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Alcoholism and Alcohol Abuse

People usually abuse various substances such as tobacco, alcohol and other forms of drugs, because of varied and rather complicated reasons. These complications are evident in the hospitals and emergency rooms through the direct damage of these substances to the human health, as well as their link to physical trauma. Abused substances normally induce some form of intoxication that alters attention, judgment, perception, and physical control. Several substances can cause withdrawal effects ranging from mild anxiety to seizures or hallucinations. These drugs can produce tolerance, whereby one must use a large amount of the substance in question to have a consistent level of intoxication. Although the use of certain drugs such as cocaine has reduced in the past years, abuse of other drugs like heroin and club drugs has risen. Long term, heavy consumption of substances and alcohol causes adverse health effects to humans. Drug use causes harm to the liver, brain, bones, endocrine system and interferes with growth.

Physical and Pharmacological Effects of Substance Use and Alcohol Abuse

Drug abuse, also known as chemical or substance abuse, is a common disorder characterized by a destructive pattern of using a substance leading to significant distress or health problems. Teens are the most affected, because they are increasingly engaging in drug abuse especially narcotics (which relieve severe pain) and stimulant drugs, which lead to disorders like attention deficit disorder. The physical and pharmacological effects of drug abuse vary based on the substance involved. The effects of substance abuse can be devastating, with intoxication or withdrawal symptoms. These adverse effects comprise euphoria with regard to alcohol, intoxication from inhalants, steroid intoxication, paranoia with marijuana, and severe depression or suicidal thoughts manifested as withdrawal symptoms with cocaine or amphetamine (Crews, 2003).


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Drug abuse has numerous causes just like other mental- health complications. There are several social, biological, and psychological factors, known as risk factors. These factors can increase the likelihood of having a disorder related to substance-abuse or substance-dependency. The frequency of occurrence of substance-abuse disorders seems to be unexplainably high with a family living in an addictive environment. Therefore, most professionals of substance-abuse recognize the genetic aspect of the risk of drug abuse and addiction. Psychological implications of substance abuse or addiction include mood disorders like anxiety, bipolar disorder, depression, as well as personality disorders such as antisocial personality disorder. The Social risk factors for substance abuse include male gender, being between 18 and 44 years of age, low socioeconomic status, and marital status as single. While men are at high risk of developing a drug dependency such as alcoholism, women tend to be more vulnerable to alcohol addiction following consumption of low amounts of alcohol.


Substance Abuse

Causes of substance abuse.

Abuse of substances such as alcohol, cigarettes, and illegal drugs may begin in the childhood or adolescent stage. Other risk factors can enhance the susceptibility rate of an individual to abuse substances. Social factors in the family set-up influences the early development of a child, and hence the susceptibility to drug abuse.  These include: poor parenting, lack of nurturing and parental attachment, or a chaotic home environment. Factors related to the socialization of a child, outside the family set up, may also increase the risk of drug abuse. These can be caused by poor school performance, poor social skills, association with a deviant peer group or autonomous isolation from peers, aggressive or shy behavior in the classroom, or the perceived approval of drug-use behavior (Dick et al, 2000).

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Substance abuse symptoms and signs.

Friends and family may be first in recognizing the signs of substance abuse. There are many signs and symptoms of substance abuse, which include abandoning past activities such as sports, homework, or hanging out with new friends; poor grades, irritation and aggressiveness, mood changes, forgetfulness, theft cases, depression, being suicidal and even selfishness. An individual can be spotted with paraphernalia such as pipes, baggies, rolling paper and small boxes; getting drunk on a regular basis, and lying concerning drug consumption. Most noteworthy, such people start avoiding family and friends especially when they experience the desirable effects of the drugs, a state dubbed as being ‘high’. Drinking sprees and episodes of drug use are intricately planned in advance. In essence, the entire life of the individual revolves around drug use and seeking drugs. With time, the drug threshold increases and tolerance response towards the drug increases. Consequently, the person will consume larger amounts of the drug for the desired effect. Eventually, ones judgment becomes blurred when an excessive amount of the substance is consumed.  Full blown addiction sets in as the individual becomes more reliant on the drug for basic functioning. Unfortunately, drug use is associated with fun and most people are under the illusion that fun is impossible in the absence of drugs. Such individuals willingly endure frequent hangovers and spans of unconsciousness, commonly referred to as ‘blackouts’. Moreover, they take risks including sexual risks, getting into trouble with the law, and constantly pressurizing others to use drugs (Emanuele et al., 2002).

