Alcoholism Sometimes The Misunderstood Misunderstood Disease
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Definition of alcoholism:
In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts of alcohol over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.
Why can someone drink alcohol on a social level and with a level of responsibility? While someone else has to drink to get drunk, and sometimes lose that feeling of responsibility to the point of slurred speech and perhaps even staggering and finally passing out.
What is the difference between these two people?
For the longest time, alcoholism was regarded as a conscious choice one makes to get drunk. Yes, sometimes there is the person who drinks for the sole idea of getting drunk, perhaps for a social occasion, to help them overcome a traumatic event, or just because everyone else is drunk.
The hangover, the realization of knowing this was just a brief encounter and now it is time to get back to doing the things you need to do to become that responsible person again. In most cases, this is acceptable behavior and laughed about after. The is the social drinker widely accepted by everyone.
Unfortunately, this is not the case for everyone. There are those who have that one drink, then two, and proceed to a level of total intoxication.
Casual drinking, alcohol abuse, & alcoholism:
Let’s start with casual drinking. Unless you have religious or personal restrictions, there’s nothing wrong with a few drinks with friends, maybe some wine with dinner, or the occasional bubbly at a party. The problem starts, though, when you begin abusing the substance.
Many people use the terms “alcohol abuse” and “alcoholism” interchangeably. However, alcoholism refers to alcohol addiction or dependence, where the individual has a physical or psychological compulsion to drink alcohol. Alcohol abuse refers to a pattern of behavior where a person drinks excessively in spite of the negative consequences.
Ten Warning Signs You’re An Alcoholic:
The following are ten warning signs of alcoholism that might help answer the question “Am I an Alcoholic?”:
- Drinking alone and in secrecy
- Losing interest in other activities that were once enjoyable
- Alcohol cravings
- Making drinking a priority over responsibilities, such as employment and family
- Alcohol withdrawal symptoms (sweating, anxiety, etc.)
- Extreme mood swings and irritability
- Feelings of guilt associated with drinking
- Having a drink first thing in the morning
- Continuing to drink, despite health, financial, and family problems
- Inability to stop or control the amount of alcohol that’s consumed
Symptoms of alcoholism and alcohol addiction:
Alcoholism is the physical and/or mental dependence on alcohol.
If you find yourself regularly thinking about your next drink, or if you’ve tried to cut back on drinking and never quite succeeded, you may have an alcohol addiction.
Alcoholism begins with tolerance. Alcohol is a drug, and as you drink more, the body becomes less susceptible to its effects. And with enough repetition, it comes to expect the presence of alcohol. This leads to alcohol withdrawal syndrome (AWS) when the body reacts to a heavy drinker stopping the supply.
Symptoms of alcohol withdrawal:
According to the U.S. National Library of Medicine, the symptoms of alcohol withdrawal include:
- Anxiety or nervousness
- Jumpiness or shakiness
- Mood swings
- Not thinking clearly
It may take a few hours or days for these symptoms to show, and they may get worse in the days following.
Withdrawal can be dangerous, but a detox program can help you move past the negative symptoms safely.
In some cases, the individual may experience the most severe form of alcohol withdrawal called delirium tremens. They can cause agitation, fever, hallucinations, confusion, and seizures. For this reason, heavy drinkers who are looking to end their addiction should seek medical assistance.
In the past, a person with this condition was referred to as an “alcoholic.” However, this is increasingly seen as an unhelpful and negative label. Health professionals now say that a person has an alcohol use disorder (AUD).
According to the National Institute of Health (NIH), in 2015, 15.1 million American adults (6.2 percent of the population) had an alcohol use problem.
According to the World Health Organization (WHO), globally, 3.3 million deaths every year result from the harmful use of alcohol.
Alcohol dependence can take from a few years to several decades to develop. For some people who are particularly vulnerable, it can happen within months.
Over time, regular alcohol consumption can disrupt the balance of:
- Gamma-aminobutyric acid (GABA) in the brain
GABA controls impulsiveness and glutamate stimulates the nervous system.
Dopamine levels in the brain rise after consuming alcohol. Dopamine levels may make the drinking experience more gratifying.
Over the long- or medium-term, excessive drinking can significantly alter the levels of these brain chemicals. This causes the body to crave alcohol in order to feel good and avoid feeling bad.
Possible risk factors:
Some risk factors may also be linked to excessive drinking.
