Alcoholism

Definition

Medical definitions describe the term "alcoholism“ as a disease known as alcohol dependence syndrome, the most severe stage of a group of drinking problems which begins with binge drinking and alcohol abuse. Dipsomania is a term which describes an uncontrollable craving for alcohol

The DSM-IV (the standard for diagnosis in psychiatry and psychology) defines alcohol abuse as repeated use despite recurrent adverse consequences. It further defines alcohol dependence as alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink and distortions in thinking

In common and historic usage, alcoholism refers to any condition that results in the continued consumption of alcoholic beverages despite the health problems and negative social consequences it cause

Alcoholism Complications

1. Physical health effects

It is common for a person suffering from alcoholism to drink well after physical health effects start to manifest.

The physical health effects associated with alcohol consumption may include cirrhosis of the liver, pancreatitis, epilepsy, polyneuropathy, alcoholic dementia, hepatitis, heart disease, increased chance of cancer, nutritional deficiencies, sexual dysfunction, and death from many sources.

2. Mental health effects

Long term misuse of alcohol can cause a wide range of mental health effects. Alcohol misuse is not only toxic to the body but also to brain function and thus psychological well being can be adversely affected

Psychiatric disorders are common in alcoholics, especially anxiety and depression disorders, with as many as 25% of alcoholics presenting with severe psychiatric disturbances. Typically these psychiatric symptoms caused by alcohol misuse initially worsen during alcohol withdrawal

Panic disorder can develop as a direct result of long term alcohol misuse.

Alcoholics have a very high suicide rate (21% of alcoholics commit suicide)

3. Social effects

loss of employment (financial problems)

can lead to legal consequences:

                             - criminal charges for drunk driving or public disorder 
                             - civil penalties for tortious behavior

impact surrounding family and friends
marital conflict and divorce
domestic violence
damage the emotional development of the alcoholic's children

Alcoholism Advantages

You are always drunk and you will not think about the money that you expend to buy drinks

Your family will not invite you for boring family parties because you stink

You can cripple yourself the times you want once that you do not feel because you are “anaesthetized”

Identification and Diagnosis

1. Screening

The CAGE questionnaire Two "yes" responses indicate that the respondent should be investigated further. The questionnaire asks the following questions:

- Have you ever felt you needed to Cut down on your drinking? 
- Have people Annoyed you by criticizing your drinking? 
- Have you ever felt Guilty about drinking? 
- Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

The Alcohol Dependence Data Questionnaire is a more sensitive diagnostic test than the CAGE test. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use.

2. Genetic predisposition testing

Applaud that alcoholism does not have a single cause, but that genes do play an important role, by affecting processes in the body and brain that interact with individual's life experiences

3. Urine and blood tests

Most common test is blood alcohol content (BAC).

Objective of these tests is recognize some effects like:

                   - Macrocytosis (enlargement of red blood cells) 
                   - High carbohydrate deficient transferrin (CDT)
                   - Elevated GGT (liver enzyme)

Treatments

1. Detoxification

Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol drinking coupled with the substitution of drugs that have similar effects to prevent alcohol withdrawal.

Detoxification treats the physical effects of prolonged use of alcohol, but does not actually treat alcoholism. After detox is complete, relapse is likely without further treatment. These rehabilitations may take place in an inpatient or outpatient setting

2. Group therapy and psychotherapy

After detoxification, various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues that are related to alcohol addiction, as well as provide relapse prevention skills. The mutual-help group-counseling approach is one of the most common ways of helping alcoholics maintain sobriety.

Organizations: Alcoholics Anonymous

3. Rationing and moderation

Rationing and moderation programs such as Moderation Management and DrinkWise do not mandate complete abstinence. While most alcoholics are unable to limit their drinking in this way, some return to moderate drinking.

A 2004 U.S. study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7% of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. However, this group showed fewer initial symptoms of dependency.

The major conclusion made by the authors of this NIAAA study was "Abstinence represents the most stable form of remission for most recovering alcoholics“.

4. Medications

Acamprosate (is thought to stabilize the chemical balance of the brain that would otherwise be disrupted by alcoholism)

Antabuse, Naltrexone, Topiramate have been found effective in helping alcoholics quit or cut back on the amount they drink

5. Dual addictions

Psychotropic drug addictions as the most common dual addiction in alcoholics is a benzodiazepine dependence that has health consequences

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Alcoholism

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