Zaid Hjab
college of health and medical technology - baghdad/Physiotherapy and Rehabilitation Department
Alcohol is the most commonly abused substance in most parts of the world
and is associated with significant morbidity and mortality. While common in the
general population, alcohol use disorders are even more frequent in hospital
patients, including 25%–50% of medical-surgical patients and up to 50%–60% of
psychiatric inpatients in some settings. People who misuse alcohol are commonly
referred to as “alcoholic” by the lay public.
There are two to three men for each woman with an alcohol use disorder,
and the usual age at onset is between ages 16 and 30. Onset is earlier in men than
women, although the medical complications progress more rapidly in women.
People in certain occupations are prone to alcohol use disorder, including
bartenders, construction workers, and writers. Other groups prone to alcoholism
include individuals who use tobacco; those with mood and anxiety disorders; those
with antisocial personality disorder; and those with a gambling disorder.
Alcoholism has became the one of the leading cause for kidney and liver diseases. In India alcoholism is the root cause of poverty, unemployment, domestic conflicts, occupational disputes and deaths all together. Several Indian studies have shown the increased risk of suicide due to alcohol dependency. Thus it has became the global cause for depletion of human species all way round. Awareness, prevention, promotion, restoration and maintenance of health should be held up as essential base to work on for diverting the substance use/abuse and misuse and directing towards the sober community norms step by step to reduce intoxication, dependency, tolerance, conditioned learning and addiction as a whole.
A DSM 5 Update: Substance - Related And Addictive DisordersChat 2 Recovery
Within the next year, most insurance providers will be expecting all claims to include the new DSM-5 nomenclature. It is imperative for all mental health professionals to be comfortable with the new diagnostic criteria and recording procedures. This presentation provides participants with a clear understanding of the revisions made in the category of Substance - Related and Addictive Disorders from the DSM-IV to the DSM-5.
Topics presented by Nick Lessa, CEO of Inter-Care: an addiction treatment program in New York City.
Includes:
Changes in the diagnostic criteria from the DSM–IV to the DSM-5
The distinction between Substance Use Disorders and the Substance - Induced Disorders
Recording procedures for Substance Related Disorders
Zaid Hjab
college of health and medical technology - baghdad/Physiotherapy and Rehabilitation Department
Alcohol is the most commonly abused substance in most parts of the world
and is associated with significant morbidity and mortality. While common in the
general population, alcohol use disorders are even more frequent in hospital
patients, including 25%–50% of medical-surgical patients and up to 50%–60% of
psychiatric inpatients in some settings. People who misuse alcohol are commonly
referred to as “alcoholic” by the lay public.
There are two to three men for each woman with an alcohol use disorder,
and the usual age at onset is between ages 16 and 30. Onset is earlier in men than
women, although the medical complications progress more rapidly in women.
People in certain occupations are prone to alcohol use disorder, including
bartenders, construction workers, and writers. Other groups prone to alcoholism
include individuals who use tobacco; those with mood and anxiety disorders; those
with antisocial personality disorder; and those with a gambling disorder.
Alcoholism has became the one of the leading cause for kidney and liver diseases. In India alcoholism is the root cause of poverty, unemployment, domestic conflicts, occupational disputes and deaths all together. Several Indian studies have shown the increased risk of suicide due to alcohol dependency. Thus it has became the global cause for depletion of human species all way round. Awareness, prevention, promotion, restoration and maintenance of health should be held up as essential base to work on for diverting the substance use/abuse and misuse and directing towards the sober community norms step by step to reduce intoxication, dependency, tolerance, conditioned learning and addiction as a whole.
A DSM 5 Update: Substance - Related And Addictive DisordersChat 2 Recovery
Within the next year, most insurance providers will be expecting all claims to include the new DSM-5 nomenclature. It is imperative for all mental health professionals to be comfortable with the new diagnostic criteria and recording procedures. This presentation provides participants with a clear understanding of the revisions made in the category of Substance - Related and Addictive Disorders from the DSM-IV to the DSM-5.
Topics presented by Nick Lessa, CEO of Inter-Care: an addiction treatment program in New York City.
