LearnWell Dental Institute

Alcohol Problems: Prevention & Treatment 

Course Number  LW03-4263-05008  Objectives At the end of this course, you will  1. understand tests for alcohol problems, 2. describe the use and  effect of alcohol, 3. explain prevention and treatment strategies.  Credit Hours and Fee  3.0 CE Credit Hours with a fee of $24.00  Instructor  Rudolf Klimes, PhD (Indiana University), MPH (Johns Hopkins University); Adjunct Professor, Folsom Lake College, Folsom, CA

Welcome to this 3-contact-hour Continuing Education  course for dental health care professionals with instant online processing and certification 24/7.  Study the course below, take the 12-question multiple-choice TEST, register and pay online. If you score 75% or above, you may print your CE certificate on your printer as soon as you finish. If you have difficulty printing your certificate, click here. You may retake the test once.

People give four main reasons why they use alcohol. Yet there are much better ways than drinking to relax, to celebrate, to enjoy another's company, and to deal with pain. Learn them.

Take the course pre-quizzes for self-study and exploration: UK Alcohol Quiz.

 1. TESTING FOR DRINKING

Describe your use of alcohol.

1.1 Questions: Do the following for self-study. Do not submit the answers.

Alcohol is a central nervous system stimulant.

Reaction to alcohol is often inborn.

The most frequent committed crime in the US is drunk driving.

Alcohol and aspirin taken together raises blood alcohol levels.

1.2 Sites that may assist in the assessment of drug-use and for drug-testing:    http://www.edc.org/hec/pubs/cara/          

1.3 Review and the meaning of terms such as BAC (blood-alcohol concentration), DTs (delirium tremens, and FAS (fetal alcohol syndrome).

 1.4 How can I tell if my friend has a drinking or other drug problem?

Sometimes it's tough to tell. Most kids won't walk up to someone they're close to and ask for help. In fact, your friend will probably do everything possible to deny or hide the problem. But, there are signs you can look for. People with serious substance abuse problems say things like," I can stop drinking or using other drugs any time I want to" -- but they don't. They may be o.k. to hang around with, until they get high -- then they often act like jerks or get into fights. No one is sure why some people get into trouble with alcohol or other drugs. There are signs, however, when substances are taking control of someone's life. Some of these signs are easy to see, others aren't, but if you see them happening over and over again, chances are your friend needs help.

If your friend has one or more of the following warning signs, he or she may have a problem with alcohol or other drugs:

• getting drunk or high on drugs on a regular basis

• lying about things, or about how much alcohol or other drugs he or she is using

• avoiding you in order to get drunk or high

• giving up activities he or she used to do, such as sports, homework, or hanging out with friends who don't drink or use other drugs

• planning drinking in advance, hiding alcohol, drinking or using other drugs alone

• having to drink more to get the same high

• believing that in order to have fun you need to drink or use other drugs

• frequent hangovers

• pressuring others to drink or use other drugs

• taking risks, including sexual risks

• having "blackouts" -- forgetting what he or she did the night before while drinking (if you tell your friend what happened, he or she might pretend to remember, or laugh it off as no big deal)

• feeling run-down, hopeless, depressed, or even suicidal

• sounding selfish and not caring about others

• constantly talking about drinking or using other drugs

• getting in trouble with the law

• drinking and driving

• suspension from school for an alcohol- or other drug-related incident

 1.5 What Are the Signs of an Alcohol Problem?

How can you tell whether you, or someone close to you, may have a drinking problem? Answering the following four questions can help you find out. (To help remember these questions, note that the first letter of a key word in each of the four questions spells "CAGE.")

• Have you ever felt you should Cut down on your drinking?
• Have people Annoyed you by criticizing your drinking?
  Have you ever felt bad or Guilty about your drinking? 
  Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?

One "yes" response suggests a possible alcohol problem. If you responded "yes" to more than one question, it is highly likely that a problem exists. In either case, it is important that you see your doctor or other health care provider right away to discuss your responses to these questions. He or she can help you determine whether you have a drinking problem and, if so, recommend the best course of action for you.

Even if you answered "no" to all of the above questions, if you are encountering drinking-related problems with your job, relationships, health, or with the law, you should still seek professional help. The effects of alcohol abuse can be extremely serious--even fatal--both to you and to others.

