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Alcohol addiction

Alcohol is a sedative hypnotic drug that depresses the central nervous system.

Many adults in India drink alcohol moderately and on a social basis and derive a lot of pleasure from doing so. Some of the adults drink in excess and become an addict or dependent eventually. Lot of people drink regularly more than the suggestion, of the Department of Health, for safe and good health. This is up to two to three units of alcohol a day for women and up to three to four units of alcohol a day for men (a unit of alcohol is equivalent to half a pint of ordinary strength beer, a glass of wine, or a single pub measure of spirits).

What are its effects?

The effects of alcohol are very dependent on the amount consumed, and can include:

1. slurred speech
2. a loss of co-ordination
3. unsteady when standing or walking
4. impaired attention and judgment
5. sleep

Relatively low doses relax the user, make them more talkative and animated, while increasingly larger does lead to uncoordinated movement, impaired decision making and sedation. The depressive effects of alcohol are the reason that it is always best to avoid alcohol when driving and never exceed the limit.

Symptoms of addiction

When someone become dependent or addicted to alcohol they:

1. Develop a strong sense of compulsion to drink
2. May drink shortly after waking to reduce feelings of alcohol withdrawal
3. Develop a reduced capacity to control how often and how much they use
4. Organize their lifestyle around drinking

Are you addicted to alcohol?

Here is a short questionnaire to evaluate your use of alcohol. The Alcohol Use Disorders Identification Test or AUDIT has been developed by the World Health Organization and is used by doctors to assess the extent to which a patient is likely to need to make some changes in their drinking to avoid health problems.

The AUDIT Questionnaire

1. How often do you have a drink containing alcohol?

1. Never (0)
2. Monthly or Less (1)
3. 2-4 times a month (2)
4. 2-3 times a week (3)
5. 4 or more times a week (4)

2. How many drinks containing alcohol do you have on a typical day when you are drinking?

1. 1 or 2 (0)
2. 3 or 4 (1)
3. 5 or 6 (2)
4. 7-9 (3)
5. 10 or more (4)

3. How often do you have 6 or more drinks on an occasion when you are drinking?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

4. How often during the past year have you found that you were not able to stop drinking once you had started?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

5. How often during the past year have you failed to do what was normally expected of you because of drinking?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

6. How often during the past year have you needed a first drink in the morning to get yourself going after a heavy drinking session?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

7. How often during the past year have you had a feeling of guilt or remorse after drinking?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

8. How often during the past year have you been unable to remember what happened the night before because you had been drinking?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

9. Have you or has someone else been injured as a result of your drinking?

1. No (0)
2. Yes, but not in the past year (2)
3. Yes, during the past year (4)

10. Has a relative, friend, or a doctor or other health care worker been concerned about your drinking or suggested you cut down?

1. No (0)
2. Yes, but not in the past year (2)
3. Yes, during the past year (4)

How did you do?

If you scored between 8-10 or more, it may be worth consulting your doctor or an alcohol advice and information service to talk about your drinking. Please, moreover, contact a qualified psychologist immediately for alcohol de-addiction treatment, before it is too late!

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Cigarette/smoking/nicotine/tobacco addiction

What is it?

Smoking a cigarette involves inhaling a complex set of elements including gases and tars. Nicotine seems both to aid concentration and relax the user.

Nicotine is one of the most powerfully addictive drugs, and smoking cigarettes and other products is directly linked with a substantially increased risk of a range of serious chronic health problems, including lung and heart disease, and cancer.

What's in cigarettes?

Many of us worry about the alarming number of additives, colorings, preservatives and other ingredients that are added to our food. But how many of us know what is in cigarettes - apart from the obvious - or what's produced when they're smoked?

Some cigarette flavorings include childhood favorites such as cocoa, vanilla, liquorice, sugar and even honey. However, more than 4,000 chemicals can be found in cigarette smoke, some of which are very familiar. Here's just a few:

• Ammonia - found in toilet cleaners.
• Acetone - found in nail varnish remover.
• Cadmium - a highly poisonous metal used in batteries.
• Vinyl chloride - used to make PVC.
• Naphthalene - used in moth balls.
• Carbon monoxide - lethal gas in your car exhaust fumes - a poisonous gas that is produced when things burn and is commonly given off by exhausts and gas fires as well as cigarette smoke. In large amounts, such as from a faulty gas fire, it is rapidly fatal, while in small amounts, as when someone smokes a cigarette, it will cut down the efficiency of the smoker's breathing.
• Tar - the stuff cigarette smoke deposits in your lungs and clogs them up. Once inhaled, smoke condenses and about 70 per cent of the tar is deposited in the lungs. Condensed tar is a sticky brown substance that stains fingers and teeth a yellow-brown color.
• Nicotine - the powerful and fast-acting drug behind addiction. When tobacco smoke is inhaled, nicotine is absorbed into the bloodstream. Immediate physiological effects include increased heart rate and a rise in blood pressure.
• Cyanide - used in the gas chambers.
• Formaldehyde - used to preserve dead bodies.
• Arsenic - poison.

