Module SevenALCOHOL & SUBSTANCES

ABUSE

Lesson 1: Alcohol (2 training hours) Lesson 2: Other substances (2 training hours) Lesson 3: Social issues (2 training

hours)

Lesson 1

ALCOHOL

Step 1: Discussion

Alcohol is the most popular toxic substance to man. Most of us use it for pleasure, but in some cases alcohol drinking might end to be a serious problem.

What is the secure alcohol consumption ?Specialized organizations have determined that The

limit of safe consumption is 21 units per week for men and 14 for women. One unit corresponds to half a pint of beer, a glass of wine or a 40gr of whiskey/vodka/liquer.

Step 2: Slide projection Slide 7.1.1: Some terms

Exceeding alcohol consumption

The regular consumption on daily or weekly basis that exceeds the recommended limit.

Step 2 (continued)

Disorder caused by alcohol

Any psychological, physical or social damage that derives from exceeding consumption.

Step 2 (continued)

Problematic alcohol consumption

Consumption that causes any disorders that can derive from alcohol drinking, but has not yet caused dependence on it.

Step 2 (continued)

Dependence on alcohol

A situation in which physical and mental disorders develop, when alcohol use is stopped.

Step 2 (continued)

Toxicosis

Is the intoxication, that is the situation that follows when alcohol levels in the blood exceed a certain limit.

Step 3

Slide 7.1.2: Characteristics of the dependence in alcohol

Withdrawal syndrome Trembling hands, tongue and eyelids Nausea, vomiting, diarrhea Intense heart beat, perspiration, high blood pressure Fever Headache Irritability, excitement, anxiety, insomnia Temporary hallucinations or delusions

Step 3 (continued)

Tolerance

Need for increasing quantity to achieve the same outcome

Furthermore : Pressurizing need to drink Standard manner of drinking regularly Priority to drinking than to other activities Failures to quit

Step 4: Slide projection Slide 7.1.3: Damages from alcohol abuse PhysicalIt can be an immediate effect of alcohol drinking, or an

indirect effect from malnutrition (lack of vitamins), accidents and general neglecting of oneself.

Gastric ulcer, hepatic damage Brain damage (and dementia) Peripheral neuritis with loss of sensing Anemia, heart failure In women that abuse alcohol during pregnancy, the infant

might have low weight and other abnormalities.

Step 5 (continued)

Psychiatric Anxiety Depression Aggression High possibility of committing suicide Psychosis with delusions or jealousy ideationSocial Family problems (quarrels, violence, divorce) Professional problems Illegal actions Accidents (car accidents or others)

Step 5: Theory presentationIt is essential to recognize persons that abuse

alcohol, as they tend not to reveal their alcohol problems.

The therapy is recommended to: Treatment of withdrawal syndrome Psychotherapies :

Recognizing and admitting the problem Try to quit drinking habit Keeping up the effort when it starts to give results

The existence of support groups (like Alcoholic Anonymous) has been proved efficient.

Step 6: Questions and comments (5΄)

Lesson 2

OTHER SUBSTANCES

Step 1: Introduction

The issue of other substances must be examined in a similar way to alcohol. The most extreme effects and problems are related to the dependence on these substances. There are of course a lot of addictive substances and the problems and dangers differs from one to another.

Step 2: Brainstorming

Which substances have you encountered in your practice?

Opiates, f. ex. Heroine, morphine Stimulants, f ex amphetamines, ecstasy, cocaine Hallucinogens, f ex. LSD Drugs, f ex benzodiazepines, barbiturates Solutions, f ex glue and aerosol Cannabis Nicotine Caffeine

Step 3: Slide projection Slide 7.2.1: Characteristics of the most common substancesOpiates (heroine, morphine)WAY OF TAKING : ingestion, intramuscularly, intravenously,

subcutaneouslyPSYCHOLOGICAL EFFECT: euphoria, relaxation, dizziness,

personality change, hypo activity, loss of appetite, low libidoPHYSICAL EFFECT: constricted pupils (pinpoint), low heart rate,

itching, nausea, constipationWITHDRAWAL SYNDROME : intense desire for the substance,

uneasiness, rapid heart rate, dilated pupils, sweating/perspiration, yawning, diarrhea, abdominal pain, dehydrated skin

