Saturday, February 15, 2014

SUBSTANCE DEPENDENCE AND DELETERIOUS EFFECTS OF ALCOHOL

Introduction

1.                  Substance may be referred to as alcohol, drugs and narcotics. I have explained the physical and psychological dependence to substance and discussed about the deleterious effects of alcohol to person and family.

Physical Dependence to Substance

2.                  Drug dependence means that a person needs a drug to function normally. This means when a person abuses substance or strong drugs a chemical reaction occurs inside the human body causing damages to the nervous system – nervous system breaks down – and there are lots of pain within his body that he could not tolerate, causing physical dependence on the particular drug. Physical dependence on a substance may not necessarily be due to addiction. There are drugs that do not cause addiction. For example, certain blood pressure medications do not cause addiction but they can cause physical dependence in order to get relieved from some physical reactions such as pain, giddiness, and diarrhea and so on. (Dugdale, D. 2012) As per Zwanger, M (2013) here some symptoms caused by physical dependence include:
a.                   Ingestion of larger amounts of drugs even for a long period.
b.                  Compulsion to take the drug with significant amount of time spent trying to obtain the substance.
c.                   Withdrawal symptoms if the drug is stopped or the amount taken is reduced
d.                  The need for increased amounts of drug to achieve the original effects.
e.                   Avoiding of Social, recreational, occupational, or pleasurable activities.
f.                   Persistent use of substance even when evidence that is harmful to the body, mood, thinking, or actions.
g.                  Addiction is elevated narcotic abuse that becomes a craving, with compulsive need to use the substance and often self-destructive behavior.
 
Psychological Dependence to Substance

3.                  Psychological dependence is defined as dependence on a psychoactive substance for the reinforcement it provides. Psychological dependence is classified under addiction. (Wikipedia, 2013) Addiction is the continued repetition of a behavior despite adverse consequences, a psychological condition, and those addicted needs a particular drug. A person can be psychologically dependent on the most common substances like nicotine, alcohol, opiates, barbiturates, and benzodiazepines. People who have psychological dependence on drugs have some of these psychological conditions as:
a.                   Have depression, bipolar disorder, anxiety disorders, and schizophrenia.
b.                  Have low self-esteem, or problems with relationships
c.                   Live a stressful lifestyle, economic or emotional
d.                  Live in a culture where there is a high social acceptance of drug use

Deleterious Effects of Alcohol

On the Individual

4.                  People consume alcohol to socialize, celebrate, and relax, but alcohol often has a strong effect on people – and throughout history, it has been very difficult to understand and manage alcohol’s power. The inverse relation in Western cultures between alcohol consumption and cardiovascular disease has been known for over 100 years. According to many physicians alcohol has health concerns and do not promote its consumption. Others have argued that the benefits of moderate alcohol consumption may be outweighed by other increased risks, including those of injuries, violence, fetal damage, liver disease, and certain forms of cancer.

5.                  According to NIAAA (2013) Here’s how alcohol can affect your body:
a.                   Brain.
Alcohol interferes with the brain’s communication pathways, and can affect the way the brain looks and works which can change mood and behavior, and make it harder to think clearly and move with coordination.  

According to some studies led by Andrew Holmes, Ph.D., in the Laboratory of Laboratory of Behavioral and Genomic Neuroscience at NIAAA found profound changes in the dorsal striatum of some experimented mice, including the expansion of neuronal dendrites, the branching projections of the nerve cell that conduct signals. Such changes are also seen with chronic exposure to drugs such as amphetamine1. These structural changes were associated with changes in synaptic plasticity, the brain’s ability to change in response to experience, and reduced activity of endocannabinoid receptors2, which are part of a signaling system that may play a role in sensation, mood, and memory.  “These findings give important insight into how excessive drinking affects learning and behavioral control at the neural level,” said Kenneth R. Warren, Ph.D., acting director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

 “The findings imply that chronic drinking may set up a concerted set of adaptions in this key brain region that produce a bias for striatal control over behavior.” Dr. Andrew Holmes.

b.                  Heart.
It is not a good idea to start drinking alcohol to protect you against heart disease. We can also argue that drinking moderate amounts of alcohol may protect healthy adults from developing coronary heart disease. But the negative effects are greater that its benefits to human health.

