dhs chapter 7 and 8

what is the blood alcohol level?

Intoxication is measured by the amount of alcohol in your blood volume in percent. It varies according to your weight. If you weigh between 110-140, your blood level will be approximately .04 per drink. If you weigh between 150-190, your blood level will likely be roughly .03. If you weigh over 200 pounds your blood level will be .02 per drink.

recovery from alcoholism

Treatment of alcoholism: -Denial as a psychological defense -Easy to relapse (relapsing syndrome) without radical shift in lifestyle -Alcohol rehabilitation and medical ramifications -More emotionally fragile than other addicts

Cerebellum

responsible for movement and balance -ethanol causes individuals to lose coordination, making it hard to walk or do complex tasks like driving

Naltrexone

- mu opioid receptor antagonist -blocks eurphoric effect of alcohol -blocks feelings of intoxication helps reduce heavy drinking

Distinctions Between "Wet" and "Dry Cultures

-"Wet" Cultures -In these cultures alcohol is integrated into daily life and activities (e.g., alcohol consumed with meals). In these cultures, abstinence rates are low and wine is largely the beverage of preference. European countries bordering the Mediterranean have traditionally exemplified wet cultures. -"Dry" Cultures - Alcohol consumption is not as common during everyday activities. Abstinence is more common; however, when drinking occurs, it is more likely to result in intoxication. Scandinavian countries, the United States, and Canada are examples of countries that are dry.

patterns of heroin abuse

-Heroin has become purer (60% to 70% purity) and cheaper (~$10/bag). •Greater purity leads users to administer heroin in less efficient ways. •IV use is associated with HIV/AIDS and viral hepatitis. •Many youth believe that heroin can be used safely if not injected. •Because of its association with popular fashions and entertainment, heroin has been viewed as glamorous and chic, especially by many young people, although lately this attitude has been changing. •Emergency room visits each year due to narcotic overdoses amount to ~ 250,000.

what is safe drinking?

-Know and plan your drinking ( what effect do you want ? Does your life suck so bad that you have to "numb" out) 1-3 drinks over time is fine-5-10 is JUST PLAIN STUPID. -Eat with drinking, it slows the metabolism and absorption. -If you can't stop drinking- YOU HAVE A PROBLEM---this is a sign of addiction- you have become. powerless!!! This is not the drug for you and you may NEED PROFESSIONAL HELP TO STOP. -Watch each other. Don't leave friends alone when passed out (DRINKING CAN KILL YOU). -Don't leave drinks to be tampered with. - Space out your drinking- drink something else in between each alcoholic drink.

BAC of 0.16% to 0.30

-alcohol poisoning -blackouts (amnesia) -vomiting -loss of consciousness

cerebral cortex (thought processing center of the brain)

-ethanol slows everything down -making it more difficult to think and speak clearly

BAC of 0.0% to 0.05%

-feel relaxed and happy -may have slurred speech -may have difficulty with: coordination, balance

other effects of alcohol on organ systems and bodily functions

-gender differences -malnutrition

how to calculate blood alcohol level

-number of drinks -math skills -gender and weight considerations -time 3 time since last drink 4 -.025% for each full hour that passed since your last drink 5 wait at till your body alcohol level is zero or if you are a women wait 30 min and also if you weight less than 150

BAC above 0.31%`

-severely suppressed breathing -death

drinking alcohol can have harmful consequences

-various cancers -gastrointestinal disease -metabolic problems Lead to; -alcohol dependence -withdrawal

a standard drink in the US contains ___ ounces of pure alcohol

.6

how alcohol is absorbed

1 mouth 2 stomach 3 small intestines 4 blood stream 5 liver 6 brain

major problems encountered during prohibition period

1.Alcohol use began to diminish for the first 2 or 3 years after Prohibition was in effect. However, after 3 years of steady decline, the use of distilled liquors rose every year afterward. 2.Enforcement against alcohol use was overthrown by corruption in law enforcement. 3.Many early European immigrants populating American cities during Prohibition came from cultures that viewed drinking as normal and customary, resulting in their refusal to give up alcohol consumption.

heavy use

21-25

ethanol's effects are directly related to blood alcohol content (BAC)

