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Dependência alcoólica : abordagens terapêuticas
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Advisor(s)
Abstract(s)
A dependência alcoólica é um transtorno mental crónico com consequências
físicas, mentais e sociais que prevalece desde a Antiguidade. Por ser fator e cofator de
inúmeras doenças o consumo de álcool é das principais causas de morte a nível mundial, estando os óbitos a ele associados na sua maioria a jovens adultos e mais prevalentes em homens.
As consequências nefastas do álcool para a saúde manifestam-se de maneira
diferente em homens e mulheres, pois devido à constituição anatómica, a absorção,
metabolização e distribuição do álcool é diferente. Assim a mulher é mais sensível ao
álcool e por isso fica alcoolizada com menores quantidades comparativamente com os
homens. Existem também mutações nos genes ADH e ADLH usados na metabolização
do álcool, que estão associados à proteção ou maior risco de intoxicação pelo álcool.
O diagnóstico da dependência é realizado por equipas multidisciplinares, de acordo com guidelines específicas e globalmente uniformes, sendo utilizado maioritariamente o questionário AUDIT.
De modo a cobrir todos os aspetos nos quais o álcool interfere na vida do doente
o tratamento é feito maioritariamente em duas áreas, farmacologicamente e
psicologicamente. Farmacologicamente existem apenas três substâncias aprovadas para uso na dependência alcoólica: dissulfiram, naltrexona e acamprosato. O dissulfiram não atua na química cerebral, mas sim por efeito psicológico, pelos efeitos adversos que este causa ao se consumir álcool concomitantemente. A naltrexona e o acamprosato atuam por inibirem o desejo e reduzirem a hiperexcitabilidade neuronal que leva ao consumo abusivo de álcool.
Na área da psicologia são várias abordagens e modelos são usados entre as quais
as mais conhecidas são: o ciclo da mudança e o grupo de autoajuda Alcoólicos Anónimos.
O apoio de familiares, amigos ou pares durante o tratamento é determinante no seu
sucesso, e deve ser mantido mesmo durante a fase de manutenção.
Alcohol dependence is a chronic mental disorder with physical, mental and social consequences that has prevailed since antiquity. Because it is a factor and co-factor of numerous diseases, alcohol consumption is a major cause of death worldwide, with deaths mostly associated with young adults and more prevalent in men. The harmful consequences of alcohol for health are manifested differently in men and women, because due to the anatomical constitution, the absorption, metabolism and distribution of alcohol is different. Thus, women are more sensitive to alcohol and for this reason they become drunk with smaller amounts compared to men. There are also mutations in the ADH and ADLH genes used in the metabolization of alcohol, which are associated with protection or increased risk of alcohol poisoning. The diagnosis of dependency is carried out by multidisciplinary teams, according to specific and globally uniform guidelines, with the AUDIT questionnaire being used mostly. In order to cover all aspects in which alcohol interferes in the patient's life, treatment is mainly carried out in two areas, pharmacologically and psychologically. Pharmacologically, there are only three substances approved for use in alcohol dependence: disulfiram, naltrexone and acamprosate. Disulfiram does not act on brain chemistry, but on the psychological side, due to the adverse effects it causes when consuming alcohol concomitantly. Naltrexone and acamprosate act by inhibiting craving and reducing neuronal hyperexcitability that leads to alcohol abuse. In the field of psychology, several approaches and models are used, among which the most striking are: the cycle of change and the self-help group Alcoholics Anonymous. The support of family members, friends or peers during treatment is crucial to your success, and must be maintained even during a maintenance phase.
Alcohol dependence is a chronic mental disorder with physical, mental and social consequences that has prevailed since antiquity. Because it is a factor and co-factor of numerous diseases, alcohol consumption is a major cause of death worldwide, with deaths mostly associated with young adults and more prevalent in men. The harmful consequences of alcohol for health are manifested differently in men and women, because due to the anatomical constitution, the absorption, metabolism and distribution of alcohol is different. Thus, women are more sensitive to alcohol and for this reason they become drunk with smaller amounts compared to men. There are also mutations in the ADH and ADLH genes used in the metabolization of alcohol, which are associated with protection or increased risk of alcohol poisoning. The diagnosis of dependency is carried out by multidisciplinary teams, according to specific and globally uniform guidelines, with the AUDIT questionnaire being used mostly. In order to cover all aspects in which alcohol interferes in the patient's life, treatment is mainly carried out in two areas, pharmacologically and psychologically. Pharmacologically, there are only three substances approved for use in alcohol dependence: disulfiram, naltrexone and acamprosate. Disulfiram does not act on brain chemistry, but on the psychological side, due to the adverse effects it causes when consuming alcohol concomitantly. Naltrexone and acamprosate act by inhibiting craving and reducing neuronal hyperexcitability that leads to alcohol abuse. In the field of psychology, several approaches and models are used, among which the most striking are: the cycle of change and the self-help group Alcoholics Anonymous. The support of family members, friends or peers during treatment is crucial to your success, and must be maintained even during a maintenance phase.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
AUD Dependência Álcool Terapêutica