ALCOHOLISM
DEFINITION
ALCOHOLISM is excessive and
prolonged intake of alcohol
which may lead to physical
and mental illness and
interferences with socio-
economic functions and
interpersonal relationships of
the individual.
CAUSES OF ALCOHOLISM
Strains and stresses
Peer group influence
Poor upbringing
Anxiety
Hereditary
People with low self-esteem
Occupation – Breweries, mortuary,
bar, etc.
Curiosity
EFFECTS OF ALCOHOL
1. The end result is depression, because
it depresses the CNS for that matter
memory and the power of reasoning is
impaired.
2. In large doses, symptoms of
alcoholism tends to appear, e.g.,
muscular in-coordination, poor
judgment, nausea, vomiting, diplopia,
ataxia, amnesia, cold, clammy skin
which may lead to coma and then death.
ALCOHOLIC PSYCHOSES
It is a group of organic
mental illness which is due
to excessive intake of
alcohol.
THE ALCOHOLIC
PSYCHOSIS
• PATHOLOGICAL INTOXICATION (MANIA A
POTU)
DIPSOMANIA
DELIRIUM TREMENS (ALCOHOL
WITHDRAWAL DELIRIUM)
ALCOHOLIC HALLUCINOSIS
KORSAKOF’S PSYCHOSIS
CHRONIC ALCOHOLISM
Pathological Intoxication (Mania
a Potu)
This is a state of acute excitement with
violence, confusion and loss of self control.
These people drink occasionally just because
some people are drinking. They become
restless and destructive. These people later
have no recollection of the event. This
condition is seen in those who are not used
in taking alcohol so they respond to quite
small doses. It is usually seen in
psychopaths, epileptics and those who have
had head injuries. They are not habitual
drinkers.
MANAGEMENT
Induce vomiting by giving salty
water to patient to drink
The individual is bathed
Give some warm sweet drinks, e.g.,
coffee or mashed kenkey with
sugar.
Encourage him to sleep
When he wakes up, educate him not
to take alcohol because it is not
good for his health.
DIPSOMANIA
This is a condition characterized
by periodic drinking of excessive
amount of alcohol for about 2-3
weeks. Whenever the individual
is in this mood, he has the
compulsion or crave for alcohol.
This strong desire vanishes for
some time and then reappears
again with renewed vigor.
When the individual is in the
drinking bouts, he neglects his
work and personal hygiene and
can take anything that contains
alcohol. The victim remains
perfectly sober at the periods of
abstinence and may find alcohol
distasteful. Observations have
shown that neurotic, depressives,
and psychopaths often suffer this
condition.
MANAGEMENT
The main management is
psychotherapy. It is done to help
the individual to understand himself
and to control himself.
Counseling and advice by a
psychiatrist or a clinical psychologist
Family therapy.
Alcoholic Anonymous (AA).
Blue cross.
DELIRIUM TREMENS (ALCOHOL
WITHDRAWAL DELIRIUM)
This is a psychiatric condition
characterized by signs and
symptoms, often seen in chronic
alcoholics who suddenly withdraw
from alcohol for about 72 hours due
to hospitalization, imprisonment or
for any other reasons that make it
impossible to have access to
alcohol.
CAUSES
Sudden withdrawal from
alcohol for 3-5 days
Reduction in alcohol
consumption
An alcoholic with existing
physical illness
Drugs, e.g., barbiturates
Malnutrition in alcoholism
CLINICAL FEATURES
Physical Signs and Symptoms
Tremors of the limbs, facial
muscles, the lips and the
tongue
Nausea and vomiting
Headache
Insomnia
Profound sweating
Palpitation
Tachycardia
Gastritis
Furred tongue
High temperature
Malaise
High BP
Seizures
•Anorexia
Psychological Signs and
Symptoms
Confusion
Disorientation
Irritability
Depression
Anxiety
Agitation
Restlessness
Illusions and hallucinations
MANAGEMENT
Hospitalization may be
necessary
Close observation and protection
fro injury
Complete bed rest
Anxiolytic/sedatives prescribed
Nutrition / copious fluid/vitamins
e.g., B- Complex
Personal hygiene (total self-care)
ALCOHOLIC HALLUCINOSIS
This refers to auditory hallucinations
reported by clients with alcohol
dependence. The hallucinations occur
approximately 24 – 48 hours after heavy
drinking and may be vivid and
threatening to the client. The auditory
hallucinations are usually voices of
unformed sounds such as Hissing or
Buzzing. Onset is about age 40 and the
individual drinking heavily for 10 years
or more.
