Alcohol Abuse and Drug Addiction

Eswaran Subramaniam
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What Parents Need To Know About Substance Abuse?
Teenagers are always trying new things. They may be involved with alcohol and drugs for many reasons:
- Curiosity
- Peer pressure
- To feel grown up
- For its 'kick' (because it may feel good)

Some adolescents may experiment and stop, or use occasionally while some may become dependent on them trying out more dangerous drugs, thus causing harm to themselves and even may be others. However, it is very difficult to predict which adolescent will stop and who will develop serious problems. Drug abuse may lead to serious drug use later in life, accidents and even suicide. Unfortunately, teenagers have a tendency to feel invincible and think that they shall never have a problem that others face with substance abuse.

Teenagers at risk of serious substance abuse are:
- Those with an inferiority complex
- Those who come from broken homes
- Those with family history of alcohol or drug abuse
- Those who are depressed

The various drugs abused are:
- Marijuana, cocaine, LSD, PCP, opium, heroin and other drugs like Ecstasy.
- Over the counter medications like hypnotics, barbiturates and amphetamines.
- Inhalants like glue, aerosols and solvents.

Warning signs of substance abuse:
- Personality changes - sudden mood changes, depression, general lack of interest, irresponsible behavior.
- Breaking family rules
- Falling grades. Absence from school.
- Fatigue
- Red and grazed eyes
- Chronic cough
- Disciplinary problems.

Parents may be able to recognize the warning signs. It would be useful to consult a doctor to rule out a medical problem followed by evaluation by a child psychiatrist. Treatment may be on out patient department basis whereas some may even require hospitalization. The teen may undergo various therapies like detoxification, abstinence, individual and family therapy, group therapy and even use of medications to control dependency.

Patient and family need to be educated in several areas.
• Keep in mind that most patients underestimate/under report their substance use (especially alcohol consumption) and that denial is the usual defence mechanism.
• When substance dependence/abuse is suspected, it is important to approach the patient in a supportive and non-judgmental manner. Focus on the consequences of continued substance use and abuse (physically/emotionally/family/employment), and discuss the need for complete abstinence or harm reduction. Even with a desire to stop, there can be relapses.
• If a substance abuser will not seek help, then family members should be encouraged to seek help through organizations such as AlAnon (families of alcoholics) or NarAnon (families of narcotic addicts). AlaTeen is for adolescent children of alcoholics, and Adult Children of Alcoholics (ACOA) is for adults who grew up with alcoholic parents. Some of these facilities are not available locally. Employers or local leaders may be contacted for help.
• For substance abusers, there is Alcoholics Anonymous, Narcotics Anonymous, Overeaters Anonymous, Smokers Anonymous, Women for Sobriety, etc. There is usually a support group available to deal with the unique issues of each addiction. Where such groups are not available, regular follow up at general hospital Psychiatry department will be useful.
• In some instances, medication may be required to manage the withdrawal phase (physical dependence) of a substance. Benzodiazepines may be needed, including inpatient detoxification.
• Naltrexone, an opioid antagonist, reduces cravings by blocking opioid-receptors in the brain and is used in heroin addiction and alcohol addiction (reduces cravings and number of drinking days).
• Educate patients and families about the possibility of co-morbidities (bipolar disease) and the need to treat these disorders as well.


Alcohol Abuse and Drug Addiction Alcohol Abuse and Drug Addiction 02/29/2016
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