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Medical Aspects of Addiction and Co-Occurring Disorders6 Hours Instructor: Dr. Dawn-Elise Snipes Ph.D., LMHC, CRC Executive Director, AllCEUs.com
Identify medical aspects of addiction and co-occurring disorders to include neurochemical imbalances, hepatitis, tuberculosis and HIV  Discuss physiological problems and negative side effects caused by different substances of abuse  Discuss methods of pain management for persons with addictive and co-occurring disorders.  Learner Objectives
Schizophrenia  Caused by impairment of dopamine-containing neurons in the brain  Medications block dopamine receptors in the brain, such as chlorpromazine and clozapine Depression  Depression is treated with drugs that affect norepinephrine and serotonin.  SSRIs inhibit the re-uptake of serotonin, increasing neurotransmitter action.  Increased serotonin activity alleviates depressive symptoms.  Neurochemicals and Mental Health
Alzheimer's disease  Seems to be caused by a loss of cells that secrete acetylcholine  Some medications to alleviate the symptoms have been developed, but there is no known treatment Generalized anxiety disorder  GAD involves several neurotransmitter systems in the brain, including norepinephrine and serotonin. Attention-deficit/hyperactivity disorder  Dopamine and norepinephrine imbalances are strongly implicated in causing ADHD.  Mental Health cont…
Drug Related Neurochemical Imbalances Serotonin (emotion, motivation) GABA (inhibition) Dopamine (pleasure, reward) Norepinepherine
Medical Aspects and Health Problems Associated with Alcoholism and Drug Abuse Pancreatitis Gastritis  Duodenal Ulcer Cancer of the Esophagus Alcoholic Hepatitis Cirrhosis of the Liver  Varicose Veins of the Esophagus Delirium Tremens  Neuritis Impotence More…
Pancreatitis The pancreas is a small organ lying in the uppermost portion of the abdomen It produces insulin and the digestive enzymes vital to life.   Inflammation of the pancreas causes severe abdominal pain, nausea, and vomiting.  Alcohol is poisonous.
Gastrititis Heavy drinking is the most common cause of serious inflammation of the lining of the stomach.   The mucosa becomes reddened, with bleeding in areas covered with thick, ropy mucus.   Symptoms include nausea, vomiting, headache, and stomach pains.
Duodenal Ulcers The duodenum is the first part of the small intestine. Ulcers develop here due to irritation from stuff coming out of the stomach. Bleeding, obstruction, and perforation may be fatal complications.
Esophageal Cancer An unknown chemical quality in alcoholic beverage causes alcoholics to have a far greater chance of developing cancer of the esophagus. Cancer causes difficulty in swallowing and a sensation of blockage behind the sternum.
Varicose Veins in the Esophagus Cirrhosis of the liver produces a secondary increase in blood pressure in the veins of the esophagus – the food tube leading from the throat to the stomach.   Death from internal hemorrhaging may occur if ballooned-out veins rupture.
Delirium Tremens The DT’s begin with tremors, sweating, and nausea, and progress to insomnia, profound confusion, delusions, hallucinations, and convulsions.   This serious complication may be fatal for about 10% of its victims.
Neuritis Prolonged intake of alcohol has a direct, poisonous effect on the nerves in the arms and legs.   Symptoms include tingling, the sensation of pins and needles, itching, numbness, weakness, and paralysis.
Impotence Alcohol is one of the most common causes of impotency.  In acute alcoholism, impotency may be caused by the depressant effect of the drug.   In chronic alcoholism, impotency may be caused by neuritis, liver damage, malnutrition, or other complications.
AIDS Intravenous (IV) drug users risk exposure to the AIDS virus when they use or share contaminated needles.   IV drug users form the group with the fastest growing number of persons with AIDS (PWAs).