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Pharmacology of drugs.

Pharmacology refers to the actions of drugs and other substance on the body. The effect of a drug is directly proportional to the substance concentration at its site of action. Drugs normally work by producing a change in a cell’s function leading to subsequent change in body function or behaviour. Initially, the drug interacts physically with a part of the cell called the drug receptor. The receptor, which is highly specific to a drug molecule, binds and alters the structure of the drug, which then alters the intensity of a cell’s response to the substance (Kanayama, 2008).

Effects of commonly abused drugs.

Some of the commonly abused drugs include inhalants, which are solvents that emit vapor causing intoxication following inhalation. The people who abuse the inhalants normally breathe in the vapors intentionally, with the intoxication levels increasing faster but not lasting for long. Symptoms associated with intoxication from inhalants’ use are much similar to those observed from alcohol intoxication. These symptoms include fatigue, dizziness, slurred speech, clumsiness, weakness, blurred vision, elation, shaking, slowed reflexes, thinking and movement, or coma. It can also lead to temperature and chemical burns, chronic mental illness, as well as withdrawal symptoms, and death. The long term damage of inhalants abuse includes damage to the nerves, brain, liver, kidney and heart failure (Howard et al., 2011).

Tobacco is another drug abused by many people for reasons such as pleasure, relief of depression, performance and vigilance, weight control or even curbing hunger. The main addicting substance in cigarettes is nicotine, as well as many other chemical components that cause damage to the health of the smoker and the people around them. The health implications of abusing tobacco include lung cancer, peptic ulcers, heart disease, emphysema or even stroke. The symptoms of withdrawal from smoking include hunger, anxiety, sleeping disorders and depression.

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Cocaine is an illicit drug that is commonly abused. It comes from the coca plant and has other names like coke, crack, snow or rock. Cocaine can be smoked, snorted, injected or swallowed, with the determination of effects being through the duration and intensity of the consumption of the drug. Cocaine usually causes the desired effects, which include pleasure and increased alertness. The short-term effects of cocaine abuse are irregular heartbeat, paranoia, constriction of blood vessels leading to heart damage or stroke or death. Withdrawal symptoms include reduced energy and severe depression. Cocaine use usually causes harmful effects to the organs such as the lungs, brain, heart, and to the kidneys (Strauss et al., 2000).

Marijuana is a commonly used drug that comes from the plant whose botanical name is Cannabis sativa. Its active ingredient is delta-9-tetrahydrocannabinol (THC), contained at a higher concentration in its resin called hashish. Marijuana is taken through smoking or even via oral consumption. Its smoke causes more irritation to the lungs and contains more cancer-causing chemicals than tobacco smoke. The common effects of marijuana use and abuse include relaxation, pleasure and impaired memory coordination.

Heroin has other brand names such as smack or horse. The most common effects caused by heroin intoxication include pleasure, drowsiness and slowed breathing. Withdrawal can be intense and is mainly manifested by abdominal cramps, vomiting, diarrhea, aches, confusion and even profuse sweating. Abuse of heroin especially overdosing can result in death from decreased breathing. Injection of heroin into the body is through using dirty needles leading to other health implications such as HIV/AIDS, infections, tetanus or botulism (Howard et al, 2011).

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Methamphetamine, also known as crank, meth, ice, crystal or speed, is a powerful stimulant known to decreases appetite, increase alertness, and gives a sensation of pleasure. A drug can be snorted, injected, smoked or eaten. Its effects are common to those of cocaine such as high blood pressure, heart attack or stroke. Withdrawal from the use of methamphetamine causes abdominal cramps, depression and increased appetite. Other long-term effects of this drug include paranoia, weight loss, hallucinations, destruction of teeth and heart damage.

Anabolic steroids are a group of drugs which includes testosterone and its synthetic components. They are commonly used by athletes and body builders with the aim of increasing muscle mass to improve performance. Several mental health effects such as mood problems and addiction to the substance are the common implications of steroids (Kanayama et al, 2003).

Club drugs are an assortment of other drugs made popular by club scenes and rave parties. Many young people believe that these drugs are not harmless or even healthy! The most popular club drugs include ecstasy, rohypnol, GHB, ketamine, LSD and PCP. Their uses include the general mood improvement and energy maintenance, often for all-night dance parties. The effects from abuse of these drugs range from brain damage, sleeping disorders, low or high blood pressure, impaired memory, amnesia, paranoia, nausea, depression, hallucinations, and mood disturbances among others.

