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Alcoholism


Alcohol is a powerful Psychoactive Chemical I.e. Ethanol that can have a wide range of adverse effects on almost every aspect of your life, including health, Finances, family & children.

Alcohol Dependence

If someone loses control over drinking & has excessive desire to drink its known as dependent drinking i.e. alcoholism. Dependent drinking usually affects person’s quality of life & relationships, but they may not always find it easy to see or accept this.

Following are the criteria.

Tolerance : - Severely dependent drinkers are often able to tolerate high level of alcohol in amount that would dangerously affect or even kill some people

Withdrawal symptoms : - A dependent drinker usually experiences physical & psychological withdrawal symptoms if they suddenly cut down or stop drinking

  • Hand tremors, 6hrs
  • Sweating, 6 to 12 hrs
  • Hallucinations, seeing things & images that are unreal, 24-48 hrs
  • Anxiety, Insomnia, sleeplessness
  • Convulsions 72hrs
  • Relief drinking: to avoid withdrawal people drink
  • Time: - More time spent on alcohol use & its effects.
  • Desire: - If there is persistent desire or unsuccessful attempts to cut down the alcohol.
  • Alternative enjoyment is lost.

Am I drinking too Much alcohol?

CAGE Criteria : - Even if one criteria present, you have to stop alcohol use

If you feel to Cut down the alcohol use

If Other people (Annoyed by) criticizing your drinking

If you feel Guilty or bad about your drinking

If you require Early morning drink to steady your nerves or get rid of hangover

Risks of alcohol use

All dimensions of the life of an alcohol user & his family gets disturbed.

Short Term effects

  • Accidents, Injuries, Trivial falls may cause head injuries, fractures & sudden deaths.
  • Alcohol Poisoning may lead to vomiting, seizures, falling unconscious & death.
  • Violent behaviour & being victim of violence.
  • Binge drinks: - heavy drink over short period of time is more likely to behave recklessly & are at greater risk of being in an accident

Long Term

  • Heart disease: Heavy drinking over a long period cause increased blood pressure, high cholesterol level which may cause heart attacks & stroke.
  • Long term alcohol misuse can weaken immune system, making u vulnerable to infections.
  • It can also weaken your bones placing u at greater risk of fracturing or breaking them.
  • Stroke & Paralysis.
  • Liver Dysfunction, Jaundice, Ascites & Liver failure.
  • Mouth, Liver & Bowel cancer.
  • Pancreatitis & Diabetes due to recurrent Pancreatitis.
  • Sexual problems like impotence, premature ejaculation, infertility.
  • "Children of alcoholics are the people who have been robbed of their childhood."
  • From the unborn child to the aged in the family, everyone is affected by alcoholic person.
  • They Ignore children, whose development is disturbed. Children may face symptoms as low self-esteem, loneliness, guilt, hopelessness, fears of abandonment & depression.
  • They also can have high levels of stress & anxiety, Frequent nightmares, bedwetting, poor schooling, school drop-out also, may develop symptoms like lying, stealing, truancy, fighting.
  • Spouse have negative effects like feeling of hatred, self-pity, avoidance of social contacts, may suffer exhaustion & become physically & mentally ill.
  • There may be premature widowhood.
  • Domestic abuse & Frequent fights can result in Family break up & divorce.
  • Alcoholics can disrupt family life & its harmful effects can last a lifetime.
  • Psychosis, delusion of infidelity, suspecting spouse that she has an affair.
  • Depression, worrying thoughts, Fear of illnesses, anxiety
  • Alcohol induced panic disorder.
  • Alcohol induced Dementia & Wernicke’s encephalopathy
  • Besides money spent on alcohol, spending on alcohol related health problems.
  • Poor become poorer due to alcohol use.
  • Work impairment, loss of job, Absenteeism, unemployment.
  • Loss of judgement in financial dealings, loans & misadventure.
  • Loss of personal possessions like wallets, keys & Mobile phones
  • Reduce the productivity. 40% of accidents at workplace are related to alcohol.
  • There may be unemployment, & homelessness.
  • Sexual advances & inappropriate behaviour.
  • The persons who start drinking early during or before graduation loose education ultimately.
  • There may be loss of respect in the society.

