Alcohol Use Disorder: Introduction, Fetal Alcohol Spectrum Disorders (FASDs), and Phases (Nursing)

00:01 Let's take a look at alcohol use disorder.

00:04 Alcohol is a CNS depressant, central nervous system depressant.

00:11 It is non-selective, general and the impact of alcohol use can be reversible.

00:20 We are going to be talking about the definition of alcohol use disorder itself and we're also going to be looking at the signs and symptoms.

00:32 There is also an impact on the fetus if a woman is pregnant and consuming alcohol.

00:37 That alcohol will pass through the placenta and impact the developing fetus.

00:43 So, what that will give us is a number of different disorders which we call fetal alcohol spectrum disorders.

00:53 The first of those disorders is fetal alcohol syndrome.

00:57 A fetus that is affected by alcohol may be born with a number of different problems directly related to the consumption of alcohol by the mother and some of those are learning disabilities and other developmental disabilities.

01:16 The second is the alcohol related neurodevelopmental disorder and that fetus, when it is born may have neurological problems secondary to the mom's ingestion of alcohol during pregnancy.

01:34 Thirdly, the baby might be born with birth defects because of the impact of that alcohol that is consumed during pregnancy that the fetus does not develop correctly and there are actual birth defects that the child will suffer for their entire life.

01:57 So, how common is alcohol use? And how common is alcohol use disorder? Well, when we think about it, we would understand that over 80% of Americans consume alcohol.

02:14 That is alcohol use.

02:16 Maybe having a glass of wine at dinner, a beer after work but as you notice, the number of persons with alcohol use disorder diminishes.

02:30 So, we need to remember that alcohol use itself is not a disorder.

02:36 That we go down to almost only 7% of the public actually have a clinical alcohol use disorder.

02:47 So, what are the phases of alcohol use disorder? How does it progress? Remember, the substance use disorders are brain disorders and like any metabolic disorders, they start and they have a progression. We want to be able to get in early.

03:07 Early intervention is always our best bet.

03:11 So, let's think about pre-alcoholic and then, early alcoholic.

03:18 So, the pre-alcoholic is that person who is just using alcohol as a gentle relaxant, as a social means, having a glass of wine.

03:31 But when that use of alcohol begins to increase and remember, there is a genetic predisposition.

03:44 So, a person who has a parent or grandparent, aunt or uncle who has alcohol use disorder is more likely to develop alcohol use disorder.

03:55 So, that pre-alcoholic phase is before there is any kind of tolerance beginning.

04:04 Early alcoholic, there becomes - a person becomes tolerant to the use of alcohol, is starting to require a little bit more might find that after having a few drinks, they don't remember what has happened in that evening.

04:21 They need more drinks in order to get to the same intoxication level and then, they find that they cannot wake up in the morning without what they would call an eye-opener or the hair of the dog that bit them.

04:37 Meaning that they need a drink early in the morning in order to settle their neurological, central nervous system.

04:46 What we find that when they move past that, it is crucial phase and crucial phase means that at that point, they really need to be able to have their alcohol.

05:00 They start to what we consider binge drinking.

05:04 Binge drinking is having four or five drinks at the same one hour period of time.

05:10 A person is unable to stop, oftentimes with people with substance use disorders and alcohol use disorder, we will say that one drink is too many and 100 are not enough because they are not able to stop once they have that first drink.

05:30 Alcohol becomes their priority. Alcohol becomes the reason that they get up.

05:35 Every moment of their day, they're thinking about where they have hidden a bottle so that in the event that they start to withdraw or feel sick, they are able to get a sip of alcohol that will what they say calm their nerves or steady their nerves.