Chronic Alcoholism : Signs & Treatment
Medically Reviewed by Dr Sravya, MBBS, MS
Introduction
Alcoholism is a chronic, genetic, psychological, and environmental illness characterized by excessive drinking and obsession. It leads to physical and emotional reliance on the drug, causing symptoms like recurrent drinking. Treatment of chronic alcoholism includes counseling, detoxification programs, and medications to reduce the desire to drink. One of the signs is continued alcohol use despite the health and legal issues that are connected to it.
Alcoholism can cause people to start their days with a drink, feel bad about how much they drink, and want to drink less. Alcohol, also known as ethanol, is a depressant found in drinks like beer, wine, and distilled spirits. It is a common recreational drug, causing effects like drunkenness and depression. However, it can cause neurocognitive impairment, dizziness, nausea, vomiting, hangover-like symptoms, and addiction. Alcohol increases GABA (Gamma-aminobutyric acid), a major inhibitory neurotransmitter, and has significant societal and cultural significance.
Introduction
Alcoholic beverages, made from fermented sugars, are regulated by nations for their production, sale, and consumption. While some countries prohibit such behavior, alcohol is generally legal elsewhere. In moderation, alcohol promotes exhilaration and social interaction, but higher doses can lead to intoxication, stupor, unconsciousness, or death. Long-term alcohol use increases the risk of cardiovascular disease, cancer, physical dependence, and alcohol use disorders.
Alcohol is considered the highest-risk-group carcinogen by the World Health Organization and is not considered safe for consumption. The Centers for Disease Control and Prevention advises against starting alcohol consumption, as moderate drinking has no positive health benefits. Alcohol is a widely used recreational drug, with 33% of humans currently drinking it. In 2015, 86% of Americans had consumed alcohol at some point. Alcoholic drinks, typically between 3% and 50%, have been consumed by humans since the Neolithic period.
Composition
Alcohol, also known as ethanol, is a depressant drug found in drinks like beer, wine, and distilled spirits. It is one of the oldest and most commonly consumed recreational drugs, causing the characteristic effects of drunkenness. Alcohol produces happiness, euphoria, decreased anxiety, increased sociability, sedation, impairment of cognitive, memory, motor, and sensory function, and generalized depression of central nervous system function. Ethanol is the only type found in alcoholic beverages or commonly used for recreational purposes.
Alcohol has short-term and long-term adverse effects, including generalized neurocognitive function impairment, dizziness, nausea, vomiting, and hangover-like symptoms. It is addictive and can result in alcohol use disorder, dependence, and withdrawal. Alcohol works in the brain by increasing the effects of γ-Aminobutyric acid (GABA), the major inhibitory neurotransmitter in the brain. It has significant societal and cultural significance and has important social roles in much of the world.1
Main Elements of Chronic Alcoholism
Signs of chronic alcoholism are:
- Craving alcohol
- Physical dependence—if the person does not drink, they will start to feel uncomfortable and sometimes life-threatening withdrawal symptoms
- Forbearance- over time it'll take further and further alcohol to reach the same position of intoxication.
Other signs of a possible problem with alcohol use are academic or employment issues, getting into dangerous situations due to alcohol use, Family or friends problems caused by alcohol consumption, and continued consumption despite adverse legal effects.
Health Risk of Chronic Alcoholism
Regularly drinking large amounts of alcohol, typically 4 or more drinks per day or week, can lead to physical and mental negative effects, affecting both men and women. Maintaining a healthy lifestyle is crucial.
- Alcohol can cause liver damage by killing liver cells, leading to cirrhosis, and long-term heavy use may result in alcoholic fatty liver disease, indicating impaired liver function.
- Heavy drinkers are more likely to experience heart disease, high fat and cholesterol levels, and difficulty pumping blood to the heart, increasing their risk of death.
- Alcohol impacts brain communication, making it difficult to think, speak, remember, and move, and can cause mental health issues like depression and dementia.
- Anemia occurs when the body lacks healthy red blood cells, leading to ulcers and inflammation. Excessive alcohol consumption can also cause meal skips, shortening iron levels.
- Heavy alcohol use is linked to various cancers, damaging cells in the mouth, throat, voice box, esophagus, liver, breast, and intestines, and facilitating the entry of cancer-causing chemicals.
- Long-term alcohol abuse can increase the threat of epilepsy, and heavy alcohol pullout after heavy drinking can also beget seizures.
- Gout is arthritis caused by excessive consumption of purines, including red meat, shellfish, and alcohol, which can lead to painful joint inflammation.
- Heavy drinking can hinder immune cells’ fight against viruses and bacteria and can harm the liver, which produces antibacterial proteins crucial for the immune system.
- Alcohol can cause digestive problems, including inflammation in the stomach, esophagus, and gut, making it difficult to digest nutrients like B12 and thiamine, and leading to pancreatitis, a condition affecting insulin production and increasing diabetes risk.
