Chemical Dependency Start Here化学依赖从这里开始. Get There..ppt

Alcoholism:  A Prototype Disease Alcohol Dependence can be viewed as a prototype of chemical (substance) use and dependence. E.M. Jellinek, pioneer of the disease model, identified phases of abuse-to-dependence Substance Profiles ALCOHOL DEPENDENCE:  Some Facts 5-7% of Americans are Alcoholics Every alcoholic touches lives of 5 people A leading cause of death: from medical complications, accidents and suicides Fetal alcohol syndrome most common cause of mental retardation in children Potentiates other CNS depressants Alcoholism underreported in women and older adults Alcohol: Intoxication Metabolism of alcohol is increased in heavy drinkers Women more easily intoxicated than men. Effects: CNS depression and Peripheral vasodilation Decreased muscle tension, lowered anxiety level, disinhibition, impaired judgment, sedation ? Toxic effects: stupor, unconsciousness (including blackouts), coma, death Alcohol Withdrawal Usually develops 4-12 hours after cessation or reduction of alcohol use Rebound phenomenon (CNS irritability) as drug effects wear off: increased anxiety, tension, psychomotor activity sweats, tremors, tachycardia, increased temp. and BP nausea, vomiting, diarrhea Alcohol Withdrawal, cont’d Withdrawal seizures may occur 7-48 hours after cessation or reduction Alcohol withdrawal delirium (also known as Delirium Tremens or DTs) may occur 48-72 hours following cessation or reduction- agitation, terror, hallucinations Use of validated withdrawal assessment rating scale assists in objective description of withdrawal severity Alcohol: Interventions Seizure precautions; anticonvulsants for DT’s Suicide assessment and precautions, if necessary Medications: for withdrawal Benzodiazepines e.g. chlordiazepoxide (Librium), oxazepam (Serax), diazepam (Valium). Administration may depend on withdrawal rating parameters. Medications to promote abstinence after detox. disulfiram (Antabuse) = Aversive Therapy; produces unpleas