Alcoholism is defined as condition manifested by repeated drinking that produced injury to the drinker’s health or to his social and economic functioning. Alcoholism is not a disease because, technically speaking, it is not a disease entity like a heart disease instead there are many separate heart ailments or combination of both.
It is also known as alcohol use disorder (AUD). It is a broad term alcohol drinking that results in problems.
Alcoholism is also known as “Alcohol dependence” is a disease that includes four symptoms
- 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 needs to drink greater amounts alcohol in order “get high”
Causes of Alcoholism
- Availability: alcohol is easily available and drinking is accepted as a norm in functions and social gathering
- Genetic factors: some excessive drinkers have a family history of excessive drinking; there is genetic relation between alcoholism
- Biochemical factors: several biochemical factors have been suggested including abnormalities in alcohol dehydrogenated or in the neurotransmitter mechanism
- Learned behavior: it has been suggested that learning process may contribute in a more specific way to the development of alcohol dependence through the repeated experiences of with drawl symptoms. Alcohol may act as a re-in force for future drinking. Children, especially boys tend to follow their parent’s drinking pattern.
- Personality factors: alcoholism is more common in anxiety and antisocial personality
- Poor coping strategies: the person unable to face stress often resort to alcoholism. The defense mechanisms involved in alcoholism include denial rationalization and projection (a plan or outline form situation)
- Psychiatric disorders: some patients with depression take alcohol in the mistaken hope that it will alleviate low mood. Persons suffering from anxiety disorders and phobic disorders are prone to take alcohol as an escape.
- Social causes: isolation, unemployment, injustice, unfair and other social causes lead to alcoholism
- High-risk groups: a person suffering from chronic physical illness, business executives, traveling salespersons, industrial workers, urban slum dwellers, a student in hostels, military personnel etc. are more prone to develop alcohol abuse.
Process of development of Alcoholism
To begin with, persons start drinking alcohol due to peer pressure and curiosity.
Further, whenever they meet like functions like marriages, hostel day or college day, parties, conferences, they drink occasionally.
Further, whenever they want relaxation, on holidays and weekends, they start enjoying their drinks and continue to do so. Hence the frequency gradually increases.
Some people who started drinking occasionally starts drinking almost daily or drinking heavily for a period of time of pleasure or to avoid the discomfort of with drawl symptoms.
Complication of alcoholism
- Gastrointestinal: vomiting, acute or chronic gastritis, peptic ulcer, cancer, alcoholism hepatitis, cirrhosis of liver, acute or chronic pancreatitis
- Cardio-vascular: alcoholic cardio-myopathy, high risk for myocardial infarction, anemia, decreased WBC production.
- Muscle: peripheral muscle weakness and wasting
- Vitamin deficiency disorder like pellagra and beriberi
- Reproductive system: sexual dysfunction in male, failure of ovulation in females
- Fetal abnormalities like mental retardation
- Nervous system: peripheral neuropathy, rum fits
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- Maladaptive behavior, fighting, irritability etc.
- Withdrawal phenomenon- tremor, nausea, tachycardia, HTN, insomnia
- Delirium tremors
- Clouding of consciousness
- Vivid hallucination and illusions
- Marked tremor and fever
- Delusion, agitation, and convulsion
- Alcoholic psychosis
- Morbid jealousy
- Alcoholism and depression
- Alcoholic amnesic disorders
- Alcoholic dementia
- Work problems: decrease work performances thus, decrease productivity and loss of job
- Family problems: marital disharmony loses trust from the family members
- Drunken driving will lead to accidents and may increase dependency
Management of alcoholism
- Assessment of patient
- His drinking patterns
- Work spot
- Motivate the patient to stop drinking
- Routine screening
- Educating the drinkers about the hazards of heavy drinking
- Motivating them to change their behavior
- Treatment of withdrawal
- Drugs- chlordiazepoxide and diazepam to control anxiety, insomnia, and tremors.
- Vitamin (Thiamine): for prevention of thiamine deficiency due to alcoholism
- Maintain diet, fluids, and electrolytes
- Alcoholics Anonymous (AA)
- A self-help group of ex-addicts, who confront, instruct and support fellow-drinkers in their efforts to stay sober one day at a time, through fellowship and acceptance.
- Aversion therapy
- Patient is subjected to pain-inducing stimuli at the time of drinking to establish alcohol rejection behavior
- Alcohol sensitizing agent: disulfiram therapy
The patients with alcohol misuse uses Disulfiram therapy for long-term. This drug produces intense headaches, severe flushing, extreme nausea, vomiting, palpitations, hypotension, dyspnea and blurred vision when an even small amount of alcohol consumed by the patient with this drugs.
Prevention of alcoholism
- Alcohol policies in order to reduce the harm of the alcoholism.
- Targeting adolescents and young adults are regarded as an important step to reduce the harm of alcohol abuse through health education, teaching etc.
- Increasing the age at which licit drugs of abuse such as alcohol can be purchased
- Banning or restricting alcohol advertisement
- Limiting the sale of alcohol, higher taxing in alcohol
- Educational campaign regarding alcohol abuse through mass media about the consequences of alcohol abuse
- Guidelines for parents to prevent alcohol abuse amongst adolescents, drinking in front of their children.