dr bob's alcohol and drug lecture

8/7/2019 Dr Bob's Alcohol and Drug Lecture

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Dr BobsDr BobsAlcohol and Drug Addiction LectureAlcohol and Drug Addiction Lecture


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Drug AddictionDrug Addiction

1818 20% of the U.S. Population20% of the U.S. Populationsuffers from drug and/orsuffers from drug and/oralcohol addictionalcohol addiction


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COST:COST:

3 Billion Dollars Annually due to3 Billion Dollars Annually due tohealthcare costs and/or job losshealthcare costs and/or job loss

20% patients of medical facilities20% patients of medical facilities

3535 55% psychiatric patients55% psychiatric patients

20% family medicine patients20% family medicine patients


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Addiction DisorderAddiction Disorder

Not enough Government ProgramsNot enough Government Programs

Not enough Government FundsNot enough Government Funds

Not enough Government ConcernNot enough Government Concern

Not enough ResearchNot enough Research

Not enough Prevention Programs

N

ot enough Prevention Programs

Public awareness for early treatment is vital.Public awareness for early treatment is vital.


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AlcoholAlcohol Second on the list of most used substances worldSecond on the list of most used substances world

wide (Smoking is 1wide (Smoking is 1stst on the list)on the list)

#1 cause of MVA#1 cause of MVA

Morbidity (illness)Morbidity (illness)

DeathsDeaths

#1 cause of household#1 cause of household

accidents/violence/homicidesaccidents/violence/homicides Enormous cost to the individual and to societyEnormous cost to the individual and to society

Enormous number of deaths directly caused byEnormous number of deaths directly caused byOverdose of EthanolOverdose of Ethanol


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DeathsDeaths 50,000 Alcohol/Drug Related Deaths per year50,000 Alcohol/Drug Related Deaths per year

550,000 Smoking Related Deaths per year in the550,000 Smoking Related Deaths per year in theU.S. (Not including 50,000 due to exposure toU.S. (Not including 50,000 due to exposure to

second hand smoke)second hand smoke) Causes of Ethanol Related Deaths:Causes of Ethanol Related Deaths:

SeizuresSeizures

M.I.sM.I.s

CNS DepressantCNS Depressant

Asphyxia/AspirationAsphyxia/Aspiration

Aortic DissectionAortic Dissection

Dosed related vs. Overdose relatedDosed related vs. Overdose related


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Alcohol Related Deaths per 100,000 peopleAlcohol Related Deaths per 100,000 people


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Etiology of AddictionEtiology of Addiction

HereditaryHereditary Approximately 6Approximately 6--10%10%(additional research pending)(additional research pending)

AddictionAddiction Physical DiseasePhysical DiseasePsychosocial PressuresPsychosocial Pressures

Neurological Brain Age ExposureNeurological Brain Age Exposure

Behavioral PathologyBehavioral PathologyDysfunctional Family UnitDysfunctional Family Unit

Psychiatric Disorders (DualPsychiatric Disorders (Dual--Diagnosis)Diagnosis)


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EthanolEthanol Brain/CNSBrain/CNS

Begins with mild Euphoria/ Loss of inhibitionBegins with mild Euphoria/ Loss of inhibition Behavioral, EmotionalBehavioral, Emotional

Impairs: judgment, memory, concentration,Impairs: judgment, memory, concentration,coordinationcoordination

Further intake/CNS Capture leads toFurther intake/CNS Capture leads to Mood SwingsMood Swings

Emotional OutburstsEmotional Outbursts

Decreased: vision, hearing, smell, taste,Decreased: vision, hearing, smell, taste,Fine/gross motor skills, reactionsFine/gross motor skills, reactions


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EthanolContd:EthanolContd: Large/Heavy DosesLarge/Heavy Doses

Induces Sleep (defense mechanism)Induces Sleep (defense mechanism)

Anesthesia for the bodyAnesthesia for the body

SeizuresSeizures Dulls, Depresses, Alters, Damages Brain CellsDulls, Depresses, Alters, Damages Brain Cells

