Nalan Ward,MD Director MGH Outpatient Addiction Services

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1 Nalan Ward,MD Director MGH Outpatient Addiction Services

2 National Survey Results (2012) (52.1 percent) of Americans aged 12 or older reported being current drinkers of alcohol Nearly one quarter (23.0 percent) of persons aged 12 or older were binge alcohol users in the 30 days prior to the survey Heavy drinking was reported by 6.5 percent of the population aged 12 or older

3 National Survey Results (2012) 17 million adults ages 18 and older have an alcohol use disorder (AUD) 1 in 10 children live in a home with a parent who has a drinking problem.

4 Underage Drinking By age 18, 70 % teenagers tried alcohol About 45% of 12 th graders tried alcohol within the last month 1 in 5 teenagers binge drink

5 What s a Standard Drink? (standard drink contains about 14 grams of pure alcohol)

6 What's "low-risk" drinking?

7 When is "low-risk" drinking still too much? Taking medications that interact with alcohol Medical condition that can be made worse by drinking Underage Planning to drive a vehicle or operate machinery Pregnant or trying to become pregnant

8 Effects of Chronic Alcohol Use on Body Systems Cognitive deficits psychosis Oral/esophageal cancer Cirrhosis Pancreatitis Cardiomyopathy arrhythmias hypertension stroke Stomach ulcers, gastritis Duodenal ulcers Sources: Schuckit MA. In: Harrison s Principles of Internal Medicine. New York: McGraw-Hill; 2001: American Psychiatric Association. DSM-IV-TR. American Psychiatric Association: Washington, DC; 2000.

9 Societal Costs Of Alcohol Abuse Total Cost: $184.6 Billion $10,085 (5%) $1,253 (1%) $24,093 (13%) $7,466 (4%) $15,963 (9%) $2,909 (2%) $36,499 (20%) Specialty Alcohol Services* Medical Consequences (except FAS ) Medical Consequences of FAS Lost Future Earnings Due to Premature Deaths Lost Earnings Due to Alcohol-Related Illness Lost Earnings Due to FAS Lost Earnings Due to Crime/Victims Crashes, Fires, Criminal Justice, etc $86,368 (47%) *Cost in millions of US dollars; FAS = fetal alcohol syndrome. Source: Harwood, H. Report prepared by the Lewin Group for the National Institute on Alcohol Abuse and Alcoholism; National Institutes of Health, NIH Publication No Rockville, MD.

10 Annual Economic Burden Alcohol misuse ($200 billion) Cancer ($107 billion) Heart disease ($96 billion). Gruel and Rehm

11 Signs of an Alcohol Problem In the past year, have you( two or more): Drinking more, or longer than you intended? Wanted to cut down or stop drinking, or tried to, but couldn t? Spent a lot of time drinking? Or being sick or getting over the aftereffects?

12 Signs of an Alcohol Problem In the past year, have you( two or more): Craving a strong need, or urge, to drink? Drinking or being sick from drinking interfered with home or family life? Job or school problems? Continued to drink despite troubles?

13 Signs of an Alcohol Problem In the past year, have you( two or more): Given up or cut back on activities in order to drink? Gotten into situations while or after drinking that increased your chances of getting hurt? Continued to drink despite health problem?

14 Signs of an Alcohol Problem In the past year, have you( two or more): Had to drink much more than you once did to get the effect you want? Had withdrawal symptoms when the effects of alcohol were wearing off?

15

16 Types of Treatment Behavioral Treatments Medications Mutual-Support Groups

17 Behavioral Treatments Developing the skills needed to stop or reduce drinking Helping to build a strong social support system Working to set reachable goals Coping with or avoiding the triggers that might cause relapse

18 Pharmacotherapy for Management of Alcohol Dependence Naltrexone (PO and IM formulations) Acamprosate Disulfiram Preliminary: Topiramate Gabapentin

19 Overcoming Alcohol Problem Alcohol use disorder can be a chronic relapsing disease, persistence is key. Relapse is part of the process. Seek treatment for any accompanying medical and mental health issues.

20 Selecting Treatment What kind of treatment does the program or provider offer? Is treatment tailored to the individual? What is expected of the patient? Is treatment success measured? How does the program or provider handle relapse?

21 Advice For Friends and Family Members Stressful for families but your participation can make a big difference changing deep habits is hard, takes time, and requires repeated efforts pay attention to your loved one when he or she is doing better or simply making an effort.

22 Thanks! MGH West End Clinic Referrals Call Psych Access Line at To learn more about our services visit us at d_home.aspx

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