• Intoxication: use of a substance that results in maladaptive behavior

• Withdrawal syndrome: refers to the negative psychological and physical reactions that occur when use of a substance ceases or dramatically decreases

• Detoxification: the process of safely withdrawing from a substance

• Substance abuse: drug is used outside the medical or social norm despite negative consequences

• Substance dependence: problem associated with addiction

Alcoholism

• First episode of intoxication → continuing problems with alcohol → first blackout → continued drinking → development of tolerance → tolerance break → continued drinking → functioning becoming affected → periods of abstinence/temporary controlled drinking → escalation of alcohol intake → more problems → subsequent crisis → continuation of cycle

• Related disorders: gambling, caffeine and tobacco additions

• CNS depressant: relaxation/loss of inhibitions

1. Slurred speech, unsteady gait, lack of coordination, and impaired attention, concentration, memory, and judgment

2. Aggressive behavior or display inappropriate sexual behavior; the person who is intoxicated may experience a blackout

• Treatment of an alcohol overdose: gastric lavage or dialysis to remove the drug and support of

respiratory and cardiovascular functioning in an intensive care unit

• Symptoms of withdrawal

1. Onset within 4 to 12 hours after cessation or marked reduction of alcohol intake; peaking on second day; complete in about 5 days

2. Severe or untreated withdrawal may progress to transient hallucinations, seizures, or delirium (DTs)

3. Benzodiazepines for safe withdrawal

Substance Abuse Treatment

• Concept: medical illnesses, chronic, progressive, characterized by remissions and relapses

• Treatment models: Hazelden Clinic model and 12-step program of Alcoholics Anonymous

• Individual, group counseling

• Treatment settings

• Pharmacologic treatment: safe withdrawal; prevent relapse

• Medications help manage withdrawal or cravings, but is not a specific treatment for substance abuse