Alkohol is Me

8/17/2019 Alkohol is Me

1/29

GANGGUAN TERKAIT ALKOHOL

Pembimbing :

dr. Satya Joewana, Sp.KJ

Disusun Oleh:

Jennifer D.M. Ohee (2014-061-036)

KEPANITERAAN KLINIK

ILMU KEDOKTERAN JIWA DAN PERILAKU

FAKULTAS KEDOKTERAN UNIKA ATMA JAA

!" N#$embe% &"'( ) '" J*nu*%i &"'+

KATA PENGANTAR

!"i dan #y!$!r $epada %!han yan& Maha '#a, $arena ata# rahat dan $a#ih $ar!nia-

ya, pen!*i#an referat den&an "!d!* +an&&!an %er$ait *$oho* dapat diw!"!d$an den&an /ai$.

en!*i# en&!ap$an teria $a#ih $epada dr. Satya Joewana, Sp.KJ ata# /i/in&an dan #aran

e*ia! #e*aa pen!*i#an referat ini. en!*i# "!&a /erteria $a#ih $epada #e!a piha$ yan&

e/ant!, /ai$ #eara *an!n& a!p!n tida$ *an!n& da*a pen!*i#an referat ini.

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2/29

Da*a $e#epatan ini, pen!*i# "!&a in&in enyapai$an perohonan aaf yan&

#e/e#ar-/e#arnya ata# #e&a*a $e#a*ahan /ai$ yan& di#en&a"a a!p!n tida$. en!*i# enyadari

/ahwa a#ih /anya$ $e$!ran&an da*a referat ini. O*eh $arena it!, #e&a*a #aran ata! $riti$ yan&

e/an&!n a$an di"adi$an #e/a&ai pea! !nt!$ e/!at $arya yan& *e/ih /ai$ *a&i. $hir

$ata, pen!*i# /erharap #eo&a referat ini /eranfaat /a&i $ita #e!a.

Ja$arta, 03 Jan!ari 2016

................................................

en!*i#

PENDAHULUAN

',' L*-*% .el*/*ng

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3/29

. D'San&&!an ter$ait a*$oho* er!pa$an #!at! &an&&!an yan& diti/!*$an dari

$on#!#i a*$oho* yan& /er*e/ihan yan& eni/!*$an per!/ahan $e#adaran, peri*a$!,

dan &e"a*a into$#i$a#i.. 'D'MOO

erda#ar$an 5i#$e#da# 200, pre7a*en#i pend!d!$ ndone#ia !!r 18 tah!n $e

ata# yan& in! a*$oho* 1 /!*an tera$hir 4,9: pada *a$i-*a$i, 0,3: pada perep!an dan

2,8: pada $ed!anya. re7a*en#i pend!d!$ per$otaan yan& in! a*$oho* tertin&&i pada

pro7in#i 5ia!, ;o&ya$arta, Jawa %i!r, anten, Ka*iantan Se*atan, ap!a arat dan

ap!a. re7a*en#i pend!d!$ pede#aan yan& in! a*$oho* tertin&&i pada pro7in#i

S!atera


4/29

Se*atan, oronta*o, dan Ma*!$! !tara. Jeni# a*$oho* yan& di$on#!#i o*eh pend!d!$

*a$i-*a$i 18 tah!n $e ata# da*a 1 /!*an tera$hir ada*ah /ir 24,:, *i$!or (whi#$ey,

7od$a d**) 9,:, wine 22,8: dan a*$oho* tradi#iona* 43,1:.

. '%OO. 5iwayat Ma#a Kana$-Kana$

ene*iti te*ah en&identifi$a#i #e"!*ah fa$tor dari riwayat a#a $ana$-

$ana$ #e#eoran& yan& $e!dian en&a*ai &an&&!an ter$ait a*$oho* #erta pada

ana$ yan& /eri#i$o tin&&i en&a*ai &an&&!an &an&&!an ter$ait a*$oho* $arena

#a*ah #at! ata! $ed!a oran& t!anya en&a*ai &an&&!an ter#e/!t. ada #t!di

e$#perienta*, ana$ yan& /eri#i$o tin&&i !nt!$ &an&&!an ter$ait a*$oho*, #eara

rata-rata dite!$an ei*i$i $i#aran defi#it pada !"i ne!ro$o&nitif, ap*it!do

&e*o/an& 300 y#n& rendah pada !"i evoked potential , #erta /er/a&ai

a/nora*ita# re$aan e*e$troen#efa*o&ra (''). %e!an ini end!&a /ahwa

f!ni ota$ /io*o&i# yan& dit!r!n$an dapat en"adi predi#po#i#i #e#eoran& !nt!$

en&a*ai &an&&!an ter$ait a*$oho*. 5iwayat a#a $ana$-$ana$ den&an

&an&&!an pe!#atan perhatian=hipera$ti7ita# ata! &an&&!an peri*a$! ata!

$ed!anya enin&$at$an ri#i$o #eoran& ana$ en&a*ai &an&&!an ter$ait a*$oho*

$eti$a dewa#a. an&&!an $epri/adian "!&a enpredi#po#i#i$an #e#eoran&

en&a*ai &an&&!an ter$ait a*$oho*.

. %eori #i$odinai$

%eori p#i$odinai$ tentan& &an&&!an ter$ait a*$oho* /erp!#at pada

hipote#i# en&enai #!pere&o yan& ter*a*! $era# dan fi$#a#i pada fa#e ora*

per$e/an&an p#i$o#e$#!a*. Men!r!t teori p#i$oana*iti$, oran& den&an #!pere&o

$era# yan& en&h!$! diri /erpa*in& $e a*$oho* #e/a&ai ara en&!ran&i #tre#

di/awah #adar. n#ieta# pada oran& yan& terfi$#a#i pada fa#e ora* dapat direda$an

den&an en&on#!#i >at, i#a*nya a*$oho*, den&an !*!t. e/erapa p#i$iater

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5/29

p#i$odinai$ en&&a/ar$an $epri/adian !! oran& den&an &an&&!an ter$ait

a*$oho* #e/a&ai #eoran& pea*!, penyendiri, tida$ #a/aran, irita/e*, ea#,

hiper#en#itif, dan terepre#i #eara #e$#!a*. Men!r!t afori#e p#i$oana*iti$ !!,

#!pere&o ter*ar!t da*a a*$oho*. ada tin&$at yan& tida$ ter*a*! teoriti#, a*$oho*

!n&$in di#a*ah&!na$an #e/a&ian oran& !nt!$ en&!ran&i $ete&an&an, an#ieta#,

dan nyeri p#i$i#. Kon#!#i a*$oho* "!&a dapat eni/!*$an pera#aan /er$!a#a

dan penin&$atan har&a diri.

