Alcohol and its effect handout

ALCOHOL AND ITS EFFECT
MENTAL HEALTH NURSING
COHORT 09TH
MARCH 2015
6TH
FEBRUARY 2018

alcohol and its effect
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ALCOHOL AND ITS EFFECT
This project is submitted for the partial fulfillment of programme of studies of the
national diploma in nursing
Central school of nursing
Victoria hospital
Candos , Quatre-bornes
AUTHORS NAME: -SHAILEND SINGH SUMMAH, RAJJOO DANIRAO, SHAMTALLY TANWIR, ROSOOL
S.M. YASINE. GIRISH SAURTY
GROUP 1
MODULE NAME: - mental health nursing
COHORT: - 09TH
MARCH 2015

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TABLE OF CONTENT
Abstract……………………………………………………………………………………. page 3
Introduction ……………………………………………………………………………. page 4
Definition of alcohol……………………………………………………………………. page 5
Definition of alcoholism………………………………………………………………......page 5
Difference between alcohol abuse and alcoholism................................page 5
The causes of alcohol abuse...................................................................page 6
The process of development of alcoholism...........................................page 7
The disease goes through distinct stage- early stage.............................page 8
The disease goes through distinct stage-middle stage.........................page 9
The disease goes through distinct stage –chronic stage.......................page 10
Physical complications of alcoholism..................................................page11
Psychiatric complications of alcoholism-short term..............................page 12
Psychiatric complications of alcoholism-long term...............................page 13
Social complications of alcoholism...................................................page 14
General management of alcoholism.................................................page 15
Medical and pharmacological management........................................page 16
Nursing management of alcoholism.....................................................page 17
Important goals in the management of alcoholism............................page 18
Prevention of alcoholism................................................................page 19
Health promotion...............................................................................page 20
Alcohol and its effect-conclusion .......................................................page21
References.........................................................................................page 22

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ABSTRACT
Alcohol beverages are widely used in many societies because of which their abuse potential
is often underestimated. Commonly used alcohol preparations are beer, wine, brandy, whisky,
rum, gin, arrack and toddy.
Alcohol is an intoxicating substance. The active ingredient in drinks containing alcohol is
ethanol. This is produced through the fermentation of grains, vegetables and fruits, which
changes sugars into ethanol. In its purest form, alcohol is colorless and has no taste. It is only
during the manufacturing process (when other ingredients are added to the ethanol) that
alcoholic drinks begin to vary in taste, smell and colour.
Often, alcohol is mistaken as a stimulant drug. This is because its consumption may initially
cause the drinker to feel relaxed or even excited, depending on the social situation they are in
and other environmental factors. For these reasons, alcohol is the most commonly used
mood-changing drug in the world. However, alcohol is actually a depressant drug. When
consumed, it depresses the actions of the central nervous system, including heart rate and
breathing rate. Concentration, coordination, balance and judgement are also adversely
impacted.
Alcoholism is the most common psychiatric disorder. Epidemiological surveys carried out in
Mauritius reveal that 20 to 40 percent of subjects aged above 15 years old are current users of
alcohol and nearly, 10 percent are nearly, 10 percent of them are regular or excessive users.
Nearly 15 to 30 percent of patients seeking admission in psychiatric facilities are alcohol-
related problems. Among the acute medical admissions in a general hospital, 10 to 20 percent
are due to alcohol –related problems.

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INTRODUCTION
The intensity of the effect of alcohol on the body is directly related to the amount consumed.
Individual reactions to alcohol vary, and are influenced by many factors; such as: age,
Gender, Race or ethnicity, Physical condition (weight, fitness level).
Amount of food consumed before drinking, how quickly the alcohol was consumed.
.
The harmful use of alcohol results in 2.5 million deaths each year.
320 000 young people between the age of 15 and 29 die from alcohol-related causes,
resulting in 9% of all deaths in that age group. Alcohol is associated with many serious social
and developmental issues, including violence, child neglect and abuse, and absenteeism in the
workplace.

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DEFINITION OFALCOHOL
Alcohol is a depressant, it will be considered separately due to the complex effects
and widespread nature of its use.
DEFINITION OFALCOHOLISM
Alcoholism is defined as a chronic disease manifested by repeated drinking that
produces injury to the drinker’s health or to his social or economic functioning.
Difference between alcohol abuse and alcoholism
Alcohol abuse is a pattern of drinking that results in harm to one’s health,
interpersonal relationships, or ability to work.
Dependency on alcohol, also known as alcohol addiction and alcoholism, is a chronic
disease.

