Discuss the regions of the brain affected by alcohol. How does this drug alter brain chemistry?
Alcohol alters the normal functioning of the body system similar to any other drug. As commonly known, excessive alcohol consumption leads to addiction whereby the affected individual develops alcohol dependency syndrome. At this stage, the person who suffers from alcohol dependency craves more and more of it. Due to increased alcohol consumption, the brain as well as other sensitive parts of the body undergoes gross damage.
Additionally, the normal operation of the brain is also altered. Some of the brain parts affected by alcohol are the nucleus, accumbency, cerebral cortex, sub cortical areas such as the hypothalamus and the limbic system, the basal forebrain, and the cerebellum (Clapp, Hofmann & Behave, 2008). The limbic system of the brain is responsible for the expression of emotional feelings whereas the thalamus is responsible for the release of hormones in response to stimuli such as stress and the general behavior and psychological effects by communicating with the brain. The cerebral cortex of the brain is affected by the neurotoxic effects of alcoholism which causes a disease known as atrophy.
Deficiency of thiamine may equally result in damage to some portions of the hypothalamus due to breakages of the blood vessels. Worse still, alcoholism may lead to vulnerability of the frontal lobe. Neuropathological studies and neuroimaging show increased vulnerability of the frontal brain areas to alcoholism. Research by behavioral neuroscientists shows that the prefrontal cortex is of the brain is responsible for emotional, cognitive, and relational activities. It controls planning and regulates behavior by inhibiting the occurrence of unwanted actions and supports adaptive skills such as good judgment, tenacity behaviors, and problem–solving capabilities (Clapp, Hofmann & Behave, 2008).
What treatments did the individual seek? Were there any available at the time?
The individual in this story happened to have suffered serious brain damage in a construction site although there were no visible and serious signs at the time when the person was injured. He quickly went to the doctor and sought h medical attention. As time went by, the patient started behaving differently shifting from his initial known personality. The company which he was working for later refused to readmit him into the job.
The patient then went to New Hampshire where he worked at a stable, became a driver of coaches in Chile, and finally joined his family members in San Francisco in the United States at the place of his death aged thirty-six having experienced several seizures. During this time, the patient was the most popular in the field of neuroscience since his condition provided a link between the change in personality and brain trauma.
At the time of gage’s accident, no known established knowledge and correlation between brain damage may cause trauma as was the case for him when his lower frontal lobes were damaged alongside the effects of this damage on personality and behavior. This is why gage became the most famous patient since doctors took a lot of interest in his case and conducted more studies to establish the relationship between brain damage and behavior which he suffered (Twomey, 2010).
This attests to the reason why his photograph is preserved at the Harvard Medicine Museum library. It is also important to emphasize that there were no viable treatment options at that time to cater to the brain damage which he sustained.
References
Clapp, P., Hofmann, P.L. & Behave, S.V. (2008.) How adaptation of the brain to alcohol leads to dependence: A pharmacological perspective. Alcohol Research & Health, 31(4):310–339.
Twomey, S. (2010). An accident with a tamping iron made Pheneas gage history’s most famous brain-injury survivor. Web.
After finding out about their pregnancy, the majority of women limit their alcohol consumption to a few portions a week or completely give up alcohol. Certainly, the risk of abnormal development of the fetus depends on the number of alcoholic beverages and the frequency of their use. The purpose of this paper is to analyze how alcohol consumption during pregnancy affects the fetus and its development.
Introduction
Alcohol gets to the fetus through the placenta, coming with blood to the baby, it can disrupt the normal process of cell formation and division and reduce their total number. “During the first trimester, the most critical stage of development, all of the major organ-systems begin to form. Because of the extensive, widespread activity, it is also the period when the developing organism is most vulnerable to the effects of drugs, radiation, and microbes.” (Tortora & Derrickson, 2018, p. 1108). The harmful effect of alcohol on the brain is revealed by a decrease in its size in a newborn; the brain functions of these children are impaired from infancy. Alcohol consumption from the beginning of pregnancy can cause developmental disorders in the embryo, such as heart disease.
Harmful Effects of Alcohol
However, not only the first trimester requires the exclusion of alcohol from the diet of a pregnant woman. The influence of alcohol on the fetus occurs throughout pregnancy, both the brain and the central nervous system, as well as all other organs and systems of the child, suffer from alcoholic beverages. Alcohol slows down the growth of the fetus during the entire period of pregnancy. The most significant harm of alcohol to the fetus lies in violations of the central nervous system, the severity of which depends on the number of doses of alcohol and the duration of its use. The longer a woman drinks alcohol during pregnancy, the more obvious and severe brain damage will be in the fetus. As a result of CNS dysfunction, serious developmental disorders may appear.
It goes without saying that the influence of alcohol on the fetus is great. According to Popova, Lange, Probst, Gmel, & Rehm, (2017), “… globally, about 10% of women in the general population consume alcohol during pregnancy, and one of every 67 of these women delivered a child with FAS” (p. 295).
In recent years, a special term has appeared in medical practice that defines an infant affected by alcohol in the womb – fetal alcohol syndrome. “One of the most disabling potential outcomes of drinking during pregnancy is the risk of developing fetal alcohol syndrome (FAS), the most severe and visibly identifiable form of fetal alcohol spectrum disorder (FASD)” (Popova et al., 2017, p. 290). Children with these features lag behind in weight and height, may have problems with vision and hearing, stuttering and tics. There are also problems with memory and attention, difficulties in learning educational material, and increased irritability.
Conclusion
Thus, if a woman does not want to interfere with the child’s development process and put a child’s health at risk, it is necessary to exclude the influence of alcohol on the fetus by eliminating the use of alcoholic beverages. A safe portion of alcohol that does not affect the development of the fetus has not been established yet; therefore, women who are trying to get pregnant or are already pregnant should avoid drinking any amount of alcohol. It has long been known that regular consumption of alcoholic beverages, even in adults, does not lead to good, let alone in an unborn, completely defenseless baby who is just growing in the womb.
References
Popova, S., Lange, S., Probst, C., Gmail, G., & Rehm, J. (2017). Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. The Lancet Global Health, 5(3), 290-299.
Tortora, G. J., & Derrickson, B. H. (2018). Principles of anatomy and physiology. Danvers, USA: John Wiley & Sons.
Abdominal pain can be caused by excessive consumption of alcohol. This pain can be acute or chronic and there are several possible causes. First, alcohol intake can cause irritation of the esophageal and stomach wall lining which then become inflamed leading to esophagitis and gastritis. It can also induce acid reflux and pain in upper gastrointestinal tract.
