+

Chemical Dependence:
Alcoholics

Introduction

Substance abusers. Substance abusers

come in many forms. These forms
include alcohol, marijuana, cigarettes,
prescription pain relievers,
hallucinogens, inhalants, stimulants,
cocaine, heroine, methamphetamines
and other types of drugs. Substance
abuse occurs when a person becomes
either mentally or physically addicted to
a drug, then proceeds to consume
amounts that are harmful to themselves.
Abuse also occurs when someone uses
a drug in a way other than intended and
prescribed.

We have chosen to focus on alcohol

specifically out of this group of
substances because abusers of alcohol
rank as the highest incidents of abuse
amongst all other drugs.

States the current population

demographics

Above chart shows what drug adolescents

age 12-17 used for the first time on an
average day during 2010 and 2011 in the
US

States the current population

demographics

Above chart shows number of adolescents between the ages

of 12-17 that used particular substances on an average day.

Continued

Moving forward in time to the

present and changing the
demographic to adults and strictly
alcoholism.

Nearly 15 million people are

affected by alcohol abuse or
dependency.

The state with highest rate of

alcohol abuse is Wisconsin, at
11.32% of the population.

State with fewest heavy drinkers

is a tie between West Virginia and
Utah, at 2.8% of population.

Roughly 6% of all college students

are considered alcohol dependent
and 31% met the criteria for
alcohol abuse.

Effect on Public Health

The background of alcoholism can

stem from many different root
causes. Many drink socially, in order
to bond with peers. Some people
drink with the sole intent to alter their
mental status due to depression or
other disorders. Unfortunately, both
of these reasons to consume alcohol
can lead to the abuse and
dependence of it as well. Besides its
harmful effects on the human body,
alcohol abuse has severe
consequences on public health in
general. Alcoholism is associated
with drinking and driving, suicide,
sexual assault, and high-risk sex.

Cultural

Recent advances in alcohol research continue

to build our understanding of alcohol
consumption and related consequences for
U.S. ethnic minority groups.

National surveys show variations across

ethnicities in drinking, alcohol use disorders,
alcohol problems, and treatment use.

Higher rates of high-risk drinking among ethnic

minorities are reported for Native Americans ,
although within-ethnic group differences (e.g.,
gender, age-group, and other subpopulations)
also are evident for ethnicities.

Whites and Native Americans have a greater

risk for alcohol use disorders relative to other
ethnic groups

Continued

National surveys show differences in alcohol

consumption across ethnic groups, including
patterns of drinking associated with greater risk
for the adverse effects of alcohol (e.g., binge
drinking, defined as five or more drinks on the
same occasion).

According to past-30-day estimates of drinking

provided by the 2007 National Survey on Drug
Use and Health (NSDUH) (SAMHSA 2008c), any
alcohol use in adults (i.e., ages 18 or older) is
most prevalent for Native Americans (59.8
percent), lowest for Asian Americans (38.0
percent), Hispanics (46.3 percent), and Blacks
(43.8 percent).

Native Americans have the highest prevalence

(12.1 percent) of heavy drinking (i.e., five or
more drinks on the same occasion for 5 or more
of the past 30 days; followed by Hispanics (6.1
percent).

A larger percentage of Native Americans (29.6

percent) also are binge drinkers.

History pertaining to population

Initiation into excessive substance use may

occur during periods of rapid social change,
often among cultural groups who have had
little exposure to a drug and have not
developed protective normative behavior.
Loss of a healthy ethnic or cultural identity,
may occur among native populations whose
cultures have been devastated by the
extensive and sudden influx of outside
influence.

Because of its low availability, few North

American Indians had any exposure to alcohol
before the arrival of whites. On the western
frontier, potent distilled alcoholic beverages
became widely available, and the only model
Native Americans had was the drunken
comportment of the frontiers . Native
American elders believe that many substance
abuse problems are related to the loss of
traditional culture

Continued

The high prevalence of alcohol use and its

consequences among American Indians may be
attributed to a number of factors, including the
influence of the European colonists who first
made large amounts of alcohol avail-able to
Indians, as well as current social and cultural
factors.

Before European colonization, the native

population of the territory that would eventually
become the United States was relatively nave
to alcohols effects. Some tribes produced weak
beers or other fermented beverages, but these
were generally used only for ceremonial
purposes.

The distillation of more potent and thus more

abusable forms of alcohol was unknown. When
various European colonists suddenly made large
amounts of distilled spirits and wine available to
American Indians, the tribes had little time to
develop social, legal, or moral guidelines to
regulate alcohol use History may have therefore
sown the seeds for the prevalence of alcohol
abuse in North American indigenous
populations.

Continued.

Early demand, with no regulation and strong

encouragement, may have contributed to a
tradition of heavy alcohol use passed down from
generation to generation, which has led to the
current high level of alcohol-related problems.

The socioeconomic picture for many tribes is

bleak. Unemployment rates are high, school
completion rates are low, and basic support
systems are underdeveloped.

