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Alcoholism |
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Definition
Alcoholism is the consumption
of or preoccupation with alcoholic beverages to the
extent that this behavior interferes with the
alcoholic's normal personal, family, social, or work
life. Alcohol consumption caused by alcoholism can
result in psychological and physiological conditions,
and ultimately in death.
Causes
- Partial genetic Predisposition -- higher rate
in twins and adopted children with alcoholic birth
parents
- Abnormalities in the brain neurotransmitters
or chemical enzymes may play a role.
- Depression
Anxiety
Addictive personality
Symptoms
Men who
consume 15 or more drinks a week, women who consume
12 or more drinks a week, or anyone who consumes 5
or more drinks per occasion at least once a week are
all at risk for developing alcoholism. (One drink is
defined as a 12-ounce bottle of beer, a 5-ounce
glass of wine, or a 1 1/2-ounce shot of liquor).
Some of the symptoms
associated with alcoholism include:
- Drinking alone
- Making excuses to drink
- Need for daily or frequent use of alcohol for
adequate function
- Lack of control over drinking, with inability
to discontinue or reduce alcohol intake
- Episodes of violence associated with drinking
- Secretive behavior to hide alcohol related
behavior
- Hostility when confronted about drinking
- Neglect of food intake
- Neglect of physical appearance
- Nausea and vomiting
- Shaking in the morning
- Abdominal pain
- Numbness and tingling
- Confusion
Alcohol withdrawal
symptoms vary from mild to severe and may include:
- Rapid heart rate and sweating
- Restlessness or agitation
- Loss of appetite, nausea, or vomiting
- Confusion or hallucinations
- Tremors and seizures
Screening and Diagnostics
All
physicians should ask their patients about their
drinking. A history may be obtained from family if
the affected person is unwilling or unable to answer
questions. A physical examination is performed to
identify physical problems related to alcohol use.
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A toxicology screen or blood
alcohol level confirms recent alcohol ingestion,
which does not necessarily confirm alcoholism.
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Liver function tests can be
elevated. GGPT (glutaryl transaminase) is often
elevated more than other liver function tests.
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CBC (complete blood count) -
MCV can be elevated (mean corpuscular volume or
size of the red blood cells).
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Serum magnesium, uric acid,
total protein, and folate tests may be abnormal.
Treatment
- Alcohol recovery programs
- Alcoholics anonymous
- Religious/spiritual support
- Treatment of Depression
,
if present:
- Psychotherapy
- Antidepressants
- Disulfiram (Antabuse) -- an aversion
medication that causes nausea/vomiting if one
drinks alcoholic beverages
- Naltrexone -- a medication that helps with
alcohol craving
- Ondansetron -- a medication that helps with
alcohol craving
- Treatment of alcohol withdrawal if it occurs
- Treating
Depression and social problems
Treatment goal
- Complete Abstinence (and not "controlled
drinking")
Prognosis
Alcoholism is a major social, economic, and public
health problem. Alcohol is involved in more than
half of all accidental deaths and almost half of all
traffic deaths. A high percentage of suicides
involve the use of alcohol in combination with other
substances. Additional deaths are related to the
long-term medical complications associated with the
disease. Only 15% of those with alcohol dependence
seek treatment for this disease. Relapse after
treatment is common, so it is important to maintain
support systems in order to cope with any slips and
ensure that they don't turn into complete reversals.
Treatment programs have varying success rates, but
many people with alcohol dependency have a full
recovery.
Complications
- Pancreatitis
- Heart muscle damage
- Nerve damage
- Esophageal bleeding
- Brain degeneration
- Cirrhosis of the liver
- Delirium tremens (DTs)
- Depression
- Erectile dysfunction
- Fetal alcohol syndrome in the offspring of
alcoholic women
- High blood pressure
- Increased incidence of cancer
- Insomnia
- Nutritional deficiencies
- Suicide
- Wernicke-Korsakoff syndrome
Prevention
Educational programs and medical advice about
alcohol abuse have been successful in decreasing
alcohol abuse and its associated problems. Alcohol
dependency requires more intensive management.
The
National Institute on Alcohol Abuse and Alcoholism
recommends that women have no more than 1 drink per
day and men no more than 2 drinks per day. One drink
is defined as a 12-ounce bottle of beer, a 5-ounce
glass of wine, or a 1 1/2-ounce shot of liquor. |
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