Includes:
Changes in the diagnostic criteria from the DSM–IV to the DSM-5
The distinction between Substance Use Disorders and the Substance - Induced Disorders
Recording procedures for Substance Related Disorders
objectives are understanding the scop of substance abuse in the elderly and realize the future implications of substance abuse in the baby bommer cohorot and understanding the definition of alcohol dependance and how to recognize them and much more
welcome to :
http://www.ethanolabuse.com
Substance Abuse in the Elderly: The Boomers Change Things Again RiverMend Health
Steven T. Dekosky M.D.-
Member, RiverMend Health Scientific Advisory Board for Addiction & Psychiatry. Professor of Neurology, Director, Alzheimer’s Disease Research Center, University of Virginia School of Medicine, Charlottesville, VA USA
Dr. DeKosky addresses the RiverMend Health Scientific Advisory Board on substance abuse in older generations and the growing need for treatment.
For more information visit: http://www.rivermendhealth.com/scientific-advisory-board-addiction.html
objectives are understanding the scop of substance abuse in the elderly and realize the future implications of substance abuse in the baby bommer cohorot and understanding the definition of alcohol dependance and how to recognize them and much more
welcome to :
http://www.ethanolabuse.com
Substance Abuse in the Elderly: The Boomers Change Things Again RiverMend Health
Steven T. Dekosky M.D.-
Member, RiverMend Health Scientific Advisory Board for Addiction & Psychiatry. Professor of Neurology, Director, Alzheimer’s Disease Research Center, University of Virginia School of Medicine, Charlottesville, VA USA
Dr. DeKosky addresses the RiverMend Health Scientific Advisory Board on substance abuse in older generations and the growing need for treatment.
For more information visit: http://www.rivermendhealth.com/scientific-advisory-board-addiction.html
Alcoholism Essay
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Closing the treatment gap in alcohol dependence thessalonika 2015Antoni Gual
Lecture on the treatment gap (underdiagnose & undertreatment) of alcohol use disorders. Presented at the 5th Conference of the Greek Psychiatric society in Thessalonika, march 21st, 2015.
Harm reduction is an approach to addiction treatment that offers an alternative to abstinence-based programs. Harm reduction operates on the idea that lives can be improved and perhaps saved by substituting a less-harmful substance for one that is more dangerous to the substance user and those around them.
With no lethal dose, and a variety of pain-relieving and possibly euphoric properties, cannabis can be a valuable harm reduction tool for those struggling with alcohol and drug dependencies. Learn more about the history, benefits and drawbacks of a harm reduction approach to addiction that views cannabis as a gateway to improved quality of life.
Haochuan Tang
Professor Xiuwu Liu
CHI 253
11/4/2019
Quotation:
Book: Hisa
Chapter 11: The Romance of The Three Kingdoms; Kuan Yu’s downfall and death
Page 48 line 8.
kuan yu's downfall and death are recounted in some of the finest chapters of the novel.an aging warrior, he is reaching the pinnacle of his fame but also exhibiting the most impossible haughtiness and folly.
Question:
What was the purpose of further developing the character even though he was willed with flaws such as his arrogance and irrationality? Acuity to the historical data would be sufficient in the development of Kuan Yu to the reader. The concept of developing a hero escapes the purpose of the narrative; however, it can be speculated that the concept of heroism according to Lo Kuan-chung relies on both historical and folk details.
Week 4: Administration Considerations for
Assessment Tools
Consider the following scenario:
Terrence is considering next steps for a client, Angela, who has come for
therapy at the family counseling center where he works. When Angela
scheduled her appointment on the telephone, she had described her
concerns with marital difficulties, insomnia, and depression. During her first
session, however, Terrence noticed that Angela had a very nervous
demeanor, picked at her skin constantly, and had a rasping cough. When
Terrence asked Angela about her employment, she admitted that she had
lost her job and that her husband was angry about it. She said she was
afraid her husband was on the brink of becoming abusive.
Terrence is not sure what to do first. He suspects Angela might have a
substance addiction, but clearly she has several interlocking problems, and
many are urgent. Should Terrence administer a screening for addiction or a
more general clinical assessment? If he does decide to administer an
addictions assessment, which of the many that are available should he
choose and why?
This week, you differentiate between the use of addictions assessment
tools and clinical assessment tools and review several assessment tools in
order to evaluate one of them.
Screening for
Alcohol Problems
What Makes a Test Effective?
Scott H. Stewart, M.D., and Gerard J. Connors, Ph.D.