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THE CAUSES OF ALCOHOL ABUSE
Availability: alcohol is easily available and its consumption is an accepted social
norm
Genetic factors: Some chronic drinkers have a family history of binge drinkers.
Biochemical factors: abnormalities in alcohol dehydrogenase or in the
neurotransmitter mechanisms suggested proneness toward alcoholism.
Learned behavior: learning process may contribute to the development of alcohol
abuse and dependence. E.g. children tend to follow their parents’ drinking pattern.
Personality factors: drinking alcohol is most common among antisocial personalities.
Poor coping strategies: person unable to face stress often resort to alcoholism.
Psychiatric disorders: person with depressive disorders take alcohol to alleviate low
mood.
Social causes: isolation, unemployment, loss, injustice and other social causes.
High risks groups: persons suffering from chronic physical illness, business
executives, traveling salespersons, industrial workers, urban slum dwellers, students
in hostels, military personnel are more prone to develop alcoholism

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The process of development of alcoholism
Experimental: individuals start drinking alcohol due to peer pressure and
curiosity
Recreational: -whenever an individual attends a functions like marriages,
parties, conferences.
Relaxation: individuals consume alcohol on holidays and weekends,
which gradually ends to alcoholism
Compulsive: some person starts drinking heavily for a period of time for
pleasure or to avoid discomfort of withdrawal symptoms

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The disease goes through distinct Stage-Early stage
(the process of development of alcoholism)
Increased tolerance –gradual increase in alcohol intake to experience the
same pleasure as experienced earlier.
Blackouts-unable to recollect or recalled memory when the latter was
under the influenced of alcohol.
Preoccupation- always thinking about drinking alcohol

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The disease goes through distinct stage- Middle stage
Loss of control over amount, time and occasion of drinking
Difficulty from refraining of taking alcohol after long time
Obsessive about drinking alcohol
Tendency toward binge drinking

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The disease goes through distinct stage- chronic stage
Getting drunk even on small amounts of alcohol.
Willing to lie, beg, borrow or steal to maintain supply of alcohol
Living to drink-alcohol takes priority over family or job

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physical complications of alcoholism
Gastrointestinal: dyspepsia, vomiting, acute or chronic gastritis, peptic
ulcer, cancer
Liver: fatty degeneration of the liver, alcoholic hepatitis, cirrhosis
Pancreas: acute & chronic pancreatitis
Cardiovascular: alcoholic cardiomyopathy, high risk for myocardial
infarction
Blood: folic acid deficiency anaemia, decreased white blood cell
production
Muscle: peripheral muscle weakness, wasting of muscles
Skin: spider angiomas, acne
Nutrition: protein malnutrition, vitamin deficiency disorders like pellagra
& beriberi
Joints: gout due to increase uric acid level
Reproductive system: sexual dysfunction in males, failure in ovulation in
females
Pregnancy: fetal abnormalities
Nervous system: alcoholic peripheral neuropathy, Wernicke’s-korsakoff
syndrome, rum fits during withdrawal

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PSYCHIATRIC COMPLICATIONS OF ALCOHOLISM-short term
Pathological intoxication: maladaptive behavioural effects, such as
fighting, impaired judgment
Physiological signs: slurred speech, incoordination, and unsteady gait
Psychological changes: mood changes, irritability, and impaired attention.
Withdrawal symptoms: tremor, nausea, vomiting, malaise, tachycardia,
elevated blood pressure, irritability, anorexia, insomnia, fits.
Delirium tremens: complicated withdrawal state, an acute organic mental
disorder treated as a psychiatric disorder with signs and symptoms of
clouding of consciousness and confusion, vivid visual hallucinations and
illusions, marked tremor and fever, delusion, agitation, increased ANS
activities.

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PSYCHIATRIC COMPLICATIONS OF ALCOHOLISM-LONG TERM
Alcoholic hallucinosis –vivid hallucination developing shortly after
cessation or reduction of alcohol
Alcoholic psychosis: paranoid schizophrenia with clinical patterns like
behavioural problem, thought disturbance, delusions and impairment of
primary mental functions
Morbid jealousy (orthello syndrome): a paranoid disorder with
predominant delusion of infidelity of spouse.
Alcoholism and depression: these are more prone to depression.
Alcoholism and criminality: alcohol reduces inhibition and increases
hostile behaviour.
Alcoholism and sex: - it increases sexual desire, but reduces libido
Alcohol amnestic disorder: impairment in short and long term memory
with disorientation & confabulation.
Alcoholic dementia: a chronic organic mental disorder, irreversible
impairment in memory, orientation, impulse control, ability to solve
problems.

