Aods 155 Chpt 5

Front 1

ASAM Definition of Addiction

Back 1

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.Addiction is characterized by an inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.

Front 2

ASAM Definition Continued

Back 2

Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

Front 3

According To Text Re: Alcohol

Back 3

Alcohol is the oldest known and at present, the most widely used psychoactive drug.

Front 4

Types of Alcoholic Beverages

Back 4

Wine

Beer

Distilled Spirits

Front 5

Digestion

Back 5

1. Digestion in the body's way of breaking down food in order to get and use the material it needs.

2. Alcohol requires no digestion. It has no nutrients (unless added).

Front 6

Fermentation

Back 6

A natural process that occurs when yeasts combine with plants. Water, yeast, and sugar required.

Front 7

Distillation

Back 7

1. Start with a fermented brew

2. Boil it and the alcohol separates from the liquid.

3. Collect the steam.

Front 8

Alcohol

Back 8

1. Ethyl alcohol (ethanol) the drinkable form.

2. "Alcohol congeners" = other chemicals that contribute to taste, aroma, etc. (especially whiskey, brandy).

Front 9

Digestion

Back 9

1. Digestion is the body's way of breaking down food in order to get and use the material it needs.

2. Alcohol requires no digestion. It has

no nutrients (unless added).

Front 10

Metabolism (In Case of Alcohol Oxidation)

Back 10

The breakdown of products into energy AND the use of energy.

Front 11

Metabolism

Back 11

1. Chemical reaction

2. Break down matter

3. Absorbs matter

4. This mostly occurs in the liver

Front 12

Alcohol Ingestion and Absorption

Back 12

1. Small amounts are absorbed in the mouth

2. 20% to 30% (men) into the stomach

3. 80% in the small intestine.

Front 13

Absorption Rate

Back 13

Increases amount of drinking absorption rate:

~Empty stomach

~High alcohol concentration

~Carbonation

~Warmed drink

Front 14

Absorption is Slowed By

Back 14

~Food presence before or during drinking

~Dilution (ice, water, juice)

Front 15

Alcohol Dehydrogenase (ADH)

Back 15

~ An enzyme called alcohol dehydrogenase (ADH) (mostly in the liver) mediates the conversion of alcohol to acetaldehyde.

~ ADH functions in the stomach in different degrees for men and women. Women have less/less water.

Front 16

Alcohol Dehydrogenase (ADH)

Back 16

1. ADH converts alcohol to ACETALDEHYDE which is very toxic to the body, especially the liver.

2. ACETALDEHYDE is converted to acetic acid (nontoxic) by ADHL.

3. Converted one chemical to one chemical which makes it toxic/enzymes change it to something tolerable.

Front 17

ALDH

Back 17

Acetaldehyde Dehydrogenase

Front 18

Blood Alcohol Concentration

Back 18

~The rate which alcohol is consumed

~The amount of alcohol consumed

~Concentration of alcohol

~Is the blood level falling or raising

~Body weight

~Amount of food in stomach

~Male or female

~Physical illness can contribute

Front 19

BAC

Back 19

Blood Alcohol Concentration

Front 20

BAC info

Back 20

~BAC is presented as a % from 0.00 - 0.7

Highest is achieved 30-90 minutes after drinking

~Goes through intestine into blood stream

~A raising BAC cause greater physical impairment at the same concentration, compared to a falling BAC. ?

Front 21

BAC Limit Defining Legal Intoxication

Back 21

.08

Front 22

Toxic BAC Level

Back 22

Above .40

Front 23

BAC Women

Back 23

~Have less ADH than men, so less alcohol

metabolized in the stomach, alcohol reaches bloodstream through the small intestine.

~Women have less water content which means alcohol is not diluted as much.

Front 24

Body Weight (Women)

Back 24

Women have a higher content of body fat which allows alcohol to remain in the system for longer.