Acute and chronic pancreatitis can be as a direct effect of alcohol consumption. Liver diseases like alcoholic hepatitis and cirrhosis can also present with abdominal pain. These liver diseases can lead to portal hypertension with development of painful esophageal varices. Alcohol consumption predisposes to tumors of the gastrointestinal tract which then present with pain (Brick, 2008).
Medical interventions in alcoholics undergoing operation
Identifying an alcoholic
Disclosure of alcohol consumption before surgery is important as alcoholism directly affect the outcome of surgery. It is therefore important for the health professionals to enquire about this and put into place measures to ensure that risks associated with alcoholism are decreased. There are several tools that can be used for this purpose, which include questionnaires and laboratory investigations.
The CAGE question, Michigan Alcoholism Screening test and Alcohol Use Disorder identification test can be used to detect alcoholism in the patient. Laboratory tests such as carbohydrate-deficient transferring and gamma-glutamyltransferase can also be used. This information can be used for early diagnosis and correct management of alcohol withdrawal in the post-operative period (Martin et al, n.d).
Pre-operative interventions
After identifying an alcoholic, the health professional should institute measures to decrease intra-operative and post-operative complications associated with it. The need for abstinence and even cessation should be stressed to the patient. He/she should have weekly meetings with a health professional during which an assessment of alcohol consumption is done. The issue of withdrawal symptoms is discussed and a schedule of their treatment, as well as supportive medication, is formulated. The patient should be well informed on the benefits of withdrawal/cessation and the possible side effects (Tonnesen et al, 2009).
The patient should be informed about the effects of alcoholism on his/her body and how they affect the outcome of surgery. He/ she should be made aware of an increased risk of post-operative infections due to the effects of alcohol on the immune system. Alcohol also affects the clotting cascade therefore there would be an increased risk of excessive bleeding.
The risk of cardiopulmonary complications should also be explained to the patient. Alcohol can alter the metabolism of various drugs, hence narrowing the choice of drugs that can be used on the patient and this should be explained (Tonnesen et al, 2009).
The role of alcohol in the causation of the disease the patient is being operated for should be explained in cases where alcohol could have played a role, like in colon cancer. The possibility of recurrence should be mentioned and the need to stop alcohol consumption to prevent this stressed. Presence of end organ diseases related to alcohol should also be explained as they will affect morbidity after surgery (Polednak, 2007).
References
Brick, J. (2008), Handbook of the medical consequences of alcohol and drug abuse, New York: Haworth press.
Martin, M., Heymann, C., Neumann, T., Schmidt, L., Soost, F., mazurek, B., Bohm, B., Marks, C., Helling, K., Lenzenhuber, E., Muller, C., Kox, W. and Spies, C. (N. D), preoperative evaluation of chronic alcoholics assessed for surgery of the upper digestive tract. Alcoholism: Clinical and experimental research, 26, 6, 836; MD; Lippincott Williams & Wilkins Inc.
Polednak, A., (2007), Documentation of alcohol use in hospital records of newly diagnosed cancer patients: A populayion-based study. The American Journal of drug and Alcohol Abuse, 33, 3, 403-409.
Tonnesen, H., Lauritzen, J., Nielsen, P. and Moller, A., (2009), smoking and alcohol intervention before surgery: Evidence for best practice, British Journal of Anaesthesia, 102, 3, 297-306.
The socio-ecological model is a highly adaptable framework which can be used by health professionals to identify and deal with health issues, particularly due to its capacity to reveal the diverse yet interrelated issues affecting human behavior across the five levels of the model – individual, interpersonal, organizational, community/environment, and society/public policy (Pearson, Vaughan, Vaughan, & FitzGerald, 2005). This means that interventions can be directed at individual levels to achieve optimal outcomes. The proposed intervention discussed in this section is based on the society/public policy level of the model.
It is already known that social exclusion is a social determinant of health that has continued to work individually and corroboratively to exacerbate the problem of excessive alcohol consumption among older adults (Briggs, Magnus, Lassiter, Patterson, & Smith, 2011). Consequently, it is important for the federal government to develop and implement legislation aimed at not only providing adequate information and education to the aged, but also assisting them to form and maintain social network groups.
The legislation should be targeted at providing funds for federal and state health agencies to operate media campaigns on how to deal with factors mentioned in the lower levels of the socio-ecological model. For example, these media campaigns should provide rich contextual information on how to cope with retirement, how to remain physically fit, how to deal with the death of a spouse, and how to maintain social relationships using already existing community networks.
Media campaigns targeting the elderly must be established in a way that demonstrates the multiple levels of influence of the various factors related to social exclusion (Pearson et al., 2005). For instance, the federal government can involve health professionals in designing pamphlets that educate the elderly on the causes of excessive alcohol consumption by linking an individual-level factor such as attaining retirement age to an interpersonal-level factor such as family dissonance, and then linking the effects of the two factors to an organizational-level factor such as loss of social and emotional support systems.
It is also important to include information on how alcohol consumption is related to the dynamics of ethnicity, race, and socioeconomic status. Information on how the minorities are most likely to die from alcohol and drug-related deaths should be availed to the elderly through targeted media campaigns.
Indeed, social exclusion is related to ethnicity and socioeconomic status, as suggested by findings that poor Black Americans and Latinos suffer more social exclusion than Whites (Briggs et al., 2011). Media campaigns should also provide direction to the elderly on “how” and “where” to access mental health services on a needs-based approach.
Overall, it is believed that targeting the elderly at the society/public policy level using extensive media campaigns will go a long way in addressing the issues and factors raised in the other levels of the socio-ecological model, hence effectively dealing with the health issue of alcohol consumption among the elderly.
References
Briggs, W.P., Magnus, V.A., Lassiter, P., Patterson, A., & Smith, L. (2011). Substance use, misuse, and abuse among older adults: Implications for clinical mental health counselors. Journal of Mental Health Counseling, 33(2), 112-127.
Pearson, A., Vaughan, B., Vaughan, B., & FitzGerald, M. (2005). Nursing models for practice (3rd ed.). Philadelphia: Elsevier Health Sciences.
Alcohol use is a health issue as abuse of alcohol has many harmful effects on the health status of the users. In Australia, the use of alcohol poses significant health problems to individuals, families, communities, and the health care system because it requires many resources to treat harmful effects and rehabilitate people who have experienced alcoholism. The rampant use of alcohol in Australia normally occurs in religious, cultural, social, and business celebrations where adults indulge in drinking as a way of life. According to the Australian National Council on Drugs (2001), the Australian culture supports alcohol consumption because statistics reveal that, about 61% of the Australian population accepts the consumption of alcohol. Moreover, given that the use of alcohol has serious health consequences, it means that Australian health care system is set to bear huge health problems associated with alcohol use (Collins & Lapsley, 2008). Thus, to understand the issue of alcohol use in Australia, this paper examines the prevalence, causal factors, preventive strategies, and then criticizes the effectiveness of these strategies in curbing the use and abuse of alcohol.
