pills and alcohol use and abuse - academy llalcohol facts men binge drink more often than women,...
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Pills and Alcohol
Use
And
Abuse
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ALCOHOL STREET DRUGS
AND
PSYCHOTROPIC MEDICATION
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GUIDELINES
Abstinence is best--at least until the dosage
and your condition is stable
Then “moderate” alcohol consumption if
desired. Moderate means
No more than 1 drink per day
Nor more than 4 drinks in a week
Some people get increased intoxication on
medication
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RISKS OF SIGNIFICANT
ALCOHOL USE WITH MEDICATION
Alterations of neurotransmitters
Driving with one foot on the gas and one foot
on the brake
Blackouts
Unpredictable
Does not mean you were unconscious, asleep or
stopped functioning
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SENIORS AND PRESCRIPTION DRUG ABUSE
To control pain
To induce sleep
To minimize anxiety
A history of experimentation
Baby boomers
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Mixing prescription medication with alcohol
LOTS OF RISKS
DRIVING WHILE IMPAIRED
Two words Broken Hip
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MOST COMMON PRESCRIPTIONS ABUSED
Benzodiazepines
(Xanax, Klonopin, Ativan….)
Sleep medications
(Ambien, Sonata, Halcion, Lunesta….)
Opioid pain Medications
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OPIOID PAIN MEDICATION
Codeine (only available in generic form)
Fentanyl (Actiq, Duragesic, Fentora)
hydrocodone (Lorcet, Lortab, Norco, Vicodin)
hydromorphone (Dilaudid, Exalgo)
meperidine (Demerol) methadone (Dolophine, Methadose)
morphine (Avinza, Kadian, MS Contin, Ora-Morph SR)
oxycodone (Percodan, Percocet, Oxycontin)
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ALCOHOL ABUSE AND
ALCOHOLISM
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ALCOHOL IS THE #1 MISUSED DRUG IN THE U.S.
4 OF 5 SENIORS WITH SUBSTANCE PROBLEMS
ABUSE ALCOHOL
ALCOHOL WITH PRESCRIPTION DRUG ABUSE IS
ON THE RISE
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WHAT IS THE IMAGE OF PERSONS WITH
ALCOHOLISM?
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THEY LOOK LIKE THE PEOPLE IN THIS
ROOM
NOT!!
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ALCOHOL FACTS
Men binge drink more often than women, but…..
Women absorb alcohol into the bloodstream faster and metabolize it slower
than men.
Women who drink regularly are at significantly greater risk for liver damage
than men, even if they drink less or drink for a shorter period of time.
Women develop alcoholic liver disease after a comparatively shorter period
of heavy drinking and at a lower level of daily drinking than men.
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ALCOHOL FACTS
Alcohol is a brain “depressant”—slows firing of
neurons as well as body and mind processes
Alcohol and most medications stay in the
system for hours and can interact even when
ingested at different times
Non-alcoholic individuals metabolize alcohol at
1 oz. per hour. Alcoholics much slower
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SENIORS AND ALCOHOL
14% of seniors in ER’s show symptoms of
alcoholism
17% of seniors abuse alcohol and drugs, yet…
Less than half of alcoholics over 65 are
diagnosed
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As we age, our ability to metabolize alcohol
slows
An amount we can safely tolerate at 55-65 may
not be safe at 75 or 80
We may develop an alcohol problem without
changing the amount we drink
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Alcohol does not relieve depression - it makes it worse.
One third of suicides are associated with alcohol misuse.
Alcohol may relieve anxiety transiently, but the brain “rebounds” and the anxiety returns
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RISKY DRINKING
More than 7 drinks in a week
More than 3 drinks in a day
Men generally OK at 2 drinks a day
Women generally OK at 1 drink per day
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ALCOHOL ABUSE
A disease that is characterized by the sufferer
having a pattern of drinking excessively despite
the negative effects of alcohol on the
individual's work, medical, legal, educational,
and/or social life.
Alcohol abuse affects about 10% of women and
20% of men in the United States,
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ALCOHOLISM
A chronic disease with genetic, psychosocial
and environmental factors which, without
treatment, is usually progressive and fatal
It is not a matter of will power, choice or moral
weakness
It is treatable but not curable
The risk of relapse remains even after long
periods of sobriety
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RISKS
http://www.medicinenet.com/alcohol_abuse_h
ealth_risks_pictures_slideshow/article.htm
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Chronic alcohol use can cause an overall reduction in brain size.
The more you drink, the smaller it gets
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RED FLAGS---THE WARNING SIGNS
Developing tolerance—a person increases their alcohol intake without feeling drunk or because they aren’t getting the “good effects”
Experiences withdrawal
A person drinks when they don’t want to
Repeatedly drinks before social situations to “get ready for the party”
Hides alcohol or lies about it
Has a “blackout”
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WARNING SIGNS
Drinking alone, to escape problems, or for the sole purpose of getting drunk
Getting irritated when you are unable to obtain alcohol to drink
Arranging your schedule to assure access to alcohol
Having social, work or family problems because of your drinking.
Having a desire to cut down, but not successful
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C A G E—IN THE PAST YEAR
Have you ever felt you should Cut down on your drinking?
• Have people Annoyed you by criticizing your drinking?
• Have you felt bad or Guilty about your drinking?
• Have you ever had a drink first thing in the morning to steady your nerves or get rid of a
hangover (Eye-opener)?
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One or more yes answers is associated with an
increased risk of alcohol-related problems for
both men and women
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THE 2 BIGGEST PROBLEMS
Problem # 1
Denial
I don’t have a problem with drinking
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THE LIES THAT ALCOHOL ABUSERS SAY THAT
UNDERSCORE DENIAL
I can stop any time I want
I can safely have just one
It’s my problem. I’m the one it hurts
I’m not an alcoholic because I have a job and I
am doing OK
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MORE LIES
Drinking is not a real addiction like drugs
I don’t drink every day so I can’t be an alcoholic
I only drink wine and beer so I can’t be an
alcoholic
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PROBLEM #2
“Cutting down” doesn’t
work
It is every alcoholics unfulfilled wish
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TREATMENT WORKS !!
With treatment, about 70% of people with alcoholism are able to decrease the number of days they consume alcohol and improve their overall health status within six months.
No matter when treatment is started
Obviously treatment is more successful when the person wants to quit
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COLORADO IS ONE OF THE TOUGHEST STATES IN
THE COUNTRY FOR ALCOHOL OFFENSES
Penalties may include a nine-month license
suspension, minimum $600 fine, and up to 96
hours of community service. In addition 48
hours or more behind bars—(although this
penalty is typically waived for first offenders if
they agree to undergo treatment for alcohol
abuse.)
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HELPING OTHERS
An Intervention—usually one time only
Even if unsuccessful, it plants the seed
Use of levers—What is important to this person?
Money
Driving
Contact with family members (children)
Separation or divorce
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EVALUATION AND TREATMENT
Visit to one’s primary care healthcare provider
Discussion
Physical exam
Laboratory tests
Referral to a specialist or program
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THERAPY
Detoxification (“Detox”) usually requires
inpatient stay
28-30 day stay programs (Insurance covered)
Intensive outpatient treatment (Day treatment)
Alcoholics Anonymous (AA)
Substance abuse oriented group therapy
Individual therapy
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Medication
Antabuse—creates very unpleasant reaction if the
person drinks—usually time limited but occasionally
long term
Revia (naltrexone)—decreases craving for alcohol
Care usually needs to be on-going
Al-anon and Alateen for families of alcoholics
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Relapses (“slips,” “falling off the wagon”)
are common but do not necessarily mean
that treatment cannot ultimately be
successful