Intensive rehabilitation

We provide Some people intensive rehabilitation & recovery support for a period after they stop drinking completely. We have 24/7 residential programme for these patients.This type of intensive treatment is usually reserved for people with medium or high levels of alcohol dependence, and particularly those who have received other forms of help previously that have not been successful.We have one of the best psycho-social-rehabilitation model for these patients. How alcohol misuse is treated depends on how much alcohol a person is drinking.

We divide this in two parts

A) Detox : -

Treatment of withdrawal once patient is admitted for alcohol deaddiction. Our strategy is to stop alcohol use completely & immediately & deal with withdrawal. We have all hospital facilities in house so we don’t need to send the patient to hospital for treating withdrawal as most deaddiction centres do. We have 24 hrs doctors & nurses in case of any emergency.
Withdrawal symptoms start with tremors, palpitations, restlessness, disturbed sleep then hallucinations or seeing images, confusion, delirium & convulsions if not treated properly. During detox you will be given plenty of fluids, IV or orally & replacement medicines like chlordiazepoxide, Lorazepam etc.

B) Rehab : -

  • A brief intervention lasts about 5 to 10 minutes. Advice to Keep a drinking diary, to record the units of alcohol you drink a week. Tips of social drinking such as alternating soft drinks with alcoholic drinks when you are out with friends
  • Cutting alcohol completely will have greater health benefits
  • However, moderation is often more realistic goal, or at least a first step on the way to abstinence

If you

  • Have Liver Cirrhosis.
  • Have medical problems like heart disease.
  • Previously been unsuccessful with moderation.
  • Severe work impairment.

Counselling : - we believe on motivational theory rather than engaging them in busy counselling programmes. We try to counsel the effects of alcohol on the client’s life & health. Alcohol is a disease & we have to treat it as a disease. It covers risk associated with client’s pattern of drinking, advice about reducing the amount you drink or complete abstinence.

Is based on the programme devised by AA. The difference is you work through the stages on a one to one basis with a counsellor, rather than in a group. The therapy may be your preferred treatment option if you feel uneasy or unwilling to discuss your problem in group setting

It is a talking therapy that uses a problem-solving approach to alcohol dependence.
The therapy involves identifying unhelpful, unrealistic thoughts & belief that may be contributing towards your alcohol dependence, such as
"I can’t relax without alcohol"
"My friends would find me boring if I was sober"
"Just drinking one pint can’t hurt"
Once these thoughts & beliefs are identified you will be encouraged to change your behaviour on more realistic & helpful thoughts such as,
"Lots of people have a good time without alcohol & I can be one of them"
"My friends like me for my personality, not for my drinking"
"I know I can’t stop drinking once I start"

CBT also helps you identify triggers & Prevent Relapse that can cause you to drink such as Stress, social anxiety, being in high risk environments such as pubs, clubs and restaurant.You will learn how to avoid certain triggers & cope effectively with those that are unavoidable

Alcohol dependence doesn’t just impact on an individual, it can also affect a whole family. Family therapy provides family members with the opportunity to learn about the nature of alcohol dependence & how to Support the member of the family who is trying to abstain from alcohol. Living with someone who misuses alcohol can be very stressful, so receiving support can be very helpful.

Yoga & meditation, Lectures, sharing & meetings.

Many people who have alcohol dependency problems find it useful to attend self-help groups such as Alcohol Anonymous(AA). One of the main belief behind AA is alcohol dependence is a long term, progressive illness & total abstinence is the only solution.
It’s a 12-step programme designed to help you overcome your addiction.