?. %eori So#io$!*t!ra*

e/erapa #it!a#i #o#ia* /ia#anya en&arah $e in! /er*e/ihan. #raa

per&!r!an tin&&i dan /a#i# i*iter er!pa$an d!a ontoh@ da*a #it!a#i ini,

in! #eara #erin& dan /er*e/ihan #erin& dian&&ap nora* dan diharap$an

#eara #o#ia*. e/erapa $e*opo$ etni$ dan /!daya *e/ih $etat di/andin& yan&

*ain terhadap $on#!#i a*$oho*. ?ontohnya, /ana #ia dan rote#tan

$on#er7atif *e/ih "aran& en&on#!#i a*$oho* di/andin& rote#tan *i/era* dan

Kato*i$.D. a$tor eri*a$! dan e/e*a"aran

Seperti ha*nya fa$tor /!daya dapat een&ar!hi $e/ia#aan in!, /e&it!

p!*a $e/ia#aan da*a #at! $e*!ar&a, $h!#!#nya, $e/ia#aan in! oran& t!a.

a!n, #e"!*ah /!$ti en&indi$a#i$an /ahwa $e/ia#aan in! da*a $e*!ar&a

yan& een&ar!hi $e/ia#aan in! ana$-ana$nya tida$ ter*a*! /er$aitan

*an!n& den&an ti/!*nya &an&&!an ter$ait a*$oho* di/andin& yan& diper$ira$an

#e/e*!nya. Dari #!d!t pandan& peri*a$!, a#pe$ pen&!atan po#itif dari a*$oho*

dapat pen&ind!$#i pera#aan #ehat dan e!phoria #erta dapat en&!ran&i ra#a ta$!t

dan an#ieta#, yan& dapat endoron& !nt!$ in! *e/ih *an"!t.

'. %eori eneti$

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6/29

%eori /io*o&i# den&an d!$!n&an ter/ai$ tentan& a*$oho*i#e /erp!#at

pada &eneti$a. Sa*ah #at! te!an yan& end!$!n& $e#ip!*an &eneti ada*ah

ri#i$o en&a*ai a#a*ah a*$oho* #eri!# ti&a #apai epat $a*i *ipat *e/ih tin&&i

pada $era/at de$at #eoran& a*$oho*i$. n&$a a#a*ah a*$oho* enin&$at #eirin&

den&an /erta/ah /anya$nya "!*ah $era/at yan& a*$oho*i$, $eparahan penya$it

ere$a, #erta $ede$atan h!/!n&an &eneti$ den&an oran& yan& dite*iti.

A. ''K KOBO. /#orp#i

Se$itar 10 per#en a*$oho* yan& di$on#!#i dia/#orp#i e*a*!i *a/!n&,

#i#anya e*a*!i !#!# ha*!#. Kon#entra#i p!na$ a*$oho* da*a darah terapai

da*a 30 #apai 90 enit dan /ia#anya da*a 48 #apai 60 enit, /er&ant!n&

apa$ah a*$oho* di$on#!#i da*a $eadaan per!t $o#on& (enin&$at$an a/#orp#i)

ata! den&an a$anan (en!nda a/#orp#i). Ca$t! !nt!$ enapai $on#entra#i

p!na$ da*a darah "!&a /er&ant!n& pada "an&$a wa$t! en&on#!#i a*$oho*@

in! den&an epat en&!ran&i wa$t! !nt!$ enapai $on#entra#i p!na$@

in! #eara *a/at enin&$at$annya. /#orp#i pa*in& epat pada in!an

yan& en&and!n& 18 #apai 30 per#en a*$oho* (30 #apai 60 per#en proof ).

%!/!h ei*i$i a*at pe*ind!n& terhadap pe/an"iran o*eh a*$oho*.

Mi#a*nya, "i$a $on#entra#i a*$oho* di *a/!n& ter*a*! tin&&i, !$!# di#e$re#i, dan

$at!p pi*ori$ en!t!p. $#i ini eper*a/at a/#orp#i dan ene&ah a*$oho*

a#!$ $e !#!# ha*!#, yan& tida$ ei*i$i ha/atan a/#orp#i yan& #i&nifi$an.

Den&an dei$ian, #e"!*ah /e#ar a*$oho* dapat tetap ta$ dia/#orp#i da*a

*a/!n& #e*aa /er"a-"a. e/ih *an"!t, #pa#e pi*or!# #erin& enye/a/$an

!a* dan !ntah. Se$a*i dia/#orp#i da*a a*iran darah, a*$oho* a$an

didi#tri/!#i$an $e #e*!r!h "arin&an t!/!h. Karena a*$oho* #eara enye*!r!h

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7/29

ter*ar!t da*a airan t!/!h, "arin&an yan& en&and!n& propor#i air yan& *e/ih

tin&&i endapat a*$oho* da*a $on#entra#i tin&&i. 'fe$ into$#i$a#i *e/ih /e#ar

$eti$a $on#entra#i a*$oho* enin&$at di/andin& /i*a #edan& en!r!n (efe$

Me**an/y). ta# a*a#an ini, *a"! a/#orp#i #eara *an!n& /erh!/!n&an den&an

re#pon into$#i$a#i.. Meta/o*i#e

Se$itar 90 per#en a*$oho* yan& dia/#orp#i dieta/o*i#e e*a*!i o$#ida#i

di hepar@ 10 per#en #i#anya die$#re#i tanpa en&a*ai per!/ahan o*eh &in"a* dan

par!. a"! o$#ida#i o*eh hepar $on#tan dan tida$ dipen&ar!hi $e/!t!han ener&i

t!/!h. %!/!h dapat eeta/o*i#a#i #e$itar 18 &=d per "a, den&an $i#aran

antara 10 #apai 34 &=d per "a. ada oran& den&an riwayat $on#!#i a*$oho*

/er*e/ihan,penin&$atan en>i yan& diper*!$an en&a$i/at$an eta/o*i#e

a*$oho* epat.