Those conditions place a great deal of stress on

the family and other socialization structures within
Indian communities. As a result, the basic
develop-mental needs of Indian children often go
unmet. To the extent that this type of social stress
predisposes a population to alcohol abuse,
American Indian communities are highly
susceptible

Psychosocial

Alcohol abuse poses great dangers to an

alcoholic's physical, mental, emotional, social
and spiritual health. Alcoholism often causes
severe social consequences on a person's
life as well. Being drunk or hung over at work
frequently results in termination from a job,
leaving a person and her dependents in
severe financial trouble. Domestic violence,
marital conflict, legal problems and isolation
from friends and family are also common
results of alcohol abuse, Being drunk also
affects your judgment and may lead to you:
Having unprotected sex, or unwanted sex.
This could lead to unplanned pregnancy or
STIs
Feeling bad about yourself and embarrassed
by your actions
Losing friends or loved ones as a result of
your behavior
Losing money that you need for other things
after reckless spending on alcohol
Drinking alcohol also increases the likelihood
of acting in a violent way.

Income Level

The rich out-drink the poor by 27.4

percent.

"Those who can afford alcohol

often look upon it as a luxury
good and thus buy more of it,

This may be why research

conducted by the Centers for
Disease Control shows that
45.2 percent of adults from
households whose incomes
are below the poverty line
report having consumed at
least one alcoholic beverage in
the last 30 days, compared to
72.6 percent of adults whose
household incomes are at
least four times the poverty
level.

Educational Level

The more income people have, the more

educated they are and the higher their
social status or class, the more likely they
are to drink alcoholic beverages. They are
also more likely to drink if they live in certain
countries or regions.

College graduates are nearly twice as likely

to drink as are people who didn't finish high
school.

Rates of alcohol use increase with levels of

education, as 68.4 percent of college
graduates and 35 percent of adults who
didn't finish high school describe
themselves as "current drinkers." Other
studies consistently show higher drinking
rates among the college-educated, for
whom "drinking good wine and cocktails is a
social thing, "and it's part of the business
meetings and social networking that their
careers often depend on." Many people
learn to drink at college, where campus life
"definitely promotes a culture of 'drink and
be wild.'"

Occupational: Top 5 Jobs that will

turn you into an Alcoholics

+ National Institute for Occupational

Safety and Health (NIOSH)
5. Cooks are 1.77 times more likely
to die from alcoholism than average

NIOSH recorded 352 deaths linked

to alcoholism among 13,470 white
male deaths. Category includes
cooks and executive short orders.

4. Painters are 1.85 times more

likely to die from alcoholism than
average

NIOSH recorded 926 deaths linked to

alcoholism among 40,571 white male
deaths. Category includes painters,
construction and maintenance.

+ National Institute for Occupational

Safety and Health (NIOSH)
3) Roofers are 1.87 times more
likely to die from alcoholism than
average.

NIOSH recorded 286 deaths

linked to alcoholism among 8,490
white male deaths.

2) Shoe machine operators are

2.00 times more likely to die
from alcoholism than average

NIOSH recorded 43 deaths

linked to alcoholism among
2,921 white male deaths.

1. Bartenders are 2.33 times more

likely to die from alcoholism than
average

NIOSH recorded 294 deaths linked to alcoholism among 8,361

white male deaths.

Video

Alcoholism and Public Health

88,000 deaths

1.2 million emergency room visits

$223.5 billion cost of excessive alcohol consumption in a year

Women

Men

Had at least one drink

59.6%

71.8

Have never drank

22.5%

11.6%

Percentage of binge drinkers

28.8%

43.1%

1 drink

48.2%

28.7%

2 drinks

29.9

29.0%

3 or more drinks

21.9%

42.3%

Amount of drinks consumed in a day

Health Concerns related to

Alcoholism

Interruption of communication
pathways in brain

Direct damage to the function

and structure of the heart

Increased stress placed on

liver

Toxins produced by pancreas

Weakened immune system

Higher Susceptibility to
cancers

Effects Alcohol on the Human Body

Short Term

Long Term

Unintentional Injury

Neurologic Disorders

Violence

Cardiovascular Disease

Risky Behavior

Psychosocial Issues

Alcohol Poisoning

Cancers and Liver dysfunction

Gastrointestinal problems

Risk Factors

Regular Drinking

Age

Family History of excessive

drinking

Depression or pre-existing
mental illness

Socioeconomic status

Dual dependence on
medication or illegal drugs

Primary Prevention

Provide information and

spread awareness

Building skills and

developing strategies in
community settings

Exposure to healthier
alternatives

Secondary Prevention

Many types of screening tools

implemented

CAGE

T-ACE

AUDIT (Alcohol Use Disorders

Identification Test)

Tertiary Prevention

Lifestyle changes and

treatment plan

Counseling or medication

Alcoholics Anonymous

Residential Treatment
Programs/Rehabilitation
Facility

Role of pub nurse

Provide essential input to interdisciplinary programs that

monitor, anticipate, and respond to public health problems

Work with communities or specific population groups within

the community to develop public policy and targeted health
promotion and disease prevention activities

Role

Evaluate health trends and risk factors of population

Participate in assessing and evaluating health care services

to ensure that people are informed of programs

Core functions of PH

Core function Applied

Research for new

insights and innovative
solutions to
environmental health
problems

Zoning Density

Advertisements
Reduction

Open social dialog with

public

Active soliciting
partners on the streets

+ Three local agencies/facilities

Glendale Adventist Alcohol & Drug Services (GAADS)

is committed to providing appropriate medical services

for those undergoing detoxification.