BAC= % ethanol in a given volume of blood affected by: -the amount of ethanol consumed -a person's blood volume =male has more volume =female has less volume situational factors -how much they've had to eat and drink -medications -how well the bod is prepped for ethanol

theory 1

GABA glutamate dopamine serotonin receptors become less sensitive to alcohol

ethanol is a

GABA agonist when it binds to GABA receptors it makes the response stronger -activates opioid receptors (induces release of endorphins)---> bind to receptors on dopaminergic neurons in the nucleus accumbents -release of dopamine and serotonin -acts as a glutamate antagonist (blocks glutamate) z excitatory--from binding with glutamate receptors

Alcohol Use by Junior High and High School Students

In 2014: • Regarding 12th graders' consumption of alcohol, white underage students are much more likely to binge drink (24%) compared with African American students (11%) and Hispanic students (20%). • Boys in 12th grade are more likely to drink alcohol on a daily basis compared with girls of the same grade and age. • Daily use among boys was reported at 3%, whereas the rate among girls was reported at 0.8%. • Boys are more likely than girls to drink large quantities of alcohol in a single sitting.

How serious is alcohol consumption?

In 2014: •Approximately 48% (139.7 million) of Americans are past-month alcohol drinkers (also referred to as current drinkers). •Approximately 6% are past-month heavy alcohol users and 22.2% (60.9 million) of Americans binge drink. •Alcohol use (age 12 or older): -57.7% of whites -49.5% of persons reporting two or more races -42.3% of American Indians or Alaska Natives -44.5% of Hispanics or Latinos -44.2% of blacks-38.7% of Asians •11% of 8th graders, 30% of 10th graders, and 50% of 12th graders said they had been drunk at least once in their lifetime. •Estimated yearly cost of excessive alcohol consumption in the U.S was $223.5 billion (72.2% in workplace productivity, 11.0% healthcare expenses, 9.4% for law enforcement and criminal justice expenses, and 7.4% in motor vehicle crash costs from impaired driving. (Alcohol is officially linked to at least half of all highway fatalities.) •In 2015, 27% of 8th graders, 66% of 12th graders, and 79% of college students reported lifetime use of alcohol. •Overall, $94.2 billion (42.1%) of total economic cost of excessive alcohol use was borne by government and $92.9 billion (41.5%) was borne by excessive drinkers and their family members.

key points to remember when drinking

REMEMBER THOUGH, each hour you metabolize one drink. So if you drank one drink and waited one hour after you finished it, your blood level will be back to zero. -One drink is typically .6 ounce of ethanol alcohol. -One drink is 12 oz BEER, 5 oz WINE, or, 1 SHOT OF HARD LIQUOR -Your BLOOD ALCOHOL LEVEL is the concentration of alcohol in your blood. This is based on your weight (usually .02-.04 % per drink) -A fact to remember is; the legal limit for drunkenness is a blood level of .08% -And, yes, this drug, can and does kill many people, Unconsciousness/COMA and even DEATH can occur at a blood level of .40. For someone who weighs 110 pounds, this could be from drinking 10 drinks!

alcohol abuse among college and university students

Results from CORE Institute (2014): •On average, approximately 81.3% of college students consumed alcohol within the year this survey was given and 68.6% consumed alcohol within the 30 days prior to when the survey was administered. •The average number of drinks that students consumed was 4.4 per week. •Approximately 42.8% engaged in binge drinking within 30 days before the Core Institute survey was administered. •Within a year (annual prevalence) of when the survey was completed, alcohol was shown to be the most heavily abused on college campuses, followed by tobacco (33%) and marijuana (32.5%). •With regard to drinking and binge drinking, other studies found that: -Students who said that religious participation is not very important to them were more than twice as likely to be binge drinkers compared to other students. -Students who said that athletic participation was very important or important to them were also one-and-a-half times more likely to be binge drinkers. -Residents of fraternities or sororities were four times as likely to be binge drinkers compared to other students. •The main reason given for binge drinking was "to get drunk." •Males binge drink more than females. •Being white, involved in athletics, or a resident of a fraternity or sorority made it more likely that a student would be a binge drinker. •Women are more easily affected by alcohol consumption, both its effects and diseases related to alcoholism—cirrhosis of the liver, stomach cancer, and so on. •On America's college campuses, alcohol is often responsible for 28% of all students who drop out of college before completing their bachelor's degree. •Seventy-five percent of male students and 55% of female students involved in acquaintance rape had been drinking or using drugs. •The transition into college is associated with a doubling of the percentages of those who drink for both males and females.

