Category: Addiction

References

Bezrutczyk, D. (2019). What are the differences in addiction between men and women?

Gainsbury, S. M. (2017). Cultural competence in the treatment of addictions: Theory, practice and evidence. Clinical psychology & psychotherapy, 24(4), 987-1001.

Hartney, E. (2019). DSM 5 criteria for substance use disorders. VeryWell Mind.

McGovern, M., & Carroll, K. (2003). Evidence-based practices for substance use disorders. Psychiatric Clinics of North America, 26(4), 991-1010.

NAADAC, the Association for Addiction Professionals (2016). NAADAC/NCC AP Code of Ethics. Alexandria, VA: NAADAC. Web.

Weinstock, R. (2012). Ethical considerations in adolescent addiction. In Richard Rosner (Ed.), Clinical Handbook of Adolescent Addiction, pp. 423-429. New York, NY: John Wiley & Sons, Ltd.

Winters, K. C., Botzet, A. M., & Fahnhorst, T. (2011). Advances in adolescent substance abuse treatment. Current Psychiatry Reports, 13(5), 416421.

Winters, K. C., Martin, C. S., & Chung, T. (2011). Substance use disorders in DSM-V when applied to adolescents. Addiction (Abingdon, England), 106(5), 882897. Web.

I have hear people argue that drug addiction should not be considered a disease and should instead be considered as a lifestyle that is detrimental to ones health, such as cigarette smoking. It is their belief that drug addiction is something that a person can start doing and then later on, quit doing cold turkey. It is my opinion, however that drug addiction is a disease that can be considered chronic in nature and relies heavily on the influence of hereditability, environmental conditions, and the ability of inability of the addict to respond to treatment programs.

The reason that drug addiction was classified as an illness is really simple and easily understandable. Drug addiction became a disease because of the following factors according to the American Medical Association:

• The illness can be described.
• The course of the illness is predictable and progressive.
• The disease is primary  that is, it is not just a symptom of some other underlying disorder.
• It is permanent.
• It is terminal. If left untreated, it results in insanity or premature death.

There have been recent human studies wherein the interacting influences of both the environment and genetics have been proven to be strong contributors to addiction. It is a case somewhat similar to a person who has a family history of cardiovascular disease and yet ignores it and continues to do things that could hasten the advent of his disease. The National Institute of Drug Abuse has described the hereditary factor as like other chronic diseases, is a heritable disorder and that genes play a role in vulnerability to addiction. Genes can also play a role in protecting individuals from addiction. (NIDA, Addiction Is A Disease).

Indeed, the actual cause of drug addiction has been long debated without success. The common perception, however, is that drug addiction is primarily a moral or character problem, something caused by degeneracy or lack of willpower. ( Firsheim. Introduction: Addiction As A Disease). This was the same argument used by alcoholics to defend their disease until 40 years ago when the American Medical Association actually declared Alcoholism to be a disease.

Thanks to recent developments in brain analysis technology, the scientific world has now managed to conclude that drug addiction causes a change in the brain that makes them lose control over an activity that they should actually be able to practice self control over. Therefore the conclusion they reached is that drug addiction is a neurologically based disease ( Addiction: A Neurological Disorder).

The reality is that addiction is not about will power or the users belief that he can stop the habit anytime. The chemicals that they absorb into their system are not like placenta or sugar tablets which are harmless. It is not like taking an aspirin. This drug cause neurological destruction in the user and therefore affects the brain and nervous system. This is explained in the medical community as changes within the neurotransmitter balances and is then  driven by millions upon millions of new living, functioning active neurological pathways which have been established to sustain the condition in the addicts brain. ( Addiction: A Neurological Disorder)

Due to the new pathways created to support the habit, the user develops a neurological disorder that will react in what it perceives to be a normal manner for the brain, causing uncontrollable cravings that overwhelm the person. So it is safe to argue that the cravings of the addict and the addictions itself stems from the new nerve impulses in the brain. It is merely a response to a habit, just as a person would respond to hunger pangs by eating to remove the craving.

Indeed, drug addiction is a disease caused by the rewiring of the brain to accept harmful behavior as a normal part of its function. These changes in the function of the brain that affect the sector of the brain known as the Midbrain is what causes the brain to malfunction.

Just like any part of the human body, the brain also experiences stress. An addicts brain is constantly under pressure to find the chemical that helps it feel different, thus, causing the brain to shut down until the craving is fulfilled. Therefore, we must realize that just like in the case of any illness or disease, the brain of a drug addict is sick. The midbrain becomes defective and causes hedonic dysregulation and the inability to decipher right from wrong, leading to the loss of control, craving, and drug use

All my readings regarding this argument has led me to believe in only one thing, that addiction can be classified as a disease of the brain and therefore cannot be treated without intervention of sorts. Just because addiction is a disease does not mean that drug addicts can no longer stop the addiction, it does not have to lead to death. Instead, by accepting that drug addiction is a disease, a drug addict can be helped to find the right medical treatment and apply the proper lifestyle changes to help him get cured of the disease.

What is important for drug addicts is for them to learn to change their behavior in order to beat the disease. After all, unhealthy people under medical care get guidance and treatments to help them surpass their illness. It is a matter of wanting to recover and having the proper cures available for the addict to use.

It may have taken the medical world a long time to get around to the concept of drug addiction as a disease, but it is even harder for the addicts to accept that they do have a disease instead of a moral problem. Being a pathological illness, the addiction causes behavioral changes detrimental to the well being of the person. However, due to the slowness of the progress of the disease, most untrained people, such as family members, would rather see the illness as an emotional weakness that can be beat through family support and nothing more.

Finally, I would like to close my argument regarding addiction as a disease by explaining that as a disease, drug addiction affects the neurological, chemical, and physical attributes of the addict and cause permanent damage. It is a severe disease that requires severe treatments. The newly developed neurological pathways the brain created in order to deal with the illness now have a direct say in the life of the person causing this illness be classified as a self contracted neurological and physical disease. Therefore medical intervention will be necessary in order to save the brain of the person and anytime medical intervention becomes necessary in order to cure a patient, that patient has a disease or actual illness. Not a weakness in personality.

Work Cited

Addiction Is A Chronic Disease. National Institute On Drug Abuse. 2008. Web.

Addiction: The Disease Concept. Solutions Outpatient Services. 2008. Web.

Florsheim, Janet. Introduction: Addiction As a Disease. Movers On Addiction: Close To Home. (2008). Web.

Hughes, David R. Addiction As A Disease. Addiction: A Neurological Disorder. (1997). Web.

McCauley, Kevin T. Is Addiction Really A Disease?. State Bar Of Texas. (1996-2008). Web.

Introduction

Drug addiction is characterized by long-term changes in the manner in which an individual acts. Drugs of addiction are believed to initiate and maintain obstinate changes in neuronal pathways especially those of the limbic system, specifically in nucleus accumbens (NAc) medium spiny neurons (MSNs). Even though evidence exists of structural modifications in these pathways, less information is known about the molecular mechanisms involved in these modifications. Scientists have identified two forms of structural modifications; namely modification in the size of cell bodies and modifications of spine morphology.

Drugs of addiction such as morphine and cocaine have been shown to rework the density of dendritic spines on medium spiny neurons in nucleus accumbens. Even though evidence exists to support structural modifications, the role of such modifications in drug addiction has eluded scientists for a long time. In addition, research carried out has shown conflicting role of such modifications. This review aims at highlighting these pertinent issues.

Modifications due to opiate and stimulant drugs of abuse

Many studies have shown that persistent administration of drugs of abuse result in neuronal modifications in the brains reward center. Studies have shown reverse structural modifications when using opiates and stimulants, such that opiates result in a decrease in number of neuronal branching, while stimulants such as cocaine increase the branching of dendrites. As of now, there is only one concession to this observation: persistent administration of morphine fosters proliferation of spine number on orbitofrontal cortex pyramidal neurons. This is a paradoxical phenomenon, since morphine and stimulants have similar phenotypic manifestation and is as such, expected to have similar underlying molecular mechanisms.

Neurophysiological importance of drug-induced structural modifications in neuronal pathways

Research has shown that the size and shape of neurons determines largely the type of plasticity observed, either long-term potentiation (LTP) or long-term depression (LTD). Researchers believe that, the duration of activity brings about transformation of a novel spine into a mature stable spine. LTD results from repudiation of spines while LTP is a consequence of either formation of new spines or enlargement of existing ones.

These changes are believed to start at the molecular level with modification in production of cytoskeletal proteins to increase anchorage and internalization of a-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate (AMPA) glutamate receptors. This may lead to either LTP or LTD depending on the stability of the involved spine. Contemporary studies have demonstrated changes in NAc MSNs that are implicated in the early stages of the addiction process.