- Genes: Some specific genetic factors may make some people more likely to develop an addiction to alcohol and other substances. There may be a family history.
- The age of the first alcoholic drink: A study has suggested that people who start drinking alcohol before the age of 15 years may be more likely to have problems with alcohol later in life.
- Easy access: There appears to be a correlation between easy access to alcohol — such as cheap prices — and alcohol abuse and alcohol-related deaths. One study registered a significant drop in alcohol-related deaths after one state raised alcohol taxes. The effect was found to be nearly two to four times that of other prevention strategies, such as school programs or media campaigns.
- Stress: Some stress hormones are linked to alcohol abuse. If stress and anxiety levels are high, a person may consume alcohol in an attempt to blank out the upheaval.
- Peer drinking: People whose friends drink regularly or excessively are more likely to drink too much. They can eventually lead to alcohol-related problems.
- Low self-esteem: Those with low self-esteem who have alcohol readily available are more likely to consume too much.
- Depression: People with depression may deliberately or unwittingly use alcohol as a means of self-treatment. On the other hand, consuming too much alcohol may increase the risk of depression, rather than reducing it.
- Media and advertising: In some countries, alcohol is portrayed as a glamorous, worldly, and cool activity. Alcohol advertising and media coverage may increase the risk by conveying 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 developing health problems related to alcohol.
More Risk Factors:
Too many people are dying, and too many families are suffering from watching a loved one on his or her journey to an early death. The mood changes, sad, happy depressed, and yes suicidal. I will repeat myself, my words may be redundant but I am an alcoholic, and I do not want to go back to being sick again. Yes, I will repeat, I am scared.
Alcohol use may begin in the teens, but alcohol use disorder occurs more frequently in the 20s and 30s, though it can start at any age.
- Steady drinking over time. Drinking too much on a regular basis for an extended period or binge drinking on a regular basis can lead to alcohol-related problems or alcohol use disorder.
- Starting at an early age. People who begin drinking — especially binge drinking — at an early age are at a higher risk of alcohol use disorder.
- Family history. The risk of alcohol use disorder is higher for people who have a parent or other close relative who has problems with alcohol. This may be influenced by genetic factors.
- Depression and other mental health problems. It’s common for people with mental health disorders such as anxiety, depression, schizophrenia, or bipolar disorder to have problems with alcohol or other substances.
- History of trauma. People with a history of emotional or other trauma are at increased risk of alcohol use disorder.
- Having bariatric surgery. Some research studies indicate that having bariatric surgery may increase the risk of developing an alcohol use disorder or relapsing after recovering from an alcohol use disorder.
- Social and cultural factors. Having friends or a close partner who drinks regularly could increase your risk of alcohol use disorder. The glamorous way that drinking is sometimes portrayed in the media also may send the message that it’s OK to drink too much. For young people, the influence of parents, peers, and other role models can impact risk.
For AUD to be diagnosed in the U.S., the individual must meet the criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APS).
The criteria include having a pattern of consumption that leads to considerable impairment or distress.
At least three of the following criteria should have been present during the past 12 months:
- Alcohol tolerance: A person needs a large quantity of alcohol to feel intoxicated. However, when the liver is damaged and cannot metabolize the alcohol so well, this tolerance may drop. Damage to the central nervous system may also reduce tolerance levels.
- Withdrawal symptoms: When the individual abstains from alcohol or cuts down, they experience tremors, insomnia, nausea, or anxiety. They may drink more to avoid these symptoms.
- Beyond intentions: The person drinks more alcohol, or over a longer period than they intended.
- Unsuccessful attempts to cut down: The person is continuously trying to cut down alcohol consumption but does not succeed. They may have a persistent desire to cut down.
- Time consumed: The person spends a lot of time obtaining, using, or recovering from alcohol consumption.
- Withdrawal: The individual withdraws from recreational, social, or occupational activities that they previously participated in.
- Persistence: The person continues consuming alcohol, even though they know it is harming them physically and psychologically.
Some signs and symptoms of alcohol abuse may be due to another condition. Aging can lead to memory problems and falls, for example.
A person may go to the doctor about a medical condition, such as a digestive problem, and not mention how much alcohol they consume. This can make it difficult for a doctor to identify who might benefit from alcohol dependency screening.
If a health worker suspects alcohol may be a problem, they may ask a series of questions. If the patient answers in a certain way, the doctor may then use a standardized questionnaire to find out more.
