ALCOHOL ABUSE AND WORLD DAY AGAINST DRUG ABUSE

Many will think why discuss alcohol ? Well firstly both cigarette smoking and alcohol are included in drug abuse according to International classification of Diseases. Secondly, according to the data provided by the Centre, the substance abusers in J&K encompass a wide spectrum, ranging from cannabis to sedatives to inhalants.  The breakdown includes approximately 5.4 lakh individuals abusing opioids, 4.20 lakh using alcohol, 1.4 lakh consuming cannabis, and 1.35 lakh inhaling substances.

According to statistics compiled by the J&K government, in 2023 alone, 11,476 patients visited various drug de-addiction centres across J&K seeking treatment and counselling to combat substance abuse, including alcohol abuse.

So here we discuss a possible case scenario of a drug abuser and doctor to clear all myths.

Patient. Hello . I need help. I have been drinking alcohol for a few years now. Am I alone? Do others drink, is it prevalent in the world as we already talked about JK?

Doctor.  Thank you for contacting me and my team,, seeking help in itself is a big achievement. You are not alone, we are with you, we have got a qualified team of medical professionals from various backgrounds from Psychology to Psychiatry to diet and natural treatments.  Dear friend, about 38 million adults in the U.S. drink too much, and 88,000 people die each year because of it.

Patient. Oh that is new to me,  but is there a difference between Psychologist and Psychiatrist?

Doctor . Both professions are complementary to each other, and help people who seek help . In your case a psychologist can help you with various therapies . With your permission a psychologist will ask you more questions about your drinking habits. They may also want to speak with members of your family if you permit. Arrange follow-up appointments to check on your progress to help you ease your alcohol use, or stop it all together.

From there, your psychologist may:-

Talk about how drinking affects you

Guide you to available treatment options

Give you tips to use in your day-to-day life that can help you cut back

Discuss your outlook

Refer you to mental health or AUD [Alcohol use disorder] specialists who can help you make changes when you’re ready.

And a psychiatrist on other hand will do a physical exam and take a detailed medical history.

Use lab and imaging tests to see if your drinking has caused organ damage.

Do an evaluation to check how your drinking might affect your emotions and behavior.

Most important work of a Psychiatrist is to save any drug abuser from “WITHDRAWAL SYMPTOMS”.

Psychiatrists always tell us that don’t ask anybody to stop drinking suddenly without consulting a doctor as following life threatening alcohol withdrawal symptoms occur; also includes Tremulousness, weakness, unstoppable vomiting, blurred vision, and  pounding heart palpitations.

Kindly remember that alcohol withdrawal delirium is a life threatening delirium and its symptoms are disorientation. Agitation, seeing or hearing people or voices which don’t exist. Seizures can result in death of patients.

Patient. Oh I see. What are two types of alcohol abusers? I hear there are many groups and classifications.

Doctor. Yes there are two groups.

Type 1: adult onset, steady, gradually escalating consumption, form 75 % of alcoholics.

Type 2: alcohol seeking from adolescence , strong family history, anti social characteristics’, 25 % of alcoholics.

Patient. How come I enjoyed my drinks and no one even noticed at the office and work, I am curious to know the reason?

Doctor.  Alcohol stimulates the release of dopamine and produces euphoria and hence is enjoyable. Over the time dopaminergic neurons atrophy and natural level of dopamine fails producing malaise, unless the level is stimulated by alcohol and hence painful urge to take alcohol again

Symptoms: In the beginning alcoholics function fairly well most of the time and go unrecognized by physicians until their social and occupational lives and their physical lives and physical health have been harmed and it results in a dysfunctional life at home and job.

Patient.I see, do Psychologists or Psychiatrists have a specific questionnaire for me and others abusing alcohol?

Doctor.  Yes many tests, one is known as CAGE. Screening tests CAGE can be used anywhere.

1. Have you ever felt you should CUT down on your drinking? C
2. Have people ANNOYED you by criticizing your drinking? A
3. Have you ever had a GUILTY feeling? G
4. Do you need a drink as the first important thing of the day? EYE OPENER? E

Patient. Any specific laboratory investigations ? And what are common complications of long term alcohol abuse?

Doctor. Yes we got Biological Markers. Chronic drinking elevates serum gamma-glutamyl transferase [GGT] and RBC MCV [together they identify 90% of alcoholics]

Complications of Alcoholism.

1. Gastric ulcer, anemia, cirrhosis, IMPOTENCE .
2. Severe nerve weakness[vitamin B deficiencies].
3. Heart diseases like myopathy and cardiac myopathy
4. Wernicke encephalopathy [triad of confusion, ataxia, and eye movement dysfunction.
5. Alcoholism leads to complete loss of memory .

Patient. It was great talking to you, I will surely book an appointment.

Doctor. My team thinks you are already a winner by asking for help in our chat box. You have got immense talent and we will be happy to guide you.

BELOW SUGGESTIONS ARE MEANT FOR FAMILY MEMBERS OF DRUG ABUSERS INCLUDING ALCOHOL.

Treatment

1. Don’t abuse a patient or use derogatory words for him/her.
2. Treat all medical complications of drinking.
3. Enlist family members in treatment. Evaluate family’s contribution to problem or help in resolving problems.
4. Group Therapy appears to be most effective.

The earlier one visits a doctor the better for him/her.

Once you’ve told your doctor about your drinking, they will:

What to Expect From Treatment?

Depending on how severe your symptoms are, how your doctor chooses to treat it can vary. The goal will be to get you to cut back or quit your alcohol use.

You may get personalized treatment from various specialists in different settings like:

One-on-one or group therapy

An outpatient program where you see specialists during brief visits to their office

A residential rehabilitation program in which you’ll stay overnight in the facility and get treatment for a period of time.