Final Exam Notes
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| Medical Complications | Heart
Hypertension - high blood pressure
Cardiomyopathy - flabby and enlarged heart
Cardio Arrhythmia - uneven heartbeat (treatment: pacemaker)
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| Medical Complications: Cont'd | Liver (used to remove toxins from your body, metabolizes (breaks down) alcohol and other drugs)
Liver damage 1) fatty liver 2) alcoholic hepatitis - inflammation of the liver 3) cirrhosis - non-treatable, only treatment is a liver transplant
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| Medical Complications: Cont'd | Skin (largest organ in the body) - thins out, see blood vessels, thinning of circulation
Brain - Korsakoff's Syndrome (short-term memory loss, elderly, men)
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| Medical Complications: Cont'd | Pancreas (secretes enzymes to help break down starches; produces insulin
Pancreatitis - blood pressure rises, not enough insulin (type 2 diabetes - untreated: blindness, amputation, heart disease), treatment: diet, oral medication, insulin injections
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| Fetal Alcohol Syndrome (FAS) | 100% preventable
Caused by a pregnant woman drinking too much (during 1st trimester)
Prone to seizures, facial features like that of an individual with down syndrome, intellectual disabilities, not fully developed physically, low birth weight
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| Cancer | Heavy drinking increases the risk of breast cancer (heavy drinking = 3+ drinks per day)
Oral cancer (cancer of mouth, lip, throat, tongue; 6x risker with alcohol use; 38x the risk when combined with tobacco use; treatable)
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| Gastritis | Stomach
Inflammation of stomach
Ulcers
Heartburn, indigestion feeling (all the time)
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| Medical Model | Alcoholism is a disease (addiction in general)
Dr. Jellneck - 1st person to think of alcoholism as a disease
AA meetings
Alcoholism = chronic disease with a genetic, psychosocial and environmental causes
Progressive (doesn't get any better) and fatal
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| Advantages and Disadvantages of the Medical Model | Advantages:
1) stigma reduces (people aren't weak)
2) easier to understand
3) research
Disadvantages:
1) quick fix (i.e. pill)
2) avoid personal responsibility
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| Withdrawal Symptoms (from alcohol) | Irritable, angry, tense
Tremors ("shakes)
Seizures
Anxiety
Rapid heart beat
Insomnia
Sweating
Hallucinations (visual, auditory, bugs crawling under skin, 4 point restraints)
5-7 days: someone needs to get over acute physical symptoms
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| Delirium Tremens (DTs) | Most serious form of alcohol withdrawal
Symptoms do not go away, they persist
Can last 10-14 days
2% chance of being fatal
More violent/serious symptoms
Withdrawal should be medically supervised
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| Antabuse | Drug that will do nothing except if you drink alcohol while on Antabuse
Get VERY sick
Will prevent someone from driving if they know they are on Antabuse
Stays in system for 14 days
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| How Substance Abuse Effects: FAMILY | Impacts the people you live with
Family members can be impaired (stress, tension, need to take more time off)
Enabling (not encourage but not doing anything about it) (i.e. paying for alcohol, calling in sick for them)
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| Family Response | 1) Denial - excuses ("dad's had a bad day"), isolated ("only on weekends), no problem
2) "Nagging", Shaming - not going away, "if you love me you will stop", "pull yourself together", difficult to hide
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| Family Response: Cont'd | 3) Chaos - no longer able to hide behavior from outside world, problems become visible, financial problems, 1st efforts to seek help (family, friends)
4) Divorce/Seperation - effort to escape, alcoholic leaves; family leaves alcoholic
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| Family Stress | 1) behaviors are unpredictable (no feeling of safety)
2) unable to understand parental behaviors (confusion, insecurity)
3) self blame
4) victims of violence
5) limited social life
6) addictive behaviors
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| Coping Skills | Responsible Child - take on the parental role, emotionally and practically, chores
"Adjuster" - follows directions, doesn't make "waves" (goes with the flow), doesn't show emotions (keeps things inside)
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| Coping Skills: Cont'd | Placater - lessen impact/anger of someone, manage emotions (calm people down), makes excuses for family/behaviors
Scape Goat - others blame you for their mistakes, identified as what is wrong with the family, bad in school, behavior problems
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| Adulthood | Responsible Child - leaders, traits of micromanagement, need to be in control, more responsibility
Adjuster - unable to trust others, unable to have relationships, hard time committing, doesn't show emotions
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| Adulthood: Cont'd | Placater - seeking to keep the peace, care for others (profession), resentment
Scape Goat - clients of the future, substance abusers, criminals
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| Physicians | High stress job
Have access to medications
Very long hours
Highest incidents of abuse come from ER physicians
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| AA Meeting Reactions | Upbeat
