Case Study: Alcohol Addiction, Treatment, and Biological Factors

This case study analyzes a scenario of a woman struggling with severe alcohol addiction. The assignment explores the information required during the first appointment, factors to assess readiness for treatment, and the decision between inpatient and outpatient detoxification. It delves into the mechanisms behind hallucinations and heart palpitations, potential preventative measures, and medications used to reduce alcohol consumption. The study also examines the mechanisms of action of various drugs like Naltrexone, Acamprosate, Disulfiram, and Baclofen (even if not suitable for the patient), as well as the cognitive problems associated with long-term alcoholism and their prevention. Finally, the assignment identifies the biological, psychological, and social factors contributing to the woman's condition, concluding with a discussion of treatment options and relevant references.

Addiction

Table of Contents
INTRODUCTION................................................................................................................................3
Q1 Information to be achieved during first appointment:...............................................................3
Q2 Factors to be considered when assessing if this lady is ready to address her alcohol use.........3
Q3 How to decide to admit the patient for an inpatient 'detox' or outpatient 'detox'?.....................3
Q4 What is likely to have happened to her on those two occasions................................................4
Q5 Mechanism for Hallucinations and Heart palpitation................................................................4
Q6 How can this be prevented?.......................................................................................................5
Q7 Medications to reduce alcohol consumption..............................................................................5
Q8 Mechanism of action of the drugs you mentioned above (even if they weren’t suitable for this
patient).............................................................................................................................................5
Q9 Mechanism of action of drug Baclofen......................................................................................5
Q10. Mechanism of cognitive problems in someone with long term alcoholism...........................6
Q11.How can it be prevented?.........................................................................................................6
Q12 Biological, psychological and social factors that are contributing to this lady’s current
presentation......................................................................................................................................6
CONCLUSION....................................................................................................................................6
REFERENCES.....................................................................................................................................7

INTRODUCTION
Alcohol addiction or alcoholism can be defined as over consumption of alcohol beverages
by people worldwide. Addiction of alcohol later results in developing dependence and affects
physiological and behavioural aspects of an individual (Johnson, 2014). It is caused due to multiple
factors such as stress, depression environmental changes and other physiological conditions.
Q1 Information to be achieved during first appointment:
It is very necessary to gather basic information about the alcohol addicted lady related to her
drinking habits in order to help her get rid of alcohol intake frequently. Answers to the below given
questions will help in deciding the type of treatment she needs to overcome her alcoholism
(Patterson and Jeste, 2014).
 Is she a working lady, a house-wife or a divorcee?
 Does she live alone or she is supported by a care taker in her house?
 What was the age when she initially started taking alcohol?
 What types of alcohol beverages she consumes often? Is it beer, wine or whisky?
 How often she drinks in a day and in a week?
 What is the quantity of alcohol that lady consumes each time during drinking session?
 Has she ever tried to quit her drinking habits?
 How her body does reacts when she stops consuming alcohol for some time?
 Has she ever been a patient of depression earlier in her life? (Maisto, Galizio and Connors,
2014).
Q2 Factors to be considered when assessing if this lady is ready to address her alcohol use.
This alcohol addicted lady revealed the reason behind her heavy drinking tendency. It is
because she lives all alone in her house as her children are grown up now and have recently moved
out from her house to a new place (Brower, Aldrich and Greden, 2014). Different screening
evaluations and assessments needs to be carries out in order to convince the lady to address her
alcohol use.
 Trauma assessments: It is essential to carry out an evaluation on different trauma levels that
she is going through. It can help in determining exact reasons for her stress and depression.
 Blood Alcohol Concentration Determination: Assessing alcohol level in blood is necessary
so that it do not exceeds the threshold limit which can be fatal to her life (McBride, Rodd
and Li, 2014).
Q3 How to decide to admit the patient for an inpatient 'detox' or outpatient 'detox'?
After studying the above case of severe alcohol addiction it would not be preferable and