*$oho* dieta/o*i#a#i o*eh d!a en>i yait! a*$oho* dehydro&ena#e

(DB) dan a*dehid dehydro&ena#e. DB en&$ata*i#a#i $on7er#i a*$oho*

en"adi a#eta*dehid, yan& er!pa$an #enyawa to$#i$@ a*dehid dehydro&ena#e

en&$ata*i#a#i $on7er#i a#eta*dehid en"adi a#a a#etat. *dehid dehydro&ena#e

diinhi/i#i o*eh di#!*fira (nta/!#e), yan& #erin& di&!na$an da*a penan&anan

&an&&!an ter$ait a*$oho*. Se"!*ah #t!di en!n"!$$an /ahwa wanita ei*i$i

$and!n&an DB da*a darah yan& *e/ih #edi$it di/andin& pria@ fa$ta ini !n&$in

enye/a/$an $eender!n&an wanita !nt!$ en"adi *e/ih terinto$#i$a#i di/andin&

pria #ete*ah in! a*$oho* da*a "!*ah yan& #aa. en!r!nan f!ni en>i

yan& eeta/o*i#a#i a*$oho* pada /e/erapa oran& #ia "!&a dapat enye/a/$an

!dahnya en&a*ai into$#i$a#i dan &e"a*a to$#i$.

?. 'fe$ pada Ota$

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8/29

.i#/imi*0i, *$oho* eni/!*$an efe$ den&an enyi#ip$an diri $e da*a

e/rane dan den&an dei$ian enin&$at$an f*!idita# e/ran pada

pen&&!naan "an&$a pende$. a!n den&an pen&&!naan "an&$a pan"an&, teori

ter#e/!t /erhipote#i# /ahwa e/rane en"adi *e/ih ri&id ata! $a$!. *!idita#

e/rane pentin& a&ar re#eptor, $ana* ion, dan protein f!niona* teri$at

e/rane *ain dapat /erf!ni nora*. $ti7ita# $ana* ion yan& di$ait$an den&an

re#eptor a#eti*$o*in ni$otini$, #erotonin 8-B%3, dan tipe ()

ditin&$at$an o*eh a*$oho*, #eentara a$ti7ita# $ana* ion yan& di$ait$an den&an

re#eptor &*!taate dan $ana* $a*#i! voltage-gated en&a*ai inhi/i#i.E1e/ Pe%il*/u, Se/a&ai ha#i* /er#ih dari a$ti7ita# o*e$!*er, a*$oho* /erf!ni

#e/a&ai depre#an #eperti ha*nya /ar/it!rate dan &o*on&an /en>odia>epine, ya&

den&an $ed!a >at ini, a*$oho* ei*i$i /e/erapa to*eran#i #i*an& dan dependen#i

#i*an&. ada $adar a*oho* 0,08 per#en da*a darah, i#i pi$ir, daya ni*ai, dan

pen&enda*ian e*on&&ar dan $adan&-$adan& ter&an&&!. ada $on#entra#i 0,1

per#en, &era$an otori$ 7o*!nter /ia#anya tapa$ $i$!$. ada #e/a&ian /e#ar

ne&ara /a&ian, into$#i$a#i *e&a* /er$i#ar dari 0,1 #apai 0,18 per#en $adar

a*$oho* darah. ada $adar 0,2 per#en, f!ni #e*!r!h area otori$ ota$ ter*ihat

en&a*ai pen!r!nan, dan /a&ian ota$ yan& en&enda*i$an peri*a$! eo#iona*

"!&a ter&an&&!. ada 0,3 per#en, #e#eoran& /ia#anya en"adi &ad!h &e*i#ah ata!

en&a*ai #t!por@ pada 0,4 #apai 0,8 per#en, oran& a$an "at!h $e da*a

$eadaan $oa. ada $adar yan& *e/ih tin&&i, p!#at priitif di ota$ yan&

en&ontro* pernapa#an dan deny!t "ant!n& a$an terpen&ar!h, dan $eatian

eny!#!* #e$!nder terhadap depre#i napa# *an!n& ata! a#pira#i !ntahan.

a!n, oran& den&an riwayat penya*ah&!naan a*$oho* "an&$a *aa dapat

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9/29

eno*eran#i $on#entra#i a*oho* yan& "a!h *e/ih tin&&i di/andin& oran& tida$

pernah en&on#!#i a*$oho*@ to*eran#i a*$oho* ere$a dapat enye/a/$an

ere$a #eo*ah tapa$ tida$ ter*a*! terinto$#i$a#i di/andin& #e/enarnya.

E1e/ Ti2u%, Me#$i a*$oho* yan& di$on#!#i pada a*a hari /ia#anya

enin&$at$an $e!dahan !nt!$ "at!h tertid!r (pen!r!nan *aten#i tid!r), a*$oho*

"!&a ei*i$i efe$ #apin& pada ar#ite$t!r tid!r. Seara #pe#ifi$, pen&&!naan

a*oho* di$ait$an den&an pen!r!nan tid!r rapid eye movement (5'M ata! tid!r

/eripi) dan tid!r da*a (#tadi! 4) #erta *e/ih /anya$ fra&enta#i tid!r,

den&an epi#ode ter/an&!n yan& *e/ih /anya$ dan *e/ih *aa. O*eh $arena it!,

&a&a#an /ahwa in! a*$oho* dapat e/ant! #e#eoran& !nt!$ tid!r ada*ah

#e/!ah ito#.

E1e/ Fisi#l#gis L*in

He3*%, 'fe$ #apin& !taa pen&&!naan a*$oho* /er$aitan den&an $er!#a$an

hepar. en&&!naan a*$oho*, /ah$an #e#in&$at epi#ode penin&$atan in!

#ein&&! pen!h, dapat en&a$i/at$an a$!!*a#i *ea$ dan protein, yan&

enye/a/$an ti/!*nya per*ea$an hati, yan& $adan& dite!$an pada

peeri$#aan fi#i$ #e/a&ai pe/e#aran hepar. B!/!n&an antara infi*tra#i *ea$

pada hepar dan $er!#a$an hepar yan& #eri!# a#ih /e*! "e*a#. a!n,

pen&&!naan a*$oho* di$ait$an den&an ti/!*nya hepatiti# a*$oho*i$ dan #iro#i#

hepati#.

Sis-em g*s-%#in-es-in*l, Min!-in! /erat da*a "an&$a pan"an& di$ait$an

den&an ti/!*nya e#opha&iti#, &a#triti#, a$h*orhidria, dan t!$a$ *a/!n&.

