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D Definition
D1

Substance stimulating the D1 receptor to Dopamine. The D1 receptor is the site of action for cocaine. Alcohol consumption increases the release of Dopamine in the brain. See also Dopamine.

Death

A consequence of chronic as well as acute alcoholic intoxication. In the case of chronic intoxication going untreated, death can be triggered by the complications of a long term associated disease such as liver disease, or cardio-vacsular disease, as well as mental disease (suicide is a common outcome). In the case of acute intoxication, the subject can slip into a coma and die of alcoholic overdose, as well as being involved in a fatal accident such as a fall or car crash. Alcohol is also known to be a co-factor in certain forms of cancer. See also Accident, Trauma.

Decriminalization

Removal of criminal penalties for the possession and use of illicit psychoactive substances.

Delirium tremens

(DT) Delirium Tremens DT's alcohol withdrawal delirium, a severe, potentially fatal, withdrawal syndrome characterized by coarse tremor, agitation, hallucinations, etc. The symptoms of delirium occur 2 or 3 days after drinking stops. DT represents an emergency situation; untreated, it can result in a high mortality rate. The delirium is associated with autonomic hyperactivity (tachycardia, fever, hypertension), visual or tactile hallucinations, hyperactivity alternating with lethargy.

Delusion

A distorted view of self or of an external object; incorrect belief in spite of clear evidence to the contrary.

Dementia

Cortical atrophy has been observed by neuroimaging in patients with a long term history of alcohol related disorders with cognitive alteration but the direct impact of alcohol is still considered as having a multifactorial pathogenesis.

Denial

Used in the definition not only in the psychoanalytic sense of a single psychological defense mechanism disavowing the significance of events, but more broadly to include a range of psychological maneuvers that decrease awareness of the fact that alcohol use is the cause of a persons problems rather than a solution to those problems. Denial becomes an integral part of the disease and is nearly always a major obstacle to recovery. Denial in alcoholism is a complex phenomenon determined by multiple psychological and physiologic mechanisms. These include the pharmacological effects of alcohol on memory, the influence of euphoric recall on perception and insight, the roles of suppression and repression as psychological defense mechanisms, and the impact of social and cultural enabling behavior. Denial is the reluctance or failure to attribute problems to alcohol consumption; it is often a psychological defense against acknowledging the pain caused by the problem.

Denial, institutional

Denial practiced by an organization or social group or integrated into the beliefs of society.

Dependence

Used in three different contexts: 1) physical dependence, a physiological state of adaptation to a specific psychoactive substance characterized by the emergence of a withdrawal syndrome during abstinence, which may be relieved in total or in part by re-administration of the substance; 2) psychological dependence, a subjective sense of need for a specific psychoactive substance, either for its positive effects or to avoid negative effects associated with its abstinence; and 3) one category of psychoactive substance use disorder. See also addiction, abuse.

Dependence addiction

Compulsive behavior related to alcohol use characterized by tolerance and/or withdrawal symptoms. See DSM-IV definition of dependence. Chemical or physical dependence is a condition in which the user's body has become altered by the repeated consumption of a drug so that withdrawal symptoms occur when the substance is withdrawn. Psychological dependence is an imprecise term related to craving with little evidence of biological need or withdrawal symptoms.

Depression

Pathological mental state in which the patient is withdrawn and experiences sadness. Alcohol being euphorigenic, it seems to provide a temporary relief to feelings of depression as well as an escape. Depression is also a consequence of alcohol abuse. Female alcoholics frequently present an associated depression, which is different from men. Almost 50% of female alcoholics have had at least one suicide attempt. Some women seem to be more susceptible, especially those in the age range 35 - 49 years, single women, divorced women. Depression is often associated with psychoactive substance dependence; some studies suggest that depression may be decisive in the dependence process in a self medication model; other studies emphasize a simple comorbidity phenomenon; in alcoholics, depressed mood, inability to experience pleasantness or find interest in ordinary life, fatigue syndrome or psychomotor retardation have to be assessed after a withdrawal period because the majority of signs decrease within three weeks following the detoxification period. See also antidepressant.