Screening tests are useful in a variety of settings and contexts, but not all disorders are
amenable to screening. Alcohol use disorders (AUDs) and other drinking problems are a
major cause of morbidity and mortality and are prevalent in the population; effective
treatments are available, and patient outcome can be improved by early detection and
intervention. Therefore, the use of screening tests to identify people with or at risk for AUDs
can be beneficial. The characteristics of screening tests that influence their usefulness in
clinical settings include their validity, sensitivity, and specificity. Appropriately conducted
screening tests can help clinicians better predict the probability that individual patients do or
do not have ...
Alcohol Addiction Treatment - An Ultimate Guide to Overcome Your AddictionInspire Change Wellness
>> Psychological Conditions Depicting Alcohol Addiction.
>> Alcohol Addiction Treatment in 3 steps.
>> Alcohol Addiction Treatment through Group Therapies.
>> Social Life and Alcohol Addiction Treatment.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
1. “PEDRO RUIZ GALLO NATIONAL UNIVERSITY”
“HUMAN MEDICINE FACULTY”
MEDICAL ENGLISH
DIAGNOSIS, PREVENTION ANDMANAGEMENT OF
ALCOHOLISM
TEACHER :
STUDENTS :
2. LAMBAYEQUE - 2011
DIAGNOSIS
Social barriers
Social Attitudes and Stereotypes Can create Barriers to the detection and Treatment of Alcohol
abuse. This is more of a barrier for women Than Men. Fear of stigmatization May lead women to
deny That They Are Suffering from a medical condition, to hide Their drinking, and to drink
alone. This pattern, in turn, leads family, physicians, and Others to be less likely to suspect That a
woman is an alcoholic They Know. In contrast, fear of stigma Apr Reduced lead men to ADMIT That
They Are Suffering from a medical condition, to display Publicly Their drinking, and to drink in
groups. This pattern, in turn, leads family, physicians, and Others to be more likely to suspect That
a man They Know is an alcoholic.
Screening
Several May Be Used tools to detect a loss of control of alcohol-use. These tools are Mostly self-
reports in questionnaire form. Another common theme is a score or tally That sums up the general
severity of alcohol-use.
The CAGE questionnaire , named for STIs four questions, is one example Such That May Be Used
To Screen Patients Quickly in a doctor's office.
Two "yes" responses the respondent Indicate That Should Be Further
Investigate. ThequestionnaireAskstheFollowingquestions:
1. Have you ever Felt You Need To C ut down on your drinking?
2. Have you people A nnoyed by criticizing your drinking?
3. Have you ever Felt About G uilty drinking?
4. Have you ever needed a drink Felt you first thing in the morning (E ye-opener) to
steady your or to get rid Nerves of a hangover?
The CAGE questionnaire have a high Demonstrate Effectiveness in Detecting alcohol-related
Problems, howeve, it've Limitations in People with less severe alcohol-related Problems, white
women and college students.
3. Other tests are Sometimes Used for the detection of alcohol dependence, Such as the Alcohol
Dependence Data Questionnaire , Which is more sensitive diagnostic test to Than the CAGE
questionnaire . It Helps Distinguish a diagnosis of alcohol dependence from alcohol, one of heavy
use. The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely by
courts to determine Used the Appropriate sentencing for People Convicted of alcohol-related
Offenses, Driving Under the Influence Being the Most Common. The Alcohol Use Disorders
Identification Test (AUDIT) in screening questionnaire developed by the World Health Organization ,
is unique in That It Has Been Validated in Six Countries and is Used Internationally. Like the CAGE
questionnaire, it use a simple set of questions - a high score earning a Deeper
Investigation. The Paddington Alcohol Test (PAT) Designed to screen for WAS Alcohol related
Problems Amongst Those AttendingAccident and Emergency Departments . Well with the Concords
It AUDIT questionnaire is Administered But in a fifth of the time.
Genetic predisposition testing
Psychiatric geneticists John I. Nurnberger, Jr., and Laura Jean Bierut Suggest That does not
alcoholism Have A single genetic cause-Including-but genes do play an That important role "in the
Processes Affecting by body and brain That Interact with One Another and With An Individual's Life
Experiences to produce protection or susceptibility. " They Also Fewer Than That report a dozen
alcoholism-related genes Have Been Identified, But That more likely await discovery.
At least one genetic test exists for an allele That Is Correlated to alcoholism and opiate
addiction. Human dopamine receptor genes to detectable variation Have Referred to as the DRD2
TaqI polymorphism. Those Who Possess the A1 allele (variation) of This polymorphism Have A
Tendency Towards small but significant addiction to opiates and endorphin-releasing drugs like
alcohol. Although this allele is more common in alcoholics Slightly opiate addicts and, it is not by
Itself an Adequate predictor of alcoholism, and Some Researchers Argue That Evidence for DRD2
is contradictory.