 Home Drug Tests: http://www.drugtestyourteen.com/order_products_here

 2. USE AND EFFECT OF ALCOHOL

 2.1 Describe how the use of alcohol has affected you.

Alcohol abuse is a pattern of problem drinking that results in health consequences, social problems, or both. However, alcohol dependence, or alcoholism, refers to a disease that is characterized by abnormal alcohol-seeking behavior that leads to impaired control over drinking. Most of the alcohol people drink enters the body through the small intestine.

Short-term effects of alcohol use include: distorted vision, hearing, and coordination, altered perceptions and emotions, impaired judgment, bad breath; hangovers. It takes two hours for the body to eliminate one pint of alcohol. In binge drinking, a person drinks 5 or more drinks at one occasion.

Long-term effects of heavy alcohol use include: loss of appetite, vitamin deficiencies, stomach ailments, skin problems, sexual impotence, liver damage, heart and central nervous system damage, memory loss.

How Do I Know If I, or Someone Close, Has a Drinking Problem?
Here are some quick clues: 
Inability to control drinking--it seems that regardless of what you decide beforehand, you frequently wind up drunk
Using alcohol to escape problems
A change in personality--turning from Dr. Jekyl to Mr. Hyde
A high tolerance level--drinking just about everybody under the table
Blackouts--sometimes not remembering what happened while drinking
Problems at work or in school as a result of drinking
Concern shown by family and friends about drinking."
(Source: www.health.org/pubs/strafact/straight.htm)

 2.2 Outline the answers to these questions.
How does alcohol affect the various parts of your body?  http://www.50plushealth.co.uk/index.cfm?articleid=1420    Answer  
What are alcohol doses and blood levels?  
How does alcohol contribute to disease and death? Answer

Study the above questions first. Then check you learning here.
Q1. With what blood-alcohol level is it save to drive? 0, 0.02, 0.06, 0.08
Q2. In the liver, alcohol is a depressant, stimulant, toxin, narcotic.
Q3. Studies show that alcoholics die prematurely by 5, 10, 20, 30 years.
Q4. Alcohol abuse and dependence are different problems. True.  False
Q5. Studies show that women who enter treatment for substance abuse, the % who have been victims of physical or sexual abuse is 20-25, 35-40, 75-80%

Alcohol-related liver disease. More than 2 million Americans suffer from alcohol-related liver disease. Some drinkers develop alcoholic hepatitis, or inflammation of the liver, as a result of long-term heavy drinking. Its symptoms include fever, jaundice (abnormal yellowing of the skin, eyeballs, and urine), and abdominal pain. Alcoholic hepatitis can cause death if drinking continues. If drinking stops, this condition often is reversible. About 10 to 20 percent of heavy drinkers develop alcoholic cirrhosis, or scarring of the liver. Alcoholic cirrhosis can cause death if drinking continues. Although cirrhosis is not reversible, if drinking stops, one's chances of survival improve considerably. Those with cirrhosis often feel better, and the functioning of their liver may improve, if they stop drinking. Although liver transplantation may be needed as a last resort, many people with cirrhosis who abstain from alcohol may never need liver transplantation. In addition, treatment for the complications of cirrhosis is available.

Cancer. Long-term heavy drinking increases the risk of developing certain forms of cancer, especially cancer of the esophagus, mouth, throat, and voice box. Women are at slightly increased risk of developing breast cancer if they drink two or more drinks per day. Drinking may also increase the risk for developing cancer of the colon and rectum.

Pancreatitis. The pancreas helps to regulate the body's blood sugar levels by producing insulin. The pancreas also has a role in digesting the food we eat. Long-term heavy drinking can lead to pancreatitis, or inflammation of the pancreas. This condition is associated with severe abdominal pain and weight loss and can be fatal.

 3.PREVENTION and TREATMENT of ALCOHOL ABUSE

 3.1 If you decide to speak to your friend about alcohol, here are some guidelines that you and your advisor should consider in planning how and what you could do to help:

• Make sure the timing is right. Talk to your friend when he or she is sober of straight -- before school is a good time.

• Never accuse your friend of being an alcoholic or a drug addict, but do express your concern. Try not to blame your friend for the problem; if you do, he or she might be turned off right away.

• Talk about your feelings. Tell your friend you're worried, and how it feels for you to see him or her drunk or high on other drugs.