Respiratory FailureRespiratory Failure

ComaComa

DeathDeath


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EthanolContd:LIVEREthanolContd:LIVER 11stst organ affected due to frequency of alcohol useorgan affected due to frequency of alcohol use

Metabolism (Breaks down Ethanol)Metabolism (Breaks down Ethanol)

Inflammation/swelling/destruction of liver cellsInflammation/swelling/destruction of liver cells(Hepatitis)(Hepatitis)

CirrhosisCirrhosis severe and possibly irreversible destructionsevere and possibly irreversible destructionof liverof liver

Reduction of ClottingReduction of Clotting

Reduction of ImmunityReduction of Immunity

Reduction of Metabolism (Nutrients, Vitamins)Reduction of Metabolism (Nutrients, Vitamins) Increase fat deposits and circulationIncrease fat deposits and circulation

FailureComaDEATHFailureComaDEATH


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Death Rates ofLiverCirrhosis bySexDeath Rates ofLiverCirrhosis bySex


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EthanolContdEthanolContdSexual/Reproductive Functions:Sexual/Reproductive Functions:

Sexual response impairedSexual response impaired

ImpotenceImpotence

InfertilityInfertilityF.A.S. (Fetal Alcohol Syndrome)F.A.S. (Fetal Alcohol Syndrome)

Physical AbnormalitiesPhysical AbnormalitiesDecreased Muscle/ToneDecreased Muscle/Tone

Decreased SpeechDecreased Speech

Decreased IntelligenceDecreased Intelligence

Decreased GrowthDecreased Growth

Higher Risk of Breast Cancer

H

igher Risk of Breast Cancer


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Areas of the Brain Affected by FASAreas of the Brain Affected by FAS


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OpiatesOpiates Forms of AdministrationForms of Administration

P.O. (By Mouth)P.O. (By Mouth)

IV/IM/SQ/ skin popping/ muscleIV/IM/SQ/ skin popping/ muscle--inin--itit

(Infection)(Infection) InhalationInhalation Smoked/ Nasal InhalationSmoked/ Nasal Inhalation

Rectal/ SuppositoryRectal/ Suppository

Highly AddictiveHighly Addictive Often prescribed by Medical ProfessionalsOften prescribed by Medical Professionals

UnawareUnaware becoming abusive/ dependentbecoming abusive/ dependent

Affects strong binding sites in brain & body (wholeAffects strong binding sites in brain & body (whole

effect)effect)


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OpiatesContdOpiatesContd

Opiate Receptors (sites of opiod binding)Opiate Receptors (sites of opiod binding)

Mu, kappa, delta, sigmaMu, kappa, delta, sigma

Affecting many neuroAffecting many neuro--substances like:substances like:

EnkephalinsEnkephalins

EndorhphinsEndorhphins DynorphinsDynorphins


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OpiatesContd:OpiatesContd:WithdrawalEffectsWithdrawalEffects

Abdominal CrampsAbdominal Cramps

AnorexiaAnorexia

AnxietyAnxiety

InsomniaInsomnia

DysphoriaDysphoria

NauseaNausea

TearingTearing

HeadachesHeadaches

High B.P.High B.P.

IrritabilityIrritability

DiarrheaDiarrhea

Hot/Cold FlashesHot/Cold Flashes

PsychosisPsychosis

Muscle Aches/SpasmsMuscle Aches/Spasms

DepressionDepression

VomitingVomiting

Runny NoseRunny Nose

RestlessnessRestlessness

TachycardiaTachycardia

AgitationAgitation

Takes days/weeks/months before feeling betterTakes days/weeks/months before feeling better


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Opiates/NarcoticsOpiates/NarcoticsAnalgesicsAnalgesics

Derived from Opium/PoppyDerived from Opium/Poppy

Papaver Somniferum =H

eroinPapaver Somniferum =H

eroinMorphineMorphine CodeineCodeine

Chemical Isolation by Germans duringChemical Isolation by Germans duringWWII because of lack of MorphineWWII because of lack of Morphine

Now SemiNow Semi--Synthetic productsSynthetic products MeperidineMeperidine--DemerolDemerol--HysromorphineHysromorphine


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TreatmentOptionsTreatmentOptions Treatment:Treatment: None!None!

