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NEWSLETTER

Alcoholism (alcohol use disorder): Causes, Symptoms, Diagnosis, Treatment

alcohol-related disorders

Alcohol use disorder (AUD, usually referred to as alcoholism) is characterised by symptoms compromising the body, mind, and behaviour. A defining feature of the disorder is that the individual continues to drink despite the negative consequences of alcohol. While there is no absolute number of drinks consumed per day or amount of alcohol consumed that characterises an alcohol use disorder, there is a point at which the dangers associated with drinking considerably increase.



The following are some of the defining traits of alcoholism:


Consuming more alcohol than anticipated. Alcoholism is characterized by a loss of control over the amount consumed.

Desire to abstain from alcohol, yet incapacity to do so.

Excessive time spent acquiring, consuming, or recovering from the effects of alcohol.

Craving for or obsession with alcohol.

Alcohol-related difficulties; ignoring those problems; drinking in the face of clear dangers, including bodily harm.

Removing oneself from critical job, family, socialising and responsibilities.



Tolerance
- The necessity to consume increasing amounts of alcohol in order to experience the same effects, or the ability to consume more alcohol than other people without becoming intoxicated.

Withdrawal symptoms include anxiety, sweating, shaking, difficulty sleeping, nausea or vomiting, and, in severe cases, physical convulsions and hallucinations. The individual may drink in order to alleviate or prevent such symptoms.

A person with an alcohol use disorder has developed a physical, psychological, and/or emotional dependence on alcohol. The brain adapts and endures permanent alterations in the presence of alcohol. When alcohol consumption is abruptly ceased, the body becomes unaccustomed to being alcohol-free. The internal environment undergoes dramatic alterations, resulting in withdrawal symptoms.

Excessive alcohol use has been linked to a wide range of psychological, interpersonal, social, economic, and physical problems in the past. It may contribute to an increased risk of depression and suicide. It has been implicated in violent crimes such as homicide and domestic violence (abuse of a spouse or child). This can result in traffic accidents and even incidents involving inebriated pedestrians who choose to walk home following a night out. Additionally, AUD can result in hazardous sexual conduct, which can result in unintended pregnancy or sexually transmitted diseases.

Alcoholism raises the risk of liver disease (hepatitis and cirrhosis), heart disease, stomach ulcers, brain damage, stroke, and other health complications. There is also a risk that pregnant women who consume alcohol will have a child with foetal alcohol syndrome, a collection of health problems that include extremely low birth weight, facial abnormalities, heart defects, and learning challenges.

Alcohol use disorder is extremely prevalent.


In the United States, over 10% of males and nearly 5% of women over the age of 18 have significant drinking issues. Millions more indulge in dangerous drinking, as experts define it. Alcohol is responsible for around 88,000 deaths in the United States each year, making it the third most preventable cause of death. Approximately one-third of driving-related fatalities are caused by alcohol usage.

Alcoholism is a result of a mix of biological predispositions and environmental effects.


Biology. Individuals who have a family history of alcohol consumption disorder are more likely to develop the condition themselves. For instance, if a parent has AUD, a child's chance of becoming a chronic drinker is fourfold greater. This is partly due to inheriting genes that increase vulnerability, possibly via regulating a person's physiologic responses to alcohol or the intoxicating experience. Alcohol is occasionally used to numb sensations associated with underlying depression or anxiety illness.

Environment. Alcohol maybe a significant element of a person's social group or family life (sometimes quite destructively). A person may abuse alcohol in order to cope with stress (which frequently backfires, because the drinking causes problems of its own). Support from family and healthy connections can help mitigate the risk.

Symptoms of Alcoholism (Alcohol use disorder)

Alcoholism can manifest itself through any of the following symptoms or behaviours:

Protracted periods of intoxication

Consumption in solitude

Workplace difficulties or financial difficulties as a result of drinking

Food aversion

Inattention to physical appearance

Blackouts

Drunk driving

Self-inflicted injury or injury to another person when intoxicated

Hide wine bottles and glasses to conceal evidence of intoxication

Changes in mood or personality

Because excessive alcohol consumption can be hazardous to the body (e.g., the cardiovascular, gastrointestinal, or nervous systems), heavy drinking may also result in physical symptoms:

nausea or tremors in the morning

Symptoms of malnutrition as a result of a poor diet

Constipation or abdominal pain

The cheeks and palms are flushed red.

Arms or legs can become numb, weak, or tingling

Accidental injuries particularly fall, occur at an unusually high rate.



Diagnosis of Alcoholism (Alcohol use disorder)


While alcohol-related disorders are extremely widespread, only a small percentage of persons admit there is a problem and seek therapy. Thus, screening is critical, whether performed by primary care physicians or by friends and family.

To determine whether or not a person is at increased risk for developing alcohol-related issues, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends that primary care physicians ask short, specific questions to gain a rapid sense of whether or not the individual is at elevated risk.

How frequently have you had the following in the last year:


(Men) Five or more alcoholic beverages per day?

(Women) Do you consume four or more alcoholic beverages every day?

Women and men have distinct limits due to recognised differences in how alcohol is absorbed, distributed, and removed from the body. Thus, the risk increases for men who consume more than four standard drinks per day (or more than 14 in a week); the limit for women is three drinks per day (and 7 drinks in a week).

People are almost always nervous or defensive about their drinking, which is one of the reasons this very prevalent problem frequently goes unnoticed or ignored. As a result, general care physicians frequently make time during a visit to educate patients about alcohol and its consequences.

