in the oral form
studied, is effective in preventing relapse to heavy drinking in alcohol dependent
individuals.
Nalmefene Treatment

Nalmefene is a newer opioid antagonist that, like naltrexone, has no agonist activity and
no abuse potential. Additional advantages include a longer half-life, greater
bioavailability and no dose-dependent liver toxicity.

Naltrexone

Marketed as Revia, Naltrexone is a narcotic antagonist which has also been shown to
reduce craving and consumption for some patients who are alcohol dependent.

Once-A-Month Naltrexone Injection Successful

Because of problems with adherence to a daily oral dose of naltrexone, the effectiveness
found in treating alcohol dependence with a once-a-month injection of naltrexone could
improve long-term treatment outcomes.

Naltrexone Injections Show Promise for Alcoholism

Findings from the first multi-site examination of the effectiveness of an inject-able, long-
acting formulation of naltrexone show significantly fewer drinking days and a greater
likelihood of total abstinence during the three-month study period.

Genetics May Determine Naltrexone's Effectiveness

Researchers have found that genetics may play a role in why Naltrexone, a medication
used to reduce cravings in people trying to quit drinking, works for some and not for
others.

Naltrexone Test Set for Schizophrenic Alcoholics

The rate of alcoholism in people who have been diagnosed as schizophrenics is much
higher than in the general population, and a New York psychiatrist plans research to see
if Naltrexone is effective in treating the problem.

Nursing interventions and treatment modalities

Several treatment modalities are used in most addiction treatment, including:

 12-step-program-focused
 cognitive or psychoeducational
 behavioral
 group psychotherapy, and
 individual and family therapy.
Reaction:
“Drink moderately” a very short ad but conveys a very long connotation. People
may say that drinking alcoholic beverages is just there way of having fun, forgetting
problems or relieving there stress and even helping them to go to sleep.
“ my friends once told me that, there’s nothing wrong in drinking a glass of it, just
to show respect to the person who invites you to drink.” And there right (haha), as long as
your drinking in a moderate amount there’s nothing wrong. For many people, the facts
about alcoholism are not clear.
People must be aware of the term alcoholism, for them to realize that drinking to much is
not just a simple habit or ways of having fun. Aside from the physical symptoms, which
most people knows but just ignore it, the alcoholic’s personal lives may be affected.
“I believe that we all have free will, we make decisions. There are bad decisions but
deciding to prevent alcoholism is a very good decision to make.”