Management:Management: Much!Much!

Treatment Programs:Treatment Programs:1.1. Full InpatientFull Inpatient Expensive but very goodExpensive but very good

2.2. Day CareDay Care SemiSemi--ExpensiveExpensive goodgood

3.3. I.O.P. (Intensive Outpatient Program) lessI.O.P. (Intensive Outpatient Program) less

expensiveexpensive good depending on yourgood depending on yourmotivationmotivation

4.4. Relapse PreventionRelapse Prevention Weekly, BiWeekly, Bi--WeeklyWeekly

5.5. Partial ProgramPartial Program Weekly, BiWeekly, Bi--WeeklyWeekly


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Medical DetoxificationMedical Detoxification

Inpatient vs. OutpatientInpatient vs. Outpatient

Multiple Medications:Multiple Medications:

Benzodiazepines/ Barbiturates:Benzodiazepines/ Barbiturates:Anxiety/AgitationAnxiety/Agitation

Methocarbomol/ Flexeril (Cyclobenzapine)/Methocarbomol/ Flexeril (Cyclobenzapine)/

Skelaxin (Metaxalone): Muscle RelaxantsSkelaxin (Metaxalone): Muscle Relaxants Lomotil (Diphenoxylate/ Atropine)/ ImmodiumLomotil (Diphenoxylate/ Atropine)/ Immodium

(Loperamide): Anti(Loperamide): Anti--diarrhealdiarrheal

Bentyl (Dicyclomide)Bentyl (Dicyclomide)


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Suboxone/Sebutex (Buprenorhine)Suboxone/Sebutex (Buprenorhine)

Partial Agonist/Antagonist OpiatePartial Agonist/Antagonist Opiate

Excellent for Maintenance ManagementExcellent for Maintenance Management

SuboxoneSuboxone

2 or 8 mg sublingual breakable tablets2 or 8 mg sublingual breakable tablets

Plus 0.5 mg or 2mg Naloxone (Narcan)Plus 0.5 mg or 2mg Naloxone (Narcan)

Blocker effect against I.V. drug abuseBlocker effect against I.V. drug abuse Take once or twice dailyTake once or twice daily

Doctor prescribing must be certifiedDoctor prescribing must be certified


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MaintenanceManagementMaintenanceManagement

Depends on age of onset/ period of useDepends on age of onset/ period of use

Depends on drug history andDepends on drug history and

dysfunctional diseasedysfunctional disease

Depends on relapse frequencyDepends on relapse frequency

Depends on detox/ treatment failuresDepends on detox/ treatment failures


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MaintenanceMaintenance: Advantages ofManagement: Advantages ofManagement

SobrietySobriety For opiod agonists (buyingFor opiod agonists (buyingtimetime

Motivates control over their livesMotivates control over their livesMotivates family unity in their livesMotivates family unity in their lives

Motivates completion & understanding ofMotivates completion & understanding of

better treatment programsbetter treatment programsMotivates adhering to AA, NA, CA, PAMotivates adhering to AA, NA, CA, PA

Motivates adhering to compliancy withMotivates adhering to compliancy withother medicationsother medications


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AdvantagesContdAdvantagesContd

Motivates compliancy with own healthMotivates compliancy with own healthand welland well--beingbeing

Motivates finding and keeping a jobMotivates finding and keeping a job

Motivates a better marital relationshipMotivates a better marital relationship

Motivates a greater sense of faithMotivates a greater sense of faith

Motivates to mend all aspects of theirMotivates to mend all aspects of theirlife!!!life!!!


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Avoid:Avoid:

HIV, Hepatitis C/B Exposure, STDsHIV, Hepatitis C/B Exposure, STDsand/or Hospitalizationsand/or Hospitalizations

Lying, Manipulation, Stealing, etc.Lying, Manipulation, Stealing, etc.

OverOver--spendingspending

Using other substancesUsing other substances

Injury, accidents, legal courts, jailInjury, accidents, legal courts, jail

dr bob's alcohol and drug lecture

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