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Alcohol
Introduction
Substance use disorder is due to substance use refers to Alcohol abuse, Psychoactive drugs and other
Chemicals.

Substance use disorder is a addiction disorder in which patient physiologic and psychologic
dependence on alcohol or other drugs, that are affect the central Nervous System.

Substance abuse is referred to a repeated taking of a substance.

Classification – A/c to ICD-10

F10-F19 Mental and behavior disorder due to psychoactive substance use.

F10 - Mental and behavior disorder due to use of alcohol

F11 - Mental and behavior disorder due to use of opioids

F12 - Mental and behavior disorder due to use of Cannabinoids

F13 - Mental and behavior disorder due to use of Sedative

F14 - Mental and behavior disorder due to use of Cocain

F16 - Mental and behavior disorder due to use of Hallucinogens.

Psychoactive Substance Drugs

Sedative Drugs

Alcohol

Narcotics

Barbiturates

Benzodiazepines

Stimulant drugs

Cocaine

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Nicotine

Caffeine

Hallucinogens

LSD

PCP

Alcohol Dependence Syndrome

Alcoholism is a disorder in which patient feels physical and psychological dependence on alcohol
and express the withdrawal symptoms after discontinue the alcohol.

Alcoholism is indicated the excessive use of alcohol to the point of causing and affect the individual,
society and both.

Alcoholic patient commonest physically depend on alcohol

Cause of Alcohol Dependence

Psychological cause – Stress, anxiety, depression

Failure in Exam

Low self esteem

Poor impulsive control

Frustration and depression

Social Cause – Religious factors

Social status and pear pressure

Easily available of alcohol

Family and occupational tension

Urbanization

Biological factor – Alcoholic family

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Family support

Social unsuccessful

Less satisfaction in social relationship.

Environmental factors

Hereditary.

Sign and symptoms of alcoholism

Euphoria

Dipsomania

Nutritional deficiency

Poor personal hygiene and untreated injuries

Increase tolerance capacity

Increase self confidence

Violence behavior and use of abuse words

Abnormal movement during walking

Slurred speech

Erectile dysfunction

Psychiatric disorder due to Alcohol Dependence

Impaired attention or memory

Inappropriate sexual or aggressive behavior

Impaired judgement capacity

Delirium Tremors

Impaired psycho-Sexual function

Alcoholic hallucinations.

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Diagnosis
Screening test – Use the CAGE questionnaires, which was given by John Ewing.

C – Cut down the quantity of alcohol

A – Annoyed

G – Guilt

E – Eye opener (do you need alcohol at awakening time)

GGT Test (Gamma glutamyl transpeptidase test)

Normal GGT Value – 9-48 I.U.

Increase the level in liver in chronic alcoholic patient.

Blood alcohol level assess

Liver function test

ECG, 2-D ECHO

Treatment
Self-control is best management.

Alcoholic anonymous (Self hep group meeting is arranging by the group of alcoholic patients)

Drug of choice of alcohol withdrawal symptoms is a Benzodiazepines

Group psychotherapy

Disulfiram drug is use for aversion therapy

Disulfiram is contraindicated in cardiac and pulmonary disease patient.

Anticonvulsants

Psychological treatment – Group therapy

Motivational interviews

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Cognitive behavior therapy

Relaxation training

Aversion conditioning therapy

Complication of alcoholism
Physical complication – Liver cancer and Liver Cirrhosis

Fracture and injury

Social complication - Social withdrawal

Financial crisis
Violence
Divorce and family broken
Loss the self-status in society
Economic crisis and loss of job.

Psychological Complication- 6th cranial nerve palsy

3rd Cranial nerve palsy

Wernicke Korsakoff Syndrome – These syndromes occur due to deficiency of Vitamin

B1 (Thiamine) and chronic alcoholic patients.

a). Wernicke Encephalopathy Symptoms are Alexia, Motor activity Disturb, Slurred Speech,
Numbness
b). Korsakoff syndrome symptoms are Confabulation, Amnesia, Recent and immediate
memory loss.
5. Marchia fava Bignami Disease- Neurological Disorder
6. Alcoholic Hallucination – Visual, tactile and auditory hallucination are present.
Auditory hallucination is most commonly present in withdrawal of Alcohol.
7. Alcoholic Fits – Occurs due to intake of excessive alcohol.
8. Delirium Tremor – Most common psychological complication. The symptoms seen are
Confusion, Disorientation, Tachycardia, Hypertension, Visual Hallucination, and Tremor.

Prevention of substance Use Disorder

Primary Prevention

Identify the substance abusers.

Motivational and encourage the all abuser to stop alcohol use

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Health Educational Provide

Improve family condition and socio- economic status

Secondary prevention

Early Detection and Counselling.

Motivation interviewing

Full assessment done - Medical, psychological and Social problems.

Detoxification with Benzodiazepines

Psychological therapy provides.

Treat the complication of treatment.

Tertiary Prevention

Disulfiram or Antabuse provide.

Alcoholics anonymous

Identify High risk situation and deal with them.

Family counselling to reduce interpersonal conflicts

Stress management

Develop the work habit and capacity

Finical management

Key points
Physiological and psychological dependence on alcohol is known – Alcohol abuse

After alcohol use, feel happy and better is known as – Euphoria

Excessive Drinking of Alcohol is known – Dypsomnia

Drug of choice of alcohol withdrawal symptom – Benzodiazepines

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Drug use for aversion therapy in alcohol abuse – Disulfiram

Most common psychological complication of alcohol abuse – Delirium Tremor

Wernicke Korsakoff syndrome occur due to – Thiamine deficiency and chronic alcohol use.

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