LTP has been shown to be mediated through N-methyl-D-aspartate (NMDA) glutamate receptors with increased expression of the NR2B gene especially after administration of stimulants like cocaine. On withdrawal of cocaine, the spines have been shown to increase expression of GluR2-lacking AMPA receptors that have been implicated in causation of craving during cocaine withdrawal. Paradoxically, studies have shown downgraded interactive sensitization to cocaine even when there is intensive expression of AMPAs GluR1subunit and this requires further studies to allow for mapping of the source of the paradoxical occurrence.

Mechanisms of opiate- and stimulant-induced structural plasticity

Majority of studies carried out, have leaned towards the molecular basis of structural modifications due to stimulants as compared to opiates. Despite these limitations, it is a well-known fact that both opiates and stimulants result in molecular changes that cause addiction. It has been demonstrated that morphine reduces Homer 1 and PSD95, integral proteins of the postsynaptic cytoskeleton in NAc. The same effect has been observed with cocaine. Other genes down regulated by both morphine and cocaine include RhoA, Rac1, and Cdc42, all of which are constituents of the actin cytoskeleton. This observation has been attributed to the ability of the groups of drugs to promote activation of same transcriptional factors DFosB and cyclic AMP response element binding protein (CREB), in NAc.

Molecular mechanisms mediating cocaine-induced structural plasticity

Changes in the actin cytoskeletal framework that bring about plasticity are under the influence of GTPases that are coded by specific genes namely Rho, Cdc42, Ras and Rac. The Activation process is tyrosine kinase dependent and it involves conversion of GDP to GTP via extracellular signals mediated through TGF-², integrins and NMDA glutamate receptors. The whole process is calcium dependent and results in series of activation steps involving a myriad of regulatory genes that follows the binding of GTP to its receptor resulting in a chain of steps that eventually lead to structural modification in the cytoskeletal proteins (Scott, et al 271).

Conclusion

Studies have shown that addiction process is interplay of many factors that result in structural modifications of neuronal pathways. A variety of studies, show that neuronal adaptations are crucial in facilitating behavioral sensitization to cocaine. However, other studies show that drug-induced spine plasticity is an occurrence that is separate from sensitization. As such, further research is needed to comprehend the association of synaptic and structural modifications in addictive behaviors. Hence, currently one is unable to conclusively lean on one side of the argument.

Work Cited

Scott, Russo, et al. The addicted synapse: Mechanisms of synaptic and structural plasticity in nucleus accumbens. Trends in Neurosciences 33.1 (2010): 267276.

Russia now acknowledges alcohol addiction as a problem. Previously, alcoholism and other harmful habits formed part of the assumed degenerate lifestyle of the western world, thus alcoholism was not considered as a problem (Fleming, Bradbeer, & Green, 2001). Presently, Russia is encountering an alcohol mortality crisis. Leon, Shkolnikov, and McKee (2009) report that in 2003-05, 43 percent of deaths of young men between the age of 23 and 25 in Izhevsk city, Western Russia were attributable to alcoholism.

The health impact of alcohol in Russia is most notable in its contribution to mortality through cardiovascular diseases. Many alcohol-poisoning deaths that occur in Russia falsely fall under circulatory deaths. However, the study by Leon, Shkolnikov, and McKee (2009) proves that most of the deaths occur because of alcoholic cardiomyopathy. Alcoholic effects on the myocardium implicate chronic effects on the myocardium to cause the condition. Death is precipitated by a final alcohol binge. Although studies have proved that binge drinking increases cardiovascular disease-related deaths, the number of sudden cardiac deaths remains low (Nicholson et.al., 2005).

In Russia, men drink alcohol more than women (Nicholson et.al, 2005). Differences in the prevalence of alcohol drinking also emerge in educational groups where university-educated men drink less alcohol than their uneducated counterparts. In families, married men tend to consume less alcohol compared to divorced men and single men. Lastly, alcoholism is widespread among unemployed Russians. In addition, heavy drinking among the working population is to blame for most job dismissals. Consequently, alcoholism in Russia leads to a negative economic effect of increasing unemployment more than it improves economic returns.

The group of binge drinkers in Russia needs recognition in the public health care programs. The confirmation of the role of alcoholism on the deaths related to circulatory conditions is evident in the fact that the heavy drinkers of Russia are a vulnerable group. While major population changes in Russia in the past are attributable to societal changes, the emerging literature points out that alcohol may be one of the mechanisms that lead to the rapid demographic change in a few decades (Malyutina, et al., 2002).

Most Russians drink to cope with stress (Leon, Scholnikov, & McKee, 2009). The privatization of the 1990s following economic reforms in the country also contribute to unemployment, which increases population stress levels. Isolation of alcoholics from community engagements is the main cause of binge drinking problems as a result of the social deprivation of the victim (Leon, Scholnikov, & McKee, 2009).

A criticism to Russian health authorities has been that they react to crises instead of building up programs to prevent diseases systematically (Aris, 2003). On a brighter note, the country now trains doctors in psychiatry to ensure that they are capable of dealing with addiction problems (Fleming, Bradbeer, & Green, 2001). Historically, Russia as part of the USSR helped develop the Alma-Ata Approach to health for all in 1978, but never took part in the implementation of the program that was to take care of primary care services (Tulchinsky & Varavikova, 1996).

Current health programs in Russia need to assign the highest priority to reducing alcohol and other risk factors. There is a need to improve existing programs and introduce new programs that are well planned on a national regional and local scale. The gravity of the matter is readable from the State Statistic Committee estimates of a population reduction from 148 million in 1992 to 134 million in 2016 (Tulchinsky & Varavikova, 1996). The ministry of health in Russia needs to overlook monetary and fiscal state benefits from alcohol and increase the zeal of promoting government policies for the reduction of alcohol-related health problems.

A little progress happens on health care development in Russia with the realization of the alcohol hazard. Nevertheless, the country should embrace an overhaul of its health and incorporate new objectives. These include the preservation of universal access to healthcare, the establishment of national targets to meet World Health Organization (WHO) levels and making healthcare at par with international standards. Nurses may ameliorate the alcoholism problem in Russia by conducting community guiding and counseling sessions. They should also be responsive and understand their patients who may be suffering from isolation due to their alcoholism. Lastly, nurses should be investigative of patient medical history to assist doctors in judging causes of circulatory illnesses to ensure that all alcoholic-related cases are noted early.

References

Aris, B. (2003). Russias health crisis fuels 20-year cut in lifespan estimates. Lancet, 362(9395), 1557.

Fleming, P., Bradbeer, T., & Green, A. (2001). Substance misuse problems in Russia: a perspective from St Petersberg. The Psychiatrist, 25, 27-28.

Leon, D. A., Scholnikov, V. M., & McKee, M. (2009). Alcohol and Russian mortality: a continuing crisis. Addiction, 104, 1630-1636.

Malyutina, S., Bobak, M., Kurilovitch, S., Gafarov, V., Simonova, G., Nikitin, Y., et al. (2002). Relation between heavy and binge drinking and all-cause and cardiovascular mortality in Novosibirsk, Russia: a prospective cohort study. Lancet, 360(9344), 1448.

Nicholson, A., Bobak, M., Murphy, M., Rose, R., & Marmot, M. (2005). Alcohol consumption and increased mortality in Russian men and women: a cohort study based on the mortality of relatives. Bulletin of the World Health Organization, 83(11), 812-819.

Tulchinsky, T. H., & Varavikova, E. A. (1996). Addressing the Former Soviet Union: Strategies for health care policy and reform. American Journal of Public Health, 86, 313-320.

The society has changed a lot with the technological developments that have come up in the world. This technology has had many advantages to the contemporary world. However, there are a number of disadvantages for excessively depending on the computer. Individuals should watch out not to use computers excessively since it can pose a lot of harm to them. People should use computers effectively and wisely when it is necessary.

Information technology has made communication easier but it has also come with the price of privacy issues. Today cell phone signals are interrupted, email hacking is happening all over and this has compromised the security of information. Many people are worried that the information that is meant to be private can become public. Tricia Ellis-Christensen states that, the definition of what constitutes computers fraud becomes ever more complex with the ingenuity of people who intend to deceive, misrepresent, destroy, steal information are some causes of where people are able to steal private information and use it to harm others. (Ellis-Christensen)This is widespread among the young people especially those still in school where someone hacks into someone elses emails, takes the information and uses it against the other person. Others use dirty language and abuses that they send to innocent teenagers making them lose their self-esteem. This trend has caused a lot of harm to many while others have ended up committing suicide.