%i/!*nya 7ari#e# e#ofa&!# dapat enyertai penya*ah&!naan a*$oho* ter!taa

yan& /erat@ r!pt!r 7ari#e# er!pa$an #!at! $edar!ratan edi# yan& #erin&

enye/a/$an $eatian a$i/at e$#an&!ina#i. an&&!an pada !#!# ha*!# #e#e$a*i

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10/29

ter"adi, dan pan$reatiti#, in#!fi#ien#i pan$rea#, #erta $an$er pan$rea# "!&a

di$ait$an den&an pen&&!naan a*$oho* /erat. #!pan a*$oho* /erat dapat

en&&an&&! pro#e# nora* penernaan dan a/#orp#i a$anan@ a$i/atnya

a$anan yan& di$on#!#i $!ran& ade$!at dierna. enya*ah&!naan a*$oho*

tapa$nya "!&a en&ha/at $apa#ita# !#!# ha*!# enyerap /er/a&ai n!trient,

#eperti 7itain dan a#a aino. 'fe$ ini, /er#aa den&an $e/ia#aan a$an yan&

#erin& $a*i /!r!$ pada ere$a den&an &an&&!an ter$ait a*$oho*, dapat

en&a$i/at$an defi#ien#i 7itain yan& #eri!# ter!taa 7itain .

Sis-em Tubuh L*in, Kon#!#i a*$oho* yan& #i&nifi$an te*ah di$ait$an den&an

penin&$atan te$anan darah, di#re&!*a#i eta/o*i# *ipoprotein dan tri&*i#erida,

#erta penin&$atan ri#i$o infar$ io$ardi! dan penya$it #ere/ro7a#$!*ar. *$oho*

ter/!$ti een&ar!hi "ant!n& pada oran& non a*$oho*i$ yan& tida$ /ia#a in!,

enin&$at$an !rah "ant!n& i#tirahat, fre$!en#i deny!t "ant!n&, dan $on#!#i

o$#i&en io$ardi!. !$ti en&indi$a#i$an /ahwa $on#!#i a*$oho* dapat

#eara #ipan& een&ar!hi #i#te heatopoieti$ #erta enin&$at$an in#iden

$an$er, ter!taa $an$er $epa*a, *eher, e#ofa&!#, *a/!n&, hepar, $o*on, dan par!.

nto$#i$a#i a$!t "!&a dapat di$ait$an den&an hipo&*i$eia, yan& /i*a tida$

terdete$#i, dapat enye/a/$an $eatian endada$ pada oran& yan& en&a*ai

into$#i$a#i. Ke*eahan otot er!pa$an efe$ #apin& *ain a*$oho*i#e. Kon#!#i

a*$oho* dapat enin&$at$an $on#entra#i e#tradio* darah pada wanita. enin&$atan

e#tradio* /er$ore*a#i den&an $adar a*$oho* darah.

D. ntera$#i O/at

ntera$#i antara a*$oho* dan >at *ain dapat /er/ahaya, /ah$an fata*. at

tertent! #eperti a*$oho* dan feno/ar/ita* (!ina*) dieta/o*i#e o*eh hepar dan

pen&&!naan da*a "an&$a wa$t! *aa dapat en&a$i/at$an a$#e*era#i

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11/29

eta/o*i#enya. i*a oran& den&an &an&&!an ter$ait a*$oho* #edan& tida$

a/!$, eta/o*i#e yan& diperepat ini e/!at ere$a *!ar /ia#a to*eran

terhadap /anya$ o/at #eperti #edatif dan hipnoti$@ na!n $eti$a ere$a

terinto$#i$a#i, o/at ini /er#ain& den&an a*$oho* !nt!$ e$ani#e deto$#ifi$a#i

yan& #aa dan $on#entra#i #e!a >at yan& ter*i/at yan& poten#ia* to$#i$ dapat

tera$!!*a#i da*a darah.

'fe$ a*$oho* dan depre#an #i#te #araf p!#at (SS) *ain /ia#anya

#iner&i#ti$. Sedatif, hipnoti$, dan o/at yan& ereda$an nyeri, a/!$ per"a*anan,

#a$it $epa*a $arena f*!, dan &e"a*a a*er&i har!# di&!na$an den&an hati-hati pada

oran& den&an &an&&!an ter$ait a*$oho*. ar$oti$a endepre#i area #en#ori$

$orte$# #ere/ri dan dapat enye/a/$an nyeri ereda, #eda#i, apati, en&ant!$,

dan tid!r@ do#i# tin&&i dapat en&a$i/at$an &a&a* napa# dan $eatian.

enin&$atan do#i# o/at hipnoti$-#edatif #eperti $*ora* hidrat (ote) dan

&o*on&an /en>odia>epine, ter!taa /i*a di$o/ina#i$an den&an a*$oho*,

eni/!*$an $i#aran efe$ dari #eda#i hin&&a hendaya otori$ dan inte*e$t!a*

#apai #t!por, $oa dan $eatian. Karena #edatif dan o/at p#i$otropi$a *ain

dapat enin&$at$an poten#i efe$ a*$oho*.A. Kriteria Dia&no#i#

an&&!an %er$ait *$oho* Men!r!t DSM A-%5

an&&!an pen&&!naan a*$oho*

Keter&ant!n&an a*$oho*

enya*ah&!naan a*$oho*

an&&!an terind!$#i a*$oho*

nto$#i$a#i a*$oho*

Keadaan p!t!# a*$oho*

%ent!$an apa$ah EDen&an &an&&!an per#ep#i

De*iri! pada into$#i$a#i a*$oho*

De*iri! pada p!t!# a*$oho*

1


12/29

Deen#ia per#i#ten terind!$#i a*$oho*

an&&!an ane#i$ per#i#ten terind!$#i a*$oho*

an&&!an p#i$oti$ terind!$#i a*$oho*, den&an waha

%ent!$an apa$ah E

Den&an on#et #aat into$#i$a#iDen&an on#et #aat p!t!# >at

an&&!an p#i$oti$ terind!$#i a*$oho*, den&an ha*!#ina#i

%ent!$an apa$ah EDen&an on#et #aat into$#i$a#i

Den&an on#et #aat p!t!# >at

an&&!an ood terind!$#i a*$oho*

%ent!$an apa$ah E


an&&!an an#ieta# terind!$#i a*$oho*

%ent!$an apa$ah EDen&an on#et #aat into$#i$a#i

Den&an on#et #aat p!t!# >at

Di#f!ni #e$#!a* terind!$#i a*$oho*

%ent!$an apa$ah E

Den&an on#et #aat into$#i$a#i

an&&!an tid!r terind!$#i a*$oho*

%ent!$an apa$ah E


an&&!an a*$oho* yan& tida$ ter&o*on&$an

', In-#/si/*si *l/#h#l

DSM-A-%5 enetap$an $riteria fora* !nt!$ endia&no#i# into$#i$a#i a*$oho*E

. ar!-/ar! ini en&on#!#i a*$oho*

. er!/ahan peri*a$! ata! p#i$o*o&i# a*adapti7e yan& #eara $*ini#

/era$na yan& tida$ pada tepatnya, *a/i*ita# ood, daya ni*ai

ter&an&&!, f!ni #o#ia* ata! o$!pa#iona* ter&an&&! yan& ti/!* #e*aa

ata! #e&era #ete*ah in&e#ti a*$oho*

?. Sat! (ata! *e/ih) tanda /eri$!t, yan& ti/!* #e*aa ata! #e&era #ete*ah

pen&&!naan a*$oho*E

‒ e/iaraan eraa! ‒ n$oordina#i

1


13/29

‒ aya /er"a*an tida$ #ta/i*

‒ i#ta&!#

‒ Bendaya aten#i ata! eori ‒ St!por ata! $oa

D. e"a*a tida$ di#e/a/$an #!at! $ondi#i edi# !! dan tida$ *e/ih /ai$

diteran&$an o*eh &an&&!an enta* *ain.

nto$#i$a#i a*$oho* /!$an #!at! $ondi#i #epe*e dan pada $ondi#i e$#tre,

dapat en&a$i/at$an $oa, depre#i napa#, dan $eatian a$i/at henti napa# ata!