ALCOHOL-INDUCED LIVER DISEASE (ALD) The three main types of ALD are fatty liver, alcoholic hepatitis and alcoholic cirrhosis.  Fatty liver is the buildup of fat inside the liver cells which leads to enlargement of the liver and abdominal pain.  Alcoholic hepatitis is severe liver inflammation where liver cells are destroyed causing scarring, tenderness and enlargement Alcoholic cirrhosis: scar tissue develops, hampering the flow of blood to the liver.  Liver Issues
HEPATITIS C Hepatitis is an inflammation of the liver caused by a virus, alcohol, medications that have a harmful effect on the liver, toxins or autoimmune disorders. There are 7 known types of hepatitis: A, B, C, D, E, F and G.  Hepatitis C may be the leading cause of chronic liver disease in the western world.  Hepatitis
How hepatitis is transmitted I.V. drug use Needle stick injuries Body piercing or electrolysis Sharing personal care items like toothbrushes, nail clippers or files, razors, and other household items that have blood on them Intranasal cocaine use through shared use of straws may lead to blood to blood contact through nasal ulcers or cuts and scrapes. Sexual activity that results in blood to blood contact
Cirrhosis Cirrhosis is the seventh leading cause of death in America Alcohol is the leading cause of cirrhosis.  Symptoms include loss of weight, chronic nausea, vomiting, weakness, loss of sex drive, abdominal pains, bloating of the abdomen, and bleeding.
Serum Hepatitis Hepatitis one of the most common problems in heroin addicts.   It is caused by a virus which is transmitted through contaminated needles.   Hepatitis causes weakness, loss of appetite, tenderness in the abdomen, dark-colored urine, and a yellowish change in the color of the skin and whites of the eyes.
Alcoholic Hepatitis Symptoms: fever, jaundice, swelling in the abdomen, and swelling of the feet.   The liver is large, firm, tender, and infiltrated with fat.   Many patients die, and others go on to develop cirrhosis of the liver.
Brain Abscess When germs are injected into the bloodstream from an unsterile  needle, they may travel through the body and lodge in the brain.  In this illustration, note the ragged, abscessed cavity filled with pus.   High fever, convulsions, coma, and death are signs of a brain abscess.
Wernicke-Korsakoffsyndrome Caused by long-term alcoholism  Triad of symptoms:  mental disturbance confusion, drowsiness and paralysis of eye movements ataxia or a staggering gait. Due to thiamine (vitamin B1) deficiency due to severe malnutrition and poor intestinal absorption of food and vitamins caused by alcohol Wet Brain
DRUG SMOKING &LUNG INFECTIONS Tobacco, marijuana, or crack cocaine increases the user’s risk of  bacterial pneumonia Bronchitis asthma Smoking anything appears to paralyze the cilia which are hair-like projections in the lungs that sweep out microbes and other matter that may cause disease. Smoking cocaine appears to weaken the lungs’ natural resistance to infection.
“Crack hack” produces black or bloody phlegm. They can also inhale small bits of metal from the use of a screen or brillo pad for smoking drugs. Thermal burns to the nasal passages and the throat may go unnoticed due to the anesthetizing effects of cocaine and crack. Cocaine may burn holes through the septum and burn away the mucous membranes in the nostrils, leading to staph infections in the nostrils which can spread to the sinuses and possibly the brain. Lung issues cont…
Bacterial Endocarditis Germs from an unclean needle, they may spread throughout the body and lodge in the valves of the heart, causing bacterial endocarditis.   The warty-like growths seen on these heart valves produce symptoms of fever, weakness, heart failure, and death.
Blood Clots When an addict’s veins are repeatedly punctured, particularly by unsterile needles, blood clots and scarring may occur within the veins.
Faces to remember Methamphetamine: Don’t be fool!!!
Methamphetamine Faces
Methamphetamine Effects Disrupt sleeping patterns, suppresses appetite, and causes irritability/aggression
More Impact from Alcohol abuse and Drug use
Suicide Suicide is the tenth leading cause of death in America and the third leading cause of death in people below the age of 30.   Alcohol is a factor in more than 60% of all suicide attempts.
Birth Defects Alcohol passes through the bloodstream of the mother into the uterus and placenta and directly into the unborn child.   Children are underweight,  their brain size is less than normal Their hearts may not be completely developed hey may have a cleft palate.  Continue to grow at a slow pace after birth and end up as smaller adults.
Child Abuse Approximately 1 in every 100 American children is physically, sexually or psychologically abused at least once.   Excessive drinking by the abuser is a major factor in a large majority of these cases.
Murder The twelfth leading cause of death in America The leading cause of death in people below the age of 30.   Alcohol is implicated in more than 70% of all murders and other violent crimes.
