28 November 2015

                                        ALCOHOL AND DRUGS

ALCOHOL


What Is an Alcohol Addiction?
Alcohol addiction, also known as alcoholism, is a widespread disease that affects people of all walks of life. While experts have long tried to pinpoint genetic, gender, racial, or socioeconomic factors that may predispose someone to alcohol addiction, it appears that it has no singular cause and can afflict anyone.
In the medical community, alcohol addiction has long been considered a psychosomatic condition (Carver, 1948). This means that social, psychological, genetic, and behavioral factors can all contribute to the disease. However, it’s important to note that it is a real disease, and once addicted, an alcoholic may physically be unable to control his or her actions. Research has shown that addiction, including alcohol addiction, causes physical changes to the brain and neurochemistry of an addict.
Alcohol addiction can show itself in a variety of ways. The severity, frequency of use, or type of alcohol consumed varies from one person to the next. Some may drink heavily all day, while others binge drink for a period and then stay sober until their next “bender.” The type of alcohol you drink does not preclude you from alcoholism.
Regardless of how the addiction looks, alcoholism is usually present if a person heavily relies on drinking and cannot stay sober for a long period of time.

What Are the Symptoms of Alcoholism?

It may be difficult to recognize alcohol addiction. Unlike drugs such as cocaine or heroin, alcohol is a widely available drug and is accepted in most cultures. It is often at the center of social situations and is closely linked to celebration, reward, and enjoyment. Drinking is a part of life for many people, young and old. Also, alcoholics are often good at hiding their drinking from loved ones or minimizing the seriousness of their habit. Because of this, it is hard to tell the difference between someone who likes to have a few drinks now and then and someone with a real problem.
The following could be signs of alcohol addiction.
  • increased quantity or frequency of use
  • higher tolerance when drinking or lack of “hangover” symptoms
  • drinking at inappropriate times (first thing in the morning) or places (church or work)
  • wanting to be where alcohol is present and avoiding situations where it is not
  • changes in friendships (an alcoholic will choose friends who drink just as heavily)
  • avoiding contact with loved ones
  • hiding alcohol where no one will find it, or hiding while drinking
  • dependence on alcohol to function or be “normal” in everyday life
  • increased lethargy, depression, or other emotional issues
  • legal or professional problems such as an arrest or loss of job
As this addiction tends to get worse over time, it’s important to look for early warning signs. If identified and treated early, the alcoholic may be able to avoid major consequences of the disease. If you are worried that an addiction is present, it’s best to approach the alcoholic and discuss your concerns in a supportive way. Avoid shaming them or making them feel guilty. This could push them further away and make them more resistant to the help you offer.





What Are the Treatment Options for Alcoholism?

Treating alcohol addiction can be complex and challenging. In order for treatment to work, the alcoholic must want to get sober. Usually, you can’t force a person to stop drinking or consider treatment if they aren’t ready. Success depends on the individual’s personal drive to get better.
The recovery process for an alcoholic is a lifetime commitment. It involves daily maintenance, and is not a quick fix. For this reason, many people say alcohol addiction is never “cured.”

Rehab

A common initial treatment option for alcoholics is an outpatient or inpatient rehabilitation. In severe cases, an inpatient program lasting anywhere from 30 days to a year can help the alcoholic handle the withdrawal symptoms and emotional challenges that come with stopping drinking. Outpatient treatment provides daily support while allowing the patient to live in his or her own home.

Alcoholics Anonymous and Other Support Groups

Many alcoholics also turn to 12-step programs like Alcoholics Anonymous (AA). However, there are also other support groups that don’t follow the 12-step model. They include SMART Recovery or Sober Recovery.
Regardless of the type of support system someone in recovery chooses, it’s usually important to get involved in at least one. Sober communities can help an alcoholic deal with the challenges of sobriety in day-to-day life. All of these options put the alcoholic in touch with other people who have gone through similar experiences. It makes them accountable and gives them new, healthy friendships. It also provides a place to turn when a relapse may be on the horizon.

