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What is the definition of addiction?
- loss of control
- use despite negative consequences
- relapse tendancies
WHat does physically dependent mean?
- brain is altered
- physical w/d sx when decrease or stop use
What are withdrawal sx?
Physical sx that occur when substance is decreased or stopped
What is tolerance?
Increased need to use more drug to gain desired effect.
What is a Type I drinker?
- Social drinker that develops an alcohol abuse problem
- Positive family hx (mom/dad)
- Less neurotransmitters available
- Feels normal when drinks
- -neurotransmitter dump
- -if doesn't drink, feel anxious, depressed
- 50% of population Type I drinkers-prone to relapse
What is a Type II Genetic alcoholic?
- Adolescent onset
- Begins drinking a lot and continues drinking a lot
- male line-father to son
- first drink age 11-13
- less than 2 years from 1st drink to disease
- before drink, less neurotransmitters available
- 1st drink skyrockets neurotransmitters
- Enjoy drinking from 1st drink
- Often don't look drunk
- Can have co-morbid ADHD, depression, anti-social personalities
- Around 75% of prison population
- Angry when 1st come into tx
- Increased medical illness and will die prematurely
- Will never be able to drink in a controlled way.
What happens when someone spends 1 year in recovery?
3 years of development: emotional, social, intellectual
How is alcohol metabolized?
- 25 mg/L metabolized every hour=1.5 oz liquor, 12 oz beer, 4 oz wine
- Person with BAC .10 w/o S/S intoxication has developed tolerance
When is there medical detoxification?
How does antabuse/disulfiram work?
- Drinking + meds->rx that feels like a heart attack
- -chest pain
How do revia and depade/naltrexone work?
blocks the pleasure from drinking alcohol and decreases cravings
How are vivitrol and naltrexone given?
ER injection 1x month
How does campral work?
helps those who recently quit remain abstinent.
What is the CAGE Assement?
- CUT DOWN
- ANNOYED WITH PEOPLE
- FEELS GUILTY
- EYE OPENER
What is criteria for alcohol intoxication?
- recent ingestion
- maladaptive behavior
- behavior not due to medical condition
- At least one
- -slurred speech
- -unsteady gait
- -impaired attn or memory
- -stupor or coma
What are S/S of alcohol withdrawal?
- Two or more;
- autonomic activity: increase in HR, increase in BP, sweating
- hand tremors
What benzos can one use for safe ETOH withdrawal?
What do you need to assess during alcohol withdrawal?
- BP and HR (V/S)
- What were you using?
- How much were you using?
- For how long?
- When did you last use?
- Have you ever tried to quit? When?
- How did it go?
- Did you have any bad things happen?
- CBC, H&H, platelets, K+, Ca+, Mg+, GGT