SUBSATNCE ABUSE PRESENTATION 2.

 QUESTION  : 

SUBSATNCE ABUSE

Namwela Zanga aged 21 years has been brought to your mental health unit with history of  alcoholism for the past 3 years. He is reported to be regular consumer of a local beer brew. This has led to self-neglect and he can no longer eat his food.

a)    Outline any five (5) theories of alcohol/substance abuse           20%

b)    Outline five (5) Social effects of alcohol abuse                                20%

c)     Discuss the seven (7) phases of alcohol intoxication                    35%

d)    Discuss five (5) ways of how alcohol abuse can be prevented  25%

INTRODUCTION

Worldwide substance use and abuse are significant problems for adolescents. They carry serious consequences such as assault and rape. Substance abuse involve use of psychological active substances which are potentially harmful to the individual. It is generally agreed by most scientists that stress, conflicts and frustration are major factors in substance abuse. The user is trying to alter the world enough to make it more tolerable. Peer pressure is another important factor in substance abuse.

Substance abuse also known as drug abuse is a harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. The user consumes the substance in amounts or methods which are harmful to themselves or others. It is a form of substance related disorder.

Individuals are considered to have a substance use disorder when use of the substance interferes with their ability to fulfill role obligations, such as at work, school, or home.

Often the individual would like to cut down or control use of the substance, but attempts fail, and use of the substance continues to increase.

There is an intense craving for the substance, and an excessive amount of time is spent trying to procure more of the substance or recover from the effects of its use. Use of the substance causes problems with interpersonal relationships, and the individual may become socially isolated.

Individuals with substance use disorders often participate in hazardous activities when they are impaired by the substance, and continue to use the substance despite knowing that its use is contributing to a physical or psychological problem.

Addiction is evident when tolerance develops and the amount required to achieve the desired effect continues to increase.

DEFINITION OF TERMS RELATED TO SUBSATNCE ABUSE

 

Intoxication is defined as a physical and mental state of exhilaration and emotional frenzy or lethargy and stupor (Townsend, 2015). With substance intoxication, the individual experiences a reversible syndrome of symptoms that occur with ingestion of a substance and that are specific to the substance ingested.

The behavior changes can be attributed to the physiological effects of the substance on the central nervous system

Substance Withdrawal

Withdrawal is defined as the physiological and mental readjustment that accompanies the discontinuation of an addictive substance (Townsend, 2015). The symptoms of withdrawal are specific to the substance that has been ingested and occur after prolonged or heavy use of the substance. The effects are of sufficient significance to interfere with usual role performance

ADDICTION.

It is a ‘chronic, progressive, potential and fatal use of drugs, (Merck, 1997).’

It is the biological and/or psychological behaviors related to substance dependence, (Stuart, G.W. and Laraia, 2005).

DEPENDANCE.

‘This is a desire to continue taking a drug, to induce pleasure or to relieve tension and avoid discomfort, (Merck, 1997).’

TOLERANCE

“This is the need to progressively increase the dose of the drug to reproduce the effect originally Achieved by small doses, (Merck, 1997).’ The need to take larger and lager dosages of a drug while still only getting the same effect as from the original dose, McMahon, et al. 1995).’

SUBSTANCE ABUSE

Drug abuse, also called substance abuse or chemical abuse, is a disorder that is characterized by a destructive pattern of using a substance that leads to significant problems or distress (American Psychiatric Association, 2000).

“ALCOHOLICS

Are those excessive drinkers whose dependence on alcohol has attained such a degree it shows a noticeable mental disturbance or an interference with their bodily and mental health, their interpersonal relations and their smooth social and economic functioning, or who show the prodromal signs of such developments.

ANSWERS/DISCUSSION.

Outline any five (5) theories of alcohol/substance abuse                       20%

Theories of substance abuse give explanations about causes/predisposing factors of substance use, abuse or dependence. They include:

GENETIC THEORY

The genetic theory suggests that substance abuse is related to genetic predisposition. Research has demonstrated a link between alcoholism in parents and incidence in offspring. Research focused on non-alcoholic foster parents raising children whose biological parents were alcoholic. Results showed prevalence of alcohol in children was higher than when the biological parents were non-alcoholic.

BEHAVIORAL THEORY

The behavioral theory of substance abuse and addiction describes drug taking behaviors as learned behaviors from the environment.  Drug abuser use drugs to cope with low esteem, personal stress, and feelings of disillusion.

FAMILY SYSTEM THEORY

The Family System theory explains substance abuse and addiction as having its roots in family dysfunction with the family adapting to the chemical dependence of its member through maladaptive responses. For example, a married woman resorts to beer drinking due to a marital problem ends up with her child taking up her roles (child parent). Other children may become addicts themselves.