Prevalence of Alcohol Use
As aforementioned, Australian culture endorses and supports the use of alcohol. Critical examination of the historical behavior of Australians shows that they used alcohol in social and cultural celebrations. The current society has embraced the use of alcohol as part of their culture, beliefs, and traditions. According to the National Preventative Health Taskforce (2008), drinking alcohol is an intricate part of Australian traditions and culture. From this knowledge, it is evident that a majority of Australians drink or support drinking alcohol. Statistics point out that about 72% of Australians regularly drink alcohol in moderations that do not have long-term health impacts (Rickwood, Magor-Blatch, Mattick, Guenert, Zavrou, & Akers, 2008). However, the drinking culture of Australians predisposes many drinkers to alcoholism, and severe harmful effects of alcohol. With culture and traditions of Australians, it is predictable that most Australians will indulge in alcohol use and abuse, if there is no change in behavior.
In the Australian population, men are the most consumers of alcohol when compared to women. This trend runs deep into Australian history, but current trends show that the number of women who consume alcohol is on the increase. Statistics indicate that about 46% of men and approximately 32 % of women consume alcohol in quantities that pose significant harm to their health (Heale, Stockwell, Dietze, Chikritzhs, and Catalono, 2000). Such statistics designate that the health care system is yet to bear the huge burden emanating from alcoholism and harmful effects of alcohol on population. It is quite alarming to see that approximately half of the alcohol drinkers predispose themselves to alcoholism, and the severe harmful effects that follow. According to National Preventative Health Taskforce (2008), out of 1.4 million drinkers of alcohol, about 72% drink in moderations that do not pose considerable health risk. The problem in drinking occurs because moderate drinkers are gradually becoming habitual drinkers, hence predisposing themselves to harmful effects of alcohol.
Distribution in Population
Alcohol use is prevalent in local areas of Australia because culture and traditions that support drinking behavior have a significant impact on the locals. The Australian National Council on Drugs (2001) notes, that Australian society views drinking alcohol as an intricate part of lifestyle in rural areas probably due to the hardiness and struggles that locals face. In rural areas, places such as clubs and hotels provide alcohol and venues where people interact in the community. Decades ago, alcohol was not available in social places such as restaurants, cultural occasions, and sporting events, but currently, there is ubiquitous supply of alcohol in every aspect of social gatherings (King, Taylor, & Carroll, 2005). The availability of alcohol in rural settings means that, a great number of people can easily access and drink alcohol. This aspect implies that, the availability of alcohol predisposes moderate drinkers into regular drinking habits, and eventually alcoholism. Hence, rural population of Australia is at greater risk of suffering from harmful effects of alcohol due to cultural predispositions and readily available alcohol.
Another group of the population at risk is the young people because they engage actively in social activities, which occur in places where alcohol is easily available. Given that social places like clubs, restaurants, hotels, and sporting areas provide an ample supply of alcohol to the drinkers, out of which majority are the youths, the suppliers predispose youths to a lifestyle of drinking alcohol. Ward and Glenda (2008) argue that adolescents and young adults are the most vulnerable group to alcoholism because they participate actively in pleasurable activities of life. Research studies indicate that people in the age bracket of between 16 and 30 years consume more alcohol as compared to other age brackets. Hence, young people are at risk of indulging in alcohol abuse.
Causal Risks Factors and Prevention
Low socioeconomic status is one of the causal risk factors that predispose Australians to alcohol abuse and subsequent harmful effects. Australians who live in rural areas belong to low socio-economic class. Lack of employment amongst the majority predisposes Australians to alcohol and drug abuse. Abuse of alcohol relates to low socio-economic status for people indulge in alcoholism to counter stresses related to poor living standards, unemployment, homelessness, and unfriendly environment (Clements & Selvanathan, 1991). Poor socio-economic conditions also lead to irresponsible drinking, since people living in low socioeconomic status prefer illicit brew because it is cheap. In search of cheap pleasure, Australian youth engages in alcohol abuse due to its availability within their local settings. Australians living in poverty tend to relieve the stress of unemployment and other social-related issues through alcohol, which in turn complicates their physical and social health. According to Spooner (1999), socio-economic status of parents, peer associations, family dynamics, and other significant factors influence adolescent drinking. Therefore, to prevent alcohol consumption, Australian government should improve the social and economic conditions of the poor people in local areas.
Culture is also another causal risk factor that contributes to alcohol abuse in Australia. As culture treasures beliefs and values of the society, a culture that supports alcohol consumption, like one Australian culture, encourages its members to indulge in the abuse of the same. Thus, such a culture continually passes on the behavior and habit of abusing alcohol from one generation to another (Brady, Nicholls, Henderson, & Byrne, 2006). In this view, as children grow up in the society that nurtures abuse of alcohol, it is probable they might adapt the same behavior and perpetuate it to the next generation. Family is a unit of society, which upholds beliefs and values of a given culture; therefore, it has a considerable impact on the growth of children coupled with shaping their destiny (Taylor, 2007). When children grow up in a family that supports aspirations of a culture, they adopt cultural beliefs and values, whether they are good or bad for their development. Moreover, parents who abuse alcohol, due to cultural demands, usually influence their children to follow dictates of the culture. Hence, community-based interventions such as health promotion are essential in helping communities to change their negative aspects of culture in order to prevent alcohol abuse due to cultural beliefs and values.
Current Prevention Strategies
Given that the abuse of alcohol is posing significant problems not only to the health of Australians, but also economic growth, Australian government together with other stakeholders has developed some preventive strategies. One of the strategies that the government has employed is the promotion of healthy lifestyle that is free from alcohol abuse. Through the health promotion strategy, the Australian government has attempted to increase awareness among communities so that people can understand the negative impacts of abusing alcohol (King, Taylor, & Carroll, 2005). In this view, health promotion aims at educating the vulnerable communities and groups so that members can discourage consumption of alcohol in contrast to their cultures and traditions, which support it.
To prevent and reduce consumption of alcohol, the Australian government has also employed several community-based interventions like restricting physical availability of alcohol, prohibition of alcohol in the workplace, and regulating alcohol promotion. The strategy of restricting physical availability of alcohol ensures that restaurants, hotels, and other social places do not sell alcohol to customers at their will. Moreover, the restrictive strategy defines the periods in which people can drink alcohol. According to the National Preventative Health Taskforce (2008), reduction in the period that Australians can access alcohol has drastically reduced consumption of alcohol. The workplace intervention has not only helped in prevention of alcohol use, but also improved productivity of workers. Employers have appreciated this strategy because it has helped improve human resources in work environment. The strategy of regulating promotion has helped in reducing early exposure of children to alcohol, as explicit adverts corrupt the naive minds of the children.