Designated driver

Person who agrees not to drink alcohol on a certain occasion in order to assume responsibility for car driving.

Destructive drinking

Drinking that can lead to death or other serious consequences.

Detoxification

A process of withdrawing a person from a specific psychoactive substance in a safe and effective manner. "drying out", the process through which a person who is physically dependent on alcohol (or other drugs) is withdrawn from the effects of the drug.

Diagnosis of drinking problem

(examination, physical aspect) Physicians may identify a drinking problem with a clinical examination and laboratory tests. The symptoms described as follows are mostly indicative and may be useful to detect chronic alcoholism: red palms, red nose, a ring-like opacity of the cornea are primary signs; an asterixis known as liver flap is in favor of an hepatic encephalopathy (the test consist in closing the eyes and to stretch the fingers and to obtain an eventual flapping movement), spider angiomas (spider-like blood vessels in the skin) may indicate long term alcoholism with hepatic dysfunction ; a painless enlargement of the liver suggests a large alcohol intake and more than the liver can metabolize. But physicians can contribute to develop a relationship without stigma to allow the patient to really approach his specific drinking problem often hidden by guilt, remorse or denial. See also cage, questionnaire, testing.

Diaphoresis

Sweating, one of the signs of alcoholic withdrawal. See also Withdrawal.

Diary

A record of daily events.

Diazepam

A benzodiazepine. Valium(R) See also anxiety, withdrawal.

Disease

A pathological process with characteristic signs and syndromes and a predictable prognosis if untreated. An involuntary disability. The use of the term involuntary in defining disease is descriptive of this state as a discrete entity that is not deliberately pursued. It does not suggest passivity in the recovery process. Similarly, use of this term does not imply the abrogation of responsibility in the legal sense. "Disease" represents the sum of abnormal phenomena displayed by the group of individuals. These phenomena are associated with a specific set of characteristics by which certain individuals differ from the norm and which places them at a disadvantage (Campbell, Scadding & Roberts, 1979).

Disorientation

Misperception of person, place or time.

Distilled spirits

Spirits obtained by distillation (such as whisky, rum, vodka, gin, cognac) have higher alcohol concentration; alcohol itself inhibits the fermentation process when the concentration rises around 12%. In order to achieve a higher concentration, a treacle distillation is needed.

Disulfiram

Antabuse, medication, treatment. Drug used as an alcohol-deterrent which causes severe symptoms when taken with alcohol. Disulfiram inhibits alcohol dehydrogenase. When an abstinent patient taking disulfiram has a single drink, he may immediately experience adverse reactions caused by acetaldehyde accumulation. These reactions include dizziness, palpitations, blurred vision, hypotension which can be severe, and nausea. The treatment may be an adjunct therapy after detoxification but requires strong motivation in out-patients. Long term treatment has been reported to induce neuropathy in some cases, and in some other cases may exacerbate psychotic illness.

DNA

Deoxyribonucleic acid. Molecule constituting the human genetic code. DNA is formed by sequences of amino acids, arranged in different order. There seems to be a genetic factor in alcoholism. See also genetics.

Domestic violence

Violence perpetrated within the home, by a spouse, a parent or a child on other members of the family. See also violence.

Dopamine

A neurotransmitter involved in different neurophysiological functions such as craving, the reward system, and motor control.

Dopamine re-uptake

The process of dopamine being taking back up into the nerve cell that released it. This process terminates the action of dopamine.

Dopamine receptor

Structures on the nerve cells that dopamine binds to, causing dopamines effects.

Dopamine transporter

The protein that accomplishes the re-uptake of dopamine.

Dosing

(medication, naltrexone, disulfiram, prozac) Has several elements, including the amount of medication given, route by which it is given (e.g., orally, intravenously, by sustained release depo), and frequency of medication administration.