- Drinking excessively can disrupt sleep quality, increase snoring, and sleep apnea, making it difficult to get a good night's rest.2
Alcoholism Stages: Early, Chronic, and End Stage
Alcoholism, a mental health disorder, is identified by the DSM-5, a nonclinical term used by professionals. Understanding its stages can help prevent dependence and addiction, as it stems from long-term abuse.
- Stage 1: Alcoholism involves occasional abuse and binge drinking, often seen in young adults, testing limits and potentially leading to coma or death.
- Stage 2: Alcohol consumption leads to increased social gatherings, stress relief, boredom, and loneliness, with emotional attachment and increased dependence, increasing alcoholism risk.
- Stage 3: Problem drinking involves uncontrolled alcohol abuse, causing negative impacts like depression, anxiety, sleep loss, increased risk of driving or legal troubles, and social changes.
- Stage 4: Alcohol dependence disrupts regular routines, leading to increased drinking and tolerance, characterized by withdrawal symptoms like hangover nausea, body tremors, sweating, irritability, racing heart, and trouble sleeping.
- Stage 5: Alcoholism involves addiction, characterized by physical and psychological cravings, and compulsive behaviors, and may also involve drug addiction.
Chronic Alcoholism : Signs & Treatment
Treatment of chronic alcoholism problems can be treated through various methods, including 12-step programs and inpatient rehab. However, there is no one-size-fits-all solution, and understanding these options is crucial for a successful recovery.
Treatment types:
- Behavior modification: Through therapy, behavioral treatments try to alter a person's drinking habits. Health specialists oversee them, and studies showing their positive potential support them.
- Behavioral remedy, also known as alcohol comforting, involves working with healthcare professionals to identify and change binge drinking actions, develop quit chops, make social support, set attainable pretensions, and address triggers.
Types of behavioral therapy
- Cognitive-behavioral therapy, conducted individually or in small groups, aims to identify triggers for binge drinking and manage stress, focusing on changing thought processes and developing alcohol-related problem-solving skills.
- Motivational enhancement therapy is a short-term treatment for changing drinking habits, focusing on identifying strengths and weaknesses, developing a plan, building self-confidence, and developing skills. Family counseling is also involved.
- Family therapy, when supported by strong family relationships, has been shown to increase the likelihood of patients staying abstinent from alcohol compared to individual counseling.
- A brief intervention is a counseling session focused on an individual's drinking behavior, involving personal feedback, goal setting, and motivational support. Treatment decisions are more important than the chosen approach, avoiding confrontation.
Medications : Some people are shocked to find that there are drugs on the market that have been approved to treat alcoholism. The most recent versions of these drugs counteract the alterations brought on by AUD in the brain. All medicines that have been approved are non-addictive and may be used alone or in conjunction with other types of therapy. Find out more about these prescribed medications.
Three medications have been given the green light in the US to help people reduce their alcohol use and prevent relapse. They are prescribed by a primary care doctor or other healthcare professional and can be taken either alone or in conjunction with psychotherapy.
Certain drugs are effective in stopping or reducing alcohol use and in preventing relapses, following are some medications approved by FDA.
- Naltrexone helps reduce heavy drinking.
- Acamprosate makes it less complicated to preserve abstinence.
- Disulfiram interferes with the breakdown (metabolism) of alcohol in the body, causing unpleasant symptoms such as nausea and flushed skin. These unpleasant effects may prevent some people from drinking alcohol while taking disulfiram.
The treatment of chronic alcoholism includes drugs, but not everyone responds to drugs, it’s important to remember that for some people, drugs can be an important tool in overcoming alcoholism. Scientists are working to develop a wide range of pharmaceutical treatments tailored to individual needs. As more drugs become available, people may be able to try multiple drugs to see which works best. Alcohol should be avoided while taking disulfiram.
Types of Professionals Involved in Care
Numerous health professionals can play a part in treatment. Below you will find a list of providers, as well as the types of services they may provide.
Provider Type | Degrees & Credentials | Treatment Type |
|---|---|---|
Primary Care Provider | M.D., D.O. | Medications, Brief Behavioral Treatment, Referral to Specialist |
Psychiatrist
| M.D., D.O. | Medications, Behavioral Treatment |
Psychologist | Psychologist | Psychologist |
Ph.D., Psy.D., M.A. | Ph.D., Psy.D., M.A. | Ph.D., Psy.D., M.A.4 |
Summary:
Consuming alcohol in temperance can be part of a balanced salutary plan, and it may indeed give some health benefits. Still, habitual heavy drinking is mischievous to health and is associated with several health conditions. Inordinate alcohol input can damage multiple organs, affect the development of habitual conditions, and increase the threat of dangerous accidents. Similarly, people should try to drink responsibly. However, they should seek treatment from professional services and contact support groups for fresh help, If a person is apprehensive that they have an alcohol reliance problem.