Critique of Preventive Strategies
Critical views of alcohol use and abuse in Australia emanate from cultural beliefs and values. The use of strategies such as health promotion is effective, but such strategies do not help the entire community to change their cultural beliefs. For effective change of behavior, the Australian government must employ individualized therapies such as cognitive behavior therapy. According to Shand and Gates (2004), “cognitive restructuring works with the client’s current beliefs and attitudes; moreover, its design helps the client identify and change unhelpful beliefs” (p.17). Hence, for individuals to change their beliefs and values, which stem from the culture, they must receive cognitive behavior therapy. Moreover, strategies that restrict alcohol consumption are not effective because they do not address the cause of alcohol abuse. The socio-economic conditions are the greatest predisposing factors to alcohol abuse as opposed to the availability of alcohol (Saunders, & Conigrave, 1990). Therefore, strategies that focus on uplifting socio-economic conditions are effective in prevention of alcohol abuse among Australian communities that reside in rural areas.
Conclusion
The use and abuse of alcohol, amongst Australian communities, is a significant problem that the health care system and the government should consider in a bid to improve the health status of the affected population. Since most drinkers of alcohol are moderate drinkers, cultural beliefs and values seem to encourage these drinkers to progress into habitual drinkers where they consume a high amount of alcohol, which is eventually harmful to their health. To avert the serious harmful effects of alcohol use and abuse, the health care system should adopt effective strategies that seek to change cultural beliefs and values, especially values that focus on improving the socio-economic status of Australians in rural areas.
References
Australian National Council on Drugs. (2001). Alcohol in Australia: Issues and Strategies. Web.
Brady, M., Nicholls, R., Henderson, G., & Byrne, J. (2006). The role of a rural Sobering-up centre in managing alcohol related harm to Aboriginal people in South Australia. Drug and Alcohol Review, 25, 201-206.
Clements, K., & Selvanathan, S. (1991). The economic determinants of alcohol Consumption. Australian Journal of Agricultural Economics, 35, 1-12.
Collins, D., & Lapsley, H. (2008). The avoidable costs of alcohol abuse in Australia and The potential benefits of effective policies to reduce the social costs of alcohol. Web.
Heale, P., Stockwell, T., Dietze, P., Chikritzhs, T., Catalono, P. (2000). Patterns of Alcohol consumption in Australia in 1998. National Alcohol Indicators Bulletin, 3, 1-34
King, E., Taylor J., & Carroll, T. (2005). Consumer perceptions of alcohol advertising and the revised Alcohol Beverages Advertising Code. Web.
National Preventative Health Taskforce. (2008). Preventing alcohol-related harm in Australia: A window of opportunity. Preventive Health Taskforce. Web.
Rickwood, D., Magor-Blatch, Mattick, R., Guenert, S., Zavrou, N., & Akers, A. (2008). Substance use: A position statement. Web.
Saunders, J., & Conigrave, K. (1990). Early identification of alcohol problems. Canadian Medical Association Journal, 143, 1060-1068.
Shand, F., & Gates, J. (2004). Treating alcohol problems: guidelines for alcohol and Drug professionals. Web.
Spooner, C. (2009). Causes and correlates of adolescent drug abuse and implications For treatment. Drug and Alcohol Review, 18 (1), 453-475.
Taylor, E. (2007). Socioeconomic factors and illicit drug demand. The Park Place Economist, 16 (2), 109-127.
Ward, B., & Glenda, V. (2008). Young people and alcohol misuse: how can nurses Use the Ottawa Charter for Health Promotion? Australian Journal of Advanced Nursing, 25 (4), 114-119.
Media outlets have been seen to repeatedly produce false premises about various medical issues among them being alcohol consumption by women and the effects to unborn children (Adickes, et.al, 1993, pp. 285). These usually reflect opinions held by the general population and leads to stigmatization of Fetal Alcohol Spectrum Disorders (FASD). This kind of repetition of producing inaccurate information results when the producers do carry through investigation and ends up conducting first-person interviews. The misconceptions however, have been found to contain some truths in it (Warnecke, 1991, pp. 120).
Media Reports on Alcohol Consumption in Pregnancy
Some of the false premises produces by the media group include; science is not accurate on alcohol consumption during pregnancy which is not true. There are many articles produced by the medical group stipulating risks of alcohol consumption to the unborn child and advising women to abstain from it because it may lead to birth defects. This has led to the warning signs on alcohol bottles in the United States (Guarnieri, and Lakatta, 1990, pp. 1460). Alcohol contains Teratogens also called neurotoxins which are very dangerous to the developing fetus at any time during pregnancy. Alcohol is also absorbed in the baby’s blood thus the harmful effects. Medical researchers having provided all those facts, there are no basis for the media to claim that there is lack of scientific prove of all the effects thus it is the role of the individuals to take care of their lives and that of the unborn babies (Shulgin, 2001, pp.64).
Media claims researchers have found that drinking alcohol responsibly or moderate use of alcohol is less likely to affect the unborn child. This is however very wrong, medical researchers argue that individuals’ dose response determines the amount that can be safely taken by a pregnant woman (Park, and Levenson, 2002, pp. 490). Moderate drinking can also be harmful to the unborn baby and occasional drinking is associated with future problems of attention seeking behavior, hyperactivity and problems in problem solving skills. Scientists therefore advise total abstinence to alcohol during pregnancy.
Media reports show that drinking distilled spirits is can be harmful to the unborn child but beer or wine has less effects. This is not true and medical research show that all beers and wine do contain alcohol and the difference is the alcohol content in the drink and the amount of drink consumed by the pregnant woman (Vanessa, et.al. pp. 148). The idea that wine and beer are not harmful only portrays societal perception but not facts. Pregnant women should know that teratogens may suffer from brain damage or any other physical damage unlike dangers posed by cocaine whose effects are not permanent (Streissguth, 1993, pp. 473).
Biological Effects of Alcohol Consumption
Medics argue that from research carried out, men suffer more than women from disorders resulting from alcohol use. They too argue that there are more physical negative effects as a result of alcohol consumption in women than in men. It is faster in women and extreme than their men counterparts (Olson, et.al, 1998, pp. 1999). This is because of the genetic composition of acts more in women in comparison to men. Various studies have been undertaken and shows genetics has a great role in the effects of alcohol consumption to all human kind. It plays a role in determining the amount and frequency of alcohol consumption (Kinzler, 1991, pp. 590). They however argue that concluding women has lesser chances of alcohol disorders than men could have resulted in sampling fewer women than men.