The issue of communication has been hampered by over dependent on computers. Since there is no face to face interaction, communication skills are neglected and one is not able to speak when they are in public. This is because computers do not allow people to think for themselves thus they are left with decreased literacy levels. This has greatly affected many young children who are not able to communicate more than a few words when they interact with others. This culture of over dependency on the computer breaks the personal bond that has always kept people together. Many people no longer socialize with their peers leading to the breaking of cultural bonds that develops among people. This threatens to disintegrate society values in many areas.

Over dependency on computers has also led to the tendency of people copying what others are doing universally. Through the various internet sites, young people are able to see the culture of the other society, which is believed to be better, thus they imitate another culture. This includes the way people dress; the language and behavior have dominated many young people all over the world. This has created issues in other societies with different customs and do not view the new culture as good. Teenagers who spend time on the computer end up neglecting their studies achieving low grades in school.

Antony states, there are certain risks involved with prolonged computer use. These health problems include Eye disease, Bad posture, Hurting hands, and Computer stress injuries. (Antony) Other problems include repetitive strain injury (RSI) from repeated hand movements, those who use until late at night may suffer drowsiness, depression, and difficulty in concentrating. One has no time for body exercises leading to overall poor physical health. There are also the problems caused by radiations that are emitted by the computer that are not good for ones health.

When one uses a computer too much, they can suffer emotional instability. This is because one withdraws slowly from the real world and is caught up in his/her own world. Those who do many computer games end up putting more value that is emotional on the activities of the game and forgets all about things that matter. In most cases, computer over dependency does more harm than good. It is important to limit how much you spend on the computer in order to ensure that other important matters are not neglected.

Works Cited

Antony.Top 4 health problems caused by computers use. 2008.Web.

Ellis-Christensen, Tricia. What is Computer Fraud? 2003. Web.

Introduction

Alcohol dependency is probably one of the most terrible and hard-to-solve problems for many people. Some so many families suffer because of inabilities to control human behavior and wishes and are under the influence of alcohol that is defined as a dangerous legal drug (Hepworth, Rooney, Rooney, 2009). In this paper, the case of a 38-year-old welder Jed is considered. He addresses the treatment center after being secondly arrested because of a DUI (driving under the influence of alcohol). Jed does not want to have more problems because of his alcohol dependency, still, he cannot find enough powers to control his life, develop good relations with his family, and be understood by his peers. This is why he needs urgent help that has to be based on thoughtful assessment and diagnosis. Alcohol and drug issues may vary, and it is crucially important to understand the situation before taking some particular steps and making decisions; and Jed, at least, understands that he has a kind of drinking dependency and should be provided with professional care to save his life and not to lose respect in society and family.

Body

First of all, several steps to assess the client and the whole situation have to be taken as usually the alcohol use history may be rather chaotic and extensive (Miller, 2010). In this particular care, the following actions are required:

The counselor has to understand that each client is unique and has his/her history; in this case, Jed is a regular alcohol user who cannot stop drinking just because to change something and improve his life, this is why it is necessary to understand that some powerful arguments should be used.

Taking into consideration the fact that it is his second arrest and his family has several complaints about his drinking, this case is all about drug dependency but not simple use or abuse.

It is obligatory to interview the client and get to know as many interesting and useful facts from his life as possible. The following questions should help assess the client:

1. What makes the client drinks so much?
2. Are there any possible alternatives for drinking?
3. Whom does he like to drink with? Why?
4. Does he want to stop drinking? Why?
5. When was it last time he used alcohol?

The counselor should remember that the interview should be organized in a friendly manner so that the client will be eager to share his emotions and thoughts. It is not necessary to create some boundaries or to divide the roles. The counselor has to become a friend who wants to help from a professional perspective.

The assessment of the clients behavior is also required; the counselor can make a deal with the client about the limit of using alcohol. In case the limit is exceeded, the counselor should demonstrate to the client that he has certain problems which need to be solved as soon as possible to overcome unpleasant outcomes.

It is also necessary to observe that Jeds alcohol dependency has genetic roots. His father drank a lot, and he died because of his inability to control the use of alcohol. This fact may be used to open Jeds eyes and define the problem.

Medical examination may be also used. It will help to determine the problem and see how the clients body reacts to frequent use of alcohol and what happens when the level of alcohol in the body is lower than usual.

With the help of such assessment, both, the client and the counselor will be able to comprehend that some problems exist and some steps have to be taken further to solve the problems. One of the most important steps, the identification of the problem, is made. Jed realizes that his situation is dangerous: he could lose his job, his family, his friends, and his freedom for some time. To avoid such outcomes, Jed has to agree to be treated and fight against his desire to use alcohol.

The next stage of treatment is the identification of the steps in diagnosing the client. They are as follows:

1. The CAGE questions may be asked to understand whether it is just a warning signal of alcohol dependency, whether the client has a kind of alcoholic abuse, or whether the client is addicted (Capuzzi & Stauffer, 2008).
2. The Michigan Alcohol Screening Test is possible for the client to take. With the help of a pencil-and-pen test, the client will evaluate the situation and help the counselor to diagnose him. As a rule, 10 minutes are required for such kinds of tests.
3. The FAST test (Miller, Strang, & Miller, 2010) may be used in this case to diagnose alcohol misuse using routing activities and events. The client has to answer the questions within a short period. With the help of such a test, the stage of alcohol dependence will be identified and used to treat the client properly.

These three steps are to be taken in a certain order to make sure the diagnosis is correct. It is not enough to rely on the results of one test only, this is why a choice and different nature of questions should help to understand what particular problems are observed and which methods are more appropriate in a particular situation. As soon as the assessment is made and the client is diagnosed, it is possible to introduce a working hypothesis with the help of which further cooperation with the client will be developed.

Working hypothesis. A 38-year-old welder has certain problems with alcohol which lead to inabilities to control the clients life, his relations with his family, and his personal needs; he suffers from alcoholic dependency that is on the genetic level as his father had the same problems before his death. The client recognizes that his problems and dependency influence his life, this is why he is ready to take some measures, still, certain control, motivation, and arguments are obligatory in this situation.

Conclusion

Jed is a man who is dependent on alcohol and its impact on the human organism. It is not enough to identify the problems and admit that some treatment is required. It seems to be more important to focus on the psychological, social, and cultural aspects of Jeds life because the problem is that he is now aware of how he can explain to his friends that he cannot drink with them anymore and to his employer that he has some problems with the court again. Alcohol is the drug that ruins human lives within a short period without any evident symptoms, this is why more control and powerful argumentation are obligatory in this case.

Reference List

Capuzzi, D. & Stauffer, M.D. (2008). Foundations of Addiction Counseling. Upper Saddle River, NJ: Merrill.

Hepworth, D.H., Rooney, R.H., Rooney, G.D. (2009). Direct Social Work Practice: Theory and Skills. Belmont, CA: Cengage Learning.

Miller, G. (2010). Learning the Languages of Addiction Counseling. Hoboiken, NJ: John Wiley and Sons.

Miller, P.G., Stang, J., Miller, P.M. (2010). Addiction Research Methods. Hoboiken, NJ: John Wiley and Sons.

Abstract

Opiate dependence is a growing problem in young adults and in patients who have developed addictions while receiving pain management regimens. A major objective of treating patients for their opiate addiction is to suppress withdrawal symptoms while facilitating the detoxification process. Buprenorphine is one of the emerging drugs that has gradually replaced methadone as the drug of choice in opioid detoxification because of safety. Recent studies show that the efficacy of buprenorphine is equivalent to that of methadone when sufficiently high buprenorphine doses are prescribed in combination with rapid induction and flexible dosing. This retrospective study reviewed data of 200 patients who were treated with buprenorphine for rapid detoxification at a medical center. Demographic information such as age and employment status characteristics of the patient were collected. Data were analyzed to determine the efficacy of buprenorphine in reducing major withdrawal symptoms that are most common among opiate drug abusers such as sweating, anxiety, tremor, nausea, and pulse rate.

Introduction

Addiction to opiates is a major risk to the well-being and health of all societies because drug dependence and reliance have been increasing. Statistics show that more than 8% of Americans abuse opiates currently; the most affected age bracket are youths between the age of 20 and 30 who have a prevalence rate of more than 50% (WHO.com, 2009). The use of opiates among youths is well documented as starting between the ages of 10 and 13 with addiction well established by late teens. In fact use of opiates among youths is so rampant that the World Health Organization (WHO) estimates that half of all American twelfth-grade students have used an illicit drug at one time in their lives (WHO, 2009). Ideally, opiates are prescribed legally to relieve pain and because of their addictiveness, they are strictly administered while the patient is under constant observation to avoid addiction. This is because once a person is addicted, it becomes a habit that is virtually impossible to quit.

