Alcoholism

A psychological and physiological dependence on alcohol, resulting in chronic disease and disruption of interpersonal, family and work relationships. It affects both sexes, but occurs more often in men than women. The incidence of alcoholism in children is increasing.

FREQUENT SIGNS AND SYMPTOMS

Early stages:

  • Increased tolerance to the effects of alcohol.
  • Low tolerance for anxiety.
  • Need for alcohol at the beginning of the day, or at times of stress.
  • Insomnia; nightmares.
  • Habitual Monday-morning hangovers, and frequent absences from work.
  • Preoccupation with obtaining alcohol and hiding drinking from family and friends.
  • Guilt or irritability when others suggest drinking is excessive.

Late stages:

  • Frequent blackouts; memory loss; depression.
  • Delirium tremens (tremors, hallucinations, confusion, sweating, rapid heartbeat). These occur most often with alcohol withdrawal.
  • Liver disease (jaundice, internal bleeding, bloating).
  • Neurological impairment (numbness and tingling in hands and feet, declining sexual interest and potency, confusion, coma).
  • Congestive heart failure (shortness of breath, swelling of feet).

CAUSES

  • Not fully understood, but include:
  • Personality factors, especially dependency, anger, mania, depression or introversion.
  • Family influences, especially alcoholic or divorced parents.
  • Abnormal metabolism of alcohol (perhaps).

RISK INCREASES WITH

  • Genetic factors. Some ethnic groups have high alcoholism rate either for social or biological reasons.
  • Use of recreational drugs.
  • Crisis situations, including unemployment, frequent moves, or loss of friends or family.
  • Inadequate, insecure and immature personality types.
  • Environmental factors such as ready availability, affordability and social acceptance of alcohol in the culture group, work group or social group.

PREVENTIVE MEASURES

  • Keep to safe limits of alcohol intake as recommended by medical authorities.
  • Drink slowly, never gulp alcoholic drinks. Do not drink on an empty stomach.
  • Do not drink to relieve stress, tension or depression.
  • Provide children with a loving, stable family environment. Use alcohol in moderation if at all to provide a healthy role model.
  • Encourage a spouse, friend or co-worker to admit when an alcohol problem exists, and seek professional care.

EXPECTED OUTCOME

  • Without treatment, alcoholism can lead to progressive brain and liver disease, job loss, divorce, possibly criminal behavior, premature death.
  • With abstinence (absence of alcohol or drugs), sobriety is a way of life. The change in lifestyle is difficult and relapses occur. If you are determined to give up alcohol, you can.

POSSIBLE COMPLICATIONS

  • Chronic and progressive liver disease.
  • Gastric erosion (raw area in stomach lining) with bleeding; stomach inflammation.
  • Neuritis, tremors, seizures and brain impairment.
  • Inflammation of the pancreas.
  • Inflammation of the heart.
  • Mental and physical damage to the fetus if a woman drinks during pregnancy.
  • Family members of alcoholics may develop psychological symptoms requiring treatment and support groups such as Al-Anon.

TREATMENT
GENERAL MEASURES

  • For successful treatment, the alcoholic must recognize the existence of the problem and be willing to grapple with it.
  • No single form of treatment works for all alcoholics. Psychological, social, and physical treatments may be combined.
  • Some patients may require detoxification (medical help in getting over the physical withdrawal symptoms when drinking is stopped).
  • Sometimes requires inpatient care at a special treatment center.
  • Keep appointments with doctors and counselors.
    · Join a local Alcoholics Anonymous group or other support group and attend meetings regularly.
  • Reassess your lifestyle, friends, work, and family to identify and alter factors that encourage drinking.

MEDICATION

  • Disufiram (Antabuse), which causes several extremely unpleasant physical symptoms when alcohol is consumed, is recommended for some patients.
  • Other medications to help control withdrawal symptoms may be prescribed.

ACTIVITY

There are usually no restrictions. Discuss physical activities with the doctor.

DIET

Eat a normal, well-balanced diet. Vitamin supplements, such as thiamine and folic acid, are often necessary.