defining alcoholism: first definition

World Health Organization (WHO) definition: •"Alcohol dependence syndrome is characterized by a state, mental and usually also physical, resulting from drinking alcohol. This state is characterized by behavioral and other responses that include a compulsion to take alcohol on a continuous or periodic basis to experience its psychic effects and sometimes to avoid the discomfort of its absence; tolerance may or may not be present" (NIAAA, 1980).

the diagnostic and statistic manual of mental disorder (5th edition)

[alcohol use disorder] a maladaptive pattern of alcohol consumption that includes two of the following: 1 consuming more alcohol than intended 2 being unable to cut down 3 alcohol use takes up a lot of time 4 cravings ton use alcohol 5 alcohol use affects responsibilities 6 using alcohol even if it cause interpersonal problems 7 giving up important activities for alcohol 8 using alcoholic in physically dangerous situations 9 using alcohol even if it worsens a problem 10 becoming tolerant to alcohol 11 feeling withdrawal symptoms from alcohol mild 2-3 moderate 4-5 severe 6+

Symptoms of Withrawal

a severe complication -delirum tremens -start a few days in -high fever -intense agitation -visual hallucinations -tactile hallucinations (symptoms can be deadly) can be awful, so people continue drinking to avoid them -leads to negative reinforcement often combines with positive reinforcement -drinking to feel euphoric leads to alcohol addiction or alcohol use disorder

acamprosate

administered immediately following acute withdrawal -reestablished some GABA and glutamate pathways

alcohol consumption

affects neurotransmitter and neutral pathways--> produces impairment ---> initially enjoyable---> becomes problematic---> unpleasant id drinking continues---> long term use can cause tolerance and dependence---> the most effective treatment includes therapy and medications

symptoms of withdrawal

anxiety depression irritability fatigue tremors palpitations clammy skin dilated pupils sweating headaches difficulty sleeping vomiting seizures

alcohol in a unfamiliar setting

at a party in this situations--- your body's not ready for alcohol there's no physiological "counterbalance" -even at a dose that the person's normally taking

medulla

automatic functions: -breathing -consciousness -body temperature ethanol -increases sleepiness -slows breathing -lowers body temperature (all life threatening)

drinks have varying amounts of ethanol

beer -5% ABV -355mL, 12 ounces wine -12% ABV -148mL, 5 ounces distilled spirits -80 proof 44mL, 1.5 ounces all have about 18mL of pure ethanol

no alcohol (homeostatsis)

brain keeps -heart rate -blood pressure -wakefulness in a normal state secret crush calls -you feel sweaty and flushed -heart rate jumps you are above normal level of homeostasis -something has changed; not for long; brain brings it back

the principal control centers of the brain affected by alcohol consumption

brain regions influenced by moderate doses of alcohol: thalamus, cerebrum, corpus callosum, hypothalamus brain region suppressed by moderately high doses of alcohol: cerebellum brain regions suppressed by very high doses of alcohol: brain stem (midbrain, pons, medulla, oblongata)

an increased dose is needed to achieve original response

can persist long after alcohol use has been decreased

the major inhibitory neurotransmitter

gamma aminobutyric acid GABA, acts as 'off' switch restricts brain activity

serious long term health consequences

heart -dilated cardiomyopathy (muscle stretches out) -arrhythmias (irregular heartbeat -stroke liver 1 healthy 2 steatosis 3 steatohepatitis 4 fibrosis and cirrhosis pancreatitis 1 healthy 2 inflamed cancers -mouth -esophagus -throat -liver -breast vitamin deficiencies (poor diet) -Wernicke- Korsakoff syndrome -thiamine deficiency -causes: vision problems -ataxia -impaired memory

disulfirm

inhibits the enzyme acetaldehyde dehydrogenase (broken down- acetaldehyde) -in body: alcohol is converted acetaldehyde -inhibits the enzyme acetaldehyde dehydrogenase -leads to buildup of acetaldehyde - causes hangover immediately after consumption of alcohol

hypothalamus and pituitary gland

regulate various hormones and mood -ethanol increases sexual arousal, but decreases a person's ability to engage in sex

binge drinking

is a term used to define drinking over 5 drinks at a time (4 FOR WOMEN) and this is when the most harm occurs ( sickness, violence, sexual assault, accidents). College students are more likely to binge drink. result in developing a TOLERANCE (needing more and more of the substance to get the desired effect). Remember, our body metabolizes one drink every hour (after 20 min absorption). So,the only way to sober up is time.