Continued abuse of opiates leads to destruction and damage of the central nervous system (CNS) by hindering the production of endorphins; it is for this reason that they are among the most dangerously addictive drugs. Continued use of opiates may lead to significantly reduced brain functionality, which happens when nervous tissue becomes dependent on opiates for proper functioning. This dependence results in the typical symptoms that are experienced by opiate drug users when they attempt to withdraw from them such as shaking, chills, and sweating (Doweiko, 2006). Most often, patients experience an array of withdrawal symptoms that can result in more serious forms of physiological symptoms once they attempt to discontinue the use of opiates (Kleber, 2008).

The current literature indicates that buprenorphine is one of the most effective therapeutic methods for treating opiate addictions due to its inherent advantages that surpasses the currently used methadone. A research study by Auriacombe et al. notes one major advantage of using buprenorphine as the drug of choice in treating opiate addiction compared to methadone is that it is unlikely to result in overdose or addiction. This is because of what the authors refer to as partial agonist at the mu receptor, which means it is metabolized differently than most standard opiates (Auriacombe, Fatseas, Dubernet, Daulouede and Tignol, 2004).

Buprenorphine

Buprenorphine is a synthetic opioid that has been widely used in detoxification processes in the United States since 2002 to minimize the effects of withdrawal.

However, in Europe the use of buprenorphine has been ongoing for several decades: As early as the 1980s one practitioner in Europe was already investigating the efficacy of buprenorphine to have it approved as a therapeutic method for treating opioid addiction (Auriacombe et al, 2004). This early research effort eventually bore fruit and buprenorphine was widely used as the standard method of treatment of opiate-addicted cases in Europe by 1996 (Auriacombe et al, 2004).

Buprenorphine is categorized in the phenanthrene class that is made of a hydrocarbon fused with benzene rings. It is not as strong as natural opiates but does have some negative effects such as its ability to cause euphoria. It is, therefore, a form of comprise that physicians accept as worth taking since it provides a high probability of patients recovering from their drug dependence despite these side effects (Marquete, 2008).

Buprenorphine attaches itself to brain cells like natural opioids, binds more strongly than opioids, and hinders natural opioids from reacting; these are the major reasons that make it so appealing as the drug of choice for treating opiate abuse (Magnelli, et al, 2010). Because of this binding ability, buprenorphine can relieve the severe stress and depression that often accompanies opiate withdrawal (Courtwright, 2009).

Buprenorphine is also favored as a method of reducing opiate addiction and dependence because it is a safe method that poses minimal threat to patients.

When patients increase intake of the drug its agonistic effects increase as well. Agonistic effects are directly proportional to the dosage, but with time the patient reaches a plateau phase when the agonistic effects do not increase (Kleber, 2008). This means that if a patient uses excessive amounts of buprenorphine it can never result in dizziness or other drug addiction classical symptoms that are characteristic of opiate drug abuse such as heroin and morphine. Buprenorphine is also convenient because it has a long half-life that makes it possible for the detoxification of patients to be done with one dose every two to three days (Orman and Keating, 2009).

Administration and Metabolism Process

The most common methods of buprenorphine administration are intravenous, intramuscular, and sublingual. The preferred method to ease withdrawal symptoms is by rapid intravenous infusion that takes about three minutes to have the drug distributed throughout the body. Intramuscular administration has a much slower distribution rate that usually takes as long as fifteen minutes. On the other hand, sublingual administration is not preferred as it is cumbersome to administer especially when the patient is in an advanced state of withdrawal; and it has a slow absorption rate that is normally between 200 and 250 minutes (Hales, 2008). Buprenorphine binds tightly to plasma proteins that increase bioavailability and take between 25 and 60 hours to be metabolized in the liver and get fully eliminated from the body. The metabolism process of buprenorphine involves the Cytochrome P4503A enzyme, which is responsible for breaking it down to form norbuprenorphine as a byproduct (Bolourian, 2010).

In the United States, buprenorphine is a relatively new drug that is being used in the treatment of opiate addicts and has not been extensively tested. Because of this, its effects on pregnant women are not yet well known and for safety, purposes are not recommended in this population. It is also not recommended for individuals who are not addicted to opiates because it is itself a form of a mild opiate, and patients who use it may exhibit some of the addictive symptoms of conventional opiates. The focus of this research was to assess the efficacy of buprenorphine in treating opiate addiction withdrawal symptoms.

Methadone was the earliest drug used to treat opiate addiction; it has been in use for over 30 years, and extensive testing and research have established its effectiveness and safety (Hales, 2008). However, its half-life is much lower than that of buprenorphine making it less effective and safe. In terms of chemical metabolism, both methadone and buprenorphine react in the same way by binding onto brain receptors thereby competitively inhibiting opiates from attaching to the same sites (Silk, 2009). This is how most drug addiction treatment drugs can prevent the addictive nature of opiates from being taken up by the body.

More importantly, methadone and buprenorphine are less likely to result in any serious form of dependence, as in the case of opiate drugs, because they get assimilated in the body and metabolize differently than opiates.

Research Design

Various factors are used to determine the effectiveness of any opiate detoxification drug such as the ones that were investigated in this research study. The major variables that were tracked in this research include the ability of buprenorphine to ease and manage various withdrawal symptoms. In this research study, the objective was to examine the effects of buprenorphine on opiate-addicted patients undergoing detoxification.

Research Findings

The study sample included 200 cases randomly selected from the target facility. Data were collected from clinical records. Analysis of data was carried out using the SPSS software program, which assessed the efficacy of buprenorphine in reducing the signs and symptoms of opiate withdrawal.

Demographics

Of the 200 patients whose records were reviewed, 64% were below the age of 40 years while half of all cases were between the ages of 18 and 32. The sample size is typical of the general population as indicated by vast literature in this field. Namely, opiate addiction primarily affects youth who are below 30 years of age. Only 7% of the randomly selected sample was above the age of 60 years. When the cases were analyzed based on occupation, 79% of patients were categorized as working while only 16% were indicated as students.

Symptom management

An ideal detoxification drug is one that is able to reduce the side effects of withdrawal while presenting minimal or little adverse effects to the patient in the process (Cowan, 2008). For this reason the determination of buprenorphine efficacy was examined based on its ability to reduce an array of classical symptoms that are most common among opiate abusers such as increased pulse rate, sweating, chills, restlessness, pupil size, bone and joint ache, running nose and tear production, nausea, vomiting, diarrhea, anxiety, irritability, and yawning. Throughout the research, patients were monitored constantly and data collected at time intervals of 30 minutes, 2 hours and 4 hours after bupenorphine was administered

Pulse rates

The data analysis on pulse rates indicated that the majority of cases (39%) had pulse rates that already surpassed the normal range, between 81 and100 at zero minutes, which is just before the bupenorphine was administered, while only 12% had normal rates that were below 80. The other 49% had pulse rates that were neither high enough to be categorized as extremely abnormal, nor low enough to be grouped as normal. At 30 minutes, more cases (20%) had pulse rates below 80, and 42% of the cases had pulse rates below 100. In addition, the patients with the highest pulse rates (above 120) had drastically reduced to less than 10% from 19% at time zero. This reduction in pulse rates indicates that the patients were generally calm and was consistent among patients at every other time interval. At four hours, less than 2% had pulse rate above 120 while the majority (63%) had normal pulse rates below 80. Thus, based on this crucial variable it appears that bupenorphine is effective in attaining the desired physiological change.

Sweating and chills

The number of patients who reported to be free from chills and sweating increased immediately after administration of bupenorphine. At the 30-minute interval, 88% of patients who were suffering from severe sweating had a marked decrease in sweating, and after another two hours an additional decrease in sweating occurred. At four hours more than 60% of patients indicated no symptoms of sweating or chills while only 10% indicated any observable symptoms.

Restlessness

Before the administration of buprenorphine at time zero the majority of patients (72%) were unable to sit still even for a few seconds, and were frequently shifting positions or experiencing extraneous limb movement. Within 30 minutes, symptoms started to ease and 58% of the patients were able to sit still; these changes became even more marked after four hours when up to 74% of the cases indicated the ability to sit still meaning they were not experiencing any form of restlessness. By this time only approximately 25% of the cases still experienced signs of restlessness exhibited through their inability to sit still, however the restlessness was not as pronounced as before bupenorphine was administered.

Pupil size

Buprenorphine was seen to have reduced the number of patients with severe pupil dilation (so that only the rim of the iris was visible) while markedly increasing the number of patients with normal pupil size. At time zero before bupenorphine was administered, less than 10% of the cases had normal pupil size while the rest had pupils that varied in dilation size. At the four-hour interval, as much as 68% of all cases had achieved normal pupil dilation with another 24% having minimal pupil dilation. By this time only 8% of all cases still experienced notable dilated pupils.

Bone / joint aches

Patients reported mild to severe and diffuse joint pain before induction of buprenorphine. In the first 30 minutes after administration of the drug, less than 5% reported any muscle or joint aches reduced from a high of 59%. By the fourth hour, 68% indicated no muscle or joint related symptoms at all with less than 3% reporting any form of muscle or joint aches pains.

