A presentation by Tony Austin Drugs and Alcohol A presentation by Tony Austin

A complicated history

Talking Porlocks Samuel Taylor Coleridge, one of the greatest intellectuals of the 19th Century was an opium addict. Author of Kubla Khan In Xanadu did Kubla Khan A stately pleasure-dome decree: Where Alph, the sacred river, ran Through caverns measureless to man  Down to a sunless sea. Conceived in a “dream” which many believe was an opium induced vision.

Gone for a Burton The Acting dynasty There is a romanticism about alcoholism and drug addiction which is part of it’s seductive myth and that we must include in our understanding of those suffering from addiction

Heroin chic

Definition of a drug A chemical agent, other than food that affects biological function in humans and other animals. Psychotropic drugs alter mood, thought processes and behaviour. The singer in a band They vary in potency and affect according to the individual and their circumstances

Major categories according to the Diagnostic and Statistical Manual of the American Psychiatric Association, DSM-iv Alcohol Heroin and other opiates Sedatives Caffeine Inhalants Stimulants (incl. Cannabis Nicotine cocaine and Hallucinogens Phencyclidine (PCP) amphetamines)

What is addiction? The traditional view was that addiction was a chronic disease where individuals lacked the will power to stop excessive use and the only cure was abstinence. The modern view is more that addiction stems from a genetic disposition accompanied by heavy use. https://www.youtube.com/watch?v=T5sOh4gKPIg It is a vast topic, so I will only be looking at opiates, specifically heroin, and alcohol

Opiates Heroin Morphine Codeine Methodone Pethidine Opiates have the highest dependence potential of any psychoactive drug after nicotine. My brief experience of nicotine addiction Heroin dependence is one of the most serious types of drug dependence in terms of persistence; mortality rate; and physical and psychological symptoms that it causes.

Trainspotting, the appeal of heroin use.

Treatment for opiate addiction Detoxification Drug free treatment

Treatment Detoxification Using substitutes such as Methodone, Levo-alpha- acetylmethodal (LAAM) or Buprenorphine or Naltrexone These help wean the user of their drug but don’t address the underlying causes of addiction Drug free treatments Residential treatment in Therapeutic communities Out patient drug counselling Self help groups (NA) Assist dependents to achieve enduring abstinence and learn to address their problems by means other than using opiates

Alcohol use disorder

Short-term effects of alcohol We are all probably familiar with the short-term effects Loss of inhibition Loss of coordination and slower reaction times Blurred vision, slurred speech, aggressive behaviour.

Alcohol use disorder is an umbrella term covering Alcohol abuse alcohol dependency Radio 4 Woman’s hour on children of alcoholics http://www.bbc.co.uk/programmes/b08qxfgj National Health Service studies estimate that 9% of men and 4% of women show some form of dependency on alcohol My experience of alcohol dependency: the psycho flat mate

Alcohol use disorder Characterised by Impaired control over the use of alcohol Obtaining, using and recovering from alcohol takes up a disproportionate amount of the individual’s time.

Diagnostic and Statistical Manual of the American Psychiatric Association, DSM-iv diagnosis of Alcohol use disorder At least three of the following experienced in a twelve month period Tolerance (greater quantities needed to achieve the desired effect). Withdrawal symptoms Use in larger amounts than intended Persistent desire or unsuccessful attempts to cut down Time spent obtaining or recovering from alcohol use Social, occupational and recreational pursuits given up due to alcohol use Continued use despite knowledge of physical and psychological harm.

Treatment Assessment is an important part of the treatment It provides feedback on the scale of the individual’s problem It helps to develop rapport between a therapist and client Alcohol Use Disorders Identification Test Interactive exercise

Additional approaches Public health policies have raised awareness of the knock-on affects: Traffic accidents; domestic violence; loss of productivity; illnesses such as cancer, heart disease, liver failure. Complexity of the issue: Police versus medicine debate (Sam and Johnny) Detoxification: diazepam; chloriazapoxide; chlormethiazole Alcoholics Anonymous CBT: teaching people to control their response to their environment by improving social, coping and problem solving skills My experience of abstinence