Alcohol Abuse

Alcohol abuse is the excessive or problematic use of alcohol. This leads to failure in fulfilling key obligations at work, school, or home. It leads to hazardous consequences such as road accidents, as well as legal problems. Alcohol dependence is an extremely serious disorder involving excessive alcohol usage. Interestingly, individuals can be impaired by alcohol use without manifesting any visible signs or symptoms. Impairment is simply not the appearance of overall physical symptoms, but loss of critical coordination and attention as well as deterioration of judgment, and control with a possible increase in reaction time, and decreasing sensory perceptions. Drug Intoxication is an enhanced state of impairment whereby the gross physical symptoms of alcohol effects are apparent. The point at which "impairment" becomes "intoxication" depends on tolerance and is unique to the subject. The rate of alcohol consumption also affects impairment. If consumed at a slow pace, impairment increases at a slow and steady rate. If consumed at a faster pace, the rate of increase in impairment becomes more rapid. This further accelerates the rate of performance deficit because alcohol absorption is rapid in the blood stream (Fillmore, 2003).

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The effect of alcohol use on an individual is a measure of an individual's rate of alcohol consumption, circumstances related to alcohol use and the subject's tolerance to alcohol. The degree of impairment relates to the dose consumed, even though this impairment is not linear or identical to all behaviour changes. Impairment of the cognitive functions begins at lower levels of consumption of alcohol than for simple tasks. This results in tolerance changes i.e. the urge to take much alcohol in order to get the desired effects. Alcohol problems can vary in the degree of severity from mild to life threatening effects, and usually affect the individual, the person's family, and the entire society in various ways. Withdrawal from alcohol use and abuse, especially those who are physically dependent on it, is more dangerous than withdrawal from drugs such as heroin or narcotic drugs.

Physical and pharmacological effects of alcohol abuse.

The common effects of alcohol abuse include:  depression, decreased muscle control and coordination, slurred speech. Prolonged use ultimately leads to alcoholism. Withdrawal symptoms include irregular heart-beat, insomnia, anxiety, nausea, agitation, seizures, tremor, liver failure and hallucinations. In its severest form, withdrawal from alcohol abuse, combined with malnutrition may lead to a serious condition called delirium tremens (DTs). Consumption of alcohol can also lead to enlargement of the heart and cancer of the pancreas, esophagus and stomach. Ultimate signs and symptoms are medical conditions such as gastritis, pancreatitis,  neuropathy, cirrhosis, anemia, alcoholic cardiomyopathy (heart disease), cerebellar atrophy, Wernicke's encephalopathy(abnormal brain functioning), central pontine myelinolysis (brain degeneration), Korsakoff's dementia, confusion, seizures, malnutrition, hallucinations, peptic ulcers, and gastrointestinal bleeding (Flensborg-Madsen, 2007).

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Alcohol abuse is related to a wide range of medical, psychiatric, legal, social, economic, occupational, and family problems. For example, parental alcoholism forms the basis of many family problems such as divorce, child abuse and neglect, spouse abuse, criminal behavior and welfare dependence. The majority of alcoholics often go unrecognized by physicians and health care professionals, largely due to the person’s ability to hide the frequency and amount of alcohol consumed, problems denial caused and  worsened through drinking, the slow onset of diseases, and the body's ability to adapt to increasing amounts of alcohol. Family members often downplay alcohol problems, thus unconsciously contributing to the persistent alcohol abuse. This is carried out via well-intended behaviors such as protecting the affected person from criticism and even monetary support. Children from parents who abuse alcohol are at a greater risk of alcohol abuse, drug abuse, anxiety disorders, conduct problems, and mood disorders, compared to those children from families without alcoholism. Alcohol abusers have a considerable risk of psychiatric disorders and suicide. Abusers usually experience shame, guilt, and depression, in most cases when their habit leads to significant losses such as job, economic security, relationships, or physical health.

Effect of alcohol on the central nervous system.

Drinkers usually perceive alcohol as an important stimulant. This perception occurs at low levels of alcohol intake, resulting from depression of inhibitory control mechanisms in the brain. Alcohol is a general anesthetic, which yields a range of central nervous system (CNS) effects that are same to those of other sedative or hypnotic drugs. First, alcohol destroys the integrating control of the brain which may lead to disorganization of thought processes. People who abuse alcohol may become disoriented and confused, with motor functions being less fluid (Flensborg-Madsen, 2007).

Liver effects.