alcohol is a depressant

makes everything slower -heart rate -blood pressure -wakefulness the next time the brain preemptively increases function since it knows that once you take the drugs everything will decrease in the situation of no alcohol the brain still increase but changes aren't countered with alcohol -person can feel awful (withdrawal symptoms; personal may need alcohol to feel normal--- dependent on alcohol)

____ metabolize alcohol faster than ___, and people who weigh more absorb alcohol faster

men; women

BAC of 0.06% to 0.15%

more impairments -speech -memory -attention -coordination more aggression and violence -complex tasks become dangerous ---often illegal to drive over BAC of 0.08%

theory 2

neurons have fewer receptors through -down regulation

inhibitory neurotransmitters make

neurons less likely to fire an action potential

actual calculation

number of drinks x .025= % blood alcohol

excessive alcohol use can end a person's life in an overdose

often due to cardiac and pulmonary depression -to the point a person may lose consciousness and stop breathing

alcohol is

one of the most widely used psychoactive substances in the world

ethanol slows behavioral inhibition center like the

prefrontal cortex: making people more relaxed and less self conscious

alcoholic drinks contain ethanol

reduces the activity of various inhibitory and excitatory neurotransmitter pathways

if 2 hours have pass since you finished your third drink,

subtract .05 from 0.075= 0.025%

treatment

the most effective treatment is a combination of individual and group therapy -motivational interviewing <used to understand <why an individual want to stop using alcohol <specific barriers for treatment cognitive behavior therapy -can help an individual learn about withdrawal -discuss thoughts, feelings, and behaviors that lead to alcohol use -create a plan navigate triggers peer support program -use group discussions to -help individuals commit to ending alcohol use -hold one another accountable medications for alcohol dependence (works best in conjunction with therapy) naltrexone, Acamprosate, disulfiram •Methadone or buprenorphine (Suboxone) are frequently used to help narcotic addicts. •These drugs block withdrawal symptoms. •Treatment should also include regular counseling and other supplemental services such as job training.

Nucleus accumbens and amygdaia

the reward centers in the brain: -ethanol produces pleasant or rewarding feelings like euphoria

alcohol tolerance

with repeated use there is decrease response to alcohol -an increased dose is needed to achieve original response

alcohol abuse

your body will experience WITHDRAWAL ( an equal and opposite effect when the drug wears off), so the hangover feeling of being anxious and irritable is likely due to withdrawal. Alcohol withdrawal effects can last up to 72 hours leading to slowed reaction time, reduced muscle strength, reduced peripheral vision, and anxiety.

____who use alcohol before age 15 are 5 times more likely to become alcohol dependent than adults who begin drinking at age 21

youths

the history of narcotics

• A 6000-year-old Sumerian tablet • The Egyptians • The Greeks • Arab traders • China and opium trade • The Opium War of 1839 • American opium use • Abuse problems often associated with war

four types of alcohol

• Methyl alcohol (poisonous) • Isopropyl alcohol (poisonous) • Ethylene glycol (poisonous) • Ethanol (drinking alcohol)

withdrawal

• Relapsing syndrome: Returning to the use of alcohol after quitting • Acute alcohol withdrawal syndrome: Symptoms that occur when an individual who is addicted to alcohol does not maintain his or her usual blood alcohol level • Delirium tremens (DTs): The most severe, even life-threatening, form of alcohol withdrawal, involving hallucinations, delirium, and fever.

defining alcoholism: second definition

•"Alcoholism is a chronic behavioral disorder manifested by repeated drinking of alcoholic beverages in excess of the dietary and social uses of the community, and to an extent that interferes with the drinker's health or his [or her] social or economic functioning" (Keller, 1958).

defining alcoholism: third definition

•"Alcoholism is a chronic, primary, hereditary disease that progresses from an early, physiological susceptibility into an addiction characterized by tolerance changes, physiological dependence, and loss of control over drinking. Psychological symptoms are secondary to the physiological disease and not relevant to its onset" (Gold, 1991).

