Module Seven ALCOHOL & SUBSTANCES ABUSE

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Module SevenALCOHOL SUBSTANCES ABUSE

• Lesson 1 Alcohol
  (2 training hours)
• Lesson 2 Other substances (2
  training hours)
• Lesson 3 Social issues (2 training
  hours)

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Lesson 1

• ALCOHOL

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Step 1 Discussion

• Alcohol is the most popular toxic substance to
  man. Most of us use it for pleasure, but in some
  cases alcohol drinking might end to be a serious
  problem.
• What is the secure alcohol consumption ?
• Specialized organizations have determined that
  The limit of safe consumption is 21 units per
  week for men and 14 for women. One unit
  corresponds to half a pint of beer, a glass of
  wine or a 40gr of whiskey/vodka/liquer.

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Step 2 Slide projection

• Slide 7.1.1 Some terms
• Exceeding alcohol consumption
• The regular consumption on daily or weekly basis
  that exceeds the recommended limit.

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Step 2 (continued)

• Disorder caused by alcohol
• Any psychological, physical or social damage
  that derives from exceeding consumption.

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Step 2 (continued)

• Problematic alcohol consumption
• Consumption that causes any disorders that can
  derive from alcohol drinking, but has not yet
  caused dependence on it.

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Step 2 (continued)

• Dependence on alcohol
• A situation in which physical and mental
  disorders develop, when alcohol use is stopped.

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Step 2 (continued)

• Toxicosis
• Is the intoxication, that is the situation that
  follows when alcohol levels in the blood exceed a
  certain limit.

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Step 3

• Slide 7.1.2 Characteristics of the dependence in
  alcohol
• Withdrawal syndrome
• Trembling hands, tongue and eyelids
• Nausea, vomiting, diarrhea
• Intense heart beat, perspiration, high blood
  pressure
• Fever
• Headache
• Irritability, excitement, anxiety, insomnia
• Temporary hallucinations or delusions

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Step 3 (continued)

• Tolerance
• Need for increasing quantity to achieve the same
  outcome
• Furthermore
• Pressurizing need to drink
• Standard manner of drinking regularly
• Priority to drinking than to other activities
• Failures to quit

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Step 4 Slide projection

• Slide 7.1.3 Damages from alcohol abuse
•  Physical
• It can be an immediate effect of alcohol
  drinking, or an indirect effect from malnutrition
  (lack of vitamins), accidents and general
  neglecting of oneself.
• Gastric ulcer, hepatic damage
• Brain damage (and dementia)
• Peripheral neuritis with loss of sensing
• Anemia, heart failure
• In women that abuse alcohol during pregnancy, the
  infant might have low weight and other
  abnormalities.

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Step 5 (continued)

• Psychiatric
• Anxiety
• Depression
• Aggression
• High possibility of committing suicide
• Psychosis with delusions or jealousy ideation
• Social
• Family problems (quarrels, violence, divorce)
• Professional problems
• Illegal actions
• Accidents (car accidents or others)

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Step 5 Theory presentation

• It is essential to recognize persons that abuse
  alcohol, as they tend not to reveal their alcohol
  problems.
• The therapy is recommended to
• Treatment of withdrawal syndrome
• Psychotherapies
• Recognizing and admitting the problem
• Try to quit drinking habit
• Keeping up the effort when it starts to give
  results
• The existence of support groups (like Alcoholic
  Anonymous) has been proved efficient.

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Step 6 Questions and comments (5?)

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Lesson 2

• OTHER SUBSTANCES

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Step 1 Introduction

• The issue of other substances must be examined in
  a similar way to alcohol. The most extreme
  effects and problems are related to the
  dependence on these substances. There are of
  course a lot of addictive substances and the
  problems and dangers differs from one to another.
  

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Step 2 Brainstorming

• Which substances have you encountered in your
  practice?
• Opiates, f. ex. Heroine, morphine
• Stimulants, f ex amphetamines, ecstasy, cocaine
• Hallucinogens, f ex. LSD
• Drugs, f ex benzodiazepines, barbiturates
• Solutions, f ex glue and aerosol
• Cannabis
• Nicotine
• Caffeine

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Step 3 Slide projection

• Slide 7.2.1 Characteristics of the most common
  substances
• Opiates (heroine, morphine)
• WAY OF TAKING ingestion, intramuscularly,
  intravenously, subcutaneously
• PSYCHOLOGICAL EFFECT euphoria, relaxation,
  dizziness, personality change, hypo activity,
  loss of appetite, low libido
• PHYSICAL EFFECT constricted pupils (pinpoint),
  low heart rate, itching, nausea, constipation
• WITHDRAWAL SYNDROME intense desire for the
  substance, uneasiness, rapid heart rate, dilated
  pupils, sweating/perspiration, yawning, diarrhea,
  abdominal pain, dehydrated skin
• DEPENDENCE YES