Research shows women have more levels of ethanol in their blood than men do. This was concluded after a sample group was administered with same amount of alcohol and the results taken (Sandor, et.al, 2001, pp.772). This was suggested could result due to women’s sizes being smaller than that of men hence water content is less in the women’s body per kilogram. On the other hand men have their enzyme Gastric Alcohol Dehydrogenase active than the women thus more alcohol is absorbed into the blood of the women than in men and hence it is more likely to affect the unborn baby (Garner and Klinger, 1999, pp. 310).
Human and animal research shows that alcohol consumption has adverse effects to the development of the Central Nervous System (CNS). They are categorized into two; teratogens which affects the CNS causing problems causing neurobehavioral dysfunction. It contains so many other toxic chemicals (Pieroq, et.al, 1999, pp.630). Alcohol do not only affect the body of the expectant mother causing general weakness hence a poor environment for growth by the unborn child but also the mother suffers general weaknesses (Hannigan, 1996, pp. 490). Alcohol also may lead to the pregnant mother losing appetite thus making the baby to suffer from malnutrition. The mother may also fall causing some physical to her and the unborn child.
Alcohol may also lead to cardiac defects to the unborn child. Experiment carried out on rats when fed with ethanol confirmed that they tend to lose the heart weight. This show that it may lead to altered myocardial (Hanson, et.al, 1996, pp. 1460). It also reduces cellular content from the heart thus explaining the reduced weight and further decreasing the cytoskeleton (Hannigan, 1996, pp. 497). Ethanol do not have the same content with the water content in the heart so it tends to diffuse leaving the heart to shrink without enough water and hence it becomes weak leading to many other heart diseases to the unborn child or even after they are born.
Conclusion
In conclusion, alcohol consumption has drastically gone up especially among teenagers giving researchers more reasons to carry out more studies on its adverse effects to them and how it may affect their future. This has also contributed to early teenage pregnancy and as a result more alcohol consumption among the pregnant women. This has then led to the many numbers of children born with Fetal Alcohol Spectrum Disorders (Abel and Hannigan, 1995, pp. 459). There has been need to educate all people on the effects of alcohol consumption during pregnancy whether responsibly or not is not good and instead people should completely abstain from it especially in pregnancy due to the lasting effects it has to the unborn child as well as the mother. It also leads to unnecessary expenditure when the child is born as they try to seek medical care which would have been avoided if the pregnant mother was more responsible. Therefore, alcohol consumption is wrong during pregnancy and should be avoided fully.
References
Abel, E. L. and Hannigan, J. H. (1995) Maternal risk factors in fetal alcohol syndrome: provocative and permissive influences. Neurotoxicology and Teratology, 71, 445–462.
Adickes, E. D., Mollner, T. J. and Makoid, M. C. (1993) Ethanol-induced teratogenic alterations in developing cardiomyocytes in culture. Alcohol and Alcoholism, 28(2), 283–288.
Garner, L.F. and Klinger, J.D. (1999) Some Visual Effects Caused by the Beverage Kava. Journal of Ethnopharmacology, 13(3), 307-311.
Guarnieri, T. and Lakatta, E. G. (1990) Mechanism of myocardial contractile depression by clinical concentrations of ethanol. A study in ferret papillary muscles. Journal of Clinical Investigation 85, 1462–1467.
Hannigan, J. H. (1996) What research with animals is telling us about alcohol-related neurodevelopmental disorders. Pharmacology, Biochemistry and Behavior. 55, 489–500.
Hanson, J., Jones, K., and Smith, D. (1996) Fetal Alcohol Syndrome: Experience with 41 patients. JAMA, 235, 1458-1460.
Kinzler, E., Kromer, J., and Lehmann, E. (1991) Effect of a Special Kava Extract in Patients with Anxiety, Tension, and Excitation States of Non-Psychotic Genesis. Double Blind Study with Placebos Over 4 Weeks. Arzneimittelforschung, 41(6), 584-588.
Olson, H.C., Feldman, J. J., Streissguth, A. P, Sampson, P D., and Bookstein, F. L. (1998) Neuropsychological deficits in adolescents with foetal alcohol syndrome: Clinical findings.Alcoholism: Clinical & Experimental Research, 22, 1998-2012.
Park, C. L., and Levenson, M. R. (2002) Drinking to cope among college students: Prevalence, problems and coping processes. Journal of Studies on Alcohol, 63, 486-497.
Pieroq, S., Chandauasu, O., and Wexler, I. (1999) Withdrawal symptoms in infants with the Fetal Alcohol Syndrome. Journal of Pediatr, 90(4), 630.
Sandor, G., Smith, D., and MacLeod, P. (2001) Cardiac malformations in the Fetal Alcohol Syndrome. Journal of Pediatr, 98(5), 771-773.
Shulgin, A. (2001) The Narcotic Pepper-The Chemistry and Pharmacology of Piper Methysticum and Related Species. Bulletin on Narcotics, 25(2), 59-74.
Streissguth, A. (1993) Fetal Alcohol Syndrome: An epidemiological perspective. Am J Epidemiol, 107(6), 467-478.
Vanessa E., Murphy, R., Warwick, B., and Vicki L. (2001) Endocrine Regulation of Human Fetal Growth: The Role of the Mother, Placenta, and Fetus Endocrine Reviews, 27 (2), 141-169.
Warnecke, G. (1991) Psychosomatic Dysfunctions in the Female Climacteric: Clinical Effectiveness and Tolerance of Kava Extract WS 1490. Fortschr Med, 109(4), 119-122.
This paper will attempt to address the problem of co-morbidity. This paper will summarize and give concrete responses and actions to this growing problem in the medical community.
Summary
The problem of co-morbidity caused by the impact of some kind of abuse is a standpoint within a majority of governmental structures and subsidiaries all over the world. The reciprocal connection between diseases is inevitable. One negative factor may cause terrible disease which in return may signal the further emergence of another disease. The problem of alcohol abuse as one of the main factors for the emergence and amplification of tuberculosis is widely discussed in medical circles and social organizations as well. It occurred with Lisa and she needs help in her problematic situation.
The way of treatment is taking into account different directions for lessening risks of further co-morbid illnesses and death as the most terrible final effect. Moreover, many doctors are learning to work out the reasons and, as it usually appears to work with, the effects of tuberculosis, to determine the diagnosis and gradual treatment plan. The prescribed methods of treatment provision are divided into inclusion and exclusion criteria, and the behavioral factor is considered in the treatment. Then the parameters of the procedures are made out and kept flowing. Alcohol-related treatment complications, forecasting tuberculosis on the initial stage and destruction of disease’s symptoms are at the core attention for many therapists and people working over this problem resolving.