negative impact of alcohol

•100,000 deaths associated with alcohol each year. •Nearly 50% of all Americans will be involved in an alcohol-related traffic accident at some time during their lives. •More than 2% of nighttime drivers have a blood-alcohol content that exceeds legal amounts (0.08%). •Alcohol causes severe dependence. •Disrupts personal, family, social, and professional functioning. •Illness, accidents, violence, and crime related to alcohol use.• Consumption by college students causes approximately 2,000 deaths per year. •Fetal alcohol syndrome. •Alcohol is the second leading cause of premature death in America. •Approximately $250 billion is spent annually dealing with social and health problems related to alcohol use.

dependence

•12.5 million alcoholics in United States •Approximately 22% high school students get drunk •Recovered alcoholics are more likely to relapse when under stress •Recovery from alcoholism is a long-term process

history of alcohol in America

•1830: Peak drinking period •Prohibition period •Alcohol has coincided with historical events: -Colonial America -Triangle trade (New England Yankees traded rum for slaves in Africa, then slaves for molasses in West Indies, and then back to New England to make rum) -Colonial taverns were key "institutions" promoting alcohol consumption •Temperance movement (1830-1850) •Prohibition era (1920-1933) -Ratification of the 18th Amendment (1919) to the U.S. Constitution (outlawing alcohol use) -Alcohol was outlawed (January 1920) • Speakeasies and bootlegging grew • Patent medicines flourished •In 1933, the 21st Amendment repealed Prohibition

withdrawal symptoms

•After the effects of the heroin wear off, the addicts have only a few hours in which to find the next dose before severe withdrawal symptoms begin. •A single "shot" of heroin lasts 4 to 6 hours. •Withdrawal symptoms: runny nose, tears, minor stomach cramps, loss of appetite, vomiting, diarrhea, abdominal cramps, chills, fever, aching bones, and muscle spasms.

alcohol consumption in the United States

•Alcohol consumption has dropped sharply since 1981. •What explains the steady decline in alcohol consumption during the past twenty years? -Demographics -Conservatism -Decrease in social acceptability -Increased awareness of risks -Increased concerns for health

alcohol as a drug

•Alcohol is a psychoactive drug that is a CNS depressant. •Some claim that alcohol is the most widely consumed drug in the world and for some is as much a part of daily life as eating. •Alcohol is an addictive substance. Of the approximately 2 million receiving treatment for drug abuse, 64% are being treated for alcoholism .•Social psychologists refer to the perception of alcohol as a social lubricant. •Four reasons why many people view alcohol as a non-drug: -Alcohol is legal. -Advertising and media promote drinking as normal. -Large distribution and sales of alcohol. -Long history of alcohol use.

alcohol and genetics

•Alcoholism is among the most inherited mental illnesses. •Specific genes contribute to: (i) excessive consumption, (ii) diminished negative feedback, (iii) enhanced sense of pleasure, and (iv) diminished hangovers. •However, environment is as important as genetics.

Abuse, Tolerance, Dependence and Withdrawal

•All the opioid narcotic agents that activate opioid receptors have abuse potential and are classified as scheduled drugs.• Tolerance begins with the first dose of a narcotic but does not become clinically evident until after 2 to 3 weeks of frequent use.

Blood Alcohol Concentration (BAC)

•Almost 95% of consumed alcohol is inactivated by liver metabolism. •The liver metabolizes alcohol at a slow and constant rate and is unaffected by the amount ingested. •Thus, if one can of beer is consumed each hour, the BAC will remain constant.

abuse of opioid narcotics

•Tolerance occurs most rapidly with high doses given in short intervals. •Doses can be increased as much as 35 times in order to regain the narcotic effect. •Physical dependence invariably accompanies severe tolerance and typically expresses when these drugs are used for more than 2-4 weeks. •Psychological dependence can also develop with continual narcotic use.

Early Characterizations of Alcoholic Types by Jellinek (1960)

•Alpha alcoholics: Mostly a psychological dependence •Beta alcoholics: Mostly socially dependent on alcohol •Gamma alcoholics: Most severe; suffers from emotional and psychological impairment •Delta alcoholics: Constantly losing control over the amount of alcohol consumed •Epsilon alcoholics: Constantly binge drinking and at times days at a time •Zeta alcoholics: Moderate drinker who becomes abusive and violent

effects of alcohol on organ systems and bodily functions

•Brain and nervous system •Liver -Hepatotoxic effect - Alcoholic hepatitis - Cirrhosis •Digestive system • Blood • Cardiovascular system - Alcoholic cardiomyopathy • Sexual organs • Endocrine system • Kidneys • Mental disorder and damage to the brain - Wernicke-Korsakoff's syndrome • The fetus -Fetal alcohol syndrome (FAS)