DSM diagnosis
The DSM-IV diagnosis of alcohol dependence Represents one approach to the definition of
alcoholism. In part this is to assist in the Development of research protocols in Findings Which Can
Be Compared To One Another. According To the DSM-IV, an alcohol dependence diagnosis is:
... Alcohol Use with maladaptive impairment Clinically significant by at least manifeste as three of
the Following Within Any one-year period: tolerance, withdrawal, or taken over in Greater Amounts
Longer Than Intended time course, Desire or unsuccessful Attempts to cut down or control use;
great deal of Time Spent Obtaining, using, or Recovering from use, social, occupational, or
4. recreational Activities Given Up or reduced; continued use despite physical or Knowledge of
Psychological sequelae .
Urine and blood tests
There are reliable tests for the current use of alcohol, one common test of Being That blood alcohol
content (BAC). These tests do not differentiate alcoholics from non-alcoholics, howeve, long-term
heavy drinking does Have A Few recognizable effects on the body, Including:
Macrocytosis (enlarged MCV )
Elevated GGT
Moderate elevation of AST and ALT and an AST: ALT ratio of 2:1
High carbohydrate deficient transferrin (CDT)
Howeve, none of These blood tests for biological markers is as sensitive as screening
questionnaire.
PREVENTION
The World Health Organization , the European Union and other regional onesies, national
governments and Parliaments Have Policies in alcohol form order to reduce the harm of
alcoholism. Targeting teens and young adults is an important step Regarded as to reduce the harm
of alcohol-abuse. Increasing the age at licit drugs of abuse Which Such as Alcohol Can Be
Purchased, Banning or restricting the advertising of alcohol, as recommended Has Been Ways of
Reducing the additional harm of alcohol dependence and abuse. Credible, Evidence
Based Educational Campaigns in the mass media About the Consequences of Alcohol Abuse Have
Been recommended. Guidelines for Parents to Prevent Alcohol Abuse Amongst adolescents, and
for helping young People with Mental Health Problems Have Been Also Suggest.
MANAGEMENT
Because Varied Treatments There are multiple perspectives are of alcoholism. Those Who
approach alcoholism as a medical condition or disease recommend differing Treatments than, for
instance, approach the condition Those Who as one of social choice. Treatments Most people
focus on helping discontinue Their Alcohol intake, follow up with life training and / or social support
5. in order to help resist a return to Them Alcohol use. Since alcoholism Involves Multiple Factors
Which Encourage the person to continue drinking, They Must All Be Addressed in order to
successfully preventive relapse. An example of This Kind of Treatment is Followed by a
combination detoxification of Supportive therapy, Attendance at self-help groups, and Ongoing
Development of coping mechanisms. The Treatment for alcoholism Typically Supports community
an abstinence-based zero tolerance approach, howeve, Some prefer a harm-reduction approach.
Detoxification
Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol-drinking couple with the
substitution of drugs s, such as benzodiazepines , That Have similar effects to Prevent Alcohol
withdrawal . Individuals Who are at Risk of mild only to moderate withdrawal Symptoms Can Be
detoxifier as outpatients. Individuals at Risk of a severe withdrawal syndrome as well as Those Who
Have acute or significant comorbid Conditions Generally Treated as inpatients are. Detoxification
does not treat alcoholism Actually, and it is NECESSARY to follow-up With An Appropriate
Treatment detoxification program for alcohol dependence or abuse in order to reduce the Risk of
relapse.
Psychological
Various forms of group therapy or psychotherapy Can Be Used To Deal With That Underlying
Psychological issues are related to alcohol, addiction, as well as Provide relapse prevention
skills. The mutual-help group-counseling approach is one of the Most Common Ways of helping
alcoholics Maintain sobriety. Alcoholics Anonymous WAS one of the first Organizations Formed to
Provide Mutual, nonprofessional counseling, and it is still the largest. Others include LifeRing
Secular Recovery , SMART Recovery , Women For Sobriety , and Secular Organizations for
Sobriety .