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Step 4 (continued)

• Cocaine
• WAY OF TAKING chewing, inhale through nose,
  smoking, intravenous injection
• PSYCHOLOGICAL EFFECT Euphoria, enthusiasm,
  Confusion, Paranoid psychosis
• PHYSICAL EFFECT dilated pupils(constricted
  pupils (pinpoint)), fear, increase heart rate,,
  runny nose (rhinorrhea), fever, heart respiratory
  attack
• WITHDRAWAL SYNDROME intense desire for the
  substance, depression, insomnia, agitation.
•  
• DEPENDENCE YES

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Step 3 (continued)

• Amphetamines
• WAY OF TAKING ingestion, intravenous injection
• PSYCHOLOGICAL EFFECT Euphoria, enthusiasm,
  hyperactivity, irritability, hostility, Paranoid
  ideation, Delusions
• PHYSICAL EFFECT constricted pupils, increase
  heart rate, increase of reflexes
• WITHDRAWAL SYNDROME sadness, unemployment
• DEPENDENCE YES  

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Step 3 (continued)

• Hallucinogens (LSD)
• WAY OF TAKING ingestion
• PSYCHOLOGICAL EFFECT Depersonalization,
  Deobjectivation, Overestimation of abilities,
  Anxiety, Effect ideas, low judgment ability,
  Psychotic characteristics, Mood swings
• PHYSICAL EFFECT red eyes, constricted pupils,
  ataxia, increased heart rate
• WITHDRAWAL SYNDROME None
• DEPENDENCE NO

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Step 3 (continued)

• Cannabis (hashish, marijuana)
• WAY OF TAKING smoking
• PSYCHOLOGICAL EFFECT euphoria, relaxation, acute
  perception
• PHYSICAL EFFECT red eyes, dry mouth, increased
  heart rate, respiratory problems
• WITHDRAWAL SYNDROME none
• DEPENDENCE YES
•  

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Step 3 (continued)

• Barbiturates
• WAY OF TAKING ingestion
• PSYCHOLOGICAL EFFECT Anxiety reduce
• PHYSICAL EFFECT Repression of respiratory
  system, Repression of Central Nervous System
• WITHDRAWAL SYNDROME Uneasiness, Insomnia,
  Nausea, Spasms, Delirium
• DEPENDENCE YES

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Step 3 (continued)

• Benzodiazepines
• WAY OF TAKING Intramuscularly, intravenously,
  ingesting
• PSYCHOLOGICAL EFFECT Anxiety reduce,
  Disturbances in concentration, judgment, memory
• PHYSICAL EFFECT ataxia, Nausea, CNS repression
• WITHDRAWAL SYNDROME Uneasiness, Insomnia, Fear
• DEPENDENCE YES

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Step 3 (continued)

• Ecstasy
• WAY OF TAKING ingestion
• PSYCHOLOCICAL EFFECT Euphoria, increased
  perceptions, Anxiety, Psychotic characteristics
• PHYSICAL EFFECT anorexia, increased heart rate,
  jaw tension, sweating, High temperature , blood
  vessel thrombosis
• WITHDRAWAL SYNDROME None
• DEPENDENCE NO / YES

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Step 3 (continued)

• Solutions (glues, aerosol)
• WAY OF TAKING inhaling
• PSYCHOLOGICAL EFFECT Euphoria followed by
  apathy, rejection of Inhibitions, poor judgment
• PHYSICAL EFFECT Sore eyes, sore throat, rushes
  breathing difficulty, CNS repression, ataxia,
  sleepiness, peripheral neuropathy, multiple
  kidney failure, arrhythmias, liver and kidney
  damage, kidney damage, aplastic anaemia
• WITHDRAWAL SYNDROME None
• DEPENDENCE RARE

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Step 4 Slide projection

• Slide 7.2.2 Treatment of substance use
• Pharmacotherapies
• (Methadone, Naltrexone, Klonidine, etc )
• Psychotherapies. Have as a target to
• Intervene in possible psychological, social,
  environmental factors that persist.
• Increase persons awareness.
• Develop alternative mechanisms of treating the
  problems.
• Inform for the strategies of treatment of intense
  desire for substance use.

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Step 7 Questions and comments (5?)