• Tell your friend what you've seen him or her do when drinking or using other drugs. Give specific examples. Tell your friend you want to help.

• Speak in a caring and understanding tone of voice, not with pity but with friendship.

• Be prepared for denial and anger. Your friend may say there is nothing wrong and may get mad at you. Many people with alcohol and other drug problems react this way. When confronted, many users will defend their use, blame others for the problem, or give excuses for why they drink or use other drugs.

• Find out where help is available. You could offer to go with your friend to get help, but be prepared to follow through. This gesture will show your friend that you really care.

• You need to tell your friend that you are worried about him or her, and that someone who can help needs to be told. Your friend might get really mad at you, but if you say nothing, things may get worse and your friend may be in more danger.

• Your friend's problem is probably hard on you, too. The situation may have left you feeling lonely and afraid. Maybe you've thought, "What if I get my friend in trouble? What if I lose my friend over this? What if I don't do anything and something awful happens?" It's hard to keep all of these questions and feelings to yourself. It's important that you talk about them. You can share these feelings with the person that you go to for help about your friend's problem. There are also support groups for people like you who are trying to help a friend, such as AL-Anon or Alateen, where you can learn more about people's alcohol and other drug use problems. Your school may have a substance abuse prevention counselor as well. (See the end of this brochure for a list of places to go to for help or to get more information.)

 3.2 What does my friend have to do to get help?

Probably the hardest decision your friend will be faced with is admitting that he or she has a problem. To get better and recover, your friend has to get some help to stop drinking or using other drugs.

Facing such a problem and asking for help can be a scary thing to do. Your friend will have to take an honest look at where drinking or other drug use has brought him or her, and admit that it has caused emotional and maybe physical pain. Your friend will have to see that it has robbed him or her of real friends, creativity, happiness, spirit, the respect of others, and even self-respect, and that it keeps your friend from growing up.

Your friend will not be able to solve this problem alone. He or she will need experienced help. A good counselor will support your friend and direct him or her to the kind of treatment and/or support groups that are most helpful.

Encourage your friend to talk to other people with drinking and other drug problems who are now in recovery, such as members of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). These groups are confidential, self-help organizations that offer assistance to anyone who has a drinking or other drug problem and wants to do something about it. AA and NA members are recovering alcoholics and addicts, so they have a special understanding of each other. Talking with others who have experienced similar problems is an important part of recovery. New members are encouraged to stay away from alcohol or other drugs "one day at a time." There is no fee for membership in these organizations. If your friend is afraid to go to a meeting alone, you can go along with him or her to an "open" meeting. Friends and family members are welcome to attend this type of meeting, and there are special meetings in most neighborhoods or communities. Local branches of AA and NA are listed in your phone directory.  Explore the AA site.

If your friend has a drinking or other drug problem, you may be the only one willing to reach out and help. Your friend may not appreciate your help right away, or he or she may realize it means you really care. Ultimately, it's up to your friend to get help. It is not your responsibility to make that happen. In fact, you can't make that happen. All you can do is talk to your friend, show how much you care, and encourage him or her to get help. Your concern and support might be just what is needed to help your friend turn his or her life around.

However, if your friend is in serious trouble with alcohol or other drugs, and you have been unable to get your friend to get help on his or her own, you should consider speaking with your friend's parents or guardian. The potential consequences to your friend's life can be too severe to do nothing.

Describe the steps that you will take to prevent alcohol abuse for yourself or someone close to you.

Pregnant women who drink 5 drinks daily have a 15%, 32%, 57% chance of having an infant with Fetal Alcohol Syndrome.

To be effective, prevention should be separate from health and social services. True. False.

What treatments are available for alcohol abuse? Rational Recovery (Also motivation training, brief intervention strategies, medications, aversion therapies, behavioral self-control training, self-help groups, relapse prevention, family therapy, social skills development, stress management, matching clients with treatments.)

Alcoholics and their families need to be treated separately. True. False.
The 12-step AA model permits controlled drinking True. False.

 About situational abstinence. The rules are as follows:
*Never drink on an empty stomach.  Show respect to people who do not drink alcohol. Remember that women do hold less alcohol than men. Listen to experienced professionals. Be on guard against drinking-pressure, even among your  best friends.
*Remember time and place where you should not drink  alcohol. Never drink alone. Quit in good time, its never a shame to say no.
*There are situation where alcohol is prohibited. These  are: traffic,  sports and outdoor life, situations in  company with children and adolescents, work, during  conflicts, and during depression.