Running nose and tear development

The induction of buprenorphine resulted in an increase of patients who claimed not to have running noses and who had only slight nasal stuffiness. There was a decrease in the number of patients who had mild running noses and those who had constant running of noses by 45%. These changes were seen 30 minutes after induction and were more pronounced at 2 hours when up to 75% indicated no such symptoms at all. Four hours after the first dose of buprenorphine was administered fewer patients complained of stuffy noses as compared to before the drug was administered. There was a large reduction in the number of patients who had constant running noses from 79% to 6%, as compared to before the drug was administered.

Effects of buprenorphine on the gastrointestinal tract

Within 30 minutes after the initial dose of the drug there was a reduction in the number of patients complaining of vomiting and multiple diarrhea episodes from 140 cases to only 25 cases. At two hours, the efficacy of the drug continued and there was an additional decrease in nausea and multiple diarrhea cases. The effects of the drug stabilized at four hours and were similar to those recorded at two hours where more than 60% of the cases experienced no gastrointestinal symptoms and less than 5% reporting any form of GI symptoms. What is notable is that the effects of buprenorphine on nausea and vomiting impulses at four hours reduced significantly after four hours implying a causal-effect association.

Anxiety and irritability

Thirty minutes after the induction of the drug, there was a decrease in the number of patients who were obviously irritable or severely irritable from 165 to 51. At three hours, there was a substantial decrease in irritability levels of the patients with 58% of the patients not being irritable at all and 30% being slightly irritable. By this time only 12% of patients were still obviously irritable or extremely irritable.

Yawning

Yawning does not have any harmful effect for patients but it is a useful tool to study the effects of buprenorphine during opiate detoxification, as yawning is a common and annoying withdrawal symptom of opiate addiction that is easily observed by the clinician. After the administration of the first dose of buprenorphine there was considerable change in the yawning characteristics of the patients. Data collected at 30 minutes after the first dose shows some change in yawning behavior of the patients. At four hours, the number of patients who were yawning, yawned once or twice during the interview, yawned three or more times and those who yawned multiple times had drastically reduced. There was an overall increase in the number of patients who did not yawn during the interview from 27% to 57%.

Chi-square analysis of the data was done to determine the effectiveness of the chosen hypothesis. Chi-square enables researchers to test the validity of observed results from expected results. In this study, there was a 5% chance that the observed readings were incorrect. The alternative hypothesis of this study was there is a correlation between the patient effects observed and the detoxification procedures used at the detoxification centre. While the null hypothesis was that there is no correlation between the patient effects observed and the opiate detoxification procedures used at the detoxification centre. Based on the chi-square figures the alternative hypothesis was accepted.

Discussion

Buprenorphine has a half-life of between 25 hours and 72 hours. The drug is able to ease severe symptoms that often accompany opiate withdrawal. The main buprenorphine drug that was used in the inpatient center was Suboxone. This is a reliable drug that has been found to have all the characteristics of a generic bupenorphine drug with similar results when administered to patients. Buprenorphine is also administered in small but effective doses of 8mg per patient, and only in rare cases is 16mg dosage given; at 8mg dosage the efficacy of the drug has been found to be reliable in reducing the classical symptoms of opiate withdrawal. A small percentage (2%) of all the patients in the study required 16mg doses which indicated that small doses of buprenorphine were ineffective in treating withdrawal symptoms for this category of patients.

Buprenorphine was found to have notable effects on reducing opiate addiction withdrawal symptoms. The use of buprenorhine in the detoxification procedure resulted in a reduction in the number and severity of symptoms experienced by the patients. There was an interesting trend among the demographic characteristics of the cases from which data were collected during the research study. Given that the sample size was randomly selected, we have to assume that the study sample selected in this case is a fair representation of the larger study population that is being studied.

The majority of the cases in the current study were employed (79%). This could indicate that this category of persons had stable incomes, which means they were able to fund their addiction. Additionally, half of all cases being treated for opiate addiction were between the age of 18 and 32. In addition to having stable incomes, they may have fewer responsibilities and be more predisposed to be adventurous.

In each of the variable for which the efficacy of bupenorphine was measured among patients, each indicated that the drug was able to markedly reduce opiate withdrawal symptoms. In fact, for the nine different variables on which this research study focused, buprenorphine was seen to reduce and stabilize more than 40% of the cases in each symptom. The range of symptoms that were monitored during this research study are most relevant since they are the ones that are found to be most common among the majority of patients undergoing opiate withdrawal treatment. One of the most important variables that the research tracked during the study was the recording of pulse rates. The relevance of this variable is that pulse rate is an important indicator of a range of other typical symptoms including the overall health status of an individual (Hales, 2008).

A snapshot of the patients pulse rates at zero minutes indicate that majority of patients (90%) had pulse rates that were already above normal. Four hours after buprenorphin was administered 63% had normal pulse rates while only 2% were still experiencing abnormally high pulse rates. If these findings are anything to go by then we would expect a drastic reduction on a range of similar symptoms among patients in similar proportions. This is because pulse rates are often an indicator of a persons physiological condition. This is because with reduced pulse rate, a person is less likely to sweat, experience chills, have muscle pains or be irritated because the emotional and physiological aspects are stabilized and thereby functioning properly.

Indeed, as the record results indicate, there was improvement in all the other symptoms. For each of the variables being monitored, a reduction of the specific symptom was achieved by the fourth hour following administration of bupenorphine. For instance, there is a reduction of patients experiencing sweating and chills shortly after they were administered bupenorphine, which continued at 4 hours. In fact, except for two types of symptoms that were observed; yawning and anxiety and irritability, all other symptoms showed improvements that were above 60%. Of all the symptoms observed, irritability was found to be the most drastically reduced among patients after four hours from the time bupenorphine was administered while yawning was the least as indicated in the data analysis section. Hence, even from a rough estimate based on all variables measured we can determine the efficacy of bupenorphine in the treatment of opiate addiction withdrawal symptoms.

Conclusion

This research study supports the use of buprenorphine as a therapeutic method of treating opiate addiction because of its efficacy in reducing the associated withdrawal symptoms. The most significant effects noted in this study were decreasing pulse rates, reducing sweating, easing pupil dilation, preventing the formation of joint pains in normal patients and easing the pains in those who are already suffering from pain. It was also seen to be effective in normalizing running nose and tear production, easing of nausea and vomiting, reducing anxiety and restlessness and easing of tremors. In conclusion the data collected from this study show that buprenorphine is effective against most withdrawal symptoms and can be effectively used to treat these symptoms for prolonged periods of time.

References

Auriacombe, M., Fatseas. M.,Dubernet, J., Daulouede, J. & Tignol, J. (2004). French Field Experience with Buprenorphine. The American Journal of Addictions, 13(1): 17-28.

Bolourian, S. (2010). Buprenorphine: A Guide for Readers. New Jersey, NJ: Dane Publishing.

Courtwright, D. (2009). Dark paradise: a history of opiate addiction in America. New York, NY: Harvard University Press.

Cowan, A. (2008). Buprenorphine: combatting drug abuse with a unique opioid. Michigan, MI: Wiley-Liss.

Doweiko, H. (2006). Concepts of Chemical Dependency. California, CA: Cengage Learning.

Hales, R. (2008). Study Guide to Substance Abuse Treatment. Arlington, VA: American Psychiatric Publishing.

Junig, J. (2009). Users Guide to Suboxone: Taking buprenorphine for opiate Dependence. Wisconsin, WI: Terminally Unique Publishing.

Kleber, H. (2008). The American Psychiatric Publishing textbook of substance abuse treatment. Arlington, VA: American Psychiatric Publishing.

Langrod, J. (2008). The Substance Abuse Handbook. Philadelphia, PA: Lippincott Williams and Wilkins.

Magnelli, J., Biondi, B., and Calabria, K., (2010). Safety and efficacy of buprenorphine/naloxone in opioid dependent patients. California, CA: Clinical Drug Investigations.

Maremmani, I. (2010). Buprenorphine-based regimens and methadone for the Medical treatment of opiate addiction. New York, NY: Med Publishers.

Marquete, P. (2008). Buprenorphine Therapy of Opiate Addiction. New Jersey, NJ: Humana Press.

Millman, R. (2007). Substance abuse: a comprehensive textbook. Philadelphia, PA: Lippincott Williams and Wilkins.

Orman, J., and Keating, G. (2009). Buprenorphine/Naloxone: a review of its use in treatment of opiate addiction. New Jersey, NJ: Humana Press.

Renner, J. (2009). Handbook of Office-Based Buprenorphine Treatment of Opioid Dependence. Arlington, VA: American Psychiatric Publishing.