$arena a#pira#i !ntahan. Keparahan &e"a*a into$#i$a#i a*$oho* #eara $a#ar

/erh!/!n&an den&an $on#entra#i a*$oho* da*a darah, yan& enerin$an

$on#entra#i a*$oho* di ota$. ada awitan into$#i$a#i a*$oho*, /e/erapa oran&

en"adi /anya$ oon& dan #!$a /er$!p!*@ yan& *ain en"adi enari$ diri dan

era"!$ ata! /er$e*ahi. Se"!*ah pa#ien en!n"!$$an *a/i*ita# ood den&an

epi#ode interiten tertawa dan enan&i#. Oran& ter#e/!t !n&$in en!n"!$$an

to*eran#i "an&$a pende$ terhadap a*$oho* dan tapa$ tida$ ter*a*! terinto$#i$a#i

#ete*ah en&ha/i#$an /anya$ "a in! di/andin& #ete*ah hanya /e/erapa "a.

&, Ke*2**n Pu-us Al/#h#l

Keadaan p!t!# a*$oho*, /ah$an tanpa de*iri!, dapat en"adi #eri!# dan

ena$!p $e"an& #erta hipera$ti7ita# otono. Kondi#i ya& dapat en"adi

predi#po#i#i ata! eper/erat &e"a*a p!t!# >at e*ip!ti $e*e*ahan, a*n!tri#i,

penya$it fi#i$, dan depre#i. Kriteria DSM-A-%5 !nt!$ $eadaan p!t!# a*$oho*

yait! E

A, en&hentian (ata! pen&!ran&an) pen&&!naan a*$oho* yan& #e/e*!nya /erat

dan /er$epan"an&an

1


14/29

., D!a (ata! *e/ih) ha* /eri$!t, yan& ti/!* da*a /e/erapa "a #apai

/e/erapa hari #ete*ah $riteria E ‒ Bipera$ti7ita# otono (th, /er$erin&at ata! fre$!en#i deny!t "ant!n&

*e/ih dari 100) ‒ enin&$atan treor tan&an

‒ n#onia

‒ M!a* ata! !ntah ‒ Ba*!#ina#i ata! i*!#i 7i#!a*, ta$ti*, ata! a!ditori$ #e#aat

‒ &ita#i p#i$ootor

‒ n#ieta#

‒ Ke"an& grand mal

4, e"a*a pada $riteria enye/a/$an penderitaan ata! hendaya yan& #eara

$*ini# /era$na da*a f!ni #o#ia*, o$!pa#iona*, ata! area f!ni pentin&

*ain

D, e"a*a tida$ di#e/a/$an #!at! $ondi#i edi# !! dan tida$ *e/ih /ai$

diteran&$an o*eh &an&&!an enta* *ain.

%ent!$an apa$ah EDen&an &an&&!an per#ep#i

%anda $*a#i$ $eadaan p!t!# a*$oho* ada*ah &eetar. eetar (/ia#anya

di#e/!t +&onan&an ata! +&!&!p) !n!* 6 #apai F "a #ete*ah

pen&hentian in! dan de*iri! treen# #ete*ah 2 "a. Sindro p!t!# >at

ter$adan& e*opati !r!tan yan& /ia#a dan, ontohnya, *an!n& ter"adi D%.

%reor pada p!t!# a*$oho* dapat #er!pa den&an treor fi#io*o&i#. e"a*a

p!t!# >at *ain e*ip!ti irita/i*ita# !!, &e"a*a &a#trointe#tina* (ontohnya

!a* dan !ntah), dan hipera$ti7ita# otono #ipati#, tera#!$ an#ieta#,

arousal , /er$erin&at, !$a eerah, idria#i#, ta$i$ardia dan hiperten#i

rin&an. a#ien yan& en&a*ai p!t!# a*$oho* /ia#anya #eara !! wa#pada

tetapi dapat den&an !dah di$a&et$an.

!, Deli%ium

1


15/29

DSM GA-%5 enant!$an $riteria dia&no#i# de*iri! a$i/at into$#i$a#i

a*$oho* da*a $ate&ori de*iri! a$i/at into$#i$a#i >at dan $riteria dia&no#i#

de*iri! pada $eadaan p!t!# a*$oho* da*a $ate&ori de*iri! pada p!t!# >at.

Kriteria dia&no#i# de*iri! a$i/at into$#i$a#i >at #e/a&ai /eri$!t E

A. Disturbance of consciousness (i.e., reduced clarity of awareness of the

environment) with reduced ability to focus, sustain, or shift attention.

B. A change in cognition (such asmemory deficit, disorientation, language

disturbance) or the development of a perceptual disturbance that is not

better acoounted for by preeisting, established, or evolving dementia.

!. "he disturbance develops over a short period of time (usually hours to

days) and tends to fluctuate during the course of the day.

D. "here is evidence from the history, physical eamination, or laboratory

findings or either (#) or ($) %

#) "he symptoms is !riteria A and B developed during substance

intoication

$) &edication use is etiologically related to the disturbance

Kriteria dia&no#i# de*iri! pada $eadaan p!t!# >at #e/a&ai /eri$!t E

A. Disturbance of consciousness (i.e., reduced clarity of awareness of the

environment) with reduced ability to focus, sustain, or shift attention.

B. A change in cognition (such asmemory deficit, disorientation, language

disturbance) or the development of a perceptual disturbance that is not

better acoounted for by preeisting, established, or evolving dementia.

!. "he disturbance develops over a short period of time (usually hours to

days) and tends to fluctuate during the course of the day.

D. "here is evidence from history, physical eamination, or laboratory

findings that the symptoms in criteria A and B developed during, or

shortly after, a withdrawal syndrome.

