Document Sample
  Presented By Dr. O. Omekara
 Consultant Medical Content Writer
     Droomekara Consulting
        Portland Oregon
          May 29, 2012
     What is alcohol abuse?
Alcohol abuse, also known as alcohol use disorder or
  alcoholism, is the consumption of alcohol in such a
  way, and to such an extent that it causes distress or
  harm to individuals and people around them. It
  makes people incapable of fulfilling their major
  responsibilities at home, school or work. They drink in
  dangerous situations like while driving and or
  operating machinery. Their lives are complicated by
  alcohol related legal problems like arrests for DUI or
  physical assaults while intoxicated, or frequent family
     Why Alcohol Abuse Is A Healthcare
• Causes 2.5 million Deaths (4% total) yearly worldwide
• # 1 Risk factor for death among men aged 15 - 59
• # 1 Risk factor for disease and disability in 2nd and 3rd
  world nations; # 3 in developed countries
• # 1 cause of accidental and unintended injuries
• Causes risky behaviors - DUI , STDs, suicides
• Costs millions of dollars in hospitalizations for
• Costs millions of dollars in jail services
• Costs millions of dollars in rehabilitation care
• Makes alcoholics chronically ill and unproductive
• Causes a lot of social and relationship problems
• Contributes to the causation of up to 200 other diseases
 Global Picture Of Alcohol Abuse
• 4 % Total Global Death (6.2%M for Males and
  1.1% for Females)
• More alcohol consumption in developed
  countries but lower alcohol abuse rate
• 4:1 ratio for Men and Women alcoholics
• More alcohol abuse among low income and
  low status populations
• 7.4 % Adult Males and 1.4 % Adult Females
  abuse alcohol
• 11.5 % alcoholics are binge drinkers
• Spirit (45% total) - most consumed alcoholic
  beverages, mostly in Asia and Europe
 Picture of Alcohol Abuse In USA
• 50.9 % Adults over 18 years drink
  alcohol regularly (South 47%, West
  52%, Midwest and NE 54%)
• 24,518 attributable deaths per year
• 15183 alcoholic liver disease deaths/yr
• 5,000 people < 21 years die from
  underage drinking related accidents,
  homicide, and suicides yearly
• More teenagers killed by alcohol abuse
  than all illegal drugs combined
  Risk Factors for Alcohol Abuse
• Availability of money for alcohol purchase
• Family history – genetic predisposition
• Race – More white males drink alcohol, but
  more African American and Hispanic males
  tend to end up with alcohol abuse
• Sex – Men are 4 x more likely to abuse
  alcohol than women
• Exposure – socially or occupationally
  increases risk
• Cigarette smoking – Drinking and smoking
  tend to go together
  Recommended Normal Alcohol
• One standard alcohol drink = 14gm (o.6
  ounces) of pure alcohol contained in 12 ounces
  of beer, 8 ounces of malt liquor, 5 ounces of
  wine or 1.5 ounces of 80% spirit.
• Maximum of 1 drink a day recommended for
• Maximum of 2 drinks a day recommended for
• Moderate alcohol consumption has its benefits
  including protection against coronary heart
       Levels of Alcohol Abuse

• Mild – Women: 1-2 drinks daily and Men: 2-
  3 drinks daily
• Moderate – Women: 2-3 drinks daily and
  Men: 4-5 drinks daily
• Severe – Women: More than 4 drinks daily
  and Men: more than 6 drinks daily
     Biochemical Basis of Alcohol
• Not well understood.
• Alcohol is known to elevate mood and suppress mental
• Mood elevation is known to be related to blood levels of
  dopamine and other neurotransmitters
• Alcohol craving could be related to low levels of these
• Craving could also be due to reinforcement of pleasurable
  feelings by social cues like favorite bars or television ads.
• Current research studies indicate that heavy drinking or
  alcohol abuse involves craving sensation created by a
  complex interaction of genes, hormones and other
  biochemical substances, inside the body cells.
• This accounts also for physical and psychological alcohol
Intoxication Susceptibility Factors
•   Age, race, gender, and body weight, fitness
•   Empty or full stomach
•   Drinking speed
•   Genetic or family predisposition
•   Current use of prescription drugs
•   Short or long term alcohol use (tolerance
    develops over time)
   Other Risk factors Boosted by
          Alcohol Abuse
• Drinking increases with drinking and makes a
  person more likely to have lung cancer
• Drinking increase risky sexual behaviors leading
  to increased STDs and HIV/AIDS
• Drinking increasing the rate of suicide attempts
• Drinking increases the risk of respiratory
  depression and aspiration pneumonia
• Drinking increases the risk of malnutrition and
 Legal Limits for Alcohol
• Age Limit in the US is 21 years
• Maximum Blood Alcohol Level for
  driving or operating machinery is
  0.08% or 80mg/100ml.
• Zero blood alcohol level for under
  21 drivers
        Stages of Intoxication
• Tipsiness - disinherited, talkative, highly
  sociable, flirtatious and vulnerable to risky
  behaviors like unprotected sex and violence.
• Drunkenness - drowsy, disoriented,
  incapable of maintaining balance, weak and
  slow in both movement and speech
• Stupor - semiconscious or delirious, drifting in
  and out of consciousness
• Coma - passes out completely, and unable to
  respond to painful stimuli.
• Death - no evidence of heart , lung or brain
  activity detectable by a physician
    Indicators of Possible Alcohol
•   Troubled relationships
•   Frequent infractions with the law
•   Frequent social frictions
•   Abnormal thoughts and feelings
•   Deterioration in health and grooming
•   Deterioration in job performance
•   Deterioration in personal finances
      Treatment of Alcohol Abuse

• Antabuse – Destroys appetite for alcohol
• Naltrexone – Disrupts the craving metabolic
• Acamprosate – Also disrupts the craving
  metabolic pathway
• Psychotherapy and Behavior therapy – Help
  the abuser to take control of risk factors
• Supportive treatments in rehab facilities
    Other Diseases Attributable to
           Alcohol Abuse
• Alcoholic withdrawal syndrome
• Liver fibrosis and cirrhosis, hepatitis, fatty liver
• Fetal alcoholic spectrum disorders
• Sudden infant death syndrome
• Pancreatitis, Gastritis
• Dilated cardiomyopathy and cardiac
• Hypertension and stroke
• Various cancers - liver (hepatoma), mouth,
  esophagus, throat, and breast.
• Depressed Immune System due to reduced
  immunoglobin production by a weakened liver
    Prevention of Alcohol Abuse
• Awareness of dangers of alcohol abuse
• Identification and voidance of risk factors
• Consult with personal health care provider at
  the earliest suspicion of alcohol abuse
• Avoiding large stock of alcohol at home
• Avoiding social groups that encourage binge
• Avoiding occupational exposure if there is a
  family history of alcohol abuse
    Long-term Outlook of Alcohol
• Alcohol abuse is a treatable life time disease
• Has about 15 % 10 year survival rate
• Amenable to good quality of life with
  supervised treatment
• Untreated alcohol abuse causes a people to
  spend greater of their lives in jail or rehab
• Most untreated alcoholics end up homeless
      Alcohol Abuse Intervention

• Mostly by family, friends and coworkers
• Police intervention when the law is broken
• Health care provider intervenes when the
  person gets delusional and paranoid
• Stranger intervention occurs when drinking
  causes accidents and injuries to total
• Employers intervene when work place
  violence occurs

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