Alcoholism

Alcoholism

Alcoholism is defined as an addiction to the consumption of alcoholic liquor or the mental illness and compulsive behavior resulting from alcohol dependency. In simple terms, alcoholism is drinking alcohol to excess frequently.

Alcoholism is a chronic, often progressive disease. A person with alcoholism typically craves alcohol and drinks despite repeated alcohol-related problems, such as multiple drunk-driving violations, job loss, or relationship problems. Alcoholism involves a physical dependence on alcohol, but other factors include genetic, psychological, and cultural influences.

Alcoholism is characterized by –

• Craving – A strong need, or compulsion, to drink.
• Loss of control – The inability to limit one’s drinking on any given occasion.
• Physical dependence – Withdrawal symptoms, such as nausea, sweating, shakiness and anxiety, occur when alcohol use is stopped after a period of heavy drinking.
• Tolerance – The need to drink greater amounts of alcohol in order to get high.

The effects of alcoholism are far reaching. Alcohol affects every body system, causing a wide range of health problems. Problems include poor nutrition, memory disorders, difficulty with balance and walking, liver disease – including cirrhosis and hepatitis, high blood pressure, muscle weakness – including the heart, heart rhythm disturbances, anemia, clotting disorders, decreased immunity to infections, gastrointestinal inflammation and irritation, acute and chronic problems with the pancreas, low blood sugar, high blood fat content, interference with reproductive fertility, increased risk of cancer of the liver, esophagus, and breast, weakened bones, sleep disturbances, anxiety, and depression. About 20% of adults admitted to the hospital are alcohol dependent. Men are more than twice as likely to be alcohol dependent than women, and smokers who are alcohol dependent are much more likely to develop serious or fatal health problems associated with alcoholism.

About 17 million people in the United States abuse alcohol, and estimates suggest that more than 70 million Americans have faced alcoholism in their families. Alcohol abuse is one of the 4 most common causes of death in the U.S., and it is involved in almost half of all traffic deaths in the U.S.

Causes

Alcohol dependence is a gradual process which can take from a few years to several decades to become a problem – with some very vulnerable people addiction can come in a question of months. Eventually, over time, regular alcohol consumption can disrupt the balance of the brain chemical GABA (gamma-aminobutyric acid), which controls impulsiveness, as well as glutamate, which stimulates the nervous system. Brain levels of dopamine are raised when we consume alcohol – dopamine levels may make the drinking experience more gratifying. Over the long- or medium-term, excessive drinking can significantly alter the levels of these brain chemicals, making the person’s body crave alcohol in order to feel good and avoid feeling bad.

Scientists say there are specific genetic factors which may make some people more likely to become addicted to alcohol, as well as other substances. People who have a family history of addiction are at higher risk for abusing alcohol. Alcoholics are six times more likely than nonalcoholic to have blood relatives who are alcohol dependent.

Who is at risk?

• Having 2 or more adverse events during childhood
• Beginning to drink early in life, by age 16 or sooner
• Drinking more than 1 to 2 drinks per day
• Smoking cigarettes (particularly teenagers)
• Being under a lot of stress
• Having a pre-existing psychiatric disorder (such as depression or anxiety)
• Men have higher rates of alcoholism than women
• Broken home

Symptoms

People who have alcoholism or alcohol abuse often:

• Continue to drink, even when health, work, or family are being harmed
• Drink alone
• Become violent when drinking
• Become hostile when asked about drinking
• Are not able to control drinking — being unable to stop or reduce alcohol intake
• Make excuses to drink
• Miss work or school, or have a decrease in performance because of drinking
• Stop taking part in activities because of alcohol
• Need to use alcohol on most days to get through the day
• Neglect to eat or eat poorly
• Do not care about or ignore how they dress or whether they are clean
• Try to hide alcohol use
• Shake in the morning or after periods when they have not a drink

Symptoms of alcohol dependence include:

• Memory lapses after heavy drinking
• Needing more and more alcohol to feel “drunk”
• Alcohol withdrawal symptoms when you haven’t had a drink for a while
• Alcohol-related illnesses such as alcoholic liver disease

Effects of Alcoholism

Alcohol exerts a depressive effect on the brain. The blood-brain barrier does not prevent alcohol from entering the brain, so the brain alcohol level will quickly become equivalent to the blood alcohol level. In the brain, alcohol interacts with various neurotransmitters to alter nerve function. Alcohol’s depressive effects result in difficulty walking, poor balance, slurring of speech, and generally poor coordination (accounting in part for the increased likelihood of injury). The affected person also may have impairment of peripheral vision. At higher alcohol levels, a person’s breathing and heart rates may be slowed and vomiting may occur (with a high risk of the vomit being breathed into the lungs, potentially resulting in aspiration pneumonia.) Still higher alcohol levels may result in coma and death.

Short term effects –

• Slurred speech
• Drowsiness
• Vomiting
• Diarrhea
• Upset stomach
• Headaches
• Breathing difficulties
• Distorted vision and hearing
• Impaired judgment
• Decreased perception and coordination
• Unconsciousness
• Anemia (loss of red blood cells)
• Coma
• Blackouts (memory lapses, where the drinker cannot remember events that occurred while under the influence)

Long-term use of alcohol affects virtually every organ system of the body –

Nervous system – An estimated 30-40% of all men in their teens and twenties have experienced alcoholic blackout from drinking a large quantity of alcohol. This results in the loss of memory of the time surrounding the episode of drinking. Alcohol also causes sleep disturbances, so sleep.