1


16/29

5, Demensi* Pe%sis-en Te%in2u/si Al/#h#l

Kriteria dia&no#i# #e/a&ai /eri$!t E

A. "he development of multiple cognitive deficits manifested by both#) &emory impairment (impaired ability to learn new information or

to recall previously learned information)$) 'ne (or) more of the following cognitive disturbances %

a) Aphasia (language disturbance)

b) Apraia (impaired ability to carry out motor activities

despite intact motor function)

c) Agnosia (failure to recognie or identify obects despite

intact sensory function)

d) Disturbance in eecutive functioning (i.e. planning,

organiing, se*uencing, abstracting)

B. "he cognitive ddeficits in criteria A# and A$ each cause significant

impairment in social or occupational functioning and represent a

significant decline from a previous level of functioning

!. "he deficits do not occur eclusivel during the course of a delirium and

persist beyond the usual duration of substance intoication or withdrawal


findings that the deficits are etiologically related to the persisting effects

of substance use (e.g., a drug of abuse, a medication).

(, G*nggu*n Amnes-i/ Pe%sis-en Te%in2u/si Al/#h#l


A. "he development of memory impairment as manifested by impairment in

the ability to learn new information or the inability to recall previously

learned information B. "he memory disturbance causes significant impairment in social or

occupational functioning and represents a significant decline from a

previous level of functioning

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17/29

!. "he memory disturbance does not occur eclusively during the course of a

delirium or a dementia and persists beyond the usual duration of

substance intoication or withdrawal.


findings that the memory disturbance is etiologically related to persisting

effects of substance use (e.g., a drug of abuse, a medication)

+, G*nggu*n Psi/#-i/ Te%in2u/si Al/#h#l


A. +rominent hallucinations or delucions B. "here is evidence from the history, physical eamination, or laboratory

findings of either (#) or ($) %

#) "he symptoms in criterion A developed during, or within a month

of, substance intoication or withdrawal $) &edication use is etiologically related to the disturbance

!. "he disturbance is not better accounted for by a psychotic disorder that is

not substance induced. vidence that the symptoms are better accounted

for by a psychotic disorder that is not substance induced might include

following % the symptoms precede the onset of the substance use

(medication use) the symptoms persist for a substantial period time (e.g.,

about a month) after the cessation of acute withdrawal or severe

intoication, or are substantially in ecess of what would be epected

given the type or amount of the substance used or the duration of use or

there is other evidence that suggest te eistence of an independent non-

substance-induced psychotic D. "he disturbance does not occur eclusively during the course of a delirium

6, G*nggu*n M##2 Te%in2u/si Al/#h#l

Kriteria dia&no#i# #e/a&ai /eri$!t E A. A prominent and persistent disturbance in mood predominates in the

clinical picture ad is characteried by either (or both) of the following %

1


18/29

#) Depressed mood or markedly diminished interest or pleasure in all,

or almost all, activities$) levated, epansive, or irritable mood

. "here is evidence from the history, physical eamination, or laboratory

findings of either (#) or ($) E


of, substance intoication or withdrawal


!. "he disturbance is not better accounted for by mood disorder that is not

substance induced. vidence that the symptoms are better accounted for

by a mood disorder that is not substance induced might include following E

the symptoms precede the onset of the substance use (medication use) the

symptoms persist for a substantial period time (e.g., about a month) after

the cessation of acute withdrawal or severe intoication, or are

substantially in ecess of what would be epected given the type or amount

of the substance used or the duration of use or there is other evidence

that suggest te eistence of an independent non-substance-induced mood

disorder.

D. "he disturbance does not occur eclusively during the course of a

delirium

. "he symptoms cause clinically significant distress or impairment in social,

occupational, or other important areas of functioning

7, G*nggu*n Ansie-*s Te%in2u/si Al/#h#l

riteria diagnosis sebagai berikut %

A. +rominent aniety, panic attacks, or obsession or compulsions

predominate in the clinical picture

B. "here is evidence from the history, physical eamination, or laboratory


1


19/29


of, substance intoication or withdrawal $) &edication use is etiologically related to the disturbance

!. "he disturbance is not better accounted for by aniety disorder that is not


by a aniety disorder that is not substance induced might include







substance-induced aniety disorder. D. "he disturbance does not occur eclusively during the course of a delirium

. "he symptoms cause clinically significant distress or impairment in social,


8, Des1ungsi Se/su*l Te%in2u/si Al/#h#l

Kriteria dia&no#i# #e/a&ai /eri$!t E A. !linically significant seual dysfunction that results in marked distress or

interpersonal difficulty predominates in the clinical picture B. "here is evidence from the history, physical eamination, or laboratory

findings that seual dysfunction is fully eplained by substance use as

manifested by either (#) or ($) %


of, substance intoication


!. "he disturbance is not better accounted for by seual dysfunction that is

not substance induced. vidence that the symptoms are better accounted

for by a seual dysfunction that is not substance induced might include

1


20/29







substance-induced seual dysfunction .

'", G*nggu*n Ti2u% Te%in2u/si Al/#h#l


A. A prominent disturbance in sleep that is sufficiently severe to warrant

independent clinical attention

B. "here is evidence from the history, physical eamination, or laboratory



of, substance intoication or withdrawal

$) &edication use is etiologically related to the sleep disturbance

!. "he disturbance is not better accounted for by sleep disorder that is not


by a sleep disorder that is not substance induced might include following %

the symptoms precede the onset of the substance use (medication use) the

symptoms persist for a substantial period time (e.g., about a month) after

the cessation of acute withdrawal or severe intoication, or are

substantially in ecess of what would be epected given the type or amount

of the substance used or the duration of use or there is other evidence

that suggest te eistence of an independent non-substance-induced sleep

disorder

D. "he disturbance does not occur eclusively during the course of a delirium

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21/29

'. "he symptoms cause clinically significant distress or impairment in social,


'', G*nggu*n Te%/*i- Penggun**n Al/#h#l 9*ng T*/ Te%g#l#ng/*n


"he alcohol-related disorder not otherwise specified category is for disorders

associated with the use of alcohol that are not classifiable as alcohol dependence,

alcohol abuse, alcohol intoication delirium, alcohol withdrawal delirium,

alcohol-induced persisting dementia, alcohol-induced persisting amnestic

disorder, alcohol-induced psychotic disorder, alcohol-induced mood disorder,

alcohol-induced aniety disorder, alcohol-induced seual dysfunction, or alcohol-

induced sleep disorder.