Alcohol Abuse and Drug use is the #1 social problem we face today. It causes a variety of health and social problems These problems have a financial impact for employers, healthcare, criminal justice,  foster care, individuals Many children who grow up in an addicted family become addicts themselves. Summary

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Medical aspects of addiction and co occurring disorders

  • 1. Medical Aspects of Addiction and Co-Occurring Disorders6 Hours Instructor: Dr. Dawn-Elise Snipes Ph.D., LMHC, CRC Executive Director, AllCEUs.com
  • 2. Identify medical aspects of addiction and co-occurring disorders to include neurochemical imbalances, hepatitis, tuberculosis and HIV Discuss physiological problems and negative side effects caused by different substances of abuse Discuss methods of pain management for persons with addictive and co-occurring disorders. Learner Objectives
  • 3. Schizophrenia Caused by impairment of dopamine-containing neurons in the brain Medications block dopamine receptors in the brain, such as chlorpromazine and clozapine Depression Depression is treated with drugs that affect norepinephrine and serotonin. SSRIs inhibit the re-uptake of serotonin, increasing neurotransmitter action. Increased serotonin activity alleviates depressive symptoms. Neurochemicals and Mental Health
  • 4. Alzheimer's disease Seems to be caused by a loss of cells that secrete acetylcholine Some medications to alleviate the symptoms have been developed, but there is no known treatment Generalized anxiety disorder GAD involves several neurotransmitter systems in the brain, including norepinephrine and serotonin. Attention-deficit/hyperactivity disorder Dopamine and norepinephrine imbalances are strongly implicated in causing ADHD. Mental Health cont…
  • 5. Drug Related Neurochemical Imbalances Serotonin (emotion, motivation) GABA (inhibition) Dopamine (pleasure, reward) Norepinepherine
  • 6. Medical Aspects and Health Problems Associated with Alcoholism and Drug Abuse Pancreatitis Gastritis Duodenal Ulcer Cancer of the Esophagus Alcoholic Hepatitis Cirrhosis of the Liver Varicose Veins of the Esophagus Delirium Tremens Neuritis Impotence More…
  • 7. Pancreatitis The pancreas is a small organ lying in the uppermost portion of the abdomen It produces insulin and the digestive enzymes vital to life. Inflammation of the pancreas causes severe abdominal pain, nausea, and vomiting. Alcohol is poisonous.
  • 8. Gastrititis Heavy drinking is the most common cause of serious inflammation of the lining of the stomach. The mucosa becomes reddened, with bleeding in areas covered with thick, ropy mucus. Symptoms include nausea, vomiting, headache, and stomach pains.
  • 9. Duodenal Ulcers The duodenum is the first part of the small intestine. Ulcers develop here due to irritation from stuff coming out of the stomach. Bleeding, obstruction, and perforation may be fatal complications.
  • 10. Esophageal Cancer An unknown chemical quality in alcoholic beverage causes alcoholics to have a far greater chance of developing cancer of the esophagus. Cancer causes difficulty in swallowing and a sensation of blockage behind the sternum.
  • 11. Varicose Veins in the Esophagus Cirrhosis of the liver produces a secondary increase in blood pressure in the veins of the esophagus – the food tube leading from the throat to the stomach. Death from internal hemorrhaging may occur if ballooned-out veins rupture.
  • 12. Delirium Tremens The DT’s begin with tremors, sweating, and nausea, and progress to insomnia, profound confusion, delusions, hallucinations, and convulsions. This serious complication may be fatal for about 10% of its victims.
  • 13. Neuritis Prolonged intake of alcohol has a direct, poisonous effect on the nerves in the arms and legs. Symptoms include tingling, the sensation of pins and needles, itching, numbness, weakness, and paralysis.
  • 14. Impotence Alcohol is one of the most common causes of impotency. In acute alcoholism, impotency may be caused by the depressant effect of the drug. In chronic alcoholism, impotency may be caused by neuritis, liver damage, malnutrition, or other complications.
  • 15. AIDS Intravenous (IV) drug users risk exposure to the AIDS virus when they use or share contaminated needles. IV drug users form the group with the fastest growing number of persons with AIDS (PWAs).
