Skip to Main Content

  • image Tobacco is the number one preventable cause of death in the United States.
  • image Nearly 17 million Americans report current heavy alcohol use or alcohol abuse.
  • image Pharmacogenomic studies have identified genotypic and functional phenotypic variants that either serve to protect patients or predispose them toward alcohol dependence.
  • image Alcohol is a CNS depressant that shares many pharmacologic properties with the nonbenzodiazepine sedative–hypnotics.
  • image The metabolism of alcohol is considered to follow zero-order pharmacokinetics, and this has important implications for the time course in which alcohol can exert its effects.
  • image Benzodiazepines are the treatment of choice for alcohol withdrawal.
  • imageDisulfiram, naltrexone, and acamprosate are FDA-approved drug therapies for the treatment of alcohol dependence. The clinical utility of these agents to improve sustained abstinence remains controversial. Relapse is common.
  • image More than three quarters of smokers are nicotine dependent. Tobacco dependence is a chronic condition that requires repeated interventions.
  • image Use of nicotine replacement therapy along with behavioral counseling doubles cessation rates.
  • imageBupropion and varenicline are efficacious alone and in combination with nicotine replacement therapy for smoking cessation.

On completion of the chapter, the reader will be able to:

  1. List the adverse health effects brought about by the use and abuse of alcohol, nicotine, and caffeine.

  2. Recommend specific drugs and dosing regimens for preventing withdrawal from alcohol.

  3. Provide evidence-based recommendations to help people to stop smoking.

  4. Describe the role of naltrexone and disulfiram as long-term treatments for alcohol dependence.

  5. Select an appropriate product to be used as nicotine replacement therapy in a given patient, considering cost, convenience, efficacy, and side effects.

  6. Explain the role of counseling and other support therapy in a comprehensive program to help people quit smoking.

  7. Explain the effects of alcohol at different concentrations in the blood.

  8. Identify risk factors that might predispose a person to alcoholism.

  9. Calculate the amount of alcohol present in various volumes of different alcoholic beverages.

  10. Discuss the economic burden imposed on our society by the abuse of alcohol, nicotine, and caffeine.

  11. Compare and contrast the five first-line pharmacotherapies that reliably increase long-term smoking abstinence rates.

  12. Recommend a starting dose and duration of treatment for a patient choosing to use bupropion as a smoking deterrent.

  13. Determine if a patient is suffering from caffeine withdrawal, given a specific set of signs and symptoms.

image Alcohol, nicotine, and caffeine are considered by most to be socially acceptable drugs, yet they impose an enormous social and economic cost on our society. Approximately 443,000 deaths each year are attributable to tobacco use, making tobacco the number one preventable cause of death and disease in this country.1,2 The three leading causes of death attributable to smoking include lung cancer, chronic obstructive pulmonary disease, and ischemic heart disease.3

image In 2011, heavy drinking was reported by 6.2% of the population aged 12 or older, or 15.9 million people,4 a decrease from the previous year’s data in which 16.9 million people were heavy drinkers. Approximately one quarter ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.