Complications of this condition may include memory loss, confusion, mental health issues, and problems with work or home life.
Drinking alcohol usually elevates a person’s mood at first.
However, a person who has been consuming unhealthy amounts of alcohol for a long time is likely to become sedated when they drink.
This is because alcohol depresses the nervous system.
Alcohol may undermine a person’s judgment. It can lower inhibitions and alter the drinker’s thoughts, emotions, and general behavior.
Heavy regular drinking can seriously affect a person’s ability to coordinate their muscles and speak properly.
Heavy binge drinking could lead to a coma.
Eventually, regular heavy drinking may cause at least one of the following problems:
- Fatigue: The person feels tired most of the time.
- Memory loss: Alcohol affects short-term memory in particular.
- Eye muscles: The eye muscles can become significantly weaker.
- Liver diseases: There is a higher chance of developing hepatitis and cirrhosis, an irreversible and progressive condition.
- Gastrointestinal complications: Gastritis or pancreas damage can occur. These will undermine the body’s ability to digest food, absorb certain vitamins, and produce hormones that regulate metabolism.
- Hypertension: Regular heavy drinking is likely to raise blood pressure.
- Heart problems: There is a higher risk of cardiomyopathy (damaged heart muscle), heart failure, and stroke.
- Diabetes: There is a high risk of developing diabetes type 2, and people with diabetes have a high chance of complications if they regularly consume more alcohol than is recommended. Alcohol prevents the release of glucose from the liver, resulting in hypoglycemia. If a person with diabetes is already using insulin to lower their blood sugar levels, hypoglycemia could have serious consequences.
- Menstruation: Excessive consumption of alcohol can stop or disrupt menstruation.
- Erectile dysfunction: There may be problems getting or sustaining an erection.
- Fetal alcohol syndrome: Consuming alcohol during pregnancy increases the risk of birth defects. The newborn may have a small head, heart problems, shortened eyelids, and developmental and cognitive problems.
- Thinning bones: Alcohol interferes with the production of new bone, leading to a thinning of the bones and an increased risk of fractures.
- Nervous system problems: There may be numbness in the extremities, dementia, and confused or disordered thinking.
- Cancer: There is a higher risk of developing several cancers, including cancer of the mouth, esophagus, liver, colon, rectum, breast, prostate, and pharynx.
- Accidents: There is a higher chance of injuries from falls, road traffic accidents, and so on.
- Domestic abuse: Alcohol is a major factor in spouse beating, child abuse, and conflicts with neighbors.
- Work or school problems: Employment or educational problems and unemployment are often alcohol-related.
- Suicide: Suicide rates among people with alcohol dependence or who consume alcohol inappropriately are higher than among those who do not.
- Mental illness: Alcohol abuse increases the risk of mental illness, and it can make existing mental illnesses worse.
- Problems with the law: People who consume alcohol are significantly more likely to spend time in court or in prison, compared with the rest of the population.
Later on, I will be talking about treatment. Personally, I do not think there is anything that can be considered a treatment for the elimination of alcoholism. I was an alcoholic and knew that if I picked up any addictive substance, I would end up going back to drinking alcohol. I have to watch out for cough mixtures, Tylenol with codeine (Tylenol 3). There is no cure, only permanent and absolute abstinence. Yes, I am fearful I may pick up a trigger. I have to watch out for what kind of social functions I attend.
What causes it?
The cause of alcohol use disorder is still unknown. Alcohol use disorder develops when you drink so much that chemical changes in the brain occur. These changes increase the pleasurable feelings you get when you drink alcohol. This makes you want to drink more often, even if it causes harm.
Eventually, the pleasurable feelings associated with alcohol use go away and the person with alcohol use disorder will engage in drinking to prevent withdrawal symptoms. These withdrawal symptoms can be quite unpleasant and even dangerous.
Alcohol use disorder typically develops gradually over time. It’s also known to run in families. It has not been proven but it is supposed to attack the males in the family. Indications imply it may skip one generation. Within this said family it may skip all the females. This is not conclusive but it happens all too often to be dismissed.
How is it treated?