Silk, K. (2009). Cambridge Textbook of Effective Treatments in Psychiatry. New York, NY: Cambridge University Press.

Strain, E. (2005). The treatment of opioid dependence. Maryland, MD: John Hopkins University Press.

Thakkar, V. (2008). Addiction. New York, NY: Infobase Publishers.

WHO.com. (2009). Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva: World Health Organization.

Substance abuse refers to the consumption of a drug or a substance of abuse in a way or in an amount that is harmful to the user. Substance abuse can lead to addiction and dependence. Chemical dependence refers to a situation in which the user cannot function normally without the drug. Some sociocultural factors contribute to the risk of an individual developing a substance abuse disorder. Specific sociocultural factors that carry the greatest risk include low socioeconomic status, a family dysfunction, social exclusion, crime, and the perception that some drugs are less harmful.

Low socioeconomic status increases an individuals vulnerability to substance abuse (Galea, Nandi & Vlahov, 2004). Low socioeconomic status leads to low educational achievements. Individuals from low-income families are not likely to complete their education. Low level of education in turn lowers an individuals chances of securing good employment. In addition, individuals with low academic achievements are likely to engage in high risk behavior during their adolescents. Poor income and inability to secure employment have been shown to increase ones chances of engaging in risky behavior like drug abuse. Poverty is associated with many social vices. People whose socioeconomic status is low are likely to be excluded from societal social activities thus worsening their situation. Low socioeconomic status may also give rise to a situation in which parents work long hours to meet family needs. Children of such parents may be left unsupervised thus increasing their risk for substance abuse. Social conditions linked to poverty have been found to predict future risky behavior.

The family is an important unit of society. It is tasked with the responsibility of imparting societal norms and values on its members. A dysfunctional family is not able to discharge this responsibility satisfactorily. Children from such families are likely to engage in risky behavior as an attention seeking strategy.

Some societies may tolerate some drugs like alcohol, cannabis, and tobacco. Some of these drugs categorized as less harmful by society (Galea, Nandi & Vlahov, 2004). However, use of these drugs may mark the beginning of a more serious problem. Some individuals may progress to stronger drugs. In addition, the perception that some drugs are less harmful is not accurate. All substances of abuse have serious consequences on the user. For example, alcohol has been linked to mental illness in some individuals. This cultural tolerance for some drugs may encourage teenagers and young adults to try them.

Substance abuse leading to addiction is associated with certain negative outcomes. Negative effects of substance abuse include crime, economic loss, psychological trauma, and physical trauma. Substance abusers encounter financial difficulties due to a number of reasons. First, substance abusers spend a substantial amount of their income on drugs. Secondly, when they become addicted, their ability to secure and keep a job declines. Addicts may eventually spend a lot of time looking for money to purchase the drugs. Indirect costs of drug addiction are equally high. For instance, rehabilitation of substance abusers is very costly for both the government and the relatives of the addict.

Drugs have a variety of negative effects on health. Addiction and dependence are associated with negative health outcomes. Drug dependence leads to nutritional problems. Loss of appetite and preference of drugs to food lead to problems like weight loss. Poor nutrition is closely correlated with low immune status. This increases the chance of an individual contracting disease. Injectable drugs are also associated with transmission of HIV. Moreover, drug addicts often suffer social exclusion leading to psychological trauma.

Substance abuse is associated with crimes like suicide, homicide, and theft (Harrell & Peterson, 1992). Economic difficulties resulting from substance abuse may compel an individual to steal in order to finance the habit. Drug addicts may commit serious crimes like homicide and suicide owing to their inability to think rationally. This is because drugs cloud judgment (Sellman, 2010). Drugs may also trigger mental illness. Some mental illnesses are associated with paranoia, delusions, and hallucinations. All of which increase an individuals chance of committing crime if intervention is delayed.

Substance abuse may lead to addiction and dependence. Addiction or dependence is considered an illness. However, addicts may not be willing to view it as a problem. Addicts often go through a process involving formation of defense mechanisms to help them adapt. Some defense mechanisms are denial, projection, rationalization, reaction formation, and regression.

Denial is refusal to accept the presence of a problem or an anxiety producing situation. In some cases an individual refuses to acknowledge the consequences of a situation. For example, refusal to accept that one is an addict. It may also manifest through refusal to accept the negative effects of the substances.

Projection is characterized by the transfer of blame to others. In this case, an individual attributes his predicament to others. For example, one may blame others for their addiction. Such individuals may say that they use drugs because they do not have peace at home.

Rationalization refers to finding an excuse or a logical reason to explain ones current situation. On the other hand, regression refers may be defined as reverting to an earlier stage of development in order to avoid the consequences of a problem. Reaction formation refers to expression of the opposite feelings.

References

Galea, S., Nandi, A., & Vlahov, D. (2004). The social epidemiology of substance use. Epidemiologic Reviews, 26, 3652.

Harrell, A., Peterson, G.E. (1992). Drugs, Crime and Social Isolation: Barriers to Urban Opportunity. Washington, D.C.: The Urban Institute Press.

Sellman, D. (2010). The 10 most important things known about addiction. Addiction, 105(1), 613. Web.

Abstract

Addiction is a continuous urge for something that the body and mind cannot function normally without it. Addiction can be in form of behavioral or chemical addiction. Both alcoholic and pornography addicts are emotionally attached to their addiction and their recommended treatment would be therapy. Many would despite therapy, but as the studies reveal, its the first step towards treatment before any medication can be administered. In this research, I will examine two alcoholic treatments therapies of both inpatient and outpatient addicts to assess the consequences of the abuse and monitor the effectiveness of the provided treatment therapies.

Introduction

Addiction is a state in which an individuals body system is completely under the influence of a substance or behavioral addiction which interferes with its normal functioning. An example of behavioral addiction is pornography. When a person gradually becomes addicted, it may be hard to live without the substances or the behavioral addiction as their lives may be rendered joyless without them. In my literature review, I will examine the consequences of alcoholism and pornography, their physical and mental effects on the addicts health, and the success of the available recommended treatments (Naken, 1996, p.2; Segal, 2009).

Alcohol Addiction

Alcohol addiction is woven into the social fabric of our culture and society. People enjoy the cultural connection of sharing a drink without caring about the long terms effects it may bring about. Consequences of alcohol abuse vary from a person to another depending on the physical, psychological, and mental ability of the abuser. Alcoholism has adverse effects on the abusers health, society and loved ones. It accounts for the thousands of lives lost every year. Alcoholism may lead a person in developing brain disease which is irreversible and hard to control (Doweiko, 2008: Segal, 2009).

Signs of Alcoholism

Alcohol abusers may show signs such as;

1. slurred speech, may suddenly become clumsy and act harebrained when intoxicated
2. they often experience blackouts
3. complain of stomach upset
4. sudden weight loss
5. their face may suddenly turn red, and
6. numbness of the joints especially the feet and the hands.

When a person misses their regular alcohol dosage, they start developing withdrawal symptoms such as shaking, sweating, nausea, and vomiting which can be relieved with treatment therapies. Severe cases of alcoholism may result in the development of mental problems such as hallucinations and seizures, increases irritability, anger and agitation (Segal, 2009, online).

It may not be easy to tell if someone is an alcoholic especially if the above-mentioned signs are not quite evident. Teenagers for instance may display changes in their appearance, behavior, become isolated, signs parents should look out for. For adults, it might be challenging to detect but obvious signs such as clumsiness, confusion, and unsteadiness should be looked out for.

Causes of Alcoholism

Alcoholism can be generated from a family history of addiction. The relationship between genetics and environment is not quite clear however researchers reveal that alcoholism can be passed on from addicted family members to children. People with such a history of alcoholism are at higher risks of being alcoholics later in life. If an addict is mentally ill, alcoholism may worsen the symptoms, and may be hard to tell if the person is getting better or worse.

Peer pressure is also a contributing factor to alcoholism. If people around us drink so heavily, its easy to be lured into the habits. Social events with alcohol pressures people into drinking and this is when the addition streams in. When stressful situations occur without any coping skills, people may resort to alcoholism as a scapegoat.

Alcoholism affects a persons health, financial and drinking stability. A person in denial may have difficulties getting any help. An addict may expose their body to serious health conditions such as heart and liver diseases, birth defects, erectile dysfunctions for male victims, and nutritional deficiencies as some people may not keep up with healthy eating habits thereby their vital organs such as the liver and the brain. Mentally, an addict may start developing withdrawal symptoms such as hallucinations, convulsions, fear and severe anxiety. Infants who bone out of addict mothers may develop fetal alcohol syndrome which could lead to mental retardation and other irreversible physical abnormalities which are impossible to cure (Segal, 2009, online).