beneficial to carryout outpatient detoxification treatment on her. As she lives alone in her house
without any caretaker's support it will not be convenient for her to visit hospital and other addiction
relief centres on a regular basis (Larimer, 2013). On other hand if she is given outpatient detox
treatment she will have an easy access to alcohol beverages which can prove to be harmful and
hazardous during the treatment.
Contrary to outpatient detox care inpatient detox treatment can be of several benefits to her.
She will be under constant supervision of healthcare professional assigned to her. Chances of severe
medical complications will be minimised because the staff will guide her for administration of
different types of drugs on daily basis. The main benefit of inpatient treatment is that she will not
have access to any kind of alcohol drinks in hospital where she is treated (Addolorato, Mirijello and
Landolfi, 2013).
Q4 What is likely to have happened to her on those two occasions
Visual and auditory hallucinations can be one of the reason which could have disturbed her
sleep because it is generally experienced by people who are chronic to alcohol consumption. The
other reason can be heart palpitation or irregular heartbeats which is caused due to anxiety.
Q5 Mechanism for Hallucinations and Heart palpitation Hallucinations: The mechanism behind hallucintions is very spontaneous which can result
in different type of hallucinations such as visual, auditory, tactile, gustatory and
proprioceptive hallucinations (Stimmel, 2014). These hallucinations which she encountered
were due to irregular fluctuating nerve and electric signals crossing through brain. She
experienced it because her consumption of alcohol is in larger quantity on daily basis. The
temporal and olfactory lobes of her brain gave abnormal and abrupt signals which in turn
caused hallucinations to occur. Persons who are patients of stress, depression, schizophernia,
cerebral palsy and epileptic disorders often suffers from various types of hallucinations.
 Heart palpitations: Palpitations can be defined as the sensation of irregular and rapid
heartbeats generally experienced during night time (Walker, Cousins and Haddad, 2013).
The alcohol addicted lady encountered this due to abnormal conduction of electrical
impulses through atries and ventricles of heart chambers. When her atries failed to pump
blood normally other cells of ventricles were activated for pumping but when both atries and
veins failed to pump normal amount of blood palpitations occurred. Irregular and abnomal
heartbeats is generally noticed in individuals whose alcohol intake is heavy. Her Palpitations
were also accompanied with night sweating and anxiety which is called as arrhythmias or
heart rhythm irregularity (Friedmann, 2013).

Q6 How can this be prevented?
General measures can be adopted by physicians to treat her reduce the severity of
hallucinations and heart palpitations.
 Over intake of alcohol and other illicit drugs by her should be stopped in order to avoid
hallucinations.
 She should be encouraged to participate in rehabilitation camps and programs for better
counselling which can further aid in relieving her from alcohol depression and anxiety
(Crum, and Pratt, 2014).
Q7 Medications to reduce alcohol consumption
Following mentioned medications can help in preventing and reducing alcohol intake
 Naltrexone (ReVia, Vivitrol): This is an anti-craving drug that can be used temporarily as
she has a serious problem of alcoholism.
 Acamprosate (Campral): This drug will inhibit neurotransmitter GABA, in her which will
further reduce craving for alcohol.
 Disulfiram (Antabuse): This drug is generally regarded as aversion drug and will make her
experience uncomfortable side effects while drinking (Addolorato, Mirijello and Landolfi,
2013).
Q8 Mechanism of action of the drugs you mentioned above (even if they weren’t suitable for this
patient)
 Naltrexone: Naltrexone and its active metabolites works by inhibiting the effect of alcohol
by binding to alcohol receptors.
 Acamprosate: Acamprosate suppresses the glutamic receptors which produces alcohol
effects on liver, lungs and kidneys (Maisto, Galizio and Connors, 2014).
 Disulfiram: It inhibits the aldehyde dehydrogenase compound and produces adverse
reactions on alcohol consumptions.
Q9 Mechanism of action of drug Baclofen
Baclofen generally known as β-(4-chlorophenyl)-γ-aminobutyric acid (β-(4-chlorophenyl)-
GABA) is used to treat patients with excessive consumption of alcohol. It functions by depressing
central nervous system and relaxing skeletal muscles of the body. Baclofen mechanism of actions
works by blocking mono-and-polysynaptic reflexes by acting as a suppressing neurochemical
agents (Maisto, Galizio and Connors, 2014). Blocking the release of simulative transmitters is also
done by Baclofen.
This drug is not suitable for her as it has many side effects like nausea, headache, irregular
heartbeats, repiratory depression and anxiety which can further disturb her to a greater extent

