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

2. A complicated history

3. 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.

4. 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

5. Heroin chic

6. 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

7. 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)

8. 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.
It is a vast topic, so I will only be looking at opiates, specifically heroin, and alcohol

9. 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.

10. Trainspotting, the appeal of heroin use.

11. Treatment for opiate addiction
Detoxification Drug free treatment

12. 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

13. Alcohol use disorder

14. 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.

15. Alcohol use disorder is an umbrella term covering Alcohol abuse alcohol dependency Radio 4 Woman’s hour on children of alcoholics
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

16. 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.

17. 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.

18. 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

19. 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