A. %%KS

. nter7en#i

%!"!an pada tahap ini, yan& di#e/!t "!&a $onfronta#i, ada*ah e!t!# ra#a

penyan&$a*an dan e/ant! pa#ien en&ena* $on#e$!en#i #ipan& yan& a$an

ter"adi "i$a &an&&!an ini tida$ dio/ati. nter7en#i, #e/a&ai #!at! pro#e#, /ert!"!an

ea$#ia*$an oti7a#i terapi dan a/#tinen#i /er$e*an"!tan.

Ke*!ar&a dapat #an&at e/ant! da*a inter7en#i. n&&ota $e*!ar&a

har!# /e*a"ar !nt!$ tida$ e*ind!n&i pa#ien dari a#a*ah yan& di#e/a/$an

a*$oho*@ /i*a tida$, pa#ien !n&$in tida$ ap! en&!p!*$an ener&y dan

oti7a#i yan& diper*!$an !nt!$ /erhenti in!. Se*aa tahap inter7en#i,

$e*!ar&a "!&a dapat enyaran$an pa#ien !nt!$ ene!i oran& yan& te*ah

#e/!h dari a*$oho*i#e, dan $e*opo$ pend!$!n& a*$oho*. Ke*opo$

pend!$!n& !nt!$ $e*!ar&a ter#e/!t /erte! pada /anya$ $e#epatan da*a #at!

in&&! dan e/ant! an&&ota $e*!ar&a #erta tean !nt!$ e*ihat /ahwa ere$a

tida$ #endiri da*a ra#a ta$!t, $hawatir dan ra#a /er#a*ah. ara an&&ota /er/a&i

1


22/29

#trate&i penye*e#aian a#a*ah dan e/ant! #at! #aa *ain !nt!$ ene!$an

#!/er di $o!nita#. Ke*opo$ ter#e/!t dapat #an&at /er&!na da*a e/ant!

an&&ota $e*!ar&a e/an&!n $e/a*i hid!p ere$a, /ah$an /i*a a*$oho*i$

ter#e/!t eno*a$ !nt!$ enari /ant!an.

. Deto$#ifi$a#i

Se/a&ian /e#ar oran& den&an $eter&ant!n&an a*$oho* ei*i$i &e"a*a

yan& re*atif rin&an /i*a ere$a /erhenti in!. Ji$a $e#ehatan pa#ien re*atif /ai$,

n!tri#i ade$!at, dan ei*i$i #i#te d!$!n&an #o#ia* yan& /ai$, #indro p!t!#

depre#an /ia#anya er!pai $a#!# f*! rin&an.

an&$ah pentin& pertaa deto$#ifi$a#i ada*ah peeri$#aan fi#i$

enye*!r!h. i*a tida$ ada &an&&!an edi# #eri!# ata! penya*ah&!naan o/at

&a/!n&an, $eadaan p!t!# a*$oho* yan& /erat "aran& ter"adi. an&$ah $ed!a ada*ah

e/eri i#tirahat, n!tri#i ade$!at, dan 7itain !*tipe*, ter!taa en&and!n&

tiain.

?. 5eha/i*ita#i

a&i #e/a&ian /e#ar pa#ien, reha/i*ita#i ena$!p ti&a $oponen !taa

yait! E (1) !paya /er$e*an"!tan !nt!$ enin&$at$an dan epertahan$an $adar

oti7a#i a/#tinen#i yan& tin&&i, (2) /e$er"a e/ant! pa#ien enye#!ai$an

$e/a*i $e &aya hid!p /e/a# a*$oho*, dan (3) pene&ahan re*ap#. O*eh $arena

*an&$ah ini di*a$#ana$an da*a $onte$# #indro p!t!# >at dan $ri#i# hid!p yan&

a$!t dan /er*ar!t-*ar!t, penan&anan e/!t!h$an pre#enta#i /er!*an& ateri

#er!pa yan& en&in&at$an pa#ien pentin&nya a/#tinen#i #erta yan& e/ant!

pa#ien en&e/an&$an #i#te pend!$!n& dari hari $e hari dan &aya penye*e#aian

a#a*ah yan& /ar!.ende$atan penan&anan !! yan& #aa di&!na$an pada #it!a#i rawat

inap dan rawat "a*an. ei*ihan etode rawat inap yan& inten#if dan *e/ih aha*

1


23/29

#erin& $a*i /er&ant!n& pada /!$ti adanya #indro p#i$iatri ata! edi# yan& /erat,

tida$ adanya $e*opo$ dan fa#i*ita# rawat "a*an yan& de$at dan #e#!ai, #erta

riwayat pa#ien &a&a* pada perawatan rawat "a*an. ro#e# penan&anan pada #it!a#i

anap!n ena$!p inter7en#i, optia*i#a#i f!ni fi#i$ dan p#i$o*o&i#,

enin&$at$an oti7a#i, en"an&$a! $e*!ar&a, dan en&&!na$an 2 #apai 4

in&&! pertaa perawatan #e/a&ai periode inten#if perto*on&an.


24/29

$a*i #ein&&! #e*aa 2 #apai 4 in&&! pertaa, dii$!ti !paya yan&

tida$ ter*a*! inten#if, !n&$in #e$a*i #ein&&!, #e*aa 3 #apai 6 /!*an

#e*an"!tnya.

Se/a&ian /e#ar $on#e*in& di&!na$an !nt!$ e/aha# /a&aiana

e/ent!$ &aya hid!p yan& /e/a# a*$oho*. Di#$!#i e*ip!ti $e/!t!han

a$an $e*opo$ #e/aya !an& tida$ a/!$, renana aara #o#ia* dan

re$rea#iona* tanpa in!-in!, dan pende$atan !nt!$ en&ada$an

$e/a*i $o!ni$a#i den&an an&&ota $e*!ar&a dan tean.

Koponen !taa $eti&a, pene&ahan re*ap#, pertaa

en&identifi$a#i #it!a#i den&an re#i$o re*ap# tin&&i. Kon#e*or har!#

e/ant! pa#ien en&e/an&$an etode penye*e#aian a#a*ah yan&

dapat di&!na$an /i*a ra#a $eta&ihan a*$oho* enin&$at ata! /i*a ada

peri#tiwa ata! $eadaan eo#iona* yan& e/!at $eender!n&an !nt!$

$e/a*i in!-in!. a&ian pentin& pene&ahan re*ap# ada*ah

en&in&at$an pa#ien tentan& #i$ap yan& tepat terhadap $e#a*ahan.

en&a*aan "an&$a pende$ den&an a*$oho* tida$ dapat di&!na$an #e/a&ai

a*a#an !nt!$ $e/a*i $e $e/ia#aan in!-in!.