Some adolescents with disorders from alcohol use experience elevated liver enzymes. This is linked to higher alanine amino transferase (ALT) and gamma-glutamyl transpeptidase (GGT) activity (Clark et al, 2001). In addition, individuals who are obese often exhibit high serum ALT levels, even with modest amounts of alcohol drinking (Strauss et al, 2000).

Endocrine effects and growth.

Early maturing adolescents who use alcohol experience dysfunctional growth and neuron- endocrine development. It is surprising to note that girls encounter early puberty, and this is linked to the early usage of drugs and alcohol (Dick et al., 2000). In human beings, puberty is the period of the hypothalamic-pituitary-gonadal (HPG) axis activation. Gonadotrophin-releasing hormone pulsatile secretion from the hypothalamus stimulates the release of LH (luteinizing hormone) as well as FSH (follicle-stimulating hormone from the pituitary, leading to increases in the output of gonadal sex steroid(testosterone and estrogen), which then increases insulin production and growth hormone (GH) (Mauras et al., 1996).

Both estrogens and androgens stimulate the production of GH, but the feedback mechanism of the production of GH during puberty depends on estrogen, same as in males (Dees et al., 2001). This increase in hormonal level not only enhances gonadal maturation, but also influences muscle mass, growth, and skeleton mineralization. Therefore, alcohol taken pending rapid development (during puberty or prior to) can disrupt the normal growth as well as the development of endocrine, through its effects on various organs such as testes and ovaries, the pituitary gland and the hypothalamus. Data on animal and human research on alcohol in relation to endocrine development shows that alcohol has strong effects on neuron- endocrine function (Emanuele et al. 2002). Ingestion of alcohol can reduce levels of estrogen in girls, and lower testosterone and LH levels in boys. Acute alcohol intoxication results in GH levels reduction without any significant change in either endocrine or insulin-like growth factor binding protein-3 (IGFBP3) IGF-1. Females using alcohol during early youth period are at a high risk of adverse effects on pubescence. However, the effects of long-term alcohol consumption on reproductive men’s function are not clear. GH, testosterone and estrogen levels, can be changed by alcohol, may have serious consequences for normal development in both sexes, because these hormones are crucial for maturation of organs (Frias et al., 2000).

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Growth effects and bone density.

Alcohol abuse can cause low growth of metaphysical and cortical bone. Such effects on skeleton may be a result of a reduction in the formation of osteoblast, which associates with a decrease in testosterone. Furthermore, with abstinence from alcohol use, normal metabolism of the bone is not fully restored. Human studies point at an opposite relationship between consumption of alcohol and the density of bone mineral in young males, but not females (Neville et al., 2002).

Conclusions and Recommendations

Efforts towards preventing drug abuse should be focused on the pre-adolescents and adolescents. Strategies are to be in place to improve communication between parents and children in order to teach children about the misconceptions and consequences of drugs, alcohol and cigarettes. A conducive environment of social disapproval from family and peers to drugs can also be set up through continuous awareness campaigns. Individuals suffering from substance abuse tend to have successful recoveries when they get the motivation to seek treatment, engage actively in their own recovery process, and receive intensive treatment services. Prognosis for substance abuse recovery is further improved by increased access to community-based social supports. Drug addiction leads to the increase in the risk of several negative life conditions and stressors. Individuals suffering from drug addiction are at a greater risk of domestic violence especially with the involvement of cocaine dependence or excessive drinking. When treated, the prognosis of alcohol abuse and drug addiction problems can be improved. Recovery from substance abuse has challenges characterized by episodes of remission (abstinence from drug use) and relapse (American Psychiatric Association, 2006).

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Most drug abusers believe they can stop using drugs by themselves, but the majority of these abusers who try to recover on their own do not succeed. Research indicates that long-term drug use interferes with the functioning of the brain and strengthens compulsions to abuse drugs, thus, the craving for these substances continues even after ceasing drug consumption. Due to these continuous cravings for drugs, the most crucial part of treatment is prevention of relapse. The treatment of substance abuse depends on the individual and the abused substance. In behavioral treatment, a counselor equips one with strategies to cope with his drug cravings, and ways to avoid relapse. The doctor may prescribe medications, such as methadone and nicotine patches, to control the symptoms of withdrawal and drug cravings. Often, a drug user or abuser has an underlying behavioral disorders or other mental illness, which increases the risk of substance abuse. These disorders need to be treated medically and through counseling along with treatment of the substance abuse (Simpson, 2003).



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