Alcohol abusers sometimes deny having an alcohol problem and often find ways to justify more drinking. In the early stages of alcohol consumption, a person underestimates the quantity of alcohol they can consume and how much money it will cost them until it grows into addiction. After that, they often spend so much time away from their daily responsibilities. Family relationships and jobs may be lost as a result of this addiction (Segal, 2009, online).

Pornography Addiction

Pornography materials can easily be found in magazines and videos. The advent of technology has given rise to a new and powerful pornography media known as the internet. There are a variety of sexual images in the internet pornography addicts may want to engage in such as online viewing my watching still photographs, watching porn films, engaging in webcam sex or meeting anonymous sexual partners to satisfy their addiction with whoever is willing to provide it online. Some individuals pay up for online prostitution while others voluntarily show up to engage in such activities. Pornography addicts replace important relationships and commitments with pornography (SRI, 2009).

Other pornography medium includes adult book stores and strip clubs. These individuals have consistence and compulsive sexual urge that develops into problems that can easily appear in a variety of settings. Pornography addicts isolate themselves when carrying out their profound hobby. Pornography addiction carries moral stigma and partners of these addicts often suffer the negative consequences more than the addicts themselves. Some addicts use masturbation to relieve their sexual urges or sometimes as an act with the other person online. The ones in anonymous relationships may perform the sexual act itself (SRI, 2009).

Signs of Pornography Addiction

Pornography often shows signs of addiction such as a) anger and irritability b) continuing with the behavior despite the awaiting consequences such as loss of relationships and jobs c) loss of time d) inability to stop the behavior (SRI, 2009).

Comparison of Alcoholism and Pornography Addiction

Addiction mostly affects the abusers family. Alcoholic parents are more likely to pass on the addiction genes to their children whereas pornography addiction can not be passed on to generations. Children in alcoholic families are more likely to suffer physical abuse and neglect. Parents may fail to attend to the childs basic needs since all their time and money is directed to drinking. Failed impulse control could lead to physical and emotional abuse on the spouse and children of the addicted family. Also, this could increase domestic violence as a result of uncontrolled emotions (Segal, 2009, online).

A pornography addict exposes his body to physical risks such as masturbation which could affect their normal body functioning and relationships. The family of a pornography addict may not directly be affected as much as the alcoholic family does. The most affected people are and the children. In alcohol addiction, children are more likely to suffer physical abuse as compared to a pornography family.

Pornography addicts often experience problems developing and maintaining positive and healthy relationships just like alcoholic victims. In a marriage or committed relation, for example, pornography may be seen as an act of cheating and once the partner discovers the habit, a trust may be severely damaged and sexual relationships may become difficult to sustain. Both addicts of alcoholism and pornography are connected to emotions; a pornography addict distances himself emotionally from real-life activities that require commitment like relationships whereas an alcoholic victim uses alcohol to escape emotional problems such as life stresses. All these addictions are often associated with escaping emotional problems (SRI, 2009).

Alcohol addiction can be treated with medication since it reduces psychological and physical adverse effects while pornography addiction can not be treated with medication.

Since both addictions are connected to past emotional injuries, counseling through treatment programs could be the first step before any medication can be undertaken.

Pornography addicts may go on with their life without damaging their public image of normalcy and respectability while alcoholics self-image is tarnished and may be hard to cope with other society members leading to stigmatization. Both victims are exposed to risks of losing their jobs as a result of lateness from staying up late feeding their habits. They both affect family unions and the economy as a whole. Individuals of pornography and alcoholism require psychotherapy to be able to break through the complexities that the addiction created. Both victims suffer denial and rationalization which increases problems at work and strains relationships.

Case Studies

A case study was conducted to determine the effects of alcoholism on family relationships in the city of Minas Gerais in Brazil. The researcher pre-examined problems related to alcoholism concerning social structure, work, family, physical, legal, and risks implications such as violence before the study was conducted. The study was aimed at identifying the effects of alcoholism on family relationships. According to the results, alcoholism contributed to high levels of interpersonal conflicts between family members and society. There were increased financial and legal problems, domestic violence, parental inadequacy due to absenteeism in family activities, child abuse such as violence, and clinical problems (Reinaldo & Pillon, 2008)

Methodology

This research used direct observation in examining the day-to-day lives of alcoholic addicts. The research gained prior knowledge of events, change processes, and experiences of the addicts before conducting the study. The subjects chosen were affected family members and alcohol users who at the time attended AA meetings in Minas Gerais city in Brazil.

Results of this case study were applied and evaluated to the subjects of the study to rule out the belief that case management applied to the subject of the study that permitted their social re-insertion. Data was collected through interviews, observations and transcripts of the events recorded in the researchers field diary and analyzed through content analysis.

Minas Gerias city was selected for the research since it contained a large part of the population characterized by economic and social inequality problems mostly contributed by high unemployment and poverty levels in the region. This has led to the increment of alcohol abuse and other substances. Distilled beverages were part of family income in the region as the study observed. The research also founded that the programs available in the area were not effectively equipped to attend to alcoholic victims. Subjects were chosen at the AA and the inclusion criteria were alcohol users who had been participating in AA for two months and the victims family.

They were all asked to sign a consent form. The researcher visited the family five times to try and obtain data from the participants. The researcher scheduled two interviews per individual participant for a maximum of one hour per subject. One was carried out during the start of the research while the other during the end. From the family perspective, the researcher included all family members who were living with the alcohol user (Reinaldo & Pillon, 2008, p.1).

Findings and Results

A case study was conducted on two families of alcoholic addiction for six months and their history was presented as a narrative for analysis.

In family 1; Daniel, a 42-year-old has been drinking for the last 28 years and during our interview, he confessed that his life has never been the same since he started the habit. He confessed that his life became more and more difficult since he started drinking. His wife adds that his drinking habits grew from weekends to weekdays and since he entered the AA group, his life changed drastically.

He continues that apart from transforming from alcoholism and finding himself a good job, his image of alcoholism still lingers in his neighborhood. His wife continues that Daniel caused much trouble while being alcoholic such as fighting with the neighbors, the children, and dislodged his mother at one time when his emotions were occupied with rage. The family of the victim confessed that after he joined AA, his drinking habits stopped gradually after a year of therapy. His wife continues that his relationship with his family has improved gradually; he plays more with his son. Its also discovered that he almost died of high blood pressure because of drinking. The research concluded that Daniel needed support from his neighbors and family to prevent him from falling (Reinaldo & Pillon, 2008, p.4).

In family 2; a 36-year-old Gustavo has been drinking for 20 years and has never been involved in a steady job. His father revealed that his drinking habits did not enable him to have a steady job. He had started his AA meetings about 2 months before the research was conducted. He denies his addiction making it hard for the therapist to administer treatment. His mother points out that Gustavo looks older since he started drinking as compared to his age mates since it affected his eating habits. She continues that there were several occasions when he got late to work due to oversleeping (Reinaldo & Pillon, 2008, p.5).

The research aim in gathering family members was to sensitize Gustavo about his alcoholic problem. The AA coordinator was asked to step in and help in counseling. The researcher asked Gustavo to start a diary about all his activities including the times he drunk alcohol for two weeks for joint analysis. The diary revealed that he drunk high amounts of alcohol on eight occasions, while others were in small doses regularly.

It was discovered that all his friends drunk abusively and most of his day was spent drinking. Its evident that his friends influenced his drinking habits. It was also discovered that his relationship with his family was affected as most of his time was spent feeding his habit and also, he had no clue of his house routine. After six months of evaluation, Gustavos alcohol consumption was reduced and he did not miss the AA appointments (Reinaldo & Pillon, 2008, p.5).

Discussion

In Latin America, men are the sole providers of families and they are seen as breadwinners of the family. Alcoholism, therefore, crumbles family relationships, contributes to conflicts, child abuse and negligence. Financial and legal difficulties are also experienced as so Gustavo is unable to pay off his debts at the bar. Clinical problems are also evidenced by alcohol abusers as we have seen Daniels high blood pressure. Gustavo isolated himself from family routines; he never played with his children or participate in any family activity.

Inpatient Treatment for Alcoholic Addicts

Nikki, a 27-year-old woman is an alcoholic addict whose family had an extensive history of alcoholism. Her drinking habits started when she was 11 years old and by 20 her drinking habits got worse. She married a man she barely knew and even got convicted of four felony theft within one year. Due to her irresponsibility, her children were taken away from her for fear of abuse. She was then admitted for inpatient treatment which consisted of two therapies; individual therapy and detoxification and group therapy. We also discover that she was diagnosed with bipolar disorder at the age of 12 and she never sought any treatment.

She first began medication during this treatment episode and her bipolar symptoms were relieved. Initially, the first two years treatments were not steady, she never committed to any detoxification center. Later in 2002, a new psychologist began working with her then recommended oral naltrexone in combination with her bipolar disorder medications.