25/29

Ji$a deto$#ifi$a#i te*ah di#e*e#ai$an dan pa#ien /!$an tera#! 10

#apai 18 per#en a*$oho*i$ yan& ei*i$i &an&&!an mood , #$i>ofrenia,

ata! &an&&!an an#ieta# independen, hanya #edi$it /!$ti yan& end!$!n&

pe/erian o/at p#i$otropi$a !nt!$ penan&anan a*$oho*i#e. Kadar

an#ieta# dan in#onia yan& a#ih enetap #e/a&ai /a&ian rea$#i terhadap

#tre# $ehid!pan dan a/#tinen#i ean"an& #e/ai$nya ditan&ani den&an

pende$atan odifi$a#i peri*a$! dan penentraan. e/erian o/at-o/atan

!nt!$ &e"a*a ini (tera#!$ /en>odia>epine) ender!n& $ehi*an&an

efe$ti7ita# *e/ih epat di/andin& $ehi*an&an in#onia@ den&an dei$ian,

pa#ien dapat enin&$at$an do#i# dan en&a*ai a#a*ah #e*an"!tnya.

Dei$ian "!&a, $e#edihan dan ood #win dapat enetap pada $adar

rendah #e*aa /e/erapa /!*an. a!n, !"i $*ini# ter$ontro*

en&indi$a#i$an tida$ ada anfaat da*a e/eri$an o/at antidepre#an

ata! *ithi! !nt!$ en&o/ati rata-rata oran& a*$oho*i$ yan& tida$

ei*i$i &an&&!an p#i$iatri independen ata! "an&$a pan"an&. an&&!an

mood a$an en&hi*an& #e/e*! o/at en!n"!$$an efe$ dan pa#ien yan&

$e/a*i in! #aat da*a pen&o/atan en&hadapi /ahaya poten#ia* yan&

#i&nifi$an. Den&an #edi$it ata! tida$ ada /!$ti /ahwa o/at /er#ifat efe$tif,

/ahaya pen&&!naan #eara r!tin e*apa!i $e!nt!n&an yan& !n&$in

didapat.Sat! $e!n&$inan pen&e!a*ian terhadap pe*aran&an pen&&!naan

o/at ada*ah a&en pen#en#iti#a#i a*$oho* di#!*fira. Di#!*fira di/eri$an

da*a do#i# harian 280& #e/e*! pa#ien dip!*an&$an dari fa#e inten#if

pertaa reha/i*ita#i rawat "a*an ata! perawatan rawat inap. %!"!annya

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ada*ah enepat$an pa#ien da*a $ondi#i diana "i$a pa#ien in!

a*$oho* a$an epre#ipita#i rea$#i fi#i$ yan& tida$ enyenan&$an,

tera#!$ !a*, !ntah, #erta ra#a ter/a$ar di wa"ah dan *a/!n&.

D!a inter7en#i fara$o*o&i# ta/ahan yan& en"an"i$an te*ah

dite*iti. ;an& pertaa e*i/at$an anta&oni# opioid na*tre$#on, yan&

#etida$nyaa #eara teoreti# dian&&ap !n&$in en!r!n$an $eta&ihan

a*$oho* ata! en!p!*$an efe$ enyenan&$an dari in!an a*$oho*.

O/at $ed!a yan& enari$ inat, a$apro#at di&!na$an pada do#i# #e$itar

2.000 & per hari. Me$ani#e $er"a a$apro#at /e*! di$etah!i, tapi

!n&$in /e$er"a *an!n& ata! tida$ *an!n& pada re#eptor ata!

-eti*-D-a#partat, den&an efe$ yan& en&&an&&! ter"adinya to*eran#i

ata! dependen#i fi#i$ terhadap a*$oho*.O/at *ain yan& en"an"i$an da*a penan&anan a*$oho*i#e ada*ah

o/at anti an#ieta# non-/en>odia>epine /!#piron e#$i efe$ o/at ini

terhadap reha/i*ita#i a*$oho* tida$ $on#i#ten antar pene*itian. a!n,

tida$ ada /!$ti /ahwa o/at anti depre#an #eperti inhi/itor reuptake

#erotonin #e*e$tif (SS5), *ithi!, ata! o/at anti p#i$oti$ #eara #i&nifi$an

#e*e$tif da*a penan&anan a*$oho*i#e.

3. *oho*i nonyo!# (Ke*opo$ Swa ant!)

n&&ota $e*opo$ ini enyedia$an /ant!an 24 "a #ehari,

terh!/!n& den&an $e*opo$ #e/aya yan& tida$ in!, /e*a"ar /ahwa ia

!n&$in dapat /erparti#ipa#i da*a f!ni #o#ia* tanpa in!, #erta

di/eri$an ode* pe!*ihan den&an en&aati penapaian an&&ota

$e*opo$ yan& tida$ a/!$. e/e*a"aran #eperti ini /ia#anya di!*ai

#aat reha/i*ita#i rawat inap ata! rawat "a*an.

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KESIMPULAN DAN SARAN

. Kesim3ul*n

an&&!an ter$ait a*$oho* er!pa$an #!at! &an&&!an yan& diti/!*$an dari $on#!#i

a*$oho* yan& /er*e/ihan yan& eni/!*$an per!/ahan $e#adaran, peri*a$!, dan &e"a*a

into$#i$a#i. re7a*en#i pend!d!$ ndone#ia !!r 18 tah!n $e ata# yan& in! a*$oho* 1 /!*an

tera$hir 4,9: pada *a$i-*a$i, 0,3: pada perep!an dan 2,8: pada $ed!anya. re7a*en#i

pend!d!$ per$otaan yan& in! a*$oho* tertin&&i pada pro7in#i 5ia!, ;o&ya$arta, Jawa %i!r,

anten, Ka*iantan Se*atan, ap!a arat dan ap!a. re7a*en#i pend!d!$ pede#aan yan& in!

a*$oho* tertin&&i pada pro7in#i S!atera


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enan&anan dapat di/eri$an /er!pa inter7en#i, deto$#ifi$a#i, dan reha/i*ita#i yan& terdiri dari

pe/erian edi$a#i, $on#e*in& dan $e*opo$ #wa /ant!.

. S*%*n

• ene*itian en&enai pre7a*en#i pend!d!$ yan& $on#!#i a*$oho* /e*! eadai

#ehin&&a di tah!n-tah!n endatan& dapat di*a$!$an pene*itian ter#e/!t.

• re7a*en#i &an&&!an ter$ait a*$oho* di ndone#ia /e*! eadai #ehin&&a per*!

di*a$!$an pendataan yan& *e/ih /ai$ *a&i.

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D%5

Alkohol is Me

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