Concrete Response
The example of my son’s friend impressed me by how tuberculosis evolved in his body and by the complexity of factors that more or less favored its spread. Zach was a gifted student in college and many of the adults in his life hoped he would make his destiny better and would certainly achieve the tops in this life. The story began changing when Zach met a group of so-called friends who made a big influence on him by means of freedom and strength expression due to the alcohol, cigarettes and immoral way of life. He looked at it as a “cool initiative for life”, but soon he became an alcoholic and could do nothing with that.
His doctor told Zach’s parents about disappointing news. It concerned the gradual development of tuberculosis in his body. Hard alcohol addiction only stimulated the emergence of disease with further complications. Thus, latent tuberculosis kept progressing due to further alcohol consumption by Zach who kept it hidden even while in the hospital. As alcohol is a substance to be a mere factor for TB (WSTSM, 2009), so the unintentional at the first sight addiction of Zach played in the box with him because of liver injury and rifampin taking which resulted in a severe form of hepatitis. No wonder, that doctors had wrongly diagnosed Zach, but all in all there were too many factors for the illness’s progression in him and alcohol along with the impact of tuberculosis stimulated immunosuppression.
Reflection
Tuberculosis treatment is effective and available today. Medication systems provide people with TB prevention services. When patients get TB, they usually wonder why did not they mention any of the ways to prevent TB to me? Precaution is a great method not to have such a complicated disease. Family and people closely related can also help greatly. In fact, it is true, because personal intentions along with the extent of the family can predict negative effects in terms of therapeutically determined and socially connected influence. (Viljoen & Croxford, 2002) If there is a problem of comorbid diseases, a detailed plan of treatment should be adhered to.
Tuberculosis is a result of bacteria penetration into the organism by means of breathing. Lisa’s example urges the medical community to provide medical and psychological treatment. When the stage of inclusion criteria (age, possible previous cases of TB, dependence by the CIDI-SAM, consent of a patient to follow doctor’s prescriptions) is through, then the exclusion ones (tests of liver functioning and retest after 5 days, opioid use in the past month, possible pregnancy or breastfeeding, etc.) take over. (Clinical Trials, 2009) Useful algorithm or flow charts for Lisa should adhere to the example of treatment for such-like diagnosed patients in Tomsk, Russia. The schedule consists of four points, namely:
A Behavioral Counseling Intervention (BCI) plus treatment as usual (TAU) (i.e. standard referral to and management by an addictions specialist);
Naltrexone/ Brief Behavioral Compliance Enhancement Treatment (BBCET) plus TAU
BCI + Naltrexone/BBCET plus TAU
TAU The RCT will be conducted only if Naltrexone use proves safe. (Clinical Trials, 2009)
Another approach gives 6-months therapy treatment where every month has a particular schedule of treatment methods and means. In this case, a doctor should check the risk factors of liver transaminases, chest x-ray analysis, and medication taking. (2001A-TB-004)
Action
Tuberculosis as a result of alcohol abuse is rather dangerous for people and presents a very bad picture of symptoms. While having a close look at the problem I would rather recommend getting a physical exam, any medical suggested and living apart from any kind of abuse and alcohol. The most shocking fact is that many young people abuse alcohol and drugs, and as a result, get TB. This can lead to complicated effects and death. Indeed, the risk to be dead by TB is high and everyone should not ignore doctor’s appointments for testing. The more we are informed about the reality of our health with further measures of its strengthening, the less we are endangered.
Reference
Clinical Trials. (2009). Effectiveness of Alcohol Interventions Among Tuberculosis (TB) Patients in Tomsk Oblast, Russia (IMPACT). Web.
Platt, A. E. (1994). Why Don’t We Stop Tuberculosis?. World Watch, 7, 31+.
Viljoen, D., Croxford, J., Gossage, J. P., Kodituwakku, P. W., & May, P. A. (2002). Characteristics of Mothers of Children with Fetal Alcohol Syndrome in the Western Cape Province of South Africa: A Case-Control Study. Journal of Studies on Alcohol, 63(1), 6+.
Alcohol has a myriad of negative effects that induce immense harm to a developing fetus and embryo. Depending on the level of exposure and developmental timing, abuse of alcohol may adversely contribute towards diverse and variable outcomes that can be observed as prenatal alcohol effects. Studies indicate that although alcohol consumption and its effects on pregnancy outcomes have been a major cause of concern throughout history, the ability of alcohol to massively interfere with teratogenicity was only realized after the 20th century. Heaman, Gupton, and Moffatt (2005) indicate that today, alcohol is the leading cause of developmental disorders and birth defects in many nations including the United States of America. As analyzed in this paper, fetal alcohol syndrome has a serious adverse consequence on Canadian children due to exposure to prenatal alcohol. This paper analyses the issue of fetal alcohol syndrome among the aboriginal and Canadian populations.
Overview of the problem and statistics
Kodituwakka (2007) indicates that in Canada, neurodevelopmental disorders, mental retardation, and other serious birth defects in children are prevalent due to prenatal exposure to alcohol by pregnant women. Eighty percent of children born with fetal alcohol syndrome have behavioral abnormalities (Public Health Agency of Canada, 2008-09). About 50% of the affected children show identifiable facial anomalies like micrognathia, cleft palate, and maxillary hypoplasia (Public health agency of Canada, 2008-09). Other related problems include decreased adipose tissue, attention deficit hyperactive disorder, hypotonia, and poor coordination. Every year, out of 1000 children born in Canada, 9 suffer from fetal alcohol syndrome. Today, there are over 300,000 Canadians who are suffering from fetal alcohol syndrome disorders (Public Health Agency of Canada, 2002). This has put pressure on the government due to the high cost of treatment per child which is about $ 23,792 (Public Health Agency of Canada, 2002).
The number of Canadian pregnant women who are aware of the dangers of drinking while pregnant is high. However, statistics indicate that most of them cannot drop drinking when pregnant, and as such, about 37% of their babies are being exposed to alcohol from binge drinking (Public Health Agency of Canada, 2002). It is important to note that 37% of children exposed to alcohol come from women who take up to 5 drinks per day. Besides, another 42% of babies are exposed to alcohol from their mothers who take about 4 drinks per day (Public Health Agency of Canada, 2002). Other reports from the Fetal Alcohol Disorders Society in Canada indicate that special education services are being offered to approximately 20% of school children who have been affected by severe FAS conditions due to prenatal alcohol exposure (FASlink, 2011). The figure below shows the number of women in Canada who would never stop drinking alcohol even when pregnant.
Other reports for the Canadian Public Health indicate that binge drinking is prevalent among women who are unmarried and those who are employed compared to pregnant women who are married and not employed (NCCAH, 2005). In every 8 pregnant women, about 12% consume alcohol in a period of 30 days (Public Health Agency of Canada, 2008-09). Statistics indicate that this has been a continuous and stable behavior in the past 15 years. 17.7% of the women who are using alcohol are between the ages of 35 and 44 years. Among them are college graduates who are approximately 14.4%, unmarried 13.4%, and employed 13.7% (Public Health Agency of Canada, 2008-09).