The single question regarding drinking patterns is just as effective as somewhat more thorough questions, such as the CAGE questions, as a screening test. However, these may be more appropriate questions for concerned family members and friends to ask, as they may be hesitant to inquire directly about the amount.

The term "CAGE" refers to a method of recalling the questions (as indicated by the highlighted words):

Are you concerned that you may need to CUT BACK on your drinking?

Are you ANNOYED by others' criticisms of your drinking?

Do you feel GUILTY about your drinking?

Do you require an EYE OPENER drink in the morning to calm your nerves or combat a hangover?

Another screening tool used by clinicians is the World Health Organization's ten-question AUDIT (Alcohol Use Disorders Identification Test).

As much embarrassment as symptoms may cause, drinking issues are a perfectly reasonable human condition. The best course of action is to be candid in response to a physician's questioning.

Doctors frequently inquire about a patient's alcohol-related difficulties at work, at home, or with the police, such as involvement in fights or driving while intoxicated.

Additionally, doctors inquire about the physical symptoms of alcoholism.

A physical examination may reveal evidence of malnutrition and liver or nerve damage caused by alcohol.

Blood tests can be used to detect anaemia, vitamin deficiencies, and abnormal liver chemical levels.

The NIAAA maintains an extensive collection of information for both the general public and physicians. They are all easily accessible through the website www.niaaa.nih.gov.




Duration Estimated


The majority of people with an alcohol use disorder have their first alcohol-related life problems in their mid-20s to early 40s. Untreated, AUD frequently persists and worsens over time. Without formal treatment, up to 30% of people with alcohol use disorders are able to abstain from alcohol or moderate their drinking. On the other side, the illness can be lethal – roughly 88,000 people die each year in the United States as a result of alcohol-related causes.

Prevention of Alcoholism (Alcohol use disorder)


There is no foolproof method of preventing alcoholism. Screening is critical, as early discovery and treatment might avert potentially fatal consequences.


Treatment of 
Alcoholism (Alcohol use disorder)


Previously, treatment was restricted to self-help groups such as Alcoholics Anonymous (established in 1935). There is now a range of evidence-based therapies for alcohol use problems, including psychotherapy and medication.

The first task is to identify the issue. Denial, a well-known aspect of sickness, frequently transforms the illness into a chronic one. Regrettably, the longer a sickness lingers, the more difficult it is to treat.

A doctor or substance abuse specialist may be able to assist an individual in considering the effects of drinking. It is critical to approach the issue objectively. If an individual begins to consider alcohol as a problem worth attempting to resolve, educational groups might assist in balancing the benefits and drawbacks of drinking.

It is never easy for family members and friends to discuss an alcoholic relative or acquaintance. A professional may be required to assist loved ones in gently but realistically discussing the painful effects of drinking with the drinker.

Once an individual makes the decision to abstain from alcohol, the physician will monitor and treat symptoms. Detoxification ( sometimes called "detox") from alcohol can be done. The doctor can either see the patient as an outpatient or as an inpatient at a hospital or drug treatment facility. This usually depends on the amount and length of drinking and any symptoms. During the withdrawal process, the doctor may prescribe a short course of an antianxiety medication called benzodiazepines to alleviate withdrawal symptoms.

After withdrawing from alcohol, medicines may help lower cravings in some circumstances. Naltrexone and acamprosate are two drugs that fall into this group. Occasionally, the medicine disulfiram may be prescribed as an alternative. While disulfiram does not eliminate cravings, it does create an incentive to abstain from alcohol, as drinking alcohol while on it produces nausea and vomiting. Topiramate, an anti-seizure medication, may help to mitigate alcohol's reinforcing effects. Topiramate is used "off-label" for alcohol treatment, which means the FDA has not legally approved it for this purpose. Additionally, although not approved by the FDA, there is some evidence that baclofen, a medication used to treat muscle spasticity, may aid in the cessation of alcohol usage.


After detoxification, many people struggling with alcohol addictions require care or counselling for some time in order to maintain their sobriety. Recovery programmes educate individuals suffering from alcoholism about the condition, its hazards, and alternative methods for coping with life's normal stressors without resorting to alcohol. Psychotherapy may assist an individual in comprehending the factors that contribute to their drinking. Numerous patients benefit from self-help groups like Alcoholics Anonymous (AA), Rational Recovery, or SMART Recovery (Self Management and Recovery Training).

Other mental health problems can contribute to an increased risk of drinking. Depression and anxiety are frequently co-occurring disorders with alcoholism. Treatment for such diseases is critical if they are contributing to the condition.


Additional tests may be ordered by a physician to determine whether alcohol has caused harm to the liver, stomach, or other organs. A nutritious diet supplemented with vitamins, particularly B vitamins, is beneficial.

When Should You Consult a Doctor


Consult your physician if you or someone you care about has an alcohol-related issue. Bear in mind that drunkenness is not an indication of weakness or immaturity. It is a treatable sickness. The sooner treatment begins, the easier it is to overcome alcoholism.

The prognosis for Alcoholism (Alcohol use disorder)


Around 30% of people who have an alcohol use disorder are able to permanently abstain from alcohol without the assistance of official treatment or a self-help programme. For the remainder, the illness progresses in a highly variable manner. Two out of every three individuals seeking treatment successfully decrease their intake and improve their overall health. Certain individuals will experience periods of sobriety followed by relapse. Others struggle to maintain any length of sobriety.

However, it is obvious that the more sober days you have, the better your chances of remaining sober. Another encouraging statistic - maintaining sobriety can boost life expectancy by 15 or more years.

Get a free consultation from the Melody Jacob Health Team, Send us an email at godisablej66@gmail.com if you have any questions.

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