Family history
Relaxed but organized
AA phrases
Sense of community
Open, honest
Inspirational
Non-judgemental
Family oriented holiday = tough
365 days a year (anytime, anyplace)
AA coins (sobriety, 24 hr., month, year; reinforcement)
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| AA Meeting Reactions: Cont'd | Held in churches, schools (religious aspect, over mention of God, churches are free to use)
"Dry Drunk" (abstinent but irritable and angry, signs of being drunk but sober, didn't go through "steps")
Economic diversity
Middle Class
Mostly men
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| Alanon Meeting | Meeting for family members/spouses
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| Women and Alcoholism | "male" = disorder, disease, problem
25% of women are alcoholics
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| Women in Treatment | 1) identify triggers easily (associated with a loss)
2) disease appears later, but progresses quicker
3) medical complications (appears more quickly, more prone)
4) earlier treatment
5) divorced (women stick around, want to help)
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| Women in Treatment: Cont'd | 6) poorer
7) anxious, depressed
8) victims of violence (come into treatment with history of trauma)
9) loss of children (fear them being taken away)
10) drink alone and at home (people don't know, secretive, shameful, guilty)
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| Adolescents and Alcoholism/Drugs | 1) change (frontal lobe - still developing, judgement, decision making)
2) live forever (think they will live forever, try more crazy things, future is hard to grasp)
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| Adolescents and Alcoholism/Drugs: Cont'd | 3) rebellion (don't listen to authority, defy rules, testing limits)
4) conformity (want to be like their peers, peer pressure)
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| Changes in Behavior | Classroom attendance
Isolation
Participation in hobbies, sports, academics
Stealing
Acting out (against parents)
Grades
Change in peers (friend groups)
Change in appearance
Unaccounted time
Increase in lying (caught lying)
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| Drunk Driving | DUI (Driving Under Influence)
Blood Alcohol Level to be legally drunk = 0.08
Downward trend of drunk driving accidents = better educated about it
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| How Alcohol Impairs Driving Skills | vision processing = slowed
reaction time
"tunnel vision" = no peripheral vision
impairs judgement, decision making
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| Criminal per se Laws (by itself) | Need BAC, but also witnesses and evidence
NOW - only need BAC to be convicted
Can now take away license on the spot (no longer by registry)
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| Reasons to Decrease Drunk Driving | PSA (Public Service Announcement)
MADD (Mothers Against Drink Driving) - pressures to increase penalties
Increase in penalties
Sobriety check points
Designated Drivers
Drunk Driver Teses (alphabet backwards, walk on a straight line, etc)
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| DRAM Shoppe Laws | umbrella term for laws that hold restaurant liable for a drunk driver
shop can be held liable for a drunk person who left their restaurant
how you cut someone off, when to cut a person off (so they aren't held liable)
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| Breathalyzer in Car | won't let you drive if you have any alcohol in your system
blow into breathalyzer to start car
periodically stop car and ask driver to breath into breathalyzer
get around it by having someone else blow into it
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| Social Host Laws | umbrella term for drunk driving laws
protect private home owners
can be held liable if a drunk driver comes from your house
home owner is held liable for drunk driver
against the law to drink in your home (minors)
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| Treatment (Goals) | 1) Abstain
2) Reduce relapse
3) Drug free lifestyle (cut out people who are bad influences, hobbies, interests, change living arrangements, learning to have fun without drugs, relax, employment, balance)
4) Medical/Health
5) Mental Health
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| Principles of Effective Treatment | 1) no 1 treatment for everyone (individualized)
2) readily available treatment
3) multiple needs (of client)
4) adequate time (90 meetings in 90 days)
5) medication are important
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| Principles of Effective Treatment: Cont'd | 6) detox is only the 1st step (need further treatment)
7) treatment does not need to be voluntary (can be involuntary, involuntary commitment)
8) long-term disorder (treatment also needs to be long-term; can be managed, not cured)
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| Relapse | An event and a process
Event: picking up and using again
Process: process of building up to that decision (not "out of the blue")
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| Risks | lack of follow up
others using (spouse/partner)
pressure
depression
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| Staying Sober | 5 or more years sober = less likely to relapse
Married or employed = less likely to relapse
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| Should avoid all of these when recovering from alcoholism | HALT
Hungry
Angry
Lonely
Tired
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| Warning Signs | forgetting (appointments, meetings)
making excuses
been "cured" (there is no cure)
substitution (i.e. MJ for cocaine, alcohol for cocaine)
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