Substance abuse and addiction are major problems in society today. Every segment of society, regardless of race, gender, or age is affected. Some of the substances that are used grow naturally, where as others are manufactured illicitly or even legitimately in laboratories. They may be smoked, inhaled, ingested, or injected and used for social, religious, or self-medicating purposes. The substance that are abused include caffeine, nicotine, alcohol, steroids, stimulants, depressants, heroin, ANd cocaine. Substance abuse and dependence were first described as disease process in the 1960s with the introduction of Jellinek’s work on alcoholism.
Dependence on alcohol and other drugs is now accepted and is classified as a psychiatric disorder. Substance abuse ranks high among serious health problems. Since 1979 illicit drug use and alcohol consumption have declined, but the widespread use of and dependence on these substance continue. Nicotine, now classified by the Food and Drug Administration as an addictive substance, is linked to more deaths annually than AIDS, cancer, and other substances combined. Alcohol is also a major social problem today. Use and abuse of alcohol are a factor in contributing to injuries and death. The cost of substance abuse is increasing in our society.
Lives are lost, and loss of work productivity costs millions of dollars each year. Alcohol is a factor in 40% of all motor vehicle accidents, and alcohol and other drugs are often implicated in boating or athletic accidents. Cost include not only lives lost but also medical care, long-term services to the disabled, and increased insurance rates. Health care cost for clients use alcohol, drugs, and nicotine are estimated to be greater than $160 billion annually.
It has been confirmed that there is link between violence and alcohol and other drugs. Alcohol and drugs is a factor in vandalism on college campuses, date rape, sexual assault, and domestic violence. Under the influence of alcohol and drugs, young adults are more likely to engage in unsafe sexual practices, and parents are more likely to abuse their children. Certain factors place some individuals at greater risk than others for the development of abuse and dependence. Biological, psychological, or environmental conditions may predispose a person to the development of a drug or alcohol problem. Risk factors may include some of the following.
Heavy use of alcohol and other drugs or the presence of abuse or dependency by family members Presence of psychological conflicts, which a person may attempt to resolve through drug use Genetic predisposition, which is derived from biological factors Inborn tolerance, which may result in excessive alcohol or other drug intake Other factors that predict that there may be a risk for alcohol and drug abuse include some of the following.
Failure in school Rebelliousness and alienation Early antisocial behavior Need for immediate gratification Lack of empathy Frequent lying Insensitivity to punishment Peer pressure and choice of peers who use drugs Siblings who use drugs Inadequate parental direction and discipline Community and cultural factors also play a role in determining risk for alcohol and drug abuse.
Communities with high levels of crime, and delinquency, as well as high population density, are high risk environments and have higher rates of dependency in these communities. The family which is the most powerful unit of socialization transmit cultural beliefs, myths, and values about alcohol and drug use. Also peers, and media personalities deliver messages about drug use, drug-using lifestyles, and the use of wines and spirits are subject of cultural traditions of families. Some groups have used wine strictly for celebratory purposes, others for religious rituals, and some for sustenance. Many cultural groups do not consider alcohol a drug.
The result is that among many groups a double standard exists for alcohol and for other drugs. Illicit drugs are considered dangerous and unhealthy, but alcohol is accepted and not considered threatening to the individual family, or society. However alcohol and drugs can be threatening to the individual, family, and our society. Substance abuse is known to affect ones behavior and personality. Abusers are known to be manipulative and often are in denial. One of the greatest consequences of alcohol abuse is the physiological damage that can be done. Alcohol is absorbed directly from the stomach and exerts system depression and physiological effects throughout the body almost immediately. In low doses, alcohol produces relaxation, loss of inhibition, loss of concentration, drowsiness, slurred speech, and sleep.
Chronic use of alcohol has two major physiological problems 1.) Wernicke’s encephalopathy, also called Wernicke’s syndrome is a form of dementia and results from thiamin deficiency . Symptoms include paralysis of ocular muscles, diplopia, ataxia, somnolence, and stupor. Korsakoff psychosis which usually accompanies Wernicke encephalopathy is characterized by confusion and short-term memory loss, and confabulation. 2.) Cirrhosis of the liver, cirrhosis involves the widespread destruction of functional liver cells that are replaced with fibrous nonfunctioning scar tissue. Complication of cirrhosis include portal hypertension, ascites, esophageal varices, and hepatic encephalopathy. Complications of Cirrhosis and Wernicke’s encephalopathy are life threatening and require aggressive treatment.
With Wernicke’s if thiamine replacement therapy is not initiated, death may occur and in those with cirrhosis further ingestion of alcohol my result in death. Other physiological problem associated with alcohol are cardiovascular effects, gastrointestinal, skin, malnutrition, neurological, and sexual dysfunction. Problematic use of alcohol is listed as three disorders: Alcohol intoxication, Alcohol abuse, and alcohol dependence. Intoxication revert to the exposure or ingestion of a substance.
Persons who are intoxicated ARe often referred to as “drunk.” These people will often experience changes in mood, belligerence or aggressive behavior, poor coordination, impaired memory and judgment, blackouts. Alcohol abuse is a pattern of excessive alcohol consumption. Excessive consumption occurring for at least a 12-month period. In these people you will notice tolerance the effects of alcohol, maladaptive drinking patterns, problems in fulfilling role obligations, social isolation, denial, changes in eating and stress management activities, and unpredictable drinking behavior. Alcohol dependence is the most severe and is characterized by loss of control over the use of alcohol, a pattern of compulsive use, and the expenditure of substantial periods of time and energy in the consumption of alcohol.
Drugs that are often abused include cocaine, amphetamines, nonamphetamine stimulants, caffeine, and nicotine. Cocaine is the most potent, but caffeine and nicotine are the most prevalent and widely used. On the street, amphetamines are known as bennies, splash, speed, crystal, and black beauties. Diet pills are called uppers, and cocaine is referred to as coke, blow, show, lady, and flake. Crack is the form of cocaine that is smoked or inhaled. Cocaine stimulated the Central Nervous System and is abused recreationally because of its pleasurable effects. Persons who abuse cocaine may “binge” on high doses of the drug on an episodic basis followed by a 2 to 3 day recuperation known as a “crash.
Or they may be chronic daily users of smaller doses that increase over time as their tolerance increases. Cocaine intoxication increases the heart demand for oxygen, resulting in an increased heart rate, artery constriction, heart attack, and sudden death may occur. When inhaled cocaine can cause pulmonary hemorrhage, bronchitis, or pneumonia. When alcohol or any drug of abuse is terminated abruptly by a person who is physiologically dependent they may begin to experience withdrawals.
Onset of symptoms of withdrawals begins within 6-12 hour following the cessation or reduction of the drug or alcohol. Withdrawal must be treated, if not withdrawal may progress to withdrawal delirium untreated delirium may result in death. In our communities there are means of intervening to prevent the onset of substance-related disorders and to treat early, middle, and late stages of substance use problems. Treatment can be approached on several differences basis. Inpatient hospitalization is usually a 2 to 4 week hospitalization in a unit of a general hospital, residential treatment center or psychiatric hospital; therapy provides corrective emotional experiences.
This atmosphere provides safety, restricts access to the drug, and monitor self-destructive behaviors. Detoxification Is a supervised medical regimen to withdraw the client from drugs that have induced psychological and physiological dependence. Rehabilitation usually is a long-term hospital that address all phases of treatment. In many areas halfway houses serve as a rehabilitation facility that provide a sheltered and emotionally and financially supportive environment with peers.