Pills and Alcohol

Use

And

Abuse

ALCOHOL STREET DRUGS

AND

PSYCHOTROPIC MEDICATION

GUIDELINES

Abstinence is best--at least until the dosage

and your condition is stable

Then “moderate” alcohol consumption if

desired. Moderate means

No more than 1 drink per day

Nor more than 4 drinks in a week

Some people get increased intoxication on

medication

RISKS OF SIGNIFICANT

ALCOHOL USE WITH MEDICATION

Alterations of neurotransmitters

Driving with one foot on the gas and one foot

on the brake

Blackouts

Unpredictable

Does not mean you were unconscious, asleep or

stopped functioning

SENIORS AND PRESCRIPTION DRUG ABUSE

To control pain

To induce sleep

To minimize anxiety

A history of experimentation

Baby boomers

Mixing prescription medication with alcohol

LOTS OF RISKS

DRIVING WHILE IMPAIRED

Two words Broken Hip

MOST COMMON PRESCRIPTIONS ABUSED

Benzodiazepines

(Xanax, Klonopin, Ativan….)

Sleep medications

(Ambien, Sonata, Halcion, Lunesta….)

Opioid pain Medications

OPIOID PAIN MEDICATION

Codeine (only available in generic form)

Fentanyl (Actiq, Duragesic, Fentora)

hydrocodone (Lorcet, Lortab, Norco, Vicodin)

hydromorphone (Dilaudid, Exalgo)

meperidine (Demerol) methadone (Dolophine, Methadose)

morphine (Avinza, Kadian, MS Contin, Ora-Morph SR)

oxycodone (Percodan, Percocet, Oxycontin)

ALCOHOL ABUSE AND

ALCOHOLISM

ALCOHOL IS THE #1 MISUSED DRUG IN THE U.S.

4 OF 5 SENIORS WITH SUBSTANCE PROBLEMS

ABUSE ALCOHOL

ALCOHOL WITH PRESCRIPTION DRUG ABUSE IS

ON THE RISE

WHAT IS THE IMAGE OF PERSONS WITH

ALCOHOLISM?

THEY LOOK LIKE THE PEOPLE IN THIS

ROOM

NOT!!

ALCOHOL FACTS

Men binge drink more often than women, but…..

Women absorb alcohol into the bloodstream faster and metabolize it slower

than men.

Women who drink regularly are at significantly greater risk for liver damage

than men, even if they drink less or drink for a shorter period of time.

Women develop alcoholic liver disease after a comparatively shorter period

of heavy drinking and at a lower level of daily drinking than men.

ALCOHOL FACTS

Alcohol is a brain “depressant”—slows firing of

neurons as well as body and mind processes

Alcohol and most medications stay in the

system for hours and can interact even when

ingested at different times

Non-alcoholic individuals metabolize alcohol at

1 oz. per hour. Alcoholics much slower

SENIORS AND ALCOHOL

14% of seniors in ER’s show symptoms of

alcoholism

17% of seniors abuse alcohol and drugs, yet…

Less than half of alcoholics over 65 are

diagnosed

As we age, our ability to metabolize alcohol

slows

An amount we can safely tolerate at 55-65 may

not be safe at 75 or 80

We may develop an alcohol problem without

changing the amount we drink

Alcohol does not relieve depression - it makes it worse.

One third of suicides are associated with alcohol misuse.

Alcohol may relieve anxiety transiently, but the brain “rebounds” and the anxiety returns

RISKY DRINKING

More than 7 drinks in a week

More than 3 drinks in a day

Men generally OK at 2 drinks a day

Women generally OK at 1 drink per day

ALCOHOL ABUSE

A disease that is characterized by the sufferer

having a pattern of drinking excessively despite

the negative effects of alcohol on the

individual's work, medical, legal, educational,

and/or social life.

Alcohol abuse affects about 10% of women and

20% of men in the United States,

ALCOHOLISM

A chronic disease with genetic, psychosocial

and environmental factors which, without

treatment, is usually progressive and fatal

It is not a matter of will power, choice or moral

weakness

It is treatable but not curable

The risk of relapse remains even after long

periods of sobriety

RISKS

http://www.medicinenet.com/alcohol_abuse_h

ealth_risks_pictures_slideshow/article.htm

Chronic alcohol use can cause an overall reduction in brain size.

The more you drink, the smaller it gets

RED FLAGS---THE WARNING SIGNS

Developing tolerance—a person increases their alcohol intake without feeling drunk or because they aren’t getting the “good effects”

Experiences withdrawal

A person drinks when they don’t want to

Repeatedly drinks before social situations to “get ready for the party”

Hides alcohol or lies about it

Has a “blackout”

WARNING SIGNS

Drinking alone, to escape problems, or for the sole purpose of getting drunk

Getting irritated when you are unable to obtain alcohol to drink

Arranging your schedule to assure access to alcohol

Having social, work or family problems because of your drinking.

Having a desire to cut down, but not successful

C A G E—IN THE PAST YEAR

Have you ever felt you should Cut down on your drinking?

• Have people Annoyed you by criticizing your drinking?

• Have you felt bad or Guilty about your drinking?

• Have you ever had a drink first thing in the morning to steady your nerves or get rid of a

hangover (Eye-opener)?

One or more yes answers is associated with an

increased risk of alcohol-related problems for

both men and women

THE 2 BIGGEST PROBLEMS

Problem # 1

Denial

I don’t have a problem with drinking

THE LIES THAT ALCOHOL ABUSERS SAY THAT

UNDERSCORE DENIAL

I can stop any time I want

I can safely have just one

It’s my problem. I’m the one it hurts

I’m not an alcoholic because I have a job and I

am doing OK

MORE LIES

Drinking is not a real addiction like drugs

I don’t drink every day so I can’t be an alcoholic

I only drink wine and beer so I can’t be an

alcoholic

PROBLEM #2

“Cutting down” doesn’t

work

It is every alcoholics unfulfilled wish

TREATMENT WORKS !!

With treatment, about 70% of people with alcoholism are able to decrease the number of days they consume alcohol and improve their overall health status within six months.

No matter when treatment is started

Obviously treatment is more successful when the person wants to quit

COLORADO IS ONE OF THE TOUGHEST STATES IN

THE COUNTRY FOR ALCOHOL OFFENSES

Penalties may include a nine-month license

suspension, minimum $600 fine, and up to 96

hours of community service. In addition 48

hours or more behind bars—(although this

penalty is typically waived for first offenders if

they agree to undergo treatment for alcohol

abuse.)

HELPING OTHERS

An Intervention—usually one time only

Even if unsuccessful, it plants the seed

Use of levers—What is important to this person?

Money

Driving

Contact with family members (children)

Separation or divorce

EVALUATION AND TREATMENT

Visit to one’s primary care healthcare provider

Discussion

Physical exam

Laboratory tests

Referral to a specialist or program

THERAPY

Detoxification (“Detox”) usually requires

inpatient stay

28-30 day stay programs (Insurance covered)

Intensive outpatient treatment (Day treatment)

Alcoholics Anonymous (AA)

Substance abuse oriented group therapy

Individual therapy

Medication

Antabuse—creates very unpleasant reaction if the

person drinks—usually time limited but occasionally

long term

Revia (naltrexone)—decreases craving for alcohol

Care usually needs to be on-going

Al-anon and Alateen for families of alcoholics

Relapses (“slips,” “falling off the wagon”)

are common but do not necessarily mean

that treatment cannot ultimately be

successful