Alcoholism

Definition

Definition of Alcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing. It is medically considered a disease, specifically a neurological disorder, and in medicine several other terms are used, specifically "alcohol abuse" and "alcohol dependence," which have more specific definitions. In 1979 an expert World Health Organization committee discouraged the use of "alcoholism" in medicine, preferring the category of "alcohol dependence syndrome". In the 19th and early 20th centuries, alcohol dependence in general was called dipsomania, but that term now has a much more specific meaning. People suffering from alcoholism are often called "alcoholics". Many other terms, some of them insulting or informal, have been used throughout history. The World Health Organization estimates that there are 140 million people with alcoholism worldwide.

Symptoms

Symptoms of Alcoholism
Alcoholism is characterised by an increased tolerance of and physical dependence on alcohol, affecting an individual's ability to control alcohol consumption safely. These characteristics are believed to play a role in impeding an alcoholic's ability to stop drinking. Alcoholism can have adverse effects on mental health, causing psychiatric disorders and increasing the risk of suicide. The onset of depression is a common symptom.

Causes

Causes of Alcoholism
A complex mixture of genetic and environmental factors influences the risk of the development of alcoholism. Genes that influence the metabolism of alcohol also influence the risk of alcoholism, and may be indicated by a family history of alcoholism. One paper has found that alcohol use at an early age may influence the expression of genes which increase the risk of alcohol dependence. Individuals who have a genetic disposition to alcoholism are also more likely to begin drinking at an earlier age than average.

Also, a younger age of onset of drinking is associated with an increased risk of the development of alcoholism, and about 40 percent of alcoholics will drink excessively by their late adolescence. It is not entirely clear whether this association is causal, and some researchers have been known to disagree with this view. A high testosterone concentration during pregnancy may be a risk factor for later development of alcohol dependence.

Diagnosis

Diagnosis of Alcoholism
In the USA a person must meet the criteria laid out in the DSM (Diagnostic and Statistical Manual of Mental Disorders), published by the APA (American Psychiatric Association). This includes a pattern of alcohol abuse which leads to considerable impairment or distress. The patient should experience at least three of the criteria below during the past 12 months:

1. Alcohol tolerance - the patient needs a large quantity of alcohol to feel intoxicated. However, when the liver is damaged and cannot metabolize the alcohol so well, this tolerance may drop. Damage to the central nervous system may also reduce tolerance levels.
2. Withdrawal symptoms - when the patient abstains from alcohol or cuts down he/she experiences tremors, insomnia, nausea or anxiety. Typically, the patient drinks more to avoid these symptoms.
3. Beyond intentions - the patient ends up drinking more alcohol, or drinks for a longer period than he/she intended.
4. Unsuccessfully attempting to cut down - the patient is continuously trying to cut down alcohol consumption, but does not succeed. Or the patient has a persistent desire to cut down.
5. Time consuming - the patient spends a lot of time obtaining, using or recovering from alcohol consumption.
6. Withdrawal - the patient withdraws from recreational, social, or occupational activities. This did not used to be the case.
7. Persistence - the patient carries on consuming alcohol even though he/she knows it is harming him/her physically and psychologically.

Treatment

Treatment of Alcoholism
The first and most important step in getting treatment for alcoholism is recognizing that you have a problem. Often, family members and close friends may urge treatment for the person with the addiction.

Treatment and ongoing recovery must address both physical and psychological addiction and may include inpatient treatment and/or Alcoholics Anonymous (AA). In an inpatient or residential program, the person generally stays in a hospital or center for 28 days, undergoing first detoxification (usually 4 - 7 days) and then individual and group therapy emphasizing abstinence. Talk to a doctor about what is best for you or your loved one.
Lifestyle

1. Attend Alcoholics Anonymous.
2. Family members should attend Al-Anon to learn how to help the person with the addiction and to get help and support themselves.
3. Exercise regularly to help reduce cravings.

Prognosis

Prognosis of Alcoholism
Consult with your doctor.