Medication

The Anti craving agents : -

  • Acamprosate: - It is used to prevent relapse in recently abstinent patient.
  • Acamprosate works by affecting GABA neurotransmitter which is responsible for craving
  • Naltrexone can be used to prevent a relapse or limit the amount of alcohol someone drinks. It works by blocking opioid receptors in the body, stopping the effects of alcohol
  • Baclofen
  • Topiramate

Antabuse treatment : - We also use Tb Disulfiram in willing patients who want to quit alcohol but unable to quit. Disulfiram can be used if you are trying to achieve abstinence but concerned with relapse, or if you have had relapses.
Disulfiram works by deterring you from drinking by causing unpleasant physical reaction if you drink alcohol like Nausea, vomiting, Chest pain, dizziness sometimes low BP etc.

Supportive medications : - We have to find out underlying psychological problem like bipolarity or personality & treat it accordingly which produces great effects on alcoholic’s life.
Usually treatment is advised with counselling for 6 months to 1 year after discharge from the centre.


Drinking Diary

If you are aiming to moderate your drinking it’s a good idea to keep a drinking diary
On daily basis, make a note of all the alcoholic drinks you’ve had.
What time you had them.
Where you were.
How many units you drank.

This will give you a good idea of how much alcohol you’re drinking, the situations in which you drink, & how you could start to cut down

Risk Limits

Alcohol Misuse means drinking excessively--- More than lower risk limits of ALCOHOL CONSUPTION

Lower risk limits : - 1 Unit of alcohol is 10 ml of Pure alcohol
Which means half pint of beer or A peg of 30ml of whisky or similar drinks

To keep your risk of alcohol harm low We advice Less than14 units of alcohol a week i.e. 14 small pegs of 30 ml If you want to drink 14 units, its best to spread evenly over the week over three or more day a week

If you want to reduce the amount of alcohol you drink, it’s good to have several alcohol-free days each week.

Regular drinking means drinking almost every day each week The risk to your health is increased by drinking any amount of alcohol on a regular basis

Short term effects of Alcohol

If you have a normal tolerance for alcohol & not dependent following are the effects of alcohol on body

1-2 units
After drinking 1-2 units of alcohol, your heart rate speeds up & your blood vessels expand, giving you the warm, sociable & talkative feeling associated with moderate drinking.

4-6 units
After drinking for to 6 units of alcohol, it begins to affect the part of your brain & nervous system, associated with your judgement & decision-making causing u to be more reckless & uninhibited.The alcohol also impairs the cells in the nervous system, making you feel light headed & adversely affecting your reaction time & co ordination

8to 9 units
After drinking 8-9 units of alcohol, your reaction time will be much slower, your speech will begin to slur & alter vision, that will lose focus.
Your liver which filters alcohol out of your body will be unable to remove all of the alcohol overnight, so it’s likely, u will wake up with a hangover.

10-12 units
After drinking 10-12 units of alcohol, your co-ordination will be highly impaired, placing u at serious risk of having an accident.
The high level of alcohol has a depressant effect on both mind & body, which makes u drowsy.
This amount of alcohol will begin to reach toxic levels, your body attempts to quickly pass out the alcohol in your urine, this will cause dehydration in morning which may cause severe headache. The excess amount of alcohol in your system can also upset your digestion leading to symptoms of nausea vomiting, diarrhoea & indigestion

More than 12 units: -
If you drink more than 12 units of alcohol, you are at considerable risk of developing alcohol poisoning, particularly if you are drinking may units over short period of time.
It usually takes the liver about an hour to remove one unit of alcohol from the body.
Alcohol poisoning occurs when excessive amount of alcohol starts to interfere with body’s automatic functions such as breathing, heart rate, gag reflex which prevents u choking. Alcohol poisoning can cause a person to fall into coma & could lead to their death

Kindling

Kindling is a problem that can occur following a number of episodes of withdrawal of alcohol. The severity of a person’s withdrawal symptoms may get worse each time they stop drinking & cause symptoms such as tremors, agitation, & convulsions.
Alcohol has a supressing effect on brain & nervous system. Research has shown that when alcohol has removed from body it activates brain & nervous system, resulting in excessive excitability, this can lead to behavioural symptoms such as seizures. With each alcohol withdrawal episode, the brain & nervous system becomes more sensitized & the resulting side effects become more pronounced.