Major Known Components of Alcoholism

•Craving: A compulsion to drink alcohol even during inappropriate times (e.g., while driving, working, at a formal event) •Very impaired or loss of control: Inability to limit drinking once begun •Physical dependence: Withdrawal symptoms when attempting to abstain (e.g., nausea, sweating, anxiety) •Tolerance: Need to increase usage to achieve the effect, the "buzz" from alcohol

narcotic related drugs

•Dextromethorphan: OTC antitussive •Clonidine: Relieves some of the opioid withdrawal symptoms •Naloxone/Naltrexone (Vivitrol): Narcotic antagonist; used for narcotic overdoses

medications for alcohol dependence

•Disulfiram (Antabuse): Makes alcohol very unpleasant by altering its metabolism •Natrexone (opiate antagonist): Helps relieve craving in 20% of alcoholics •Acamprosate (Campral): Reduces withdrawal in abstinent alcoholics

Additional Facts Regarding Alcohol Use/Abuse

•Drinking and driving: On most weekend nights throughout the United States, 70% of all fatal single-vehicle crashes involve a driver who is legally intoxicated. •Income/wealth: Less affluent people drink less than more affluent individuals. •The average "alcoholic": The largest percentage of alcoholics are secret or disguised drinkers who look very much like common working people. •On average: Most people who consume alcohol do not become problem drinkers.

opioid side effects

•Drowsiness •Respiratory depression •Nausea/vomiting •Inability to urinate •Constricted pupils •Constipation •Physical dependence and withdrawal

culture and alcohol

•Drunken comportment: Behavior exhibited while under the direct influence of alcohol determined by the norms and expectations of a particular culture •Disinhibitor: A psychoactive chemical that depresses thought and judgment functions in the cerebral cortex, which has the effect of allowing relatively unrestrained behavior (as in alcohol inebriation) •Pseudointoxication: Acting inebriated even before the quantity consumed produces its effects •Some psychologists contend that both set and setting can often overshadow the pharmacological effects of most drugs, including alcohol. -Set: An individual's expectation of what a drug will do to his/her personality -Setting: The physical and social environment where most drugs, including alcohol, are consumed •Culture provides how alcohol use is perceived (e.g., violation of norms, "normal" to drink, sexy, sophisticated, mature). •Cultural rules state how much one can drink and where one can drink. •Cultures provide ceremonial meaning to alcohol use. -Drinking rates among Jews -Drinking rates among Irish •Culture provides a model of alcoholism. •Culture provides attitudes and stereo-types regarding drinking behavior.

heroin and crime

•Factors related to crime: -Pharmacological effects encourage antisocial behavior that is crime-related -Heroin diminishes inhibition -Addicts are often self-centered, impulsive, and governed by need -Cost of addiction -Similar personality of criminal and addict

heroin addicts and AIDS

•Fear of contracting HIV from IV heroin use has contributed to the increase in smoking or snorting heroin. •Many who start by smoking or snorting progress to IV administration due to its more intense effects. •Mainlining drugs (IV) damages veins causing them to collapse and become inaccessible.

heroin abuse

•Heroin is classified as a Schedule I drug. -In 2015, 0.5% of high school seniors used heroin. -It is illicitly used more than any other drug of abuse in the United States (except for marijuana) until 20 years ago, when it was replaced by cocaine. -Some of the recent increases in heroin use likely due to increased abuse of prescription opioid painkillers.

heroin and prenancy

•Heroin use by a pregnant woman leads to: -Physical dependence on heroin in the newborn- Withdrawal symptoms after birth in the newborn (Note: Similar withdrawal occurs in newborns of any woman who uses significant amounts of opiate drugs during pregnancy, including prescribed opiate painkillers)

alcohol and the family

•Important Key Terms: -Codependency (or co-alcoholism):Behavior displayed by either addicted or nonaddicted family members (codependents) who identify with the alcohol addict and cover up the excessive drinking behavior, allowing it to continue and letting it affect the codependent's life -Enablers: Those close to the alcohol addict who deny or make excuses for enabling his or her excessive drinking •Children of alcoholics (COAs) are 2-4 times more likely to become alcoholics themselves. •Adult children of alcoholics (ACOAs) are 2-4 times more likely to develop alcoholism. •Approximately 9.7 million children age 17 or younger are living in households with one or more adults classified as having an alcohol abuse or dependence problem. -Seventy percent of these children were biological, foster, adopted, or stepchildren. -As a result, 6.8 million children, or about 15% of children aged 17 or younger, meet the formal definition of children of alcoholics. •COAs and ACOAs are more likely to marry into families where alcoholism is prevalent. •Twenty-five percent of American children are exposed to an alcoholic before the age of 18.

