ALCOHOL TOBACCO AND OTHER ADDICTIVE SUBSTANCES Anderson Spickard

ALCOHOL, TOBACCO AND OTHER ADDICTIVE SUBSTANCES Anderson Spickard, Jr. , M. D. Web Site: www. mc. vanderbilt. edu/cph

APPROACHES TO ADDICTION PREVENTION l EARLY IDENTIFICATION l TREATMENT l RELAPSE PREVENTION l POLICY AND ENVIRONMENTAL CHANGE l

Addiction Progression l USE l ABUSE l DEPENDENCE

THE DISEASE OF ADDICTION l BIOPSYCHOSOCIAL AND SPIRITUAL

BIOLOGICAL l Alcohol affects: – – Brain and Nerves GI (liver, stomach, pancreas) Lungs (with smoking) Reproductive organs

PSYCHOLOGICAL Emotions (Fear and Anger) l Dual Diagnosis (Depression, Bipolar, Schizophrenia, Personality Disorders, etc) l Role of Adult Children of Alcoholic/Addict Issues l

SOCIAL Work impaired l Family life impaired l Recreational life impaired l

SPIRITUAL Guilt l Shame l Issue of sin for the faith community l

SUBSTANCES OF ADDICTION l l l l Alcohol Opiates Benzodiazepines and Hypnosedatives Cocaine, Amphetamines Cannabinoids Hallucinogens Inhalants Tobacco

ABUSE (1 YR. OF AT LEAST 1 OF THESE) l l Major obligations not completed Use in dangerous situations Legal difficulties Social problems

DEPENDENCE (1 YR. OF AT LEAST 3 OF THESE) l l l l Withdrawal syndrome Tolerance Greater use than intended Attempts to reduce use Excessive time to obtain substance Important activities curtailed or stopped Persistent use despite problems

ASSESSMENT l History of: – – – – l quantity frequency kind other drugs family history other treatments support systems CAGE questions History of DT’s

CAGE l l C=Have you ever tried to Cut down on your drinking? A=Have people Annoyed you by criticism of your drinking? G=Have you ever felt Guilty about your drinking? E=Have you ever taken a morning Eye opener to steady your nerves or to get rid of a hangover?

Physician Intervention in Patient’s Alcoholism May be life saving to certain individuals l Very important to family, employer l Very effective if done well l