How to assess the level of nicotine addiction?

If you want to help someone assess the extent to which a cigarette smoker is addicted to nicotine, you need ask just two key questions: how long after waking do they smoke their first cigarette and how many cigarettes do they smoke a day? The shorter the time and the more cigarettes smoked reflects how addicted they are.

The Fagerstrom Test is the most widely used assessment procedure for seeing how addicted to nicotine someone is. Try completing it now for yourself or for someone else.

Fagerstrom Test for Nicotine Dependence

1. How soon after you wake up do you smoke your first cigarette?

• After 60 minutes (0)
• 31-60 minutes (1)
• 6-30 minutes (2)
• Within 5 minutes (3)

2. Do you find it difficult to refrain from smoking in places where it is forbidden?

• No (0)
• Yes (1)

3. Which cigarette would you hate most to give up?

• The first in the morning (1)
• Any other (0)

4. How many cigarettes per day do you smoke?

• 10 or fewer (0)
• 11-20 (1)
• 21-30 (2)
• 31 or more (3)

5. Do you smoke more frequently during the first hours after awakening than during the rest of the day?

• No (0)
• Yes (1)

6. Do you smoke if you are so ill that you are in bed most of the day?

• No (0)
• Yes (1)

How did you do?

If your score is below 4 points, your addiction to nicotine is not all that severe and you should be able to stop smoking fairly easily. If you score above 7 points your nicotine dependence is high. For your situation, the best strategy is to consult your doctor about stopping.

For help and advice to help you kick the habit, contact a qualified psychologist immediately for smoking de-addiction treatment, before it is too late!

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Treating addictions

Treating addiction involves matching the patient to one or more types of therapy depending on the patient's motivation, the severity of their problems, and the level of support they have at home.

Counseling
Counseling can be very effective, and may involve anything up to 12 sessions or more.

It involves helping the person to look at all aspects of their problem, and then helping them build strategies for overcoming it. The therapist-client relationship seems to be a critical ingredient for successful treatment.

Counseling can be provided by a Psychological Counselor or a community advice and treatment centre. It is also a component of residential treatment programs.

Residential treatment
The most widely used approach for long term rehabilitation is the Therapeutic Community (TC) model and programs based on the 12-step Minnesota model of addiction recovery treatment (this is the model used by Alcoholics Anonymous).

Residential rehabilitation programs are quite diverse in the way that they operate, but most share some of the following basic features:

A ban on drugs (and alcohol) in a controlled or semi-controlled therapeutic environment
Communal living with other drug users in recovery
Emphasis on shared responsibility by peers and group counseling
Counseling and support aimed at preventing relapse
Individual support
Promotion of education, training and vocational experience
Improved skills for activities of daily living
Housing advocacy and resettlement work
Aftercare and support

Some residential programs combine a medically supervised withdrawal program as the first stage of a rehabilitation program.

Treatment is provided on a 24-hour-a-day basis, and medical care is available. This treatment usually has a planned duration of between six and twelve weeks depending on the complexity of need.

How can a patient be best matched to the right treatment?
The best way of ensuring that someone gets the treatment that is right for them is by a thorough assessment.

When a person contacts a community-based service the staff will talk through the situation with the patient and see what the best course of action to take is. This involves judging how many personal and medical problems have been caused by the use of the substance, the extent to which the person is dependent on each substance that they have been using, and what their personal preferences are for the treatments that are available.

The first step is to find out the location of the nearest advice service on drugs (there should be one in most towns across the country) - Contact your GP directly.

Hypnotherapy
Hypnotic techniques can induce anything from a light to a deep hypnotic state to help a patient/client overcome a craving for cigarettes, alcohol, and overeating. Trained hypnotherapists work with a wide variety of addictions.

In Hypnotherapy, a deep state of relaxation is achieved through focused attention. While in this trance-like state, the unconscious mind is highly receptive to new perspectives and ideas. The use of imagery or visualization and positive suggestions at this time can help a patient/client imagine and actually experience herself in the future, as one desires to be. This makes the changes one wants in one's life happen much faster and with less resistance, as a result of the hypnosis experience.

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