PSYCHOANALYTIC THEORY

According to Psychoanalytic theory, drug use, abuse and dependence lie in mental processes. The compulsivity to use drugs functions as an “artificial affect defense,” to numb overwhelming feelings, e.g. people with feelings of jealousy, panic attacks, shame, or rage, may abuse hypnotics or narcotics. Those with feelings of hopelessness, depression and emptiness will resort to defending their feelings with stimulants like cocaine.

CULTURAL INFLUENCES THEORY

Cultural influence play a role in substance abuse. In some societies drinking occurs within ceremonial and social contexts. For example, in Zambia, drinking during parties like weddings, kitchen parties and traditional ceremonies like, Nçwala of the Ngoni people of Eastern province. These festivals are affirm group identity and the drinking is rarely disruptive.

MORAL EXPLANATION THEORY

The moral explanation of addiction holds that bad habits and values determine if a person becomes an addict. In societies where there are strict laws and penalties for possession of specified quantities of illicit drugs like in Jewish countries, have very low substance abuse. If a man believes or values alcohol, he will engage in alcohol abuse.

Outline five (5) Social effects of alcohol abuse                                           20%

1.      Increased levels of Abuse of Family Members

Significant others of alcoholics are often subjected to alcohol-related abuse, such as verbal, emotional physical abuse and even sexual abuse. Heavy drinking has been strongly linked to violence between partners and to a lesser extent to violence towards others, possibly because proximity increases the opportunities for violence. Alcohol plays a role in a substantial number of domestic violence incidents, especially in the case of abusing husbands.

2.      Increased participation in unprotected sex and other risky activities

 Alcohol reduces someone’s judgement and correct evaluation of risk involved in  indulging in some activities. A person who is intoxicated by alcohol may end up indulging in risky activities such as protected sex. 

3.      Unplanned pregnancies and increased chances of Contracting sexually transmitted infections.

A person who is intoxicated by alcohol may end up indulging in risky activities such as protected sex thereby leading to unplanned pregnancies and increased risk of contracting sexually transmitted infections.

4.      Family Disruption

Research indicates that marriages in which only one spouse drinks heavily end in divorce 50% of the time. The spouse who does not drink may decide to pull out of the marriage because of failure to tolerate alcoholic behaviour.

5.      Poverty

Alcoholics may spend more money on alcohol. The financial costs of alcohol purchase as well as lost wages due to absenteeism can leave other family members destitute. In worse cases alcoholism can lead to unemployment due to the alcoholic being fired leaving the employee and his or her family in poverty.

6.      Increased Substance Abuse

Children of substance abusers are 3-4 times more likely than peers to become addicted to alcohol or other drugs. This can lead to increase in the number of substance abusers thereby perpetuating the problem.

7.      Increased Risk of Emotional Problems

Children of alcoholics are at higher risk for developing an array of emotional problems including mistrust, guilt, shame, confusion, ambivalence, fear and insecurities as result of what they pass through in their homes.

Discuss the seven (7) phases of alcohol intoxication                               35%

Alcohol Intoxication

When a person consumes alcohol, the full effects may take some time to become apparent. Depending on a number of factors—including the amount consumed, the rate of consumption, gender, body weight, and whether the drinking episode took place on an empty or full stomach, there are somewhat predictable stages of alcohol intoxication through which the individual may progress as their drinking continues.

A chart breaking down the progressive effects of intoxication as blood alcohol content or concentration (BAC) rises can be used to estimate just what increasing levels of drinking could do to the body and the individual’s judgment and behaviours.

It’s important to remember that the same number of drinks will not produce the exact same BAC among different individuals. A person’s size, metabolism, ethnicity, and other factors can impact how they are affected by alcohol

BAC stands for blood alcohol concentration or blood alcohol content. BAC is the metric used to measure the amount of alcohol intoxication for legal or medical purposes in the United States. BAC is expressed as a percentage of alcohol in the blood.

Seven (7) Stages/ Phases of Alcohol Intoxication   .

Stage 1: Sobriety, or Subclinical Intoxication

The blood alcohol concentration or blood alcohol content is at 0.01-0.05.  The individual is unlikely to appear intoxicated, though certain tests may detect impairment. Effects of alcohol are not obvious or clearly visible. The behavior is nearly normal , however the impairment can be detected with the aid of special tests. Depending on the individual, judgment and reaction time may be slightly impaired.

One drink will generally result in a blood alcohol concentration within this range for both males and females, with the exception of women weighing under 100 pounds.

Stage 2: Euphoria

The second stage of intoxication, referred to as euphoria, occurs between 0.03 and 0.12 blood alcohol concentration (which may correspond to roughly 1-4 drinks for a woman or 2-5 for a man, depending on size). In this stage, the individual may feel more confident, may be more talkative and animated, and may feel slightly euphoric. Inhibitions also begin to decline.

Most people refer to this stage as being “tipsy.” (Slightly drunk)

While many of the effects of alcohol may be pleasurable to the drinker, the negative effects of alcohol, such as impaired judgment, memory, and coordination begin to appear at this time, as well.