Treatment for alcohol use disorder varies, but each method is meant to help you stop drinking altogether. This is called abstinence. Treatment may occur in stages and can include the following:
- detoxification or withdrawal to rid your body of alcohol
- rehabilitation to learn new coping skills and behaviors
- counseling to address emotional problems that may cause you to drink
- support groups, including 12-step programs such as Alcoholics Anonymous (AA)
- Medical treatment for health problems associated with an alcohol use disorder
- medications to help control addiction
There are a couple of different medications that may help with alcohol use disorder:
- Naltrexone (ReVia) is used only after someone has detoxed from alcohol. This type of drug works by blocking certain receptors in the brain that are associated with the alcoholic “high.” This drug, in combination with counseling, may help decrease a person’s craving for alcohol.
- Acamprosate is a medication that can help reestablish the brain’s original chemical state before alcohol dependence. This drug should also be combined with therapy.
- Disulfiram (Antabuse) is a drug that causes physical discomfort (such as nausea, vomiting, and headaches) any time the person consumes alcohol.
You may need to seek treatment at an inpatient facility if your addiction to alcohol is severe. These facilities will provide you with 24-hour care as you withdraw from alcohol and recover from your addiction. Once you’re well enough to leave, you’ll need to continue to receive treatment on an outpatient basis.
What’s the outlook for a person with alcohol use disorder?
Recovering from alcohol use disorder is difficult. Your outlook will depend on your ability to stop drinking. Many people who seek treatment are able to overcome the addiction. A strong support system is helpful for making a complete recovery.
Your outlook will also depend on the health complications that have developed as a result of your drinking. Alcohol use disorder can severely damage your liver. It can also lead to other health complications, including:
- bleeding in the gastrointestinal (GI) tract
- damage to brain cells
- cancer in the GI tract
- high blood pressure
- Pancreatitis (inflammation of the pancreas)
- nerve damage
- changes in mental status, including Wernicke-Korsakoff syndrome (a brain disease that causes symptoms such as confusion, vision changes, or memory loss)
Alcoholism is a result of a combination of genetic, psychological, environmental, and social factors. The more risk factors a person exhibits, the more likely they are to become an alcoholic. And sometimes those risk factors are entirely out of the person’s control. Let’s cover some of them below:
1. STRESSFUL ENVIRONMENTS
While not every person turns to alcohol to relieve stress, some people do. When a person has a stressful job, for example, they may be more likely to drink heavily. This is often the case with certain occupations such as doctors and nurses – their day-to-day lives can be extremely stressful. To lower this risk factor, take the time to de-stress with healthy methods, like reading a good book, exercising, or taking a nap.
Eight percent of high school students have reported binge drinking alcohol to the point of vomiting.
Twelve percent of students have reported participating in a drinking game with their peers.
2. DRINKING AT AN EARLY AGE
According to the Mayo Clinic, those who begin drinking at an early age are more likely to have an alcohol problem or a physical dependence on alcohol as they get older. Not only is this because drinking may become a comfortable habit but also because the body’s tolerance levels may increase.
3. MENTAL HEALTH PROBLEMS LIKE DEPRESSION
Anxiety, depression, bipolar disorder, or other mental health issues can increase the risk of alcoholism. It’s easy to turn to alcohol when a person is feeling anxious or depressed – and the effects of alcohol may seem to temporarily ease those feelings. They can resort to drinking more and more, leading to alcohol addiction.
4. TAKING ALCOHOL WITH MEDICINE
Some medicines can increase the toxic effects of alcohol on the body. When a person continually takes alcohol with their medications, they may become addicted to the effects that follow – some of which have the capability to be very dangerous and even life-threatening.
5. FAMILY HISTORY
If you have a parent or other relative who is an alcoholic, your risk of alcoholism automatically increases. Part of this is due to genetics, but the other part has to do with your environment. Spending time around people who drink heavily or abuse alcohol can influence you to do the same.
Multiple factors can play a role in a person’s risk of alcoholism. While the above may not directly be considered “causes” of alcoholism, they can play a role in its development. It’s important to understand your risk and do what you can to lower it as much as possible.
- More than 15 million people struggle with an alcohol use disorder in the United States, but less than eight percent of those receive treatment.
- More than 65 million Americans reported binge drinking in the past month, which is more than 40 percent of the total of current alcohol users.
- Teen alcohol use kills 4,700 people each year. That’s more than all illegal drugs combined.
- Drunk driving costs the United States more than $199 billion every year.
ALCOHOL AND WOMEN:
- According to the National Institute on Alcohol Abuse and Alcoholism, more than 5.3 million women ages 18 and older have an alcohol use disorder.