Gastrointestinal system – Alcohol causes loosening of the muscular ring that prevents the stomach’s contents from re-entering the esophagus. Acid from the stomach flows backward into the esophagus(acid reflux), burning those tissues, and causing pain and bleeding. Inflammation of the stomach also can result in ulcers, bleeding, pain, and a decreased desire to eat. A major cause of severe, uncontrollable bleeding (hemorrhage) in an people with alcoholism is the development of enlarged (dilated) blood vessels within the esophagus, which are called esophageal varices.

Blood – Alcohol may cause changes to all the types of blood cells. Red blood cells become abnormally large. White blood cells (important for fighting infections) decrease in number, resulting in a weakened immune system.

Heart – Small amounts of alcohol cause a drop in blood pressure, but with increased consumption, alcohol raises blood pressure into a dangerous range (hypertension). High levels of fats circulating in the bloodstream increase the risk of heart disease. Heavy drinking results in an increase in heart size, weakening of the heart muscle, abnormal heart rhythms, a risk of blood clots forming within the chambers of the heart, and a greatly increased risk of stroke due to a blood clot entering the circulatory system and blocking a brain blood vessel.

Reproductive system – Heavy drinking has a negative effect on fertility in both men and women. It decreases testicle and ovary size and interferes with both sperm and egg production.

Accidents – Alcoholics are vulnerable to injuries from falls, car crashes, being run over, etc. The NIH says that over half of all American traffic deaths are alcohol-related.

Domestic abuse – Alcohol is a major factor in spouse beating, child abuse, and conflicts with neighbors.

Work (school) problems – Employment problems, unemployment, school problems, are often alcohol-related.

Suicide – Suicide rates among people who are alcohol-dependent or who abuse alcohol are much higher than among other people.

Mental illness – Alcohol abuse can cause mental illness and make existing mental illnesses worse.

Problems with the law – The percentage of alcoholics who end up in court or in prison is significantly higher compared to the rest of the population.

Treatment

Medications –

• Disulfiram (Antabuse), which causes unpleasant physical symptoms when alcohol is consumed, or naltrexone, which lessens the pleasure of alcohol.
• Drugs used for withdrawal symptoms include benzodiazepines, tranquilizers, antipsychotics and anticonvulsants (if seizures occur).
• Anticonvulsants may also help with withdrawal symptoms, and do not have the potential for abuse (as benzodiazepines do). They include:
  • Carbamazepine (Tegretol)
  • Valprioc acid (Depakote)
  • Phenytoin (Dilantin)
  • Gabapentn (Neurontin)
  • Baclofen (Lioresal, Lioresal Intrathecal, Gablofen)

Counseling – A qualified counselor can help the alcoholic talk through his/her problems and then devise a plan to tackle the drinking. CBT (cognitive behavioral therapy) is commonly used to treat alcohol dependency.

Treating underlying problems – The alcoholic may have a problem with self-esteem, stress, anxiety, depression, or some other mental health problem. It is important to treat these problems too. It is crucial for the alcoholic to realize that drinking will probably make mental health problems worse. As alcoholics commonly suffer from hypertension, liver diseases, and possibly heart diseases, these will need to be treated too.

Alternative treatment

Detoxification – The patient takes some medication to prevent withdrawal symptoms (delirium tremens) which many alcoholics experience when they give up drinking. Treatment usually lasts from four to seven days. Chlordiazepoxide, a benzodiazepine medication, is frequently used for detoxification (detox).

Yoga – Yoga’s series of postures and controlled breathing exercises may help you relax and manage stress.

Meditation – During meditation, you focus your attention and eliminate the stream of jumbled thoughts that may be crowding your mind and causing stress.

Acupuncture – With acupuncture, hair-thin needles are inserted under the skin. Acupuncture may help reduce anxiety and depression.

Cognitive behavioral therapy with a psychologist or psychiatrist is a very effective treatment approach for alcohol addiction. This type of therapy, which is geared toward changing your beliefs and thought process about drinking

Nutritional Supplements – Malnutrition caused by long-term alcohol use may be addressed by nutrition-oriented practitioners with careful attention to a healthy diet and the use of nutritional supplements such as vitamins A, B complex, and C, as well as certain fatty acids, amino acids, zinc, magnesium, and selenium. Thiamine (vitamin B1) supplements during withdrawal. Heavy use of alcohol causes thiamine deficiency, which can lead to a serious brain disorder called Wernicke-Korsakoff syndrome.

Includes intravenous (IV) nutritional therapies, along with targeted amino acid supplementation, to modulate brain function.

Herbs – The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications.

Milk thistle – Milk thistle is often used to treat liver problems. Some studies looking at milk thistle to treat alcoholic liver disease have found significant improvements in liver function.

Kudzu – Studies suggest that kudzu, used in traditional Chinese medicine to treat alcohol abuse, might help reduce cravings.

Dandelion – Dandelion is used traditionally for liver-related problems, although there is evidence that it helps alcohol withdrawal symptoms. It is often combined with milk thistle.

Arsenicum album – For anxiety and compulsiveness, with nausea, vomiting, and diarrhea.

Nux vomica – For irritability and compulsiveness with nausea, vomiting, and constipation.

Lachesis – For alcohol cravings, headaches, and difficulty swallowing.

Staphysagria – For angry individuals who tend to suppress their emotions and may have been abused physically, sexually, or psychologically in the past.

Reference –

http://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/basics/definition/con-20020866

https://www.nlm.nih.gov/medlineplus/alcoholismandalcoholabuse.html

https://www.nlm.nih.gov/medlineplus/alcoholismandalcoholabuse.html

http://www.webmd.com/mental-health/addiction/understanding-alcohol-abuse-basics

http://www.drugfreeworld.org/drugfacts/alcohol/what-is-alcohol-dependence.html

http://www.theguardian.com/society/alcoholism

http://www.faslink.org/alcoholism–defined%20&%20explained.htm