Stage 3: Excitement

The person has a blood alcohol concentration between 0.09 and 0.25 .The person begins to experience emotional instability, a lack of critical judgment, and a significant delay in reaction time. The person may start slurring his/her speech. He/she may also experience impaired perception and memory, vision issues, including decreased peripheral vision, blurriness, and delayed glare recovery, loss of balance, drowsiness, nausea and vomiting. Those around the person will likely notice that they are visibly drunk.

Stage 4: Confusion

Someone with a blood alcohol concentration level of 0.18 to 0.30 is in the confusion stage. It is characterized by sudden change in emotional  (emotional upheaval)and disorientation. Coordination is markedly impaired, to the extent that the person may not be able to stand up, may stagger if walking, and may be very dizzy. Those in this stage of intoxication are highly likely to forget things that happen to or around them. “Blacking out” (losing memory of events that occurred while drinking) without actually passing out can happen at this stage.⁵ In addition, a person may have and markedly increased pain threshold, meaning they could injure themselves and not feel the effects until later.

Stage 5: Stupor

Stupor occurs at a blood alcohol concentration between approximately 0.25 and 0.40. Someone in this stage is extremely intoxicated and in dangerous territory, as he/she is  at great risk of alcohol poisoning and death. The person has likely lost a significant amount of motor function, is not responding to stimuli (or responding very slowly) and may be unable to stand or walk, stuporous or completely passed out, unable to voluntarily control certain bodily functions, such as maintaining continence and vomiting.

Someone in this stage should get medical help. Individuals left to “sleep it off” may end up suffering from slowed breathing or respiratory arrest or may choke on their own vomit. Other risks include hypothermia, arrhythmia, and seizures.  

Stage 6: Coma

A person who has reached 0.35-0.45  blood alcohol concentration is at significant risk of lapsing into a coma.  Respiration and circulation are severely depressed, motor response and reflexes are markedly decreased, and the person’s body temperature drops. The person who has reached this stage is at risk of death.

Stage 7: Death

At about 0.45 blood alcohol concentration or above, many are unable to sustain their vital life functions, and the risk of respiratory arrest and death is significant. Note that death is also possible at lower blood alcohol concentration.

Discuss five (5) ways of how alcohol abuse can be prevented             25%

Conducting Awareness campaigns about Alcohol

Awareness campaigns are aimed at preventing young people from drinking before they turn 18, preventing harmful alcohol consumption, preventing people from becoming psychologically or physically dependant on alcohol and reducing harm caused by alcohol abuse, such as public antisocial behaviour, domestic.

Identifying and counselling People at increased risk of Alcoholism

Alcoholism can impact anyone irrespective of gender, personal beliefs, ethnicity, age, or body type. However, certain individuals are at a higher risk of developing a dependence on intoxicating drinks. These include individuals with unhealthy drinking patterns, individuals who over drink, individuals with a family history of alcoholism, individuals with mental health problems such as anxiety and depression, youth experiencing peer pressure or low self-esteem, individuals with high-stress jobs and work pressure, families and cultures where drinking is traditional. Such individuals will require preventive counselling so that they do not become alcoholics.  

Conducting Lifestyle campaigns to ease stress

One of the leading causes of alcohol abuse in adults is work-related stress. Alcohol prevention programs at the workplace are an effective way to prevent abuse in employed individuals. Lifestyles that can reduce stress and thereby prevent substance abuse include regular exercising eating a healthy diet reducing  caffeine and sugar and getting enough sleep.

Seeking Help to Prevent Alcoholism

Community members should be advised to seek help if they begin to show high-risk behavior for abuse so that early intervention can be instituted to  help prevent adverse effects of alcoholism. Some of the things they can do when a drinking problem is suspected include seeking therapy from a trained counselor, talking to the family physician, and finding a support group for adults with alcohol problems.

Avoiding socializing at bars/Drinking Places

Community members should be advised to avoid socializing at bars instead, they should plan activities with friends at places that do not sell alcohol to prevent indulgence in alcohol consumption.

Avoiding Keeping Alcohol at Home

Access to alcohol increases the likelihood of drinking. Fully-stocked liquor cabinets and half-drunk bottles of wine can set off drinking triggers.  If there is no social purpose, alcoholic drinks should be kept out of the house. In alcoholic drinks can be substituted with other drinks such as tea and lemonade.

Engaging young people in recreational Activities

Teenagers and young adults are more likely to succumb to peer pressure and adopt inappropriate drinking behaviors. Research has shown that young people tend to consume 90 percent of their total intake of alcohol through binge drinking. Binge drinking has dangerous consequences such as drunk driving, sexual assault, injuries, impaired judgment, and increased risk of alcoholism later in life. It is, therefore, essential to engage young people in recreational activities to prevent them from indulging in alcohol.