Prevention

Prevention of Alcoholism
If you drink, do so only in moderation -- no more than 2 drinks per day if you are a man and no more than 1 drink per day if you are a woman.

Early intervention is important, especially with teenagers. To prevent teen drinking, consider the following:

1. Stay involved and interested in your teenager's life.
2. Talk openly to your children, especially pre-teens and teens, about the widespread presence and dangers of alcohol and drugs.
3. Have clear, non-negotiable rules about not using alcohol and drugs.
4. Act as a role model -- don' t drink excessively, use other drugs, or smoke.
5. Strongly urge your children to not smoke.
6. Encourage your children to become active in sports, music, the arts, or other activities.
7. Know where your children and teens are at all times and make sure they always have adult supervision.
8. Monitor your teenager for aggressive behavior, feelings of anger or depression, and poor school performance. If any of these develop, consider whether alcohol may be a reason.
9. Never drink and drive or allow your teenager to be driven in the car by someone who has been drinking.

Complications: Usually, drinking alcohol initially elevates the person's mood. However, after a long period of regular heavy drinking the person's nervous system will become depressed and the drinker will become sedated by alcohol. Alcohol may undermine a person's judgment; it can lower inhibitions and alter the drinker's thoughts, emotions and general behavior. Heavy regular drinking can have a serious effect on a person's ability to coordinate his/her muscles and speak properly. Heavy binge drinking could cause the patient to go into coma.

Eventually, regular heavy drinking may cause at least one of the following problems:

1. Fatigue - the patient is tired most of the time.
2. Memory loss - especially the patient's short-term memory.
3. Eye muscles - the eye muscles can become significantly weaker.
4. Liver diseases - the patient has a considerably higher chance of developing hepatitis, and cirrhosis. Cirrhosis of the liver is an irreversible and progressive condition.
5. Gastrointestinal complications - the patient can develop gastritis, or pancreas damage. These problems also seriously undermine the body's ability to digest food, absorb certain vitamins, and produce hormones which regulate metabolism.
6. Hypertension - regular heavy drinking invariably raises the person's blood pressure.
7. Heart problems - regular heaving drinking can lead to cardiomyopathy (damaged heart muscle), heart failure, and stroke.
8. Diabetes - alcoholics have a very high risk of developing diabetes type 2. Patients who have diabetes will invariably have serious complications if they are regular heavy drinkers of alcohol. Alcohol prevents the release of glucose from the liver, causing hypoglycemia. A person with diabetes is already taking insulin to lower his/her blood sugar levels - hypoglycemia could be devastating.
9. Menstruation - alcoholism will usually stop menstruation or disrupt it.
10. Erectile dysfunction - alcoholic men are much more likely to have problems getting an erection, or sustaining one.
11. Fetal alcohol syndrome - women who abuse alcohol during their pregnancy are much more likely to have babies with birth defects, including a small head, heart problems, shortened eyelids, as well as developmental and cognitive problems.
12. Thinning bones - alcoholics invariably suffer from thinning of the bones because alcohol interferes with the production of new bone. This means an increased risk of fractures.
13. Nervous system problems - alcoholism often causes numbness in the extremities, dementia and confused/disordered thinking.
14. Cancer - alcoholics have a much higher risk of developing several cancers, including cancer of the mouth, esophagus, liver, colon, rectum, breast, prostate and pharynx.

An international study found that the key causes of bowel cancer are alcohol and smoking.

In fact, even moderate alcohol consumption is linked to a higher incidence of cancer among women, a study found. Another study found that consuming just two or more drinks per day could increase a person's risk of pancreatic cancer by about 22%.

1. 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.
2. Domestic abuse - alcohol is a major factor in spouse beating, child abuse, and conflicts with neighbors.
3. Work (school) problems - employment problems, unemployment, school problems, are often alcohol-related.
4. Suicide - suicide rates among people who are alcohol-dependent or who abuse alcohol are much higher than among other people.
5. Mental illness - alcohol abuse can cause mental illness and make existing mental illnesses worse.
6. 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.