KORSAKOF’S PSYCHOSIS
This is a psychiatric disorder found in
alcoholism. It is sometimes referred to
as Dysmnesic syndrome or Alcohol
Amnesic Disorder. It is associated with
lack of nutritious food and vitamins
particularly vitamin B1 (Thiamine),
leading to Wernicke’s Encephalopathy.
It was first described by a Russian
Neurologist and Psychiatrist called
Sergei Korsakov in 1877. Onset is
gradual
CAUSES
Alcoholism
Malabsorption syndrome
Severe anorexia
Upper – gastro intestinal
obstruction
Prolonged intravenous feeding
Thyrotoxicosis
Thiamine deficiency
Hemodialysis
MENTAL SYMPTOMS
Poor memory of recent events
(Anterograde Amnesia)
Mistaking of identity, e.g., patient
cannot identify members of his own
family
Episodes of confusion and disorientation
Confabulation
Emotional liability (mood swings)
Illusions are common
Patient has no insight into his condition
PHYSICAL SYMPTOMS
Malnutrition
Damage to the peripheral nerves
particularly in the legs which may
lead to pain and tenderness in the
calfs weakness of the muscles of the
feet.
Sensory loss of the hands and feet,
and absence of tendon reflexes.
There may be ocular palsies and
nystagmus
MANAGEMENT
Hospitalization may not be
necessary
Vitamin B complex and Ascorbic
acid may be prescribed by
doctor, and good nutritious diet
is given
General Nursing Care
CHRONIC ALCOHOLISM
This is a condition found in
those who have been habitual
drinkers for many years. They
gradually deteriorate mentally
and physically
CLINICAL MANIFESTATIONS
Patient neglects his work and personal
hygiene
Memory defects, i.e., forgetfulness
Failure in judgment
Irritability, childishness and easy to be
suggested to
May become violent
At times shed “Crocodile” tears
He accuses his friend, employers and
relatives for letting him down
CLINICAL MANIFESTATIONS
Lack of sexual drive, impotency.
Pathological jealousy.
Confabulation.
Neglect personal hygiene.
Negligence or responsibilities- that lends
to won of job, divorce, broken homes,
etc.
Suicide tendencies
Kindly problems.
Liver cirrhosis.
Tremors
GENERAL MANAGEMENT OF
CHRONIC ALCOHOLISM
Hospitalization is necessary
Prevention of delirium tremens in
the in the first problem to tackle..
Some tranquilizers may prescribed
Nutrition and hydration(vitamin B
complex)
Observation for suicidal tendencies
Attention to other physical needs
and personal hygiene
Aversion therapy (antabuze or
Apomorphine)
Psychotherapy-counseling, AA,
Blue Cross
Recreational therapy
Occupation therapy
Rehabilitation for patient to obtain
a suitable job
PREVENTION OF
DRUG/ALCOHOL DEPENDENCE
There is the need to educate the general public
particularly the youth on the effects of abuse
of drugs. Places for these educational
programs can as follow; churches, mosques,
schools, lorry parks, social gathering, and the
general public.
Means of education
Health talks
Film shows
Distribution of leaflets
On the media, e.g., TV, Radio, newspapers
Means of legal action
Banning of the sale of heard
drugs
Drugs must be prescribed
only by qualified physicians
Drugs must be sold by
qualified pharmacists
Those who sell or found to
possess these drugs illegally
must be prosecuted
PREVENTION OF
DRUG/ALCOHOL DEPENDENCE
D. D.A. Regulations must always be
applied in giving these drugs
Drugs must be under lock
Drugs collected and served must
be witnessed and both nurses and
senior nurses sign for.
People who cultivate some of these
drugs illegally must be arrested
and prosecuted
Children under age must not be
allowed to buy alcohol or sell it.
There must be proper checking
at ports and border.
Only some specified companies
must be allowed to produce
these drugs.
There should be proper
distribution of these drugs so
that it does not go into wrong
hands.
PREVENTION OF DRUG/ALCOHOL
DEPENDENCE
In the community
There should be recreational facilities for
the youth
Job avenues for the general public
Vocational institutions for the youth
Parents must serve as a good models to
their children
Parents create harmonious atmosphere at
homes for their children’s proper
development
Teachers must identify students with drug
problems so that they can be counseled.
THANKS