DEPENDENCE: YES

Step 4 (continued)

CocaineWAY OF TAKING : chewing, inhale through nose, smoking,

intravenous injectionPSYCHOLOGICAL EFFECT: Euphoria, enthusiasm,

Confusion, Paranoid psychosisPHYSICAL EFFECT: dilated pupils(constricted pupils

(pinpoint)), fear, increase heart rate,, runny nose (rhinorrhea), fever, heart respiratory attack

WITHDRAWAL SYNDROME : intense desire for the substance, depression, insomnia, agitation.

 DEPENDENCE: YES

Step 3 (continued)

AmphetaminesWAY OF TAKING : ingestion, intravenous injectionPSYCHOLOGICAL EFFECT: Euphoria,

enthusiasm, hyperactivity, irritability, hostility, Paranoid ideation, Delusions

PHYSICAL EFFECT: constricted pupils, increase heart rate, increase of reflexes

WITHDRAWAL SYNDROME : sadness, unemployment

DEPENDENCE: YES  

Step 3 (continued)

Hallucinogens (LSD)WAY OF TAKING : ingestionPSYCHOLOGICAL EFFECT: Depersonalization,

Deobjectivation, Overestimation of abilities, Anxiety, Effect ideas, low judgment ability, Psychotic characteristics, Mood swings

PHYSICAL EFFECT: red eyes, constricted pupils, ataxia, increased heart rate

WITHDRAWAL SYNDROME : None

DEPENDENCE: NO

Step 3 (continued)

Cannabis (hashish, marijuana)WAY OF TAKING : smokingPSYCHOLOGICAL EFFECT: euphoria, relaxation, acute

perception PHYSICAL EFFECT: red eyes, dry mouth, increased heart

rate, respiratory problemsWITHDRAWAL SYNDROME : noneDEPENDENCE: YES 

Step 3 (continued)

BarbituratesWAY OF TAKING : ingestionPSYCHOLOGICAL EFFECT: Anxiety reduce

PHYSICAL EFFECT: Repression of respiratory system, Repression of Central Nervous System

WITHDRAWAL SYNDROME : Uneasiness, Insomnia, Nausea, Spasms, Delirium

DEPENDENCE: YES

Step 3 (continued)

BenzodiazepinesWAY OF TAKING : Intramuscularly, intravenously,

ingestingPSYCHOLOGICAL EFFECT: Anxiety reduce,

Disturbances in concentration, judgment, memoryPHYSICAL EFFECT: ataxia, Nausea, CNS repression WITHDRAWAL SYNDROME : Uneasiness, Insomnia, FearDEPENDENCE: YES

Step 3 (continued)

EcstasyWAY OF TAKING : ingestionPSYCHOLOCICAL EFFECT: Euphoria, increased

perceptions, Anxiety, Psychotic characteristicsPHYSICAL EFFECT: anorexia, increased heart

rate, jaw tension, sweating, High temperature , blood vessel thrombosis

WITHDRAWAL SYNDROME : NoneDEPENDENCE: NO / YES

Step 3 (continued)

Solutions (glues, aerosol)WAY OF TAKING : inhalingPSYCHOLOGICAL EFFECT: Euphoria followed

by apathy, rejection of Inhibitions, poor judgmentPHYSICAL EFFECT: : Sore eyes, sore throat,

rushes breathing difficulty, CNS repression, ataxia, sleepiness, peripheral neuropathy, multiple kidney failure, arrhythmias, liver and kidney damage, kidney damage, aplastic anaemia

WITHDRAWAL SYNDROME : NoneDEPENDENCE : RARE

Step 4: Slide projection

Slide 7.2.2: Treatment of substance usePharmacotherapies:(Methadone, Naltrexone, Klonidine, etc ) Psychotherapies. Have as a target to: Intervene in possible psychological, social,

environmental factors that persist. Increase person’s awareness. Develop alternative mechanisms of treating the

problems. Inform for the strategies of treatment of intense

desire for substance use.

Step 7: Questions and comments (5΄)