 4. Related Studies

ERIC_NO: ED312601, Alcohol-Related Problems in High-Risk Groups. EURO Reports and Studies 109. Report on a WHO Study. By Plant, Martin, Ed., 1989
ABSTRACT: Alcohol consumption has risen dramatically in many countries since the Second World War. Accompanying this rise has been a rise in alcohol-related problems, including liver cirrhosis mortality, alcohol dependence, and alcohol-related crimes and accidents. Alcohol misuse presents huge health, social, and legal problems throughout most of Europe and in many Third World countries. This report resulted from the cooperation between the European Regional Office of the World Health Organization and researchers from seven European countries. Its purpose was to discuss a number of practical issues related to the conduct of alcohol research, to indicate certain recent trends in alcohol use and misuse, and to highlight both problems and priorities for research and policy. "The Epidemiology of Alcohol Use and Misuse" (Martin Plant) reviews five general issues that have recently interested researchers and others concerned with alcohol misuse.

ERIC_NO: ED426123, Preventing Alcohol Problems among Young People: Californians Support Key Public Policies. Growing Up Well. Focus on Prevention. By Mosher, James F., 1998
ABSTRACT: This report, fourth in a series of eight, highlights the views of Californians about policies local communities and the state can establish to reduce the potential for alcohol problems among young people. In the California Center for Health Improvement (CCHI) "Children and Youth Survey," 51% of the adults surveyed said that they were very worried about teen substance abuse, including the abuse of alcohol. When asked about specific policy measures intended to reduce alcohol problems among young people, 78% of the adults believe that alcoholic beverage promotions to minors should be prohibited. Such promotions include advertising paraphernalia. Adults (77%) also agree that billboard advertising should be restricted in residential areas and near schools. Californians also overwhelmingly support expanding local government authority to include the power to suspend or revoke a liquor store's license if the store repeatedly sells alcohol to minors. Eighty-nine percent of adults (and 96% of registered voters) expressed agreement with this policy. A concrete measure of the public's concern that alcohol and drug problems pose a serious threat to the health and safety of young people is provided by the public's expressed willingness to pay more in taxes to address these problems. Seventy-five percent of adults surveyed said they would be somewhat willing to pay more in taxes to make better services available through substance abuse programs. Furthermore, Californians expressed high levels of support for increases in the state beer excise tax to fund services for children and families.

ERIC_NO: ED436699, A Profile of Clients Entering Treatment for Alcohol Problems.By Finkbiner, Richard, 1999
ABSTRACT: Large numbers of clients entering publicly-funded substance abuse treatment facilities cite problems with alcohol as one reason for seeking treatment. This report presents the results of a secondary analysis of the National Treatment Improvement Evaluation Study (NTIES) data set. It profiles the treatment experiences of three study groups that were subsets of the total client sample (N=4,411): clients who entered treatment for alcohol only (n=464), for alcohol plus other drugs (n=1,523), and for other drugs only (n=2,424). Clients using alcohol only tended to be older, more often white, somewhat more educated, and more likely to be employed prior to entering treatment. The majority of alcohol only clients were treated primarily in outpatient settings (61%), whereas clients having problems with other drugs only were treated in a wider range of settings: outpatient (29%), methadone [outpatient] (17%), long-term residential (18%), and short-term residential (20%). Alcohol plus other drugs clients significantly reduced their consumption of drugs following treatment, whereas alcohol only clients showed minor, but statistically significant post-treatment increases in marijuana (10%), cocaine (3%), and crack (3%) use. With the exception of DUI/DWI offenses, alcohol only clients had fewer criminal behaviors and arrests prior to treatment, yet they were more often referred to treatment by the criminal justice system and were less frequently self-referred. Nevertheless, all study groups demonstrated substantial reductions in criminal behaviors across the follow-up periods. Employment, general health, and mental health outcomes also showed improvement for all study groups. No significant post-treatment reductions in the self-reported use of any alcohol were observed across the three groups, a finding that may be of clinical concern for the alcohol only treatment group. (Source for all: www.askeric.org )

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