DSM IV CRITERIA FOR ADDICTION

*Pre-occupation between use*Using more than has been anticipated – Loss of Control*Development of Tolerance*Characteristic Withdrawal Syndrome*Use to avoid or control Withdrawal symptoms*Repeated efforts to stop or cut back*Intoxication at inappropriate times or when Withdrawal interferes with daily functioning*Reduction in social, occupational or recreational activities in favour of further use*Use continues despite social, emotional and physical problems related to such use

Occasional escape drinking

Frequent escape drinking

Early alcoholic phase

True alcoholic phase

Complete alcohol dependence

Last phase

Detoxification

Rehabilitation

After-Care

12-Step Meetings

DISEASE MODEL

Has a causeHas specific signs and symptomsHas a natural history and courseHas an outcomeMay or may not have a treatmentRecovery may or may not be possibleRelapse is likely if appropriate treatment is not followed

Facts about Alcoholism

Alcoholism - chronic, progressive and fatal disease- tolerance, physical dependency, pathological organ changes

7-10% of alcohol consumers are alcoholic. Formal treatment for 15% in developed countries

For every alcoholic, four people are directly affected

More than 50% fatalities caused by Cirrhosis, alcohol-related psychosis, accidents, homicides and suicides

Facts about Alcoholism

Disease disregards sex, age, ethnicity, religion, geographic location, social-economic status

5-10% employees are alcoholic

Drunk driving causes 50% traffic fatalities

Alcoholics 10 times more likely to die from fires, falls and suicide

Treatment is possible

Alcoholism is preventable

UNDERSTANDING RELAPSE SYMPTOMS

Become over-confident - ignore follow-up measure

Appear depressed, not communicate, prefers loneliness

Becomes irritable, angry, argumentative, resentful over minor issues

Indulges in gambling etc

Makes major decisions without adequate thinking

Is unable to eat/sleep properly

Goes with drinking friends

Stops meeting counsellor/going to AA meetings

Talks about social drinking

WAYS OF HELPING IF YOUR LOVED ONE IS AN ALCOHOLIC

Don’t regard this as a family disgrace

Don’t nag, preach or lecture to the alcoholic

Guard against a "holier than thou" attitude or martyr-like attitude

Don’t use the "if you loved me,” appeal

Avoid any threat unless you think it through carefully and definitely intend to carry it out.

Don’t hide liquor or dispose of it

Don’t let the alcoholic persuade you to drink with him

WAYS OF HELPING .

Don’t be jealous of the method of recovery the alcoholic chooses

Don’t expect immediate 100% recovery

Don’t try to protect the recovering alcoholic from drinking situations

Do learn all the facts and put them to work in your life

Do attend AA meetings, Al-Anon meetings

Remember you are emotionally involved

Encourage all beneficial activities of the alcoholic

Encourage all beneficial activities of the alcoholic

Causative Theories

1. Genetic Causation (inherited predisposition to contract disease)

2. Social Learning Causation (environment condition reinforces chemical use and addiction).

3. Psychological Causation (chemical reduces stress)

4. Biological Causation (organic predisposition to disease)

5. Spiritual Causation (Spiritual separation/ bankruptcy cause disease)

Identifiable Symptoms

1.Craving for alcohol/other drugs

2.Blackouts

3.Lose of control

4.Loss of memory

5.Changes in tolerance

6.Withdrawal symptoms

7.Compulsion to drink/use

Harmful consequences

Physical/Mental health

Marital /family health

Social Health

Job health

Financial health

Legal health

Spiritual health

Volitional (Will/Desire)

Alcoholism/Chemical

dependency is

1.PRIMARY

2.PROGRESSIVE

3.CHRONIC

4.FATAL

5.PERMANENT

6.TREATABLE

MISUNDERSTOOD

1.Willpower Myth

2.Moral myth

3.Skid row myth

4.Popularity myth

5.Prescription myth

6.Self-infliction

Symptoms and Characteristic of

Depression

1. Depressed, sad, blue, or irritable mood

2. Poor appetite or weight loss

3. Trouble sleeping or sleeping too much

4. Loss of energy, fatigue, or listlessness

5. Loss of interest or pleasure in usual activities

6. Decreased sex drive

Symptoms and Characteristic of Depression

7. Feeling of guilt, inadequacy, or worthless.

8. Trouble concentrating, thinking, or making decisions.

9. Suicidal thoughts and behaviours.

10. Psychomotor retardation or restlessness.

11. Frequent crying spells.

12. Feeling of helplessness and hopelessness.

Denial

1. Justifying- (I drank because, I had a tough job).

2. Minimising- (I drank, but always gave the pay cheque to my wife).

3. Blaming- (I drank because wife kept on nagging).

4. Threatening- (If you object to my drinking, I will find another woman).

5. Silence- (See, I am so quiet, I am not doing anybody harm).

6. Diverting- (Why are the children not studying/why is the house not in order)

7. Bribing- (You can go for a film tonight-here is the money)

WHAT IS INTERVENTION?

Intervention consists of a crisis or crises that, in an objective, unequivocal and non-judgmental way, confront the alcoholic with the reality of his condition.

Accept the definition of addiction

Realize that the effect of the alcohol itself further reduces the strength of even "normal" willpower

Realize that the alcoholic has developed a defense system so effective that it results in a serious degree of self-delusion

Understand that because of this degree of self-delusion, the alcoholic is absolutely unable to look at his behavior objectively and realistically