Alcoholism And Drug Dependence

The Maharaja Bhupinder Singh Punjab

Sports University
Bsc Sports Sciences
Guided by- Dr.Madhvi
Created by- Yuvraj yadav
 Alcoholism
 A chronic disease characterised by uncontrolled drinking and
preoccupation with alcohol.
 Alcoholism is the inability to control drinking due to both a physical
and emotional dependence on alcohol.
 Symptoms include repeated alcohol consumption despite related
legal and health issues. Those with alcoholism may begin each day
with a drink, feel guilty about their drinking and have the desire to cut
down on the amount of drinking.
 Key takeaways
Global prevalence of alcohol consumption
According to recent data published by the World Health Organization (WHO),
the total per capita consumption of alcohol by individuals above 15 years of age
is 6.2 L of pure alcohol per year, which equals 13.5 g of pure alcohol per day.
However, there is a wide variation between the WHO regions and member
states. Nearly 5.1% of the global burden of disease is attributable to alcohol
consumption, and it causes nearly 3.3 million deaths every year.
Alcohol consumption and its associated factors in various parts of India
Alcohol consumption practices vary across different parts of India because of
various socio-cultural diversity and difference in laws governing individual
States within India. 
 Disease burden because of alcohol consumption

• At the global level:-

Alcohol use disorder (AUD) (which includes a level that's is

sometimes called alcoholism) is a pattern of alcohol use that involves
problems controlling your drinking, being preoccupied with alcohol,
continuing to use alcohol even when it causes problems, having to
drink more to get the same effect or having withdrawal symptoms
when you rapidly decrease or stop drinking. The prevalence of AUDs
is highest in Europe (7.5%) and the lowest among eastern
Mediterranean regions, which includes Afghanistan, Bahrain and
Egypt. Globally, 50% of the deaths caused by liver cirrhosis, 30% of
the deaths because of oral and pharyngeal cancers, 22% of the
deaths caused by inter-personal violence, 22% of the deaths
because of self-harm, 15% of the deaths caused by traffic injuries,
12% of the deaths because of tuberculosis (TB) and 12% of the
deaths caused by liver cancer were attributed to alcohol consumption
• At the national level:-
• The 12-month prevalence of AUDs in India in the year 2010 was
2.6% and that of alcohol dependence was 2.1%. In 2012, 33.1% of all
the road traffic accident deaths were attributable to drunk and driving.
The National Mental Health Survey of India 2015–16 found the
prevalence of AUDs to be 9% in adult men. In India, the alcohol-
attributable fraction (AAF) of all cause deaths was found to be 5.4%.
Around 62.9% of all the deaths due to liver cirrhosis were attributable
to alcohol use.
Medical consequences of alcohol use
When alcoholic beverages are consumed, alcohol gets absorbed from
the stomach and small intestine. It is distributed through blood
circulation to every organ in the body. The alcohol gets absorbed by the
liver at a rapid pace and excreted through the kidneys, which accounts
for 95% to 98% of the alcohol consumed.In a study it was Founded
that, because of the increase in the alcohol consumption occurring all
over the country, the hospital admission rates because of alcohol
consumption were also increasing with 20% to 30% of admissions
because of direct or indirect problems caused because of alcohol
consumption.
Gastrointestinal (GI) 
complications: The direct effect of alcohol on the lining of the stomach
can lead to acute gastritis and present as vomiting, usually associated
with heavy drinking. Repeated damage can lead to hyperacidity leading
to peptic ulcer disease. Alcohol is one of the most important reasons
for haemorrhagic gastritis. The most common complication of long-term
alcohol is alcoholic liver disease.
Cancer:
Drinking as few as 1.5 drinks per day increases a woman's risk of
breast cancer. For both the genders, four drinks per day increase the
risk for oral and oesophageal cancers ,rectal cancers by.In a study done
by Bangardi et al., it was found that alcohol most strongly increased the
risk of cancers of the pharynx, oral cavity, oesophagus and larynx.