Rationing and moderation Programs Such as Moderation Management do not and DrinkWise full
term abstinence. While most alcoholics are unable to limit their drinking in this way, some return to
moderate drinking. A 2002 US study by the National Institute on Alcohol Abuse and
Alcoholism (NIAAA) showed that 17.7 percent of individuals diagnosed as alcohol dependent more
than one year prior returned to low-risk drinking. This group, however, showed fewer initial
6. symptoms of dependency. A follow-up study, using the same subjects that were judged to be in
remission in 2001–2002, examined the rates of return to problem drinking in 2004–2005. The
estudy found abstinence from alcohol was the most stable form of remission for recovering
alcoholics. A long-term (60 year) follow-up of two groups of alcoholic men concluded that "return to
controlled drinking rarely persisted for much more than a decade without relapse or evolution into
abstinence."
Medications
A variety of medications may be prescribed as part of treatment for alcoholism.
Disulfiram (Antabuse) prevents the elimination of acetaldehyde , a chemical the body
produces when breaking down ethanol. Acetaldehyde itself is the cause of
many hangover symptoms from alcohol use. The overall effect is severe discomfort when
alcohol is ingested: an extremely fast-acting and long-lasting uncomfortable hangover. This
discourages an alcoholic from drinking in significant amounts while they take the medicine.
A recent nine-year study found that incorporation of supervised disulfiram and the related
compound carbimide into a comprehensive treatment program resulted in an abstinence
rate of over 50 percent.
Calcium carbimide (Temposil) works in the same way as Antabuse; it has an advantage in
that the occasional adverse effects of disulfiram, hepatotoxicity and drowsiness, do not
occur with calcium carbimide.
Naltrexone is a competitive antagonist for opioid receptors, effectively blocking the effects
of endorphins and opiates . Naltrexone is used to decrease cravings for alcohol and
encourage abstinence. Alcohol causes the body to release endorphins, which in turn
release dopamine and activate the reward pathways; hence when naltrexone is in the body
there is a reduction in the pleasurable effects from consuming alcohol. Naltrexone is also
used in an alcoholism treatment method called the Sinclair Method , which treats patients
through a combination of Naltrexone and continued drinking.
Acamprosate (Campral) stabilises the brain chemistry that is altered due to alcohol
dependence via antagonising the actions of glutamate , a neurotransmitter which is
hyperactive in the post-withdrawal phase. A 2010 review of medical studies demonstrated
that acamprosate reduces the incidence of relapse amongst alcohol dependent persons.
A study of a large number (>27,000) of alcohol dependence-related insurance claims suggested
that healthcare utilization, such as the number of inpatient detoxification days, alcoholism-related
inpatient days, and alcoholism-related emergency department visits was significantly reduced in the
7. patient population receiving alcoholism medications (naltrexone, naltrexone XR [an injectable
sustained-release form of naltrexone], disulfiram [Antabuse], acomprosate) when compared to the
patient population that did not take any medications.
Benzodiazepines , whilst useful in the management of acute alcohol withdrawal, if used
long-term cause a worse outcome in alcoholism. Alcoholics on chronic benzodiazepines
have a lower rate of achieving abstinence from alcohol than those not taking
benzodiazepines. This class of drugs is commonly prescribed to alcoholics for insomnia or
anxiety management. Initiating prescriptions of benzodiazepines or sedative-hypnotics in
individuals in recovery has a high rate of relapse with one author reporting more than a
quarter of people relapsed after being prescribed sedative-hypnotics. Those who are long-
term users of benzodiazepines should not be withdrawn rapidly, as severe anxiety and
panic may develop, which are known risk factors for relapse into alcohol abuse. Taper
regimes of 6–12 months have been found to be the most successful, with reduced intensity
of withdrawal.
Dual addictions
Alcoholics may also require treatment for other psychotropic drug addictions. The most common
dual addiction in alcohol dependence is benzodiazepine dependence , with studies showing 10–20
percent of alcohol-dependent individuals had problems of dependence and/or misuse problems of
benzodiazepines. Benzodiazepines increase cravings for alcohol and the volume of alcohol
consumed by problem drinkers. Benzodiazepine dependency requires careful reduction in dosage
to avoid benzodiazepine withdrawal syndrome and other health consequences.
Dependence on other sedative hypnotics such as zolpidem and zopiclone as well as opiates and
illegal drugs is common in alcoholics.
Alcohol itself is a sedative-hypnotic and is cross-tolerant with other sedative-hypnotics such
as barbiturates , benzodiazepines and nonbenzodiazepines . Dependence upon and withdrawal
from sedative hypnotics can be medically severe and, as with alcohol withdrawal, there is a risk
of psychosis or seizures if not managed properly.