Chapter 23 - Alcoholism, nicotine dependence and drug abuse

Summary

This chapter focuses on alcoholism and smoking since these are the most prevalent addictive disorders in women and are most commonly seen and treated in family practice. Alcohol problems have been shown to predict the subsequent use of tranquilizing drugs in older women. Approximately 50% of the genetic effects for nicotine dependence are shared with alcoholism whereas 15% of the genetic effects for alcoholism are shared with nicotine dependence. The principal harmful effects of heavy drinking include liver pathology (hepaptitis, hepatoma and cirrhosis), neurological complications and cancers of the mouth, larynx, esophagus and breast. The treatment options that a family physician may discuss with a patient depends on the severity of the alcohol problem, the presence of comorbid medical and psychosocial problems, the patient's motivation to change and also the patient's gender. Mixed-gender treatment groups are usually composed primarily of men and may therefore ignore woman issues.