stages of dependence

•Initially, the effects of heroin are often unpleasant. •Euphoria gradually overcomes the aversive effects. •The positive feelings increase with narcotic use, leading to psychological dependence. •In addition to psychological dependence, physical dependence occurs with daily use over a 2-week period. •If the user abruptly stops taking the drug after physical dependence has developed, severe withdrawal symptoms result.

facts about heroin abuse

•What is the estimated number of heroin addicts in the United States?-600,000 •What are "shooting galleries"? -Locations that serve as gathering places for addicts

Short term effects of alcohol

•Low to moderate doses -Disinhibition -Social setting and mental state may determine individual response • Euphoric, friendly, and talkative • Aggressive and hostile -Interfere with motor activity, reflexes, and coordination • Moderate quantities -Slightly increases heart rate -Slightly dilates blood vessels in arms, legs, and skin -Moderately lowers blood pressure -Stimulates appetite -Increases production of gastric secretions -Increases urine output •At higher doses -Social setting has little influence on effects -Difficulty in walking, talking, and thinking -Induces drowsiness and causes sleep -Induces a hangover when drinking stops •Large amounts consumed rapidly -Severe depression of the brain system and motor control area of the brain •Lack of coordination, confusion, and disorientation •Stupor, anesthesia, coma, or death •Lethal level of alcohol between 0.4 and 0.6 by volume in the blood

alcohol and pregnancy

•Moderate to excessive drinking during pregnancy can result in: -Spontaneous abortion -Damage to fetus •Fetal alcohol syndrome (FAS) -Damage dose-related -A safe lower level of alcohol consumption has not been established for pregnant women.

other narcotics

•Morphine •Methadone •Fentanyl •Hydromorphone •Oxycodone (OxyContin) •Meperidine •Hydrocodone (Vicodin) •Buprenorphine •MPTP •Codeine •Pentazocine •Tramadol

guidelines to avoid prescribed opiate abuse

•Only use opioid analgesics when pain severity warrants. •Doses and duration of use should be as conservative as possible. •Patients should store these medications securely to prevent their theft and misuse. •Do not share with anyone else .•Doctors should screen patients for abuse risk before prescribing opioid drugs. •Patients should be educated about potential abuse problems prior to being prescribed opioid drugs. •If significant abuse is suspected, the clinician should discuss concerns with patient to find appropriate steps to stop the abuse.

helping the family recover

•Psychodrama: A family therapy system developed by Jacques Moreno in which significant interpersonal and intrapersonal issues are enacted in a focused setting using dramatic techniques. •Role-playing: A therapeutic technique in which group members play assigned parts to elicit emotional reactions. •Genogram: A family therapy technique that records information about behavior and relationships on a type of family tree to elucidate persistent patterns of dysfunctional behavior. •Post-traumatic stress disorder (PTSD): A psychiatric syndrome in which an individual who has been exposed to a traumatic event or situation experiences psychological stress that may manifest itself in a wide range of symptoms, including re-experiencing the trauma, numbing of general responsiveness, and hyperarousal.

heroin combinations

•Pure heroin is a white powder. •More than 90% of world's heroin is from Afghanistan although the primary source of heroin to the United States is Mexico. •Heroin is usually "cut" (diluted) with lactose •When heroin first enters the United States, it may be 95% pure; by the time it is sold, it may be 3% to 70% pure. •If users are unaware of the variance in purity and do not adjust doses accordingly, results can be fatal. •Heroin has a bitter taste and is often cut with quinine, which can be a deadly adulterant. •Heroin plus the artificial narcotic fentanyl can be dangerous due to its unexpected potency. •Heroin is most frequently used with alcohol. •Heroin combined with cocaine is called "speedballing."