- Approximately one in two women of child-bearing age drink, and 18 percent of women in this group binge drink (five drinks per binge, on average).
- Excessive drinking can interrupt the menstrual cycle and lead to infertility.
- Women who binge drink are more likely to have unprotected sex, increasing the risk of unintended pregnancy and sexually transmitted diseases.
- Women who drink while pregnant increase the risk of fetal alcohol syndrome, which can cause mental and physical birth defects.
- Binge drinking dramatically increases the risk of sexual assault on women, especially those living in a college setting.
- More than 45 percent of adult women report drinking alcohol in the last month, and 12 percent of these report binge drinking.
- Alcohol abuse disorder in women has increased by 83.7% between 2002 and 2013, according to a 2017 study sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
- High-risk drinking, defined as more than three drinks in a day or seven in a week for women, is on the rise among women by about 58%, according to a 2017 study comparing habits from 2001-2002 and 2012-2013.
- Death from liver cirrhosis rose in women from 2017 to 2020.
The rapid increase in deaths due to alcohol-related liver disease:
The deaths linked to the end stages of liver damage jumped by 65 percent with alcohol a major cause, adults aged 25-34 the biggest victims, and fatalities highest among whites, American Indians, and Hispanics.
Liver specialist Elliot B. Tapper, M.D., says he’s witnessed the disturbing shift in demographics among the patients with liver failure he treats at Michigan Medicine. National data collected by Tapper and study co-author Neehar Parikh, M.D., M.S., confirms that in communities across the country, more young people are drinking themselves to death.
The data published in the journal BMJ shows adults aged 25-34 experienced the highest average annual increase in cirrhosis deaths — about 10.5 percent each year. The rise was driven entirely by alcohol-related liver disease, the authors say.
Other Treatments for Alcohol Addiction:
Acupuncture for Alcohol Addiction:
Acupuncture (a needle-based therapy long used in traditional Chinese medicine) is often recommended to help reduce alcohol cravings, relieve withdrawal symptoms, and ease the anxiety and depression frequently experienced by alcoholics.
Indeed, a 2002 study of 34 alcoholics found that two weeks of acupuncture treatments (combined with carbamazepine, a drug sometimes used in managing alcohol withdrawal) helped decrease the participants’ withdrawal symptoms. However, a systematic review published in 2009 concluded that there is insufficient evidence to support acupuncture’s effectiveness in alcoholism treatment.
Detoxing Herbs for the Liver & Blood:
Herbs to Overcome Cravings:
Kudzu is one of the oldest known herbal medicines, used in Traditional Chinese Medicine for reducing the craving for alcohol and as a hangover cure. A recent Harvard Medical School study corroborates this use.
More at Home Help:
If using natural methods to home-detox, take a dose of a vitamin-B complex, plus a thiamine (vitamin B1) supplement and large doses of vitamin C, selenium, magnesium, and zinc. A combination of amino acids or a large dose of L-glutamine will help combat cravings.
Milk thistle and alpha-lipoic acid supplements can help the liver recover after prolonged alcohol abuse.
An over-the-counter sleep remedy such as melatonin or valerian can help with insomnia brought on by alcohol withdrawal.
Abruptly stopping drinking when you have withdrawal symptoms is not advisable without medication. For hundreds of years, long before medications were available, people have successfully used alcohol for alcohol withdrawal symptoms. The optimal drink to use is beer, as anything stronger will likely lead to drunkenness.
The idea is to drink small amounts of beer, tapering down gradually until all possibilities of suffering withdrawal symptoms have passed. Usually, within 24 to 48 hours the patient is able to stop drinking the beer safely.
The amount of beer will depend on each individual. Generally, 12 ounces every hour is a reasonable starting point, then slowly reduce the amount of beer, or increase the amount of time between taking the beer. After three hours, you should be able to safely take only 8 ounces per hour, which can then be reduced to 4 ounces every two or three hours.
Combine the beer tapering with your vitamin supplements, and drink plenty of water. Lemon juice added to the water will also help your body detox.
Eat only light foods, such as fresh fruits or vegetables, and then only if you feel hungry. Do not force food because you feel you should be eating. Your body has enough to cope with eliminating the alcohol, and it will let you know when it feels ready for food. By eating before your body is ready, you are simply putting more of a burden on overworked organs.
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