Alcohol Abuse Alcohol Dependence

Alcohol dependence is a chronic pattern of alcohol abuse. An alcoholic gets used to the effects of alcohol andrequires more alcohol to get the desired effect. This is called tolerance. Aperson with alcohol dependence may experience an uncontrollable need foralcohol.

What is going on in the body?

Alcohol is a depressant. At a blood alcohol level of 0.05%,thought, judgment and restraint are affected. At a level of 0.1%,motor skills become clumsy. When the blood alcohol level reaches0.2%, the entire area of the brain that controls motor function is negativelyaffected. Alcohol also affects the parts of the brain that control emotions andbehavior. At 0.3%, the person is likely to be confused andstuporous. An individual at a blood alcohol level of 0.4% or higher may go into a coma. If blood alcohol levels exceed 0.5%, an individual might choke on vomit or stop breathing.

Prolonged alcohol use can actually alter the genes in the brain. People withalcoholism may have impaired memory, poor concentration, and inability to focusafter a distraction.

What are the causes and risks of the condition?

No one knows for sure what causes alcohol abuse and dependence. Factors that increase a person’s chance of becoming dependent on alcohol include:

frequent social situations that encourage drinking

childhood history of attention deficithyperactivity disorder or conductdisorder

personality disorders

one or both parents dependent upon alcohol

alcohol abuse by a young adult that begins as weekend or eveningdrinking

What are the signs and symptoms of the condition?

Signs and symptoms of alcohol dependency include:

alcohol withdrawal when drinking stops suddenly. Withdrawal symptomsinclude nervousness, shaking, irritability, and nausea.

increased tolerance to alcohol

alcohol consumed in largeramounts or over a longer period than was intended

unsuccessful attempts to stop drinking

considerable time devoted to activities associated with alcohol use or obtaining alcohol

neglected daily activities

disregard for consequences of negative behaviors

How is the condition diagnosed?

There is no test to determine if an individual is an alcoholic. But thenegative effects of alcohol on the body can be identified with laboratorytests. These laboratory tests will show damage to various organs or bodysystems.

What can be done to prevent the condition?

Teaching people, particularly those who are at risk for the disease, about alcoholism is important. This education needs tobe started at a young age.

What are the long-term effects of the condition?

The long-term effects of alcohol dependency include:

pancreatitis, or inflammation ofthe pancreas

heart disease, including coronary artery disease

neuropathy, or damage to the nerves

bleeding esophageal varices, orenlarged veins in the tube that connects the windpipe to the stomach

brain degeneration and alcoholic neuropathy

cirrhosis of the liver, achronic disease that causes destruction of liver cells and loss of liverfunction

depression, insomnia, anxiety, and suicide

high blood pressure

increased incidence of many types of cancer, including breast cancer

nutritional deficiencies

Wernicke-Korsakoff’s syndrome, a neuropsychiatricdisorder caused by thiamine deficiency that results from poor nutrition in alcoholics

significant damage to occupational, social, and interpersonal areas,including sexual dysfunction

Children and teenagers who abuse alcohol are at increased risk for furtherdrinking problems, depression, othersubstance abuse, and personalitydisorders as they get older. Adolescents who drink alcohol heavily can develop significant impairments in their ability to remember new information, and theirschoolwork may suffer.

People who are heavy drinkers also tend to smoke and eat an unhealthy diet.This combination puts the person at higher risk for coronary artery disease, stroke, heart attack, diabetes, and other chronic diseases.

What are the risks to others?

If a woman drinks alcohol during pregnancy, her fetus is at great risk for developingfetal alcohol syndrome. or FAS. Drinking reduces judgment, impulse control,and motor control. A person with alcohol dependency places himself or herselfand others at risk for accident or emotional injury.

What are the treatments for the condition?

Treatment begins with helping the person to recognize the problem. Alcoholdependency is associated with a tendency to deny the severity of the problem.There is an refusal to admit it to others. Once the person has recognized andadmitted a problem, treatment begins with sobriety, or no alcohol intake.

Some individuals who are alcohol dependent will need to be medicallydetoxified. This is done in a healthcare setting. Potential complications aremonitored during the detoxification process. Tranquilizers and sedatives areused 4 to 7 days to control the symptoms of alcohol withdrawal.

Alcohol recovery programs help people identifysituations that trigger the desire to drink. These programs also help people develop coping skills and lifemanagement systems, so they can live without alcohol. Self-help groups such as Alcoholics Anonymoushave been effective in helping thousands of alcoholics remain sober.

Occasionally medications, such as disulfram, that interfere with the metabolismor the effects of alcohol are used as a deterrent.

What are the side effects of the treatments?

Disulfram may cause drowsiness, depression, and erectile dysfunction.

What happens after treatment for the condition?

Individuals who complete treatment for alcohol dependence often will continuesome form of counseling or self-help group. A person in alcohol recovery willoften voluntarily continue to attend self-help groups indefinitely.

How is the condition monitored?

Alcohol dependence is monitored by healthcare providers, counselors, family, andfriends. Any new or worsening symptoms should be reported to the healthcareprovider.