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social complications of alcoholism
Work problems: decreased work performance, decreased productivity due to chronic
absences.
Family problems: loss of job, loss of income will make condition of the family
miserable.
Reversed role model: bread winner becomes alcoholic and the wife takes the role of
earning money.
Marital disharmony: frequent dispute and socioeconomic issues
Drunken driving: will lead to accidents

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General management of alcoholism
Assessment of the patient: his drinking pattern, work spot, family, environment
Physical method: detoxification, disulfiram therapy
Psychological methods: counselling, individual and group psychotherapy, military
and family therapy, behavioural modification, relapse prevention therapy
Rehabilitation
Alcoholic anonymous

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Medical and pharmacological management
Detoxification: alcohol dependent recovers from the intoxicating effect of alcohol.
Administration of minor tranquilizers (diazepam): to control anxiety, insomnia,
agitation and tremors.
Hydration: IV fluids is administered to correct fluid and electrolyte imbalance.
Nutrition: re –establish proper nutrition by giving a diet high in protein, carbohydrate,
vitamins C and vitamins b complex
Disulfiram (Antabuse) therapy: this drug produces intense headaches, severe flushing,
extreme nausea, vomiting, palpitations, hypotension, dyspnea and blurred vision.
Aversion therapy: patient is subjected to pain- inducing stimuli at the time of drinking
to establish alcohol rejection behaviour.

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NURSING MANAGEMENT OF ALCOHOLISM
Patients is kept in a quiet environment to avoid excessive stimuli leading to increase
patient’s agitation.
Ensure safety of patients-observe and monitor behaviour of patient
Observe any sign of developing delirium tremens (DT)
Side rails and bed barrier are placed when patient is in bed.
Restrained patient if he/ she is hyperactive
Keep potentially harmful object out of reached of patients.
Ensure cleanliness, wrinkled free bed for incontinent patient
Monitor vital signs every 15 minutes initially
Orient patient to time, space and surroundings

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Important goals in the management of alcoholism
Improving social relationship and supports
Developing confidence and ability to change
Identifying reasons to change
Developing alternative activities
Learning to prevent relapse

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Prevention of alcoholism
Educational approach: programs for children, risk group, electronic media
legal approach: control production and sale, raising prices and taxes, raising minimum
age, ban advertisement
low use of alcohol content
Improve mental health and coping mechanism to stress
Parents to be role model to their children.

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HEALTH PROMOTION
Although people must assume personal responsibility for maintaining their health,
there is wide recognition that environmental cues and reinforcers exert an important
influence on behavioural choices and outcomes.
Drinking behaviour is shaped by individual choices and motivation, and also strongly
influenced by organizational, economic, environmental & social factors.
Therefore, approaches that attempt to bring about change in drinking behaviour
through education alone are likely to have limited no success, whereas those that
combine educational with other behavioural, environmental, policy and organizational
changes are likely to be the most effective.

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Alcohol and its effect- conclusion
About 4% of the global burden of disease is attributed to alcohol.
Contributes to 3.2% of deaths of the disability-adjusted life years lost.
Of the 2 billion alcohol consumers worldwide, over 76 million have been diagnosed
with alcohol use disorders.
Despite the scope of alcohol related problems globally and the difficulty in preventing
them, there is increasing evidence of effectiveness of some prevention strategies,
especially those aimed at reducing alcohol –related injuries.

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REFENRENCES
AIHW. Australian Institute of Health and Welfare. 1999, 1998 National drug strategy
household survey: First results, AIHW, Canberra
Babor, T, Caetano, R, Casswell, S, Edwards, G, Giesbrecht, N, Graham, K, Grube, J,
Gruenewald, P, Hill, L, Holder, H, Homel, R, Osterberg, E, Rehm, J, Room, R & Rossow,
I. 2003, Alcohol: No ordinary commodity – research and public policy, Oxford
University Press, Oxford.
Cohen, D, Mason, K & Scriber, R. 2001, “The population consumption model, alcohol
control practices, and alcohol-related traffic fatalities”, Prev. Med., vol. 34, pp. 187–197.
Daly, J, Campbell, E, Wiggers, J & Considine, R. 2002, “Prevalence of responsible
hospitality policies in licensed premises that are associated with alcohol related harm”,
Drug Alc. Rev., vol. 21, pp. 113–120
Elder, R, Shults, R, Sleet, D, Nichols, J, Thompson, R, Rajab, W & Services. 2004,
“Effectiveness of mass media campaigns for reducing drinking and driving and
alcoholinvolved crashes: A systematic review”, Am. J. Prev. Med., vol. 27, no. 1, pp. 57–65.
Foxcroft, D, Ireland, D, Lister-Sharp, D, Lowe, G & Breen, R. 2003, Primary prevention
for alcohol misuse in young people, The Cochrane Library, Oxford.
Psychiatry for nurses First edition: 1998 ISBN 978-93-5152-379-6

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