Front 25

Female Sex Hormones

Back 25

Women absorb more during premenstrual period

Front 26

Binge Drinking

Back 26

5 or more drinks for men

4 or more for females

Front 27

Heavy Drinking

Back 27

Binge at least 5 times a month

Front 28

Drugs Used to Treat Alcohol Dependence

Back 28

~Campral (Acamprosate) - Does not make you ill.

~Antabuse (Disulfiram - Makes you ill, inhibits ADH

~Naltrexone or Vivitrol - diminishes rumination. Used for Heroin

Front 29

Pancreatitis

Back 29

Inflammation of Panatris

Front 30

Pancreas

Back 30

Breaks down what you eat.

Front 31

Gallstones

Back 31

Decreases risk

Front 32

Visible Symptoms of Chronic Use

Back 32

~Increased perspiration

~Bruises

~Enlarged nose

Front 33

Cirrhosis

Back 33

~Permanent destruction of the liver cells

~Cells replaced by permanent scar tissue

Front 34

Alcoholic Heart Disease

Back 34

Beriberi Heart Disease

Front 35

Organ not Affected By Alcohol

Back 35

Kidneys

Front 36

Chronic/Heavy Use

Back 36

~Testicles smaller

~Redness or yellowing of the skin (Jaundice)

Front 37

Affects on The Respiratory System

Back 37

~Lung cancer

~Pneumonias

~Sleep apnea

Front 38

Effects on The Skeletal System

Back 38

~Arthritis

~Muscle damage 40% to 60%

Front 39

Blackout

Back 39

Amnesia

Front 40

Delirium Tremens-DT's

Back 40

~Hallucinations

~Confusion

~Tremulousness

~Agitation

Front 41

Withdrawal Symptoms

Back 41

~Hyperarousal(increased psychological and

physiological tension, reduced pain tolerance,

anxiety,exaggerated startle responses, insomnia, fatigue, and accentuation of personality traits)

~Seizures

~Lowers blood alcohol

Front 42

Jaundice

Back 42

Caused by bile produced in the liver

Front 43

Ascites

Back 43

~Fluid in the abdominal cavity

~Makes you look pregnant

Front 44

Benefits of Low Doses of Alcohol

Back 44

~Relaxes muscle tension

~Stimulaters appetite

~Reduces Heart Disease

~Decreases Gallstones

~Slows bone loss

~Lowers risk of strokes

~Sleep induction

Front 45

Neurotransmitters Involved

Back 45

~Serotonin (Depression, Anxiety, poor impulse control)

~Dopamine (compulsion)

~Norepinephrine (create fear)

~Endorphines/Enkephalins (pain killer)

~Gluamate (staggering, slurred speech and memory blackouts)

~GABA (lowers inhibitions)

Front 46

Wernicke's Encephalopathy

Back 46

~Delirium

~Loss of balance

~Visual problems

~Unsteady gate

Front 47

Korsakoffs Psychosis

Back 47

~Disorientation

~Poor memory

~Confabulation

Front 48

Neurochemistry - Axon Terminals

Back 48

~Increases release of Dopamine and

Norepinephrine (Reward Pleasure System)

~Initially increases Serotonin (calmness) then causes depression)

~Endorphines/Enkephalins (relief of pain)

~Glutamate (pleasurable sensation/reinforces drinking)

Front 49

Neurochemistry - Postsynaptic Receptor Sites

Back 49

~Increases Dopamine

~Reduces Glutamate (decreases memory processing/Blackouts)

~Stimulates GABA (lowers inhibitions/slows brain processes, takes longer to respond)

Front 50

Neurotransmitters & Withdrawal

Back 50

1. Initially, increases effects of GABA, causing drowsiness and depressing other body functions.

2. Over time the brain compensates causing hyperarousal, causing anxiety, increased muscle activity, tachycardia (rapid heart rate), hypertension and seizures.

3. 30% reduction in Serotonin, correlates to depression and anxiety.

Front 51

Alcohol Withdrawal

Back 51

~Rapid pulse

~Sweating

~Increased body temperature

~Tremors

~Anxiety

~Depression

~Insomnia

~Nausea or vomiting