Ideally, the initial assessment takes place at GAADS,

where withdrawal risk is gauged through careful
observation, obtaining vital signs, and eliciting an
accurate alcohol and drug history.

Acute detoxification is provided on a medical unit at

Glendale Adventist Medical Center. The nursing staff is
specially trained to understand the signs, symptoms
and behavior of withdrawal along with practical
medication protocols for the treatment of alcohol, opiate
and benzodiazepine withdrawal syndromes. Large
doses of medication may be indicated upon admission
to assure that the patient's vital signs remain within
normal limits, followed by tapering down the dose.

Sub-acute detoxification is used to finish a medication

protocol begun in acute care, or as an option for direct
admission. Sub-acute care includes a full time
registered nurse, physician presence and supervision,
and patient observation rounds every 20 minutes.

Continued
Alcoholics Anonymous

is a fellowship of men and women who share

their experience, strength and hope with each
other that they may solve their common problem
and help others to recover from alcoholism. The
only requirement for membership is the desire to
stop drinking. There are no dues or fees for AA
membership; we are self supporting through our
own contributions. AA is not allied with any sect,
denomination, politics, organization or
institution; does not wish to engage in any
controversy, neither endorses nor opposes any
causes. Our primary purpose is to stay sober
and help other alcoholics to achieve sobriety.

Continued
Promises West Los Angeles

Opportunities to integrate real world

experiences into drug rehab treatment
through local outings and activities
Personalized treatment plans
Comprehensive addiction treatment
delivered by a team of experienced,
credentialed professionals, many of
whom are in recovery themselves
Superior staff-client ratio
Commitment to the highest standards of
privacy and confidentiality
Gourmet, chef-prepared meals
Family program designed to help loved
ones heal from addiction
Extensive alumni services and continuing
care resources

+ Lacking Services Within Alcoholic community

Guidance on the culture of drinking

More drug dependence clinic

multimedia

Advertising to parents to talk

lack of service app

Clinic

Ads

Other efforts

Resources

Alcohol's Effects on the Body. (n.d.). National Institute on Alcohol Abuse and Alcoholism
(NIAAA). Retrieved from http://www.niaaa.nih.gov/alcohol-health/alcohols-effects-body

Alcoholism. (2012, August 9). Mayo Clinic. Retrieved from

http://www.mayoclinic.org/diseases-conditions/alcoholism/basics/definition/CON20020866?p=1&DSECTION=all

Beckerman , M. (2010). Drinking Statistics by Income - Chart of Drinking Habits vs Income

- Esquire. Retrieved 2013, from http://www.esquire.com/blogs/food-for-men/drinkingstatistics-by-income-080210

Drinking Statistics. (n.d.). National Institute on Alcohol Abuse and Alcoholism (NIAAA).
Retrieved from http://www.niaaa.nih.gov/alcohol-health/overview-alcoholconsumption/drinking-statistics

Fact Sheets- Alcohol Use and Health. (2013, December 26). Centers for Disease Control
and Prevention. Retrieved from http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

Giang, B., & Lubin, G. (2011). The 17 Jobs Where You're Most Likely To Become An
Alcoholic - Business Insider. Retrieved from http://www.businessinsider.com/mostalcoholic-jobs-2011-10?op=1

Resources

Module-Preventing Alcohol Abuse and Dependence. (2009, March 1). National Institute on Alcohol Abuse and
Alcoholism. Retrieved from http://pubs.niaaa.nih.gov/publications/Social/Module3Prevention/mODULE3.HTML

Newport, F. (2010). U.S. Drinking Rate Edges Up Slightly to 25-Year High. Retrieved 2013, from
http://www.gallup.com/poll/141656/Drinking-Rate-Edges-Slightly-Year-High.aspx

NIH (2003). National Institute on Alcohol Abuse and Alcoholism. Retrieved from:
http://pubs.niaaa.nih.gov/publications/aa59.htm

PubMed (2013). Alcohol abuse and dependence among U.S. college students. Retrieved from:
http://www.ncbi.nlm.nih.gov/pubmed/12086126

Rufus, A. (2010). Drinking Stats: Who Drinks the Most Alcohol? - The Daily Beast. Retrieved from
http://www.thedailybeast.com/articles/2010/12/29/drinking-stats-who-drinks-the-most-alcohol.html

SANHSA. (2010, April 20). Underage drinking prevention begins with a conversation. Retrieved from
http://www.samhsa.gov/samhsanewsletter/Volume_18_Number_2/UnderageDrinking.aspx

Screening Test. (n.d.). National Institute on Alcohol Abuse and Alcoholism. Retrieved from
http://pubs.niaaa.nih.gov/publications/arh28-2/78-79.htm

THE
END