Muscular changes:
Between one-half and two-thirds of alcoholics can have skeletal muscle
weakness caused by the acute alcoholic myopathy, which may improve
with abstinence, but it is not fully cured. Effects of alcohol consumption
on the skeletal system can include lower bone density. In a study done
by Venkat et al., it was found that those who suffer from chronic
alcoholism suffered from avascular necrosis of the femoral head and
reduced bone density
Neurological complications:
The short-term effects of alcohol consumption that can get relieved after
stopping alcohol consumption include blackouts, blurred vision, impaired
memory and slower reaction times.In a study done by Peng et al., it was
found that chronic alcohol use can lead to the development of alcoholic
tremors, myopathy and cerebellar degeneration

Psychiatric complications:
Consuming alcoholic beverages to overcome depression and anxiety has
been a common practice. Though alcohol can relieve those conditions to
some extent initially, it starts to deplete the neurotransmitter serotonin in the
brain, causing depression and anxiety and the need to consume more
alcohol to medicate depression arises. This chronic use can lead to
increased risk for suicide, personality disorders and risk-taking behaviours.
Problems related to alcohol consumption made up to 17.6% of psychiatric
emergencies in an Indian general hospital
Social consequences of alcohol use

Alcohol consumption not only affects the individuals but also his family
members get affected in one way or the other. The person in an
intoxicated state may indulge in domestic violence with his family
members; may exhaust the savings of the family, which can negatively
affect the education of his children, and the children of alcoholic fathers
will have strained relationship with their family members, which can
affect their psychological wellbeing. In a study done by Gururaj et al., in
Bangalore, it was found that emotionally abusing the spouse was found
to be 2.5 times more common among persons who consume alcohol,
23.3% of the users physically abused their spouse and 7.8% of them
physically abused their spouse resulting in injuries. In a study done by
Markowitz et al., domestic violence was reported by 20% of women
and husband's practice of alcohol consumption was reported by them
as the most significant cause for domestic violence
 Road traffic accidents

In a study conducted by the National Institute of Mental Health and

Neurosciences (NIMHANS) in 12 major hospitals of Bangalore city, it
was found that nearly 28% of injuries because of road traffic accidents
were directly attributable to alcohol. The roadside survey revealed that
nearly up to 40% of the drivers were under the influence of alcohol. In a
study done by Aditya et al., it was found that 20% of the fatal road
traffic accidents were because of alcohol use. The blood alcohol
concentration (BAC) of 38% of those alcohol users were above the
permissible limits. In a study done by Gururaj it was found that alcohol
abuse was reported in over 20% of the traumatic brain injuries.
According to the latest data released by the National Crime Records
Bureau (2015), Tamil Nadu recorded the highest number of drunk and
driving accidents in the country.
 Treatments
Treatment consists of therapy and sedatives
Treatment involves counselling by a healthcare professional. A
detoxification programme in a hospital or medical facility is an option
for those who need additional assistance. Medications are available
that reduce the desire to drink.
Detox
No longer consuming toxins or clearing toxins from the body through
dieting, fasting or colon cleansing.
Alcoholism medication
Treats chronic alcoholism by decreasing cravings or by causing
unpleasant side effects when alcohol is consumed.
 Therapies
Support group
In a support group, members provide each other with various types of
help, usually nonprofessional and nonmaterial, for a particular shared,
usually burdensome, characteristic. Members with the same issues can
come together for sharing coping strategies, to feel more empowered
and for a sense of community.
Cognitive behavioral therapy 
Cognitive behavioral therapy is a psycho-social intervention that aims
to reduce symptoms of various mental health conditions, primarily
depression and anxiety disorders.
Behavior therapy
Behaviour therapy or behavioural psychotherapy is a broad term
referring to clinical psychotherapy that uses techniques derived from
behaviourism and/or cognitive psychology.
 Conclusion

Alcohol consumption is emerging as a major public health problem in

India. Multi-centric scientific community-based research studies have to
be conducted in various individual states to understand the problem
better. Various policymakers, media, professionals and society have to
be educated about the consequences of chronic alcohol through
sensitisation programmes and health education campaigns. There is a
dire need for rational alcohol control policy with specific objectives like
alcohol taxation, production and promotion policy.
 Drug dependence
Substance dependence, also known as drug dependence, is a
biopsychological situation where-by an individual's functionality is
dependent on the necessitated re-consumption of a psychoactive
substance, because of an adaptive state that has developed within the
individual from psychoactive substance consumption, which results in
the experience of withdrawal which necessitates the re-consumption of
the drug.
 Keyfacts
155 to 250 million people, or 3.5% to 5.7% of world’s population aged 15-64 used other psychoactive
substances, such as cannabis, amphetamines, cocaine, opioids, and non-prescribed psychoactive
prescription medication (WHO-2008). Globally, cannabis is the most commonly used substance (129-
190 million people), followed by amphetamine type stimulants, then cocaine and opioids.