Comparison of the problem between the aboriginal and Canadian populations
The problem of drinking in Canada among pregnant women has been a major issue of concern and has been attributed to several factors both social and economic. Research indicates that per-capita drinking among aboriginals is relatively higher than that of the general population with findings indicating approximately 14.8 liters per Aboriginal as compared to the general population of 9.5 liters per person (Public Health Agency of Canada, 2008-09). Tait (2003) argues that although the level of drinking of the Aboriginal population is higher, findings indicate that many Aboriginals have the ability to abstain from alcohol more than the rest of the Canadian population. However, due to economical and social issues like poverty and lifestyles, a majority of the Aboriginal pregnant women in Canada involve themselves in the drinking of alcohol which has a massive impact on their health and that of their children
NCCAH (2005) indicates that daily consumption of alcohol among aboriginal women in Canada can be less frequent than among the general population in terms of proportion due to a variety of factors such as age. However, among them, psychological distress is a major issue that contributes to their heavy drinking rates than the rest of the general population and is likely to result from levels of acculturation (Tait, 2003). High intensities of drinking occur among groups that have less attachment to their indigenous culture. It is however noted that while this fact is true for the major part of the indigenous people, most of the victims who go through psychological problems apparently turn to the abuse of alcohol. This is contrary to the case of the ordinary population which has not been affected by alcohol abuse or binge consumption of alcohol.
Tait (2003) argues that the high alcohol abuse rates have been linked to the low economic status of the indigenous people due to factors such as marginalization, political segregation, and dispossession of their properties due to low levels of literacy. Such continual frustrations lead to the accumulation of more psychological problems leading to over-indulgence (NCCAH, 2005). The general Canadian population is well organized, knows constitutional rights, and is wealthy compared to the indigenous population. However, those who undergo myriads of financial problems as a result of lower-level incomes have also been found to engage in rampant abuse of alcohol compared to the general population. Nonetheless, the lower-income earners are not affected much in comparison to the rest of the population bearing in mind that they can only drink a limited number of times every single day.
Why do Aboriginals need many health programs
Due to the economic and social difficulties faced by Canadians, especially the Aboriginals, alcohol consumption and other related drug use among pregnant women have increased. Impacting their children by causing birth defects and delays in the development of children exposed to prenatal alcohol. Reports from the national midwifery and nursing associations as well as those from the public health indicate that several programs are being implemented geared towards offering prevention efforts. In comparison, Aboriginals need more primary, secondary, and tertiary prevention programs than the other populations as they are the most affected.
Excessive alcohol consumption among Aboriginal pregnant women is directly linked to other factors such as demographic and economical factors. Tait (2003) reiterates that there is an urgent and dire need for government authorities to devise viable health and empowerment programs. This will assist in creating or improving awareness of the negative effects of abusing alcohol. Needless to say, it will also reduce maternal alcohol exposure which is common among the aboriginal population in Canada. As a matter of fact, maternal-fetal alcohol syndrome has been found to be most prevalent among this segment of the Canadian population.
This is why health organizations in Canada have boosted their programs and geared them towards assisting Aboriginal women and children through empowerment and health care services.
Conclusion
In summation, the discussion in this paper supports the thesis statement that alcohol and its many distinct actions induce immense harm to a developing fetus and embryo. Depending on exposure and developmental timing, it may contribute to diverse and variable outcomes that can be observed as prenatal alcohol effects. It is evident that alcohol consumption among pregnant women causes immense harm to a child. In Canada, the Aboriginal population is greatly affected and as such requires more health programs. More efforts should be put forth by the Canadian health organizations and the government to minimize the problem of drinking among women to sustain the health of children and save health care costs. While alcohol consumption by pregnant women has several adverse effects on the growing fetus or embryo, the syndrome that results from binge drinking may be quite difficult to deal with. Aboriginals among the Canadian population and how alcohol consumption has adversely affected the proper development of the fetus is just an example of how this may be a global health concern to contend within contemporary society.
References
FASlink. (2011).Fetal alcohol disorders society: research, information and communications. Web.
Heaman, M., Gupton, A.L., & Moffatt, M.E. (2005). Prevalence and predictors of inadequate prenatal care: A comparison of aboriginal and non-aboriginal women in Manitoba. Journal of Obstetrics and Gynaecology Canada 27(3): 237-46.
Kodituwakka, P.W. (2007). Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: A review. Web.
NCCAH. (2005). Knowledge gap FASD. Web.
Public Health Agency of Canada (2002). Aboriginal head start initiative: children making a community whole: a review of aboriginal head starts in urban and northern communities. Web.
Public Health Agency of Canada (2008-09). Summative evaluation: fetal alcohol spectrum disorder initiative. Web.
Tait, C. L. (2003).Fetal Alcohol Syndrome among Aboriginal People in Canada: Review and Analysis of the Intergenerational Links to Residential Schools. Web.
Although alcohol use is widespread among United States citizens, recent reports indicate that this trend is a burgeoning public health disaster. According to a recent article published in the Center for Disease Control and Prevention (CDC), excessive alcohol use in the United States ought to be recognized as a national health problem that is frequently associated with increased risk of death, the prevalence of chronic diseases, and numerous cases of personal injury (Center for Disease Control and Prevention, 2011). According to this report, although binge and underage drinking is a preventable cause of death, it has been linked to more than 79, 000 deaths annually (Center for Disease Control and Prevention, 2011). The report also cites that, alcohol-related problems cost the United States taxpayer billions of dollars to the tune of $185 billion annually, both in terms of healthcare costs and criminal justice expenses. This revelation is a cause for alarm because, in Bernard Turnock’s analysis on the leading causes of death in the United States in 2000, alcohol abuse was not ranked even among the top twenty. In Table 2-2 the leading cause of death (as per the number of deaths) was heart disease, Cancer, and Cardiovascular diseases respectively (Turnock, 2007). Bearing in mind that, alcohol abuse increases the prevalence and risks factors leading to chronic diseases (health problems, some forms of cancer, and cardiovascular diseases), this current news report is neither overrepresented nor underrepresented. On further analysis, other health factors outlined in Table 2-2 such as; unintentional injuries (5), chronic liver disease and Cirrhosis (12), and Chronic Obstructive lung disease (4) could also be attributed to alcohol abuse (Turnock, 2007 ).
