Today in Health & Wellness
HEALTH CONDITIONS
Alcohol Use Disorder
Overview
Symptoms
Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Doctors to Consult
Overview

Alcohol use disorder is a pattern of alcohol drinking that leads to repeating problems. Problems due to alcohol abuse include the inability to fulfill responsibilities at work, school or family, drinking-related legal problems and problems in personal relationships. Continued alcohol abuse leads to alcohol dependence or alcoholism which is a chronic disease wherein the patient continues to drink alcohol despite the problems it causes. An alcoholic patient is already physically or mentally addicted to alcohol.

Alcohol is a depressant that can affect any organ in the body. It is rapidly absorbed into the bloodstream. The intensity of effects is directly related to the amount of alcohol consumed. Several factors such as age, gender, ethnicity, physical condition and amount of food consumed prior to drinking can affect a person’s response to alcohol.

Alcohol use disorder and its severity can be diagnosed by asking questions related to drinking habits. There are physical, laboratory and imaging tests that can strongly suggest alcohol use disorder.

Symptoms

A patient can be diagnosed with alcohol use disorder by manifesting a number of the following symptoms over a 12-month period:

  • Drinking alcohol in larger amounts or over a longer period than intended
  • Persistent desire or unsuccessful attempts to decrease or stop alcohol use
  • A lot of time spent to obtain, use or recover from alcohol and its effects
  • Craving or strong desire to drink alcohol
  • Repeated failure to fulfill major obligations at work, school or home due to alcohol use
  • Continued alcohol use despite the social or interpersonal problems it causes
  • Giving up important social, occupational or recreational activities for alcohol use
  • Alcohol use even in physically hazardous situations
  • Continued alcohol use despite having recurrent physical or psychological problems that may be caused or worsened by alcohol
  • Tolerance to alcohol wherein an increased amount of alcohol is needed to achieve pleasurable effects
  • Withdrawal symptoms

Manifesting 2 to 3 symptoms is classified as mild alcohol use disorder. Moderate alcohol users have 4 to 5 symptoms while severe alcohol users present with at least 6 symptoms.

Alcohol withdrawal symptoms usually occur 4 to 12 hours after alcohol use is reduced or stopped. Withdrawal symptoms include the following:

  • Sweating
  • Rapid heartbeat
  • Hand tremors
  • Insomnia
  • Nausea and vomiting
  • Hallucinations
  • Restlessness and agitation
  • Anxiety
  • Seizures
Risk Factors
  • More than 15 drinks per week (male) or 12 drinks per week (female)
  • More than 5 drinks per day at least once a week
  • Started drinking at an early age
  • Family history of alcohol use disorder
  • Having mental health disorders such as depression, anxiety, schizophrenia or bipolar disorder
  • Being with someone who drinks regularly
  • Experiencing peer pressure, high levels of stress or having low self-esteem

One drink is defined as:

  • 12 ounces of regular beer
  • 8 to 9 ounces of malt liquor
  • 5 ounces of wine
  • 1.5 ounces of 80 proof hard liquor or 40% alcohol

Complications

Short-term effects of alcohol use include:

  • Accidents or injuries that require hospital treatment
  • Violent and aggressive behavior
  • Unprotected sex that can lead to pregnancy or sexually transmitted diseases (STDs)
  • Poor performance at work or school
  • Memory loss
  • Hangovers

Persistent alcohol use increases the risk of serious health conditions such as:

  • Liver disease like increased fat in liver, liver inflammation or scarring of the liver tissue
  • Inflammation of stomach lining, stomach and esophageal ulcer or inflammation of pancreas
  • Hypertension, heart enlargement, heart failure or stroke
  • Low blood sugar especially for diabetic patients who are taking medications
  • Erectile dysfunction or menstrual cycle interruptions
  • Involuntary rapid eye movement, weakness and paralysis of eye muscles
  • Miscarriage or fetal alcohol syndrome
  • Osteoporosis, low platelet count
  • Numbness and pain on hands and feet, disordered thinking or dementia
  • Weakened immune system
  • Higher risk for mouth, throat, liver, colon and breast cancer
Commonly Prescribed Drugs
  • Disulfiram can be given to prevent a patient from drinking alcohol. The drug produces undesirable reactions similar to alcohol use such as flushing, nausea, vomiting and headache.
  • Acamprosate is given to patients who have successfully stopped drinking alcohol. This reduces alcohol cravings by affecting the levels of gamma-amino-butyric acid (GABA) in the brain.
  • Naltrexone blocks the pleasurable feelings caused by alcohol use and reduces the urge to drink alcohol.
Treatment and Management
  • A patient should consult a doctor for proper diagnosis and appropriate treatment.
  • The main goal of the treatment is to help the person abstain or stop the intake of alcohol.
  • Treatment for alcohol usually starts with a detoxification program wherein the patient will be medically managed to undergo alcohol withdrawal. This is usually done in a hospital.  Patient should drink plenty of water and eat regular meals during the detox.
  • Counselling and therapy can be done in groups or individually to better understand alcohol problems. This can also provide support in recovering from the psychological effects of alcohol use. Alcoholics Anonymous is a support group of people who have a desire to stop drinking. They conduct regularly scheduled meetings to share experiences and provide support for others.
  • Patients are encouraged to keep a drinking diary to monitor his/her daily alcohol consumption. The contents of the diary include the type and amount of alcoholic drinks a person had, what time it was drank and the place or situation the alcohol was consumed.

Prevention

  • Alcohol use disorder can be prevented by limiting a person’s alcohol intake. The daily alcohol consumption for women is one drink and for men is 2 drinks.
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