Other Options

An alcoholic may also benefit from other treatment methods, such as drug therapy, counseling, or nutritional changes. A doctor may prescribe something like antidepressants if the alcoholic was self-medicating for an existing problem like depression. They can also prescribe drugs to assist with the emotions common in recovery. A therapist is useful in teaching someone to manage the stress of recovery and the skills needed to prevent relapse. Also, a healthy diet can help undo damage that the alcohol may have done to the person’s health, including any weight gain or loss.
In general, alcohol addiction involves several different treatment methods that vary from one person to the next. It’s important that the alcoholic has a recovery program that will work for him or her and support long-term sobriety. This could mean an emphasis on therapy for someone who is depressed, or inpatient treatment for someone with severe withdrawal symptoms. The right treatment for you depends on your specific needs
What Are the Health Complications of Alcoholism?

Untreated, alcohol addiction can result in heart disease and liver disease. Either of these can cause death. Untreated alcoholism can also cause:
  • ulcers
  • diabetes complications
  • sexual problems
  • birth defects
  • bone loss
  • vision problems
  • increased cancer risk
  • suppressed immune function
If the alcoholic takes risks while drinking, he or she could put others in harm’s way. According to the Centers for Disease Control and Prevention (CDC), drunk driving, for example, takes 30 lives every day in the United States. Drinking is also associated with increased incidence of suicide and homicide.
These serious complications are another reason it’s important to treat this addiction early. But, nearly all of the risks of alcohol addiction are avoidable or treatable with long-term, successful recovery.
DRUGS




drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences.[1][2] An addictive drug is a drug which is bothrewarding and reinforcing.[1] ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral addiction and drug addictions, but not dependence.
Within the framework of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), substance dependence is redefined as a drug addiction, and can be diagnosed without the occurrence of a withdrawal syndrome.[6] It is now described accordingly:
When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. This, along with Substance Abuse are considered Substance Use Disorders. 

Withdrawal

Main article: Drug withdrawal
Withdrawal is the body's reaction to abstaining from a substance upon which a person has developed a dependence syndrome. When dependence has developed, cessation of substance use produces an unpleasant state, which promotes continued drug use through negative reinforcement; i.e., the drug is used to escape or avoid re-entering the associated withdrawal state. The withdrawal state may include physical-somatic symptoms (physical dependence), emotional-motivational symptoms (psychological dependence), or both. Chemical and hormonal imbalances may arise if the substance is not introduced. Psychological stress may also result if the substance is not re-introduced. 

Psychological Dependence

Two factors have been identified as playing pivotal roles in psychological dependence: the neuropeptide "corticotropin-releasing factor" (CRF) and the gene transcription factor"cAMP response element binding protein" (CREB).[8] The reward system is partly responsible for the psychological part of drug dependence. The CREB protein is activated bycyclic adenosine monophosphate (cAMP) immediately after a high and triggers changes in gene expression that affect proteins such as dynorphin, which cuts off DA release and temporarily inhibits the reward pathway. A sustained activation of CREB thus forces a larger dose to be taken to reach the same effect. In addition, it leaves the user feeling generally depressed and dissatisfied, and unable to find pleasure in previously enjoyable activities, often leading to a return to the drug for another dose.[15]
In addition to the reward pathway, it is hypothesized that stress mechanisms play a role in dependence. Boob and Kreek have hypothesized that during drug use, thecorticotropin-releasing factor activates the hypothalamic-pituitary-adrenal axis (HPA) and other stress systems in the extended amygdala. This activation influences the dysregulated emotional state associated with psychological dependence. They have found that as drug use escalates, so does the presence of CRF in human cerebrospinal fluid(CSF). In rat models, the separate use of CRF antagonists and CRF receptor antagonists both decreased self-administration of the drug of study. Other studies in this review showed a dysregulation in other hormones associated with the HPA axis, including enkephalin which is an endogenous opioid peptide that regulates pain. It also appears that theµ-opioid receptor system, which enkephalin acts on, is influential in the reward system and can regulate the expression of stress hormones.

ECEM CAGLAYAN

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