Conversely, while analyzing the actual causes of death in the United States, Turnock (2011) associated alcohol consumption with 85,000 deaths in 2000 (Table 2-4). This number is higher than the current estimates of 79,000, which indicates a slight underestimation bearing in mind that alcohol consumption has been escalating steadily. On the same note, recent research findings published in ScienceDaily concluded that social-economic factors could be blamed for causing a considerable number of deaths in the United States (ScienceNews 2011). Previously, researchers have been concerned about the contribution of physiological factors such as; heart and cancer problems as well as behavioral risks factors including dietary, physical inactivity, and dietary patterns to the numerous untimely deaths in the United States. However, recent research has shifted towards the role of social factors and increasing cases of premature death in the United States (ScienceNews 2011). Consequently, the current research study conducted by researchers from Colombia University Mailman School of Public health concluded that poverty, lack of effective social support, poor education levels, and other social factors led to as many deaths as those caused by a heart attack, lung cancer and strokes in the United States (ScienceNews 2011). Likewise in Table 2-5, Turnock (2011) underscores that low-income families were susceptible to myriad preventive health problems as compared to high-income families. According to Turnock (2011), the likelihood of low incomes families succumbing to adverse health risk conditions was two to five times higher than that of higher-income families. Similarly, the current research report estimates that over 4.5% of deaths in the U.S could be directly linked to poverty (ScienceNews 2011). This projection falls within the previous range; hence it is neither underestimated nor overestimated. In Table 2-5, Turnock (2011) highlights various health outcomes in regard to low income such as severe asthma, infant mortality, low birth weight, fatal injuries, fair or poor health among other outcomes. The aforementioned health outcomes have been blamed for numerous preventable deaths; thus healthcare policy should be formulated to address these social factors to reduce preventable mortality in the United States.
The significant role of mass media in informing and educating the public on health matters has attracted noteworthy research. Of great concern is the implication of utilizing mass media as the key disseminating tool for public health issues. According to Leask, Hooker, and King (2010), health authorities have always entrusted the media to disseminate and educate the wider public on essential health information, due to its ability to reach out to a wider audience. The most public have access to at least one of the myriad mass media channels such as radio, newspapers, television, and the internet (Leask, Hooker & King, 2010). However, although the media plays an enormous role in generating public responses to public health issues, it has also been blamed for encouraging unhealthy choices (Leask, Hooker & King, 2010). For instance, although it is through the media that we get to know the devastating effects of excessive alcohol consumption, the same medium has been accused of promoting alcohol consumption through enticing advertisements.
In addition, the fact that the media has unparalleled reach indicates that it would be grievous if erroneous health information was to be broadcasted (Leask, Hooker & King, 2010). The latter authors underscore that health authorities should ensure that only truthful and justifiable health information was leaked to the media to avoid instances of misinforming the public. The above implies that the role of the media in public health should be viewed as both a blessing and a curse. Moreover, considerable effort should be aimed at eliminating the negative implications of the media in order to promote positive public health responses.
References
Center for Disease Control and Prevention. Excessive Alcohol Use Addressing a Leading Risk for Death, Chronic Disease, and Injury at a Glance 2011. Web.
Leask, J., Hooker, C. & King, C. (2010). Media coverage of health issues and how to work more effectively with journalists: a qualitative study. BMC Public Health, 10: 535-550.
ScienceNews (2011). How Many US Deaths Are Caused by Poverty and Other Social Factors? About the Same as Deaths from Heart Attacks and Stroke, Study Finds. ScienceDaily. Web.
Turnock, B. J. (2007). Essentials of Public Health. Sudbury, MA: Jones & Bartlett Learning.
Symptoms of patient MLS, 40 years old, indicate Moderate Alcohol Use Disorder. Its pathophysiology involves damage to the gastrointestinal tract, cardiovascular and nervous systems, reduced immunity. For these reasons, pharmacology for this diagnosis will include drugs that reduce alcohol craving, as well as helping to restore and balance chemicals in the brain.
Diagnostic Testing Recommended by National Guidelines and Labs
The primary tool to help determine the disease’s presence are surveys – CAGE-test, Alcohol Use Disorders Identification Test (AUDIT), usage of DSM 5 criteria, and others (Buddy, 2020). Physical examination may show signs of complications and comorbidities:
redness on the face due to high blood pressure;
changes in complexion due to harm to the liver;
lack of coordination;
tremor.
There are no specific laboratory tests to determine an alcohol use disorder. Still, some can help determine a relapse or chronic condition by the presence in the blood or urine of certain substances:
Phosphatidyl ethanol (PEth), ethyl glucuronide (EtG), and ethyl sulfate (EtS) appear as a result of the breakdown of alcohol (“Alcoholism,” 2017).
Medications
Acamprosate (Campral®): Two pills three times a day
Disulfiram (Antabuse®): One pill once a day
Naltrexone (Revia®, Vivitrol®): One pill once a day
Topiramate (Topamax®, Trokendi XR®, Qudexy XR®): One pill once a day (“Medicines,” 2016)
Interventions
Detoxification is necessary to remove the withdrawal symptoms.
Psychological counseling. Therapy for alcohol addiction helps find the cause of the disease and ways to eliminate it. If a dependent person consciously understands the negative consequences of the condition and actions, he or she will be able to use the internal resources of the body and actively enter the fight for health.
Group therapy. The alcohol-dependent, who is treated in the group, understands the condition more quickly. MSL has the opportunity to evaluate behavior and know that she is not alone with this problem.
Taking medications – reduces the craving for alcohol and restores the balance of microelements.
Education
MSL, after treatment, will need therapy to change lifestyle and adopt new patterns of behavior. It involves developing healthy habits, taking care of mental and physical health.
Follow up
After completing a rehabilitation course, the patient needs constant support. Meeting with support groups or group therapy, as well as personal treatment with a psychologist, is recommended.
Referrals
MSL needs referrals to
alcohol treatment specialists for a more accurate treatment plan;
psychotherapist for the treatment of depression and support;
a gastroenterologist, cardiologist, and neuropathologist to check health status;
support groups.
Analysis
Agency for Healthcare Research and Quality (supported by the U.S. Department of Health & Human Services) guidelines were used to diagnose and develop a treatment plan. Also, for diagnosing mental disorders, a DSM-5 guide is needed to determine the criteria for the disease (“Diagnosis reference guide,” n.d.). Based on them, Moderate Alcohol Use Disorder was diagnosed, and treatment was also prescribed. Considering the personal approach to the client, she was also given the referrals and advice on fighting with depression. For future patients with a similar diagnosis, the same sources will be used, but other referrals will be proposed depending on the disease’s cause and its severity. Coding: 303.90 (F10.20).
References
Alcoholism. (2017). Lab Tests Online. Web.
Buddy, T. (2020). Alcohol screening tests ideal for healthcare settings. Verywell Mind. Web.
Diagnosis reference guide. (n.d.). Contra Costa. Web.
Medicines to treat alcohol use disorder. (2016). Agency for Healthcare Research and Quality. Web.