At first, Nikki dismissed the idea of medical treatment. The therapist designed a treatment program that would relieve her from alcoholic symptoms and help her have a steady meaningful life. She began by recommending regular employment, four meetings with peers and counselors once a week, individual counseling has done once weekly and twice-weekly group in combination with her medication. Her medications were supervised for three months within her cravings for alcohol consumption lessened, she confessed.

She continues that when she craving a stroke, she would talk to her therapist in the treatment program or engage in activities that her therapist had recommended. She said that the oral naltrexone helped her continue with the lifelong process. During her medication of naltrexone, she relapsed on one occasion but did not feel any of the high as their effects were blocked by the medication she was undertaking.

Discussion

Alcoholism treatment for inpatients was seen to be effective when the therapies were combined with medication. Within two years of treatment, the relapse symptoms were lessened since the medication blocked the effects. With these successful results, we conclude that alcoholism can effectively be treated if patients strictly adhere to treatment programs as recommended by the therapist.

Conclusion

In pornography, a person continues to seek new ventured of sexual entertainment to satisfy his or her urges. They graduate from image viewing to engaging in the act itself and when this continues, relationships as seen to crumble and jobs lost. These addicts should consider therapies as the first step towards their treatment and completely cooperate with treatment programs therapist for eminent results.

The first step towards the treatment should start by destroying all pornographic materials at home and work including magazines, webcams and disengage from any sexual relationships that were strung from the behavior. Recommended treatment programs we have seen in in-patient treatment program alcoholic patients are seen be yielding fruitful results but soon the patient recovers, they should consider re-building a lost relationship with their family members as this would a positive step towards full recovery.

References

Doweiko, H. E. (2008) (7ed.). Concepts of Chemical Dependency. Brooks Cole.

DiClemente, C. C. (2007). Alcohol dependence treatment: case studies in medication use. Addiction Professional, p.1-6.

Nakken, C. (1996). The addictive personally; Understanding the addictive process and compulsive behavior. Hazelden Publishing.

Reinaldo, M.S., & Pillon, S.C. (2008). Alcohol Effects on Family Relations; Case Study. Rev Latino-am Enfermagem, vol 16, pp. 1-6.

Segal, J. (2009). Alcohol Abuse and Alcoholism. HelpGuide. Web.

SRI. (2009). Pornography Addiction. Web.

Abstract

Drug abuse and substance use has negative consequences on the society. Governments the world over invest heavily in enhancing rehabilitation services to eradicate drug abuse. However, the rate of drug abuse remains high. This paper evaluates social-cultural factors that influence drug abuse. It also provides an overview of the dynamics of drug abuse, the link that exists between addition and crime. Besides, the paper presents factors that, despite financial, physical, and psychological costs of drug abuse, influence addiction. Finally, it provides an overview of the most common defence mechanisms. Some of the mechanisms are useful while others are detrimental to life.

Chemical Dependence: Crisis of Addiction

Drug abuse and substance are the problems that affect negatively the economic, academic, and social development of a nation. The effects of these items can be seen in patients of specialized hospitals. Drug addicts form a significant part of patients who are seeking medical assistance. Despite the unfavourable effects of drug abuse and substance use, the rate of addictions is still on the increase. Research partly attributes this increase to socio-cultural determinants of addiction and defence mechanisms that addicts rely on (Lyman & Potter, 2007). These influence substance abuse by providing the abusers with perceived psychological benefits.

Socio-cultural factors considerably determine the approach and behaviour pertaining drug use and abuse. First of all, the widespread use of drugs in the society encourages teenagers and adolescents to get addicted. According to Lyman & Potter (2007), peer influence has led to a significant increase in the number of drug addicts among young people. Adolescents whose parents abuse drugs are highly likely to abuse the same drugs. The authors present that young people also abuse drugs to fit in a group, and not merely to manage emotions. Among teens, weak family ties, poor parental supervision, and lack of parental concern and affection are major causes of drug and substance abuse.

Indirect and direct financial costs also influence abuse of drugs. There is a higher possibility of adolescents who are smoking to give up or lessen smoking in reaction to cost increments than adults to do the same. Research has shown that 15 to 17 years old individuals are more likely to respond to increase in cigarette price by quitting smoking compared to 18 to 20 old individuals. In addition, alcohol use among young people is extremely sensitive to price increase. On the other hand, the use of drugs and substances among college students is typically not affected by price changes (Lyman & Potter, 2007).

Apart from the impact of direct costs on drug and substance abuse, indirect costs influence the use of these items. The cost of treating diseases that are caused by substance abuse is high. In addition, most economies spend millions yearly to acquire special equipment to take care of addicts. The costs discourage many people from abusing certain drugs. However, peer pressure and other determinants still make the vice to thrive in the society.

Apart from the financial cost, drug abuse and substance use influence psychological and physical costs as well. The first psychological effect is depression. As individuals use drugs, they develop tolerance to this particular substance. With time, addicts intake of drug begins to increase. Eventually, they need for more and more of the same drugs or substance that they cannot afford. Consequently, the individuals begin feeling remorse about their condition and chronic depression set in leading to a cycle of addiction (Long Term Drug Addiction Effects, n. d.).

Another psychological effect of addiction is paranoia. This condition makes addicts of marijuana and cocaine feel that everybody is out to fix them. The condition in worsened by the awareness of the risk to be arrested. The other effect of addiction is anxiety, which is characterised by restlessness. The problem often becomes more serious while addicts wait for the next dose of the drugs.

Addicts also suffer from physical impact of the drugs. Foremost, the use of some drugs over a long duration cause harms to the kidney. Users of drugs such as heroin and crystal meth have high risks of suffering from kidney failure. Alcoholism is another common cause of liver damage. Individuals using Vicodin and Oxycontin routinely also risk suffering from liver failure. Besides, abusers of stimulants such as cocaine do great harm to their heart. They increase the risk of suffering from various heart diseases. Drug addiction also damages the lungs. Smokers are highly prone to this problem. Smokers put their lives in jeopardy because nicotine that is found in tobacco and other drugs. (Long Term Drug Addiction Effects, n. d.).

Drug abuse is also a major cause of crime and accidents. Experts say that alcohol and drug use disorders have a strong link with suicide. A recent research has also indicated that men who abuse drugs are 2.3 times more prone to taking their own lives than non-addicts. In case of women, the research has indicated that they are 6.5 times more prone to attempting suicide than man.

Addiction has also lead to homicides in many countries. The Ford Hood and the Shooting in Oregon are examples of homicides that happened in the US and blamed on substance abuse (Reinhart, 2007). Substance abuse also affects interpersonal relationships. It makes parents to neglect their responsibilities. It also leads to domestic violence, verbal assaults, and criminality (Substance Abuse and Interpersonal Relationships, n. d.).

Addiction has several dynamics. It involves habit forming, deterioration at work, and using defence mechanisms in an attempt to regain respect. Some of the common defence mechanisms include denial, regression, displacement, intellectualism, and rationalization (Grohol, 2007).

Denial enables addicts to assume that nothing wrong is occurring. This is one of the many primitive defence mechanisms. It involves hiding real problems by citing success in other fields. Another defence mechanism is regression. It involves the reversion to actions of earlier life stages. When addicts are under significant deal of stress, they may engage in primitive acts, such as refusing to take part in everyday life activities. Other addicts also use displacement as defence mechanism. Individuals who cannot express their frustration openly turn to displacement. For instance, when they disagree with their bosses and cannot express their feelings, they come home and begin kicking dogs or crying without any proper reason.

Another common defence mechanism is intellectualization. It is the overemphasis on reasoning when a stressful condition arises. For instance, when most addicts are diagnosed to be suffering from terminal medical problems, they focus on the possibility of having gone to unqualified physicians. Alternatively, they may use rationalisation to put a concept into a different perspective. For instance, when a man abandons a woman, she may reframe in her mind that the man is destined to failure before feeling relieved. The dynamics of addiction and the defence mechanisms make abusers of drugs live in a non-realistic world making it difficult for them to make rational decisions.

References

Grohol, J. M. (2007). 15 common defense mechanisms: Psych central  Part 3. Psych Central.com. Web.

Long Term Drug Addiction Effects. (n.d.). Psychological and physical effects of drug addiction. Web.

Lyman, M. D., & Potter, G. W. (2007). Drugs in society: causes, concepts, and control (5th ed.). Newark, NJ: LexisNexis / Anderson Pub..

Reinhart, C. (2007). Under the influence crimes. Hartford: Connecticut General Assembly, Office of Legislative Research.

Substance Abuse and Interpersonal Relationships. (n.d.). DARA Drug Alcohol Rehab Asia. Web.