Drinking for a prolong time or too much on a one occasion can damage the heart, causing:
1)                  Cardiomyopathy – Stretching and drooping of heart muscle
2)                  Arrhythmias – Irregular heart beat
3)                  Stroke
4)                  High blood pressure  
[1] A potent central nervous system stimulant of the phenethylamine class that is used to treat ADHD and narcolepsy
2 A group of neuromodulatory lipids and their receptors that are involved in a variety of physiological processes including appetite, pain-sensation, mood, and memory.

c.                   Liver.
Heavy drinking takes a toll on the liver, and can lead to a variety of problems and liver inflammations including:
1)                  Steatosis, or fatty liver
2)                  Alcoholic hepatitis
3)                  Fibrosis
4)                  Cirrhosis

d.                  Pancreas.
Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion. 

e.                   Cancer.
Drinking too much alcohol can have a risk of developing certain cancers, including cancers of the:
1)                  Mouth
2)                  Esophagus
3)                  Throat
4)                  Liver
5)                  Breast

f.                   Immune System.
Drinking too much can weaken your immune system, making your body a much easier target for disease.  Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much.  Drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk.

6.                  The diagram below shows the potential long-term effects of ethanol to an individual:



                                                         Diagram by: en.wikipedia.org

On the Family

7.                  According to Ackerman, R. (1987) we already know that a person can have serious deleterious effects by alcohol and so to their families. The individual is the beginning unit of the assessment to understand family dynamics in an alcoholic home. This is true for both alcoholic as well as the non-alcoholic members of the family. Different members of the family get affected differently when regarding the following factors:
a.                   whether or not a parent is recovering from alcoholism or still drinking
b.                  sex of the child and sex of the alcoholic parent
c.                   age of the child
d.                  race
e.                   ordinal position
f.                   socio-economic factors of the family
g.                  offsetting factors which can be either people or institutions that have had a positive impact on the children

8.                  Other than these factors the severity of alcoholism also disturbs the family by the alcoholic. One is the belligerent type who is verbally abusive and looks forward for arguments. The other effect is from someone who likes to laugh a lot and is preoccupied with entertaining. Being around this alcoholic may be emotionally stressful, due to inappropriate joking, or the inability to express himself or herself seriously

9.                  Giving a thought of my personal experiences as I have observed in different cultures the men of the families are consumers of alcohol. The ladies do not like their men to drink, but in order to respect them as the men are their care takers they are forced to ignore the fact their loved ones (men) are consumers of alcohol. I have personally seen and witnessed two families where the wives do not admire their husbands drink alcohol and they even said to me that liked people who do not drink. When regarding these facts also we know that psychologically also these women are affected badly.

10.              Responses to alcoholism in the family can be divided into four phases. These are called reactive, active, alternative and family unity phases. Ackerman, R (1987) had also described that “many families, unfortunately, remain in the first phase and never reach the fourth state of sobriety and family growth”.

11.              During the reactive phase, three typical family characteristics emerge. They are family denial, coping strategies, and social disengagement. During the active phase the family begins to realize that the problem of alcoholism cannot be denied away. And they become aware about alcohol and starts behaving normal. During the third phase, the alternative phase, family members begin to withdraw from each other, and are often forced into “choosing sides.” Parents may begin to make threats to each other or statements to the children that they are considering a legal separation or divorce. Separation also may occur in some families. If a child perceives that he or she will be worse off after the separation, then the child views the change as undesirable, and is opposed to it or vice versa. Unfortunately, many alcoholic families never reach the family unity phase, because of continuing alcoholism.

Conclusion

12.              We must understand the fact that abusing any substance will lead to chronic health problems. Regular use of substance often leads to a tolerance where the user will require more substance to achieve the desired effects. Excessive use of substance eventually will lead to a physical and psychological dependency. It is understood that small amount of these substance will not cause us harm but it is better to totally avoid any substance which may cause deleterious effects to our body and family.


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