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Alcoholism

Definition


Disease: Alcoholism Alcoholism
Category: Endocrine and metabolic diseases

Disease Definition:

Alcoholism is a chronic disease that makes a person’s body dependent on alcohol. Despite the fact that drinking will end up causing serious problems with the person’s health, work, finances and relationships, however, they won’t be able to control how much they drink. Alcoholism is a treatable disease, unlike what most people believe. To help a person recover from alcoholism there are medications, counseling and self-help groups that provide ongoing support. Alcohol abuse means that a person drinks excessively, causing health and social problems. People who abuse alcohol aren't dependent on alcohol and haven't fully lost control over the use of it.
 

Work Group:


Symptoms, Causes

Symptoms:

Signs and symptoms of alcoholism and alcohol abuse include:

 

  • Denial
  • "Blacking out", which means not remembering commitments or even conversations.
  • Drinking alone or in secret
  • Feeling a need or compulsion to drink
  • Having drinks before, with or after dinner and becoming annoyed when this routine is disturbed or questioned.
  • Being unable to limit the amount of alcohol they drink.
  • Keeping alcohol in unusual places at home, work or in the car.
  • Losing interest in activities and hobbies that used to bring pleasure.
  • Having problems with employment, finances, relationships, or even legal problems.
  • Irritability, especially if there's no alcohol when their usual drinking time nears.
  • Ordering doubles, gulping drinks and becoming intentionally intoxicated in order to feel good or "normal".
  • Needing an increased number of drinks to feel alcohol's effects because of the tolerance that they’ve built.
  • When not drinking, experiencing nausea, sweating and shaking, which are physical withdrawal symptoms.

 

Although alcohol abusers don't feel the same compulsion to drink and don't experience physical withdrawal symptoms when they don't drink, but they may experience the same signs and symptoms as alcoholics. Inability to control drinking and having a tolerance to alcohol is created by dependence on alcohol.
 

Causes:

Over time, the balance of some chemicals in the brain will be altered because of alcohol, such as glutamate, which excites the nervous system and gamma-aminobutyric acid (GABA), which inhibits impulsiveness. Alcohol also raises dopamine levels, which is associated with the pleasurable aspects of drinking alcohol. To restore good feelings or to avoid negative feelings, the body craves alcohol because excessive, long-term drinking has lowered or increased the levels of some chemicals causing all this. Other factors can also lead to excessive drinking, such as:

 

Emotional state:

Emotional pain, anxiety or even high levels of stress can lead to drinking. Certain stress hormones may be associated with alcoholism.

 

Genetics:

Some genetic factors may put a person at an increased risk of alcoholism or other addictions.

 

Psychological factors:

Having friends who drink regularly can lead to excessive drinking. Also, having low self-esteem or depression may make a person more likely to abuse alcohol.

 

Social and cultural factors:

Media can play an enormous role in promoting the idea that it's ok to drink excessively.
 

Complications

Complications:

The central nervous system becomes depressed by alcohol. Although in some people the initial reaction could be stimulation, but as the person continues to drink, they will become sedated.

 

  • A person’s inhibitions can be lowered and their thoughts, judgment and emotions affected by alcohol.
  • Their speech and muscle coordination may also be impaired with sufficient amounts of alcohol.
  • The vital centers of the brain could be severely depressed by too much alcohol.
  • A life-threatening coma may be caused by heavy drinking.
  • Over time, exhaustion and short-term memory loss can also be caused by excessive alcohol use, as well as weakness and paralysis of the eye muscles.

 

Some of the other health problems that alcoholism may cause include:

 

Cardiovascular problems:

Because of excessive drinking, a person may have high blood pressure. Drinking also damages the heart muscle, causing cardiomyopathy. These two conditions increase the risk of heart failure or stroke.

 

Diabetes complications:

Alcohol can prevent the release of glucose from the liver and increase the risk of low blood sugar (hypoglycemia), which is very dangerous if a person has diabetes and already takes insulin to lower their blood sugar level.

 

Gastrointestinal problems:

The pancreas, which produces the hormones that regulate metabolism and the enzymes that help digest fats, proteins and carbohydrates, may be damaged by heavy drinking. Alcohol can also result in the inflammation of the lining of the stomach (gastritis) and it could interfere with the absorption of the B vitamins, especially folic acid and thiamin, as well as other nutrients.

 

Liver disorders:

Alcoholic hepatitis (inflammation of the liver) can be caused by heavy drinking. Its signs may include loss of appetite, vomiting, nausea, abdominal pain and tenderness, yellowing of the skin (jaundice), fever, and sometimes confusion. Cirrhosis, which is the irreversible and progressive destruction and scarring of liver tissue, could by caused after years of drinking.