methods of administration

•Sniffing the powder •Injecting it into a muscle (intramuscular) •Smoking •Mainlining (intravenous injection)

physical effects of alcohol

•The body is affected by alcohol in two ways: -Direct contact in mouth, esophagus, stomach, and intestine -Influence on almost every organ system in the body after entering the bloodstream •Absorption is the process by which the drug molecules reach the bloodstream. •The effects of alcohol on the human body depend on the blood alcohol content (BAC). •BAC produced depends on -Presence of food in the stomach -Rate of alcohol consumption -Concentration of alcohol -Drinker's body composition •Alcoholic beverages have no vitamins, minerals, protein, or fat—just a large amount of carbohydrates and associated calories. •Alcohol can cause severe physical and psychological dependence. -Cross-tolerance -Behavioral tolerance: Compensation of motor impairments through behavioral pattern modification by chronic alcohol users

polydrug use

•The common practice of taking alcohol concurrently with other drugs. •Reasons why individuals may combine alcohol with other drugs: -Alcohol enhances properties of other CNS depressants. -Decreases the amount of an expensive and difficult-to-get drug required to achieve the desired effect. -Helps diminish side effects of other drugs. -There is a common predisposition to use alcohol and other drugs.

pharmacological effects

•The most common clinical use of the opioid narcotics is as analgesics to relieve pain. •The opioid narcotics relieve pain by activating the same group of receptors that are controlled by the endogenous substances called endorphins. •Activation of opioid receptors blocks the transmission of pain through the spinal cord or brain stem but can also reduce the effects of stress. •Morphine is a particularly potent pain reliever and often is used as the analgesic standard by which other narcotics are compared. •With continual use, tolerance develops to the analgesic effects of morphine and other narcotics. •Physicians frequently under prescribe narcotics, for fear of causing narcotic addiction. •The principle side effects of opioid narcotics, besides their abuse potential, include: -Drowsiness, mental clouding -Respiratory depression -Nausea, vomiting, and constipation -Inability to urinate -Drop in blood pressure

what are narcotics?

•The term narcotic currently refers to naturally occurring substances derived from the opium poppy and their synthetic substitutes. •These drugs are referred to as the opioid (or opiate) narcotics because of their association with opium. •In 2014 it was estimated that ~2 million people in the United States had an opioid use disorder related to prescription painkillers. •Although opioid narcotics possess abuse potential, they also have important clinical value (e.g., analgesic, antitussive, antidiarrheal). •The term narcotic has been used (somewhat incorrectly) to label many substances, from opium to marijuana to cocaine.

defining alcoholism

•There is no agreement regarding at what specific point someone is an alcoholic. •Alcoholism is a state of physical and psychological addiction to a psychoactive substance known as ethanol. •Most definitions include chronic behavioral disorders, repeated drinking to the point of loss of control, health disorders, and difficulty functioning socially and economically.

women and alcohol

•Women possess greater sensitivity to alcohol, have a greater likelihood of addiction, and develop alcohol-related health problems sooner than men (e.g., stomach cancer, cirrhosis of the liver). •More women in alcohol treatment come from sexually abusive homes (70%) in comparison to men (12%). •Three major reasons why women are more sensitive to the effects of alcohol: -Body size (men are generally larger than women) -Women absorb alcohol sooner—women possess more body fat and body fat does not dilute alcohol -Women possess less of a metabolizing enzyme that gets rid of (processes out) alcohol •Alcohol consumption patterns of women: -Women 21 to 34 years of age were least likely to report alcohol-related problems if they had stable marriages and were working full time .-Women tend to marry men whose drinking habits match their own. -Between 35 to 49 years of age, the heaviest drinkers were divorced or separated women without children. -Between 50 to 64 years of age, the heaviest drinkers were women whose husbands/partners drank heavily. -Women 65 and older comprised less than 10% of drinkers with drinking problems.

types of alcoholics by moss and colleagues in 2007

•Young Adult (31.5% of U.S. alcoholics): Young adult drinkers without major problems regarding their drinking •Young Antisocial (21% of U.S. alcoholics): Mid-20s, had earlier onset of regular drinking and alcohol problems, and come from heavy alcohol use families •Functional (19.5% of U.S. alcoholics): Middle-aged, well-educated, with stable jobs and families •Intermediate Familial (19% of U.S. alcoholics): Middle-aged, with 50% from families with multigenerational alcoholism •Chronic Severe (9% of U.S. alcoholics): Mostly middle-aged, high rates of antisocial personality disorder and criminality