Double addiction

Addiction to more than one drug, polydrug addiction.

Downer

Depression of the central nervous system, causing slowed reactions, slurred speech, and unconsciousness (passing out).

Drinking

At-risk drinking in a fashion which could affect a person's health or social well being. Drinking hazardously, but without overt problems.

Drinking problem

The inability to control one's drinking or to avoid hazardous drinking.

Drinking, high risk

Drinking that is likely to result in adverse consequences. Quantitatively, drinking daily, taking more than 12 drinks per week for a man or 9 for a woman, or having more than four drinks in a day. Also, drinking in inappropriate situations, e.g., before driving a car or operating heavy machinery, or during pregnancy.

Driver

The person operating a motor vehicle; the person responsible for the operation of the motor vehicle.

Driver, designated

A person who has agreed to obstain from consuming alcohol during an event in order to operate the motor vehicle to transport others.

Driving, car accident

The act of driving a vehicle under the influence of alcohol that results in a traffic accident.

Driving, drunk

The act of driving a motor vehicle while under the influence of alcohol.

Drug court

(court, law) Provides entry into diversionary programs offered to drug and alcohol related offenders as an alternative to a jail sentence.

Drug Czar

Director of the U.S. Office of National Drug Control Policy (ONDCP).

Drug Intoxication

Dysfunctional changes in physiological functioning, psychological functioning, mood state, cognitive process, or all of these, as a consequence of consumption of a psychoactive substance; usually disruptive, and often stemming from central system impairment.

Drug testing

(testing, diagnosis) Required mandatory testing for alcohol or other drugs.

DrugAbuse Sciences, Inc.

(DAS) DrugAbuse Sciences is dedicated to improving the management of chronic substance abuse. A private, specialty pharmaceutical company with operations in the U.S. and France, DAS is the first company worldwide solely focused on developing treatments for addiction care!

Drugs of abuse

(substance of abuse) A drug not needed for therapeutic purposes that is used habitually, such as solely to alter ones mood, affect, or state of mind, or to affect a body function unnecessarily.

Drunk

n. Colloquial expression for the state of intoxication or an intoxicated person.

Drunk driving

see Driving, drunk

Drunkenness

Intoxication. Maladaptive behavior resulting from recent ingestion of alcohol. State of alcoholic intoxication; the term implies a consumption and does not always result in dependence. There is an individual vulnerability making some people feel the alcohol behavioral effect earlier than others or (i.e., with lower blood alcohol concentration). In general, at the level of 0.05% alcohol in the blood, judgment and restraint may be disrupted or blunted. At 0.1%, voluntary motor actions become clumsy. At 0.2%, motor areas in the brain appear depressed and lack of emotional control. At 0.3%, the person becomes confused or may be stuporous. From 0.4% or 0.5%, coma is possible. Death is possible at a higher intoxication degree as a result of the direct action of alcohol on the brain system controlling breathing and heart rates. Death may occur by respiratory depression or may be secondary to aspiration of vomitus while unconscious. Persons with a long term history of alcohol abuse may develop tolerance and may seem less intoxicated than they are.

Dry out

Withdrawal from intoxicating effects of alcohol. Reduction in blood alcohol levels.

DT

See Delirium tremens

Dual diagnosis

Presence of both alcohol dependency and a mental illness not caused by alcoholism. Alcohol dependence may be associated with other syndromes. Addiction treatment programs have to cope with such association or comorbidity to reduce the relapse process caused by another morbid process (e.g., bipolar disorders are often associated with alcohol abuse and their relationship is complex). As mood disorders may induce alcohol use, treatment in such cases must also deal with mood stabilizers.

DUI

see Driving, drunk

Dupont Merck

(ReVia, natrexone) Pharmaceutical company, producer of Revia, a naltrexone for the treatment of alcohol and opiate addiction.

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