ALCOHOLISM
ALCOHOLISM
• It is a term used to designate heavy drinkers of all
kinds.
• It refers to people who are dependent on alcohol to
such an extent as to produce physical and
psychological ill health or interference with
interpersonal relationship and normal
socioeconomic function.
Aetiology
• Social situations e.g. business, bar men, mortuary
attendants, easy availability, permissive social attitude
etc
• Physical illness
• Psychopathic personality
• Hereditary factors e.g. some families have alcoholic
tendencies
• Gender. It is consistently higher in women than in men
• Age. The heaviest drinkers are men in their late teens
or early twenties
Clinical features
• The drinker will experience blackouts, i.e. amnestic
periods for events that occur while intoxicated.
• Loss of appetite and indigestion
• Outbursts of aggressive behaviour
• Loss of control
• Morning shakes, sweating, malaise, enlarged liver
and impairment of functions of digestive and
respiratory systems.
PHYSIOLOGICAL EFFECTS OF ALCOHOL
• On The Brain: Alcohol acts as a depressant affecting
thought and judgement. Initially it removes
inhibitions leading to feelings of euphoria and a sense
of well-being
• Later judgement is impaired, thinking and decision-
making are4 reduced as well as loss of psychomotor
control leading to poor co-ordination of movements.
• Memory lapses (blackout) i.e. block of time
may be forgotten e.g. he may not remember
drinking.
• There is loss of sensation due to anaesthetic
effect of alcohol.
• On the Cardiovascular System: Vasodilatation
may occur, and chronic use may result in heart
damage and blood dyscrasias may result.
• On the Reproductive System: Reproductive
and sexual problems are common
PSYCHOLOGICAL EFFECTS
• Feelings of guilt, shame, fear, anger and hurt
• Use of defense mechanisms like denial, rationalization,
and projections may indicate signs of maladjustment
• Feeling of low self esteem
• Emotional problems like depression, hyperactivity,
impairment of judgement leading to poor decision-
making
• SOCIAL EFFECTS
• Family dysfunction may manifest as:
• Marital problems like arguments,
violence, reproach from spouse, and feelings
of guilt and shame
• Dependent spouse may become enabler
(promotes alcoholism rather than reduce it
• Children assume survival roles i.e. hero
scapegoat child, last child role and mascot role
• Child abuse
• conomic drain leading to low household
income
• Broken homes
• Separation or divorce
• Increased cost of health care
Community
• Increased incidence of motor accidents
• Bankruptcy
• Increased juvenile delinquency and school dropouts
• Increased divorce rate
• Low productivity leading to decreased output especially of
agricultural produce
MANAGEMENT
• Admission to a hospital may be necessary
especially where withdrawal symptoms are
severe or physical illnesses are present.
• Physical Care
• Assess level of alcohol use
• Detoxification: Alcohol is withdrawn and
withdrawal symptoms managed.
• Complete bed rest
• Observe patient regularly
• Quiet environment to reduce stress and stimuli
• Room light should not be too bright or dull
• Stay with patient during acute phase
• Administer prescribed intravenous and monitor
fluid and electrolyte balance
• Supplementary vitamins and high protein diet is
served. Food is served in small bits.
• Treat pressure areas two hourly if patient is bed
ridden or inactive
• Take seizure precautions
• Maintain personal hygiene
• Medication: two main drugs are used
• Alcohol deterrent drug e.g. disulfiram or
apomorphine
• Psychotropic drugs e.g. anti anxiety and anti
depressant drugs
• Psychological Care
• Supportive or insight therapy
• Group therapy to help learn coping skills
• Behavioural – aversion, relaxation, assertive
training, self-control training, counseling
• Social Care
• Support group like the Alcoholic Anonymous
(AA)
• Half way homes are used to help discharged
alcoholic
• Family therapy
• Occupational therapy
• Follow up care in the community-based
resource centre