People who inject drugs (psychoactive drugs for non medical purposes) are at increased risk of HIV,
hepatitis B and hepatitis C. Around 13 million people inject drugs globally and 1.7 million of them are
living with HIV; injecting drug user accounts for approximately 10% of HIV infections. The estimated
global prevalence of hepatitis C in people who inject drugs is 67%

In India opioids are commonly used by IDUs. These opioids include heroin (‘smack’ / ‘brown sugar’)
as well as pharmaceutical opioids (such as buprenorphine, pentazocine and dextro-propoxyphene). In
the north-eastern region, heroin and dextropropoxyphene are the most commonly used opioids;
impure heroin (smack), and buprenorphine are the most commonly used opioids in metropolitan cities
such as Delhi, Mumbai, Chennai and Kolkata. Pentazocine is the most commonly injected opioid in
Karnataka, Andhra Pradesh, Chattisgarh. In the states of Punjab and Haryana, buprenorphine is
commonly used by injectors. As per the HIV sentinel surveillance report, HIV prevalence among IDUs
in India is 7.2%. However, some states have much higher HIV rates among IDUs such as HIV
prevalence among IDUs is 21% in Punjab, 18% in Delhi and around 12% in Manipur and Mizoram.
 Symptoms
Acute intoxication 
can occur as a result of a single episode of drug use. Intoxication is highly dependent on
the type and dose of drug and is influenced by an individual's level of tolerance and other
factors. Problems may be-
• Ataxia, vomiting, fever and confusion
• overdose and loss of consciousness
•  prone to accidents and injury
• aggressive, unpredictable behavior and violence
• Regular use
• tolerance (person no longer responds to the drug in the way that person initially
responded),
• anxiety, depression, mood swings, irritability,
• criminal offences,
• relationship problems,
• cognitive problems relating to memory or attention,
• difficulties with regular job or study
 Risk factors
• Smoking and drinking alcohol during pregnancy can affect a developing fetus with altered growth
and physical development and cognitive impairments in the child.
• Infancy and childhood:
• Insecure attachment during the child’s first year of life can cause a child to be aggressive or
withdrawn and have difficulty interacting with other children or adults. Uncontrolled aggression during
early childhood can lead to poor social skills and problems during preschool period.
• Lack of classroom structure in the school environment can lead to additional social and behavioral
problems in children and academic failure. At the same time, they may be exposed to greater
availability of drugs, drug abusers, and social activities involving drugs. These challenges can
increase the risk that they will abuse alcohol, tobacco, and other substances.
• Parental abuse and neglect are commonly seen as part of the cause of drug abuse. An adolescent
or pre-adolescent may be trying to gain attention from an inattentive parent or escape an abusive
one by using drugs; prolonged attempts through drug use can be a cause of drug abuse.
• Parental substance use can also affect child both directly and indirectly by disturbing family
environment and poor parenting. There are increased chances of child abuse and neglect in such
families.
• Parental smoking in home can also expose children to secondhand smoke; putting them risk for
health and behavioral problems as well as increasing children’s likelihood of smoking when they
grow older.
• Association with drug abusing peers is often the most immediate risk for exposing adolescent.
• Mental illnesses can increase risk for drug abuse.
• Genetic factors also influence the person’s vulnerability to addiction
 Manangement
•Substance abuse is treatable.
•Treatment varies depending on the type of drug and the characteristics of the patients
•Treatment needs to be readily available.
•Effective treatment must address the individual drug abuse and any associated medical,
psychological, social, vocational and legal problems.
•Behavioral therapies including individual, family, or group counseling are the most commonly used
forms of drug abuse treatment.
•Medications are an important element of treatment for many patients (such as alcohol,
nicotine, heroin or other opioids), especially when combined with counseling and other behavioral
therapies.
•The appropriate duration of treatment for an individual depends on the type and degree of the
patient’s problems and needs. Usually recovery from drug addiction is a long-term process and
frequently requires multiple episodes of treatment.
•Several sub groups within the larger population of individuals affected by drug use disorders such as
adolescents, women, pregnant women, people with medical and psychiatric co-morbidities, sex
workers, and socially marginalized individuals, prisoners often require targeted and specialized care.
•Target populations, their families, community members and local organization should be actively
involved in the planning, implementation and monitoring of drug dependence treatment services.
•As drug related crimes are highly prevalent, there should be coordination between drug dependence
treatment and criminal justice system for such individuals.
 Prevention
Prevention of drug abuse can be achieved by-
i) To take effective and practical primary prevention measures that
protect people, in particular children and youth, from drug use initiation:
• by providing them with accurate information about the risks of drug
abuse,
• by developing supportive parenting and healthy social environments
and
• by promoting skills and opportunities to choose healthy lifestyles and
• by ensuring equal access to education and vocational training;
Thank You
sources of information
https://www.ncbi.nlm.nih.gov/
https://en.wikipedia.org/
https://www.nhp.gov.in/