 

Sexual function and menstruation:

In women, alcohol abuse can interrupt menstruation, while in men it can cause erectile dysfunction.

 

Birth defects:

During pregnancy, alcohol use can cause fetal alcohol syndrome, which can result in birth defects, including heart defects, a shortening of the eyelids, a small head, various other abnormalities as well as developmental disabilities.

 

Bone loss:

Because alcohol interferes with the production of new bone, it will increase the risk of having fractures and thinning bones.

 

Neurological complications:

Because excessive drinking could affect the nervous system, a person may experience numbness of hands and feet, as well as disordered thinking and dementia.

 

Cancer:

Higher risks of various cancers, including cancer of the mouth, larynx, pharynx (throat), esophagus, rectum, liver and colon and breast have been associated with severe alcohol abuse.

 

Alcohol abuse is also associated with:

 

  • Poor performance at school or work.
  • Divorce and domestic abuse.
  • A greater risk of accidental injuries from other causes.
  • A higher occurrence of murder and suicide.
     

Treatments:

Because many alcoholics and alcohol abusers are in denial, they go to treatment unwillingly. Sometimes, intervention can help some people in recognizing their problem and getting treatment, other times legal difficulties or health problems may encourage treatment. Depending on the circumstances, several treatments are available including an evaluation, a brief intervention, counseling or an outpatient program, or a residential inpatient stay.

 

Discovering whether a person is alcoholic or not is the first step of determining the needed treatment. In case a person is dependent, reducing the amount of alcohol is quite useless; one of the treatment goals should be complete sobriety. But if the person is not dependent and hasn’t lost control over their use of alcohol, cutting back on the drinks might be a part of the treatment, especially if they’re experiencing the negative effects of drinking, in which case the objective of treatment will be to reduce these alcohol-related problems through intervention or counseling that involves alcohol-abuse specialists that will establish a specific treatment plan.

 

One of the many types of therapy is aversion therapy, in which a strong aversive response, such as nausea or vomiting induced by a medication, is associated with drinking alcohol. After a while, this aversive response will be caused by alcohol itself, which will reduce the likelihood of relapse.

 

Counseling may include cognitive behavioral therapy, in which the distorted thoughts that trigger psychological stress are identified. In this type of treatment the patient will develop a sense of mastery and control of their thoughts and feelings and learn new ways to view and cope with traumatic events. Interventions may include behavior modification techniques, use of self-help manuals, goal setting, counseling and follow-up care at a treatment center. Some of the steps of a residential treatment program for alcoholism may include:

 

Withdrawal and detoxification:

This step takes about four to six days, at which time the patient will need to take sedating medications to prevent delirium tremens or other withdrawal seizures. Detoxification and withdrawal is the first step of treatment for alcoholism.

 

Medical evaluation and treatment:

High blood pressure, increased blood sugar and liver and heart disease are some of the typical complications that are related to alcoholism.

 

Psychiatric treatment and psychological support:

Therapy and counseling may be individual or in a group and it helps in the recovery of the psychological aspects of alcoholism. Because family support is an important part of the recovery process, most of these programs offer couples and family therapy as well. Involving a spouse in the treatment may increase the chances of successful recovery.

 

Abstinence and acceptance:

If a person doesn’t accept that they’re addicted and can't control their drinking, treatment will be impossible.

 

Drugs:

Disulfiram is an alcohol-sensitizing drug which may be of some help. When a person drinks alcohol, a severe physical reaction will be produced by the drug including headaches, flushing, nausea and vomiting, though it can't cure alcoholism or eliminate the desire to drink. Another drug is naltrexone, which blocks the narcotic high as well as the urge to drink. Yet another one is Acamprosate, which is an anti-craving drug that may help in remaining abstinent from alcohol and resist alcohol cravings. These last two drugs, unlike disulfiram, don't make the person sick soon after drinking alcohol.

 

There are aftercare programs as well as support groups that help people who are recovering from alcoholism to cope with the necessary lifestyle changes.

 

The first injectable drug to treat alcohol dependence was approved in June 2006 by FDA (the Food and Drug Administration). The drug is a version of naltrexone. It is injected once a month in the buttocks by a health care professional. By blocking the neurotransmitters in the brain, which are thought to be associated with alcohol dependence, it may reduce the urge to drink, though it doesn't affect alcohol withdrawal symptoms. Although the same medication could be taken in the pill form, it's much easier for people recovering from alcoholism to receive the injectable version, which they can use consistently. This drug is intended for alcoholics who haven't had a drink for at least a week and who are receiving counseling. 
 

Prognosis:

Not available

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