Alcoholism

Definition
Alcoholism is a chronic and often progressive disease that includes problems controlling your
drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems,
having to drink more to get the same effect (physical dependence), or having withdrawal symptoms
when you rapidly decrease or stop drinking.

Symptoms
Alcoholism signs and symptoms include those below. You may:

Be unable to limit the amount of alcohol you drink

Feel a strong need or compulsion to drink
Develop tolerance to alcohol so that you need more to feel its effects
Drink alone or hide your drinking
Experience physical withdrawal symptoms such as nausea, sweating and shaking
when you don't drink
Not remember conversations or commitments, sometimes referred to as a "black out"
Make a ritual of having drinks at certain times and become annoyed when this ritual is
disturbed or questioned
Be irritable when your usual drinking time nears, especially if alcohol isn't available
Keep alcohol in unlikely places at home, at work or in your car
Gulp drinks, order doubles or become drunk intentionally to feel good, or drink to feel
"normal"
Have legal problems or problems with relationships, employment or finances due to
drinking
Lose interest in activities and hobbies that used to bring you pleasure

Long term-effects
Alcohol depresses central nervous system. In some people, the initial reaction may be stimulation. But
as you continue to drink, you become sedated. Alcohol lowers inhibitions and affects thoughts,
emotions and judgment.

Health problems caused by excessive drinking can include:

Liver disease. Heavy drinking can cause alcoholic hepatitis an inflammation of the
liver. After years of heavy drinking, hepatitis may lead to irreversible destruction and
scarring of liver tissue (cirrhosis).
Digestive problems. Heavy drinking can result in inflammation of the stomach lining
(gastritis), as well as stomach and esophageal ulcers. It also can interfere with absorption
of B vitamins and other nutrients. Heavy drinking can damage your pancreas which
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produces hormones that regulate your metabolism and enzymes that help digestion
and lead to inflammation of the pancreas (pancreatitis).
Heart problems. Excessive drinking can lead to high blood pressure and increases your
risk of an enlarged heart, heart failure or stroke.
Diabetes complications. Alcohol interferes with the release of glucose from your liver
and can increase the risk of low blood sugar (hypoglycemia). This is dangerous if you
have diabetes and are already taking insulin to lower your blood sugar level.
Sexual function and menstruation. Excessive drinking can cause erectile dysfunction in
men. In women, it can interrupt menstruation.
Eye problems. Over time, heavy drinking can cause involuntary rapid eye movement
(nystagmus) as well as weakness and paralysis of your eye muscles due to a deficiency of
vitamin B-1 (thiamine).
Birth defects. Alcohol use during pregnancy may cause fetal alcohol syndrome, resulting
in giving birth to a child who has physical and developmental problems that last a
lifetime.
Bone loss. Alcohol may interfere with the production of new bone. This can lead to
thinning bones (osteoporosis) and an increased risk of fractures.
Neurological complications. Excessive drinking can affect your nervous system, causing
numbness and pain in your hands and feet, disordered thinking, dementia and short-term
memory loss.
Weakened immune system. Excessive alcohol use can make it harder for your body to
resist disease, making you more susceptible to illnesses.
Increased risk of cancer. Long-term excessive alcohol use has been linked to a higher
risk of many cancers, including mouth, throat, liver, colon and breast cancer. Even
moderate drinking can increase the risk of breast cancer.

Causes
Genes - scientists say there are specific genetic factors which may make some people more
likely to become addicted to alcohol, as well as other substances. People who have a family
history of addiction are at higher risk for abusing alcohol. Alcoholics are six times more likely
than nonalcoholic to have blood relatives who are alcohol dependent. Researchers from the
Universidad de Granada, Spain, revealed that "the lack of endorphin is hereditary, and thus that
there is a genetic predisposition to become addicted to alcohol".
The age of first alcoholic drink - a study found that people who started drinking alcohol
before the age of 15 were much more likely to have an alcohol problem later in life.
Smoking, especially non-daily smokers - A study by Yale University researchers found that
non-daily smokers are five times more likely to have a problem with alcohol compared to people
who have never smoked.
Easy access - Experts say there is a correlation between easy access to alcohol (cheap prices)
and alcohol abuse and alcohol-related deaths. A US study found a strong link between alcohol
tax increases in 1983 and 2002 and a significant drop in deaths related to alcohol use in one
American state - the effect was found to be nearly two to four times that of other prevention
strategies such as school programs or media campaigns.
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 Stress - some stress hormones are linked to alcoholism. If our levels of stress, anxiety are high
some of us may consume alcohol in an attempt to blank out the upheaval. Military service
members returning from Iraq and Afghanistan are likely to experience posttraumatic stress
disorder and alcohol use disorders simultaneously, according to researchers at the National
Institute on Alcohol Abuse and Alcoholism.
Peer drinking - people who have friends who drink regularly or abuse alcohol are more likely
to drink excessively and eventually have an alcohol problem.
Low self-esteem - experts say that people with low self-esteem who have alcohol readily
available are more likely to abuse it.
Depression - people with depression may deliberately or unwittingly use alcohol as a means
of self-treatment. On the other hand, a statistical modeling study suggested that alcohol abuse
may lead to depression risk, rather than vice versa.
Media and advertising - in some countries alcohol is portrayed as a glamorous, worldly and
cool activity. Many experts believe that alcohol advertising and media coverage of it may convey
the message that excessive drinking is acceptable.
How the body processes (metabolizes) alcohol - people who need comparatively more
alcohol to achieve an effect have a higher risk of eventually having an alcohol problem, a study
carried out by researchers at the University of California, San Diego, found.

Treatment
1. Detoxification (detox): This may be needed immediately after discontinuing alcohol use
and can be a medical emergency, as detox can result in withdrawal seizures,
hallucinations, delirium tremens (DT), and in some cases may result in death.
2. Rehabilitation: This involves counseling and medications to give the recovering alcoholic
the skills needed for maintaining sobriety. This step in treatment can be done inpatient or
outpatient. Both are equally effective.
3. Maintenance of sobriety: This step's success requires an alcoholic to be self-driven. The
key to maintenance is support, which often includes regular Alcoholics Anonymous (AA)
meetings and getting a sponsor.

Key Terms
Blood-brain barrier
A network of blood vessels characterized by closely spaced cells that prevents many
potentially toxic substances from penetrating the blood vessel walls to enter the brain.
Alcohol is able to cross this barrier.
Detoxification
The phase of treatment during which a patient stops drinking and is monitored and cared
for while he or she experiences withdrawal from alcohol.

Neurotransmitter
One of a group of chemicals secreted by a nerve cell (neuron) to carry a chemical
message to another nerve cell, often as a way of transmitting a nerve impulse. Examples
of neurotransmitters include acetylcholine, dopamine, serotonin, and norepinephrine.
Relapse
A return to a disease state, after recovery appeared to be occurring. In alcoholism, relapse
refers to a patient beginning to drink alcohol again after a period of avoiding alcohol.
Tolerance
A phenomenon during which a drinker becomes physically accustomed to a particular
quantity of alcohol, and requires ever-increasing quantities in order to obtain the same
effects.
Withdrawal
Those signs and symptoms experienced by a person who has become physically
dependent on a drug, experienced upon decreasing the drug's dosage or discontinuing its
use.