  • 16. ALCOHOL-INDUCED LIVER DISEASE (ALD) The three main types of ALD are fatty liver, alcoholic hepatitis and alcoholic cirrhosis. Fatty liver is the buildup of fat inside the liver cells which leads to enlargement of the liver and abdominal pain. Alcoholic hepatitis is severe liver inflammation where liver cells are destroyed causing scarring, tenderness and enlargement Alcoholic cirrhosis: scar tissue develops, hampering the flow of blood to the liver. Liver Issues
  • 17. HEPATITIS C Hepatitis is an inflammation of the liver caused by a virus, alcohol, medications that have a harmful effect on the liver, toxins or autoimmune disorders. There are 7 known types of hepatitis: A, B, C, D, E, F and G. Hepatitis C may be the leading cause of chronic liver disease in the western world. Hepatitis
  • 18. How hepatitis is transmitted I.V. drug use Needle stick injuries Body piercing or electrolysis Sharing personal care items like toothbrushes, nail clippers or files, razors, and other household items that have blood on them Intranasal cocaine use through shared use of straws may lead to blood to blood contact through nasal ulcers or cuts and scrapes. Sexual activity that results in blood to blood contact
  • 19. Cirrhosis Cirrhosis is the seventh leading cause of death in America Alcohol is the leading cause of cirrhosis. Symptoms include loss of weight, chronic nausea, vomiting, weakness, loss of sex drive, abdominal pains, bloating of the abdomen, and bleeding.
  • 20. Serum Hepatitis Hepatitis one of the most common problems in heroin addicts. It is caused by a virus which is transmitted through contaminated needles. Hepatitis causes weakness, loss of appetite, tenderness in the abdomen, dark-colored urine, and a yellowish change in the color of the skin and whites of the eyes.
  • 21. Alcoholic Hepatitis Symptoms: fever, jaundice, swelling in the abdomen, and swelling of the feet. The liver is large, firm, tender, and infiltrated with fat. Many patients die, and others go on to develop cirrhosis of the liver.
  • 22. Brain Abscess When germs are injected into the bloodstream from an unsterile needle, they may travel through the body and lodge in the brain. In this illustration, note the ragged, abscessed cavity filled with pus. High fever, convulsions, coma, and death are signs of a brain abscess.
  • 23. Wernicke-Korsakoffsyndrome Caused by long-term alcoholism Triad of symptoms: mental disturbance confusion, drowsiness and paralysis of eye movements ataxia or a staggering gait. Due to thiamine (vitamin B1) deficiency due to severe malnutrition and poor intestinal absorption of food and vitamins caused by alcohol Wet Brain
  • 24. DRUG SMOKING &LUNG INFECTIONS Tobacco, marijuana, or crack cocaine increases the user’s risk of bacterial pneumonia Bronchitis asthma Smoking anything appears to paralyze the cilia which are hair-like projections in the lungs that sweep out microbes and other matter that may cause disease. Smoking cocaine appears to weaken the lungs’ natural resistance to infection.
  • 25. “Crack hack” produces black or bloody phlegm. They can also inhale small bits of metal from the use of a screen or brillo pad for smoking drugs. Thermal burns to the nasal passages and the throat may go unnoticed due to the anesthetizing effects of cocaine and crack. Cocaine may burn holes through the septum and burn away the mucous membranes in the nostrils, leading to staph infections in the nostrils which can spread to the sinuses and possibly the brain. Lung issues cont…
  • 26. Bacterial Endocarditis Germs from an unclean needle, they may spread throughout the body and lodge in the valves of the heart, causing bacterial endocarditis. The warty-like growths seen on these heart valves produce symptoms of fever, weakness, heart failure, and death.
  • 27. Blood Clots When an addict’s veins are repeatedly punctured, particularly by unsterile needles, blood clots and scarring may occur within the veins.
  • 28. Faces to remember Methamphetamine: Don’t be fool!!!
  • 30. Methamphetamine Effects Disrupt sleeping patterns, suppresses appetite, and causes irritability/aggression
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  • 35. More Impact from Alcohol abuse and Drug use
  • 36. Suicide Suicide is the tenth leading cause of death in America and the third leading cause of death in people below the age of 30. Alcohol is a factor in more than 60% of all suicide attempts.
  • 37. Birth Defects Alcohol passes through the bloodstream of the mother into the uterus and placenta and directly into the unborn child. Children are underweight, their brain size is less than normal Their hearts may not be completely developed hey may have a cleft palate. Continue to grow at a slow pace after birth and end up as smaller adults.
  • 38. Child Abuse Approximately 1 in every 100 American children is physically, sexually or psychologically abused at least once. Excessive drinking by the abuser is a major factor in a large majority of these cases.
  • 39. Murder The twelfth leading cause of death in America The leading cause of death in people below the age of 30. Alcohol is implicated in more than 70% of all murders and other violent crimes.
  • 40. Alcohol Abuse and Drug use is the #1 social problem we face today. It causes a variety of health and social problems These problems have a financial impact for employers, healthcare, criminal justice, foster care, individuals Many children who grow up in an addicted family become addicts themselves. Summary