(Johnson, 2014).
Q10. Mechanism of cognitive problems in someone with long term alcoholism
The long term effects of alcohol can be beneficial and serious life threatening consequence
on her. It includes various disorders and abnormalities like alcoholism, food and water deficiency
disease, alcoholic liver disease and different malignant tumours in lungs and brain. Long term
alcohol consumption will destabilizes mental and physical health of that lady which can increase the
risk of liver damage, kidney failure and other psychotic disturbances. She can also suffer from
neuropathic disorders and sever arrhythmia and depression resulting in loss of mental growth and
stability (Friedmann, 2013).
Q11.How can it be prevented?
 Different cognitive therapies can be adopted to treat her with this problem.
 Drugs which boost and increases the level of neurotransmitters should be prescribed so that
it reduces her craving for alcohol.
 Various therapeutic and behavioural therapies can be used to study and rtreat her behaviour
changes due to alcohol consumptions.
 Awareness on side effects of alcoholism is necessary to be given to her so that she reduces
her daily intake.
Q12 Biological, psychological and social factors that are contributing to this lady’s current
presentation
Different causes contributed in developing present condition of this lady with heavy
drinking habit.
 Separation from her husband and children increased her lonliness which further resulted in
anxiety and depression (Stimmel, 2014).
 Different behavioural changes also contributed in her present day condition.
 Family history of father being an alcoholic was again the major riskl factor which resulted in
her alcoholism (Maisto, Galizio and Connors, 2014).
 Stress reduction was also of the factors which forced her to indulge in alcoholic activities.
CONCLUSION
It is concluded that various biological and psychological factors were responsible for lady's
alcoholism in the above discussed case. Different medications and therapies have been adopted to
overcome and reduce alcohol dependence in her.

REFERENCES
Books and Journals
Johnson, B.A., 2014. Medication treatment of different types of alcoholism. The American journal
of psychiatry. 23(12). pp.356-357.
Patterson, T.L. and Jeste, D.V., 2014. The potential impact of the baby-boom generation on
substance abuse among elderly persons. Journal on Psychiatric Services. 12(2). pp.122-
130.
Maisto, S., Galizio, M. and Connors, G., 2014. Drug use and abuse. Cengage Learning.
Brower, K.J., Aldrich, M.S. And Greden, J.F., 2014. Insomnia, self-medication, and relapse to
alcoholism. American Journal of Psychiatry. 56(11). pp.559-570.
McBride, W.J., Rodd, Z.A. and Li, T.K., 2014. The alcohol-preferring and high-alcohol- drinking
(HAD) rats–Animal models of alcoholism. Alcohol. 48(3). pp.209-215.
Larimer, M., 2013. Preventing alcohol abuse in college students: A harm-reduction approach.
Alcohol problems among adolescents: Current directions in prevention research. 11(3)
pp.147-160
Addolorato, G., Mirijello, A. and Landolfi, R., 2013. Management of alcohol dependence in patients
with liver disease. CNS drugs 27(4). pp.287-299.
Stimmel, B., 2014. Drug abuse and social policy in America: The war that must be won. Routledge.
Walker, R.K., Cousins, V.M. and Haddad, G.E., 2013. The good, the bad, and the ugly with alcohol
use and abuse on the heart. Alcoholism: Clinical and Experimental Research. 37(8).
pp.1253-1260.
Friedmann, P.D., 2013. Alcohol use in adults. New England Journal of Medicine. 368(4). pp.365-
373.
Crum, R.M. and Pratt, L.A., 2014. Risk of heavy drinking and alcohol use disorders in social
phobia: a prospective analysis. American Journal of Psychiatry. 17(5). pp.785-796.
Online
Biological and Psychological factors. 2015. [Online]. Available through:
<https://www.google.co.in/search?
client=ubuntu&channel=fs&q=urine+alcohol+concentrtion&ie=utf-8&oe=utf-
8&gfe_rd=cr&ei=XFisVpCDLMn08weuhoboBw#channel=fs&q=Biological>.
[Accessed on 30th January 2016].