ALCOHOLISM

DEFINITION

Alcoholism is the popular term for two disorders: alcohol abuse and alcohol dependence. The key element of these disorders is that a person's use of alcohol has repeatedly caused problems in his or her life. Alcoholism has serious consequences on a person's health and personal life, on family and friends, and on society at large.

DESCRIPTION

The effects of alcoholism on the body are quite far-reaching. Alcohol abuse can result in poor nutrition, memory disorders, difficulty with walking and balance, liver disease, high blood pressure, muscle weakness, heart problems, anemia (a blood disorder that causes weakness and fatigue; see anemias entry), problems with blood clotting, low resistance to infections, disorders of the digestive system, problems with the pancreas, low blood sugar, high blood fat content, reduced sexual abilities, reproductive problems, and weak bones.

Alcoholism can also lead to a number of personal problems, including depression, unemployment, family problems, and child abuse. The effects of alcoholism also extend to society at large. For example, alcohol is a contributing factor in about half of all deaths from motor vehicle accidents. The condition also causes or contributes to other social issues, such as homelessness, murder, suicide, injury, and violent crime. According to some estimates, more than $130 billion are spent each year in the United States to deal with alcohol-related problems.

CAUSES

Most scientists believe that alcoholism is caused by a number of factors including the physical make-up of a person, the environment in which they grew up, and other social and psychological reasons. One of the most important of these factors is heredity. Studies have shown that children who are born to alcoholic parents are four times more likely to become alcoholics than children who are not from alcoholic backgrounds. This trend holds true even when the children are raised away from their biological parents. Current research is being developed to identify other factors that contribute to alcoholism.

SYMPTOMS

The symptoms of alcoholism can be broken down into two major categories: symptoms of acute (immediate) alcohol use and symptoms of chronic (long-term) alcohol use.

Acute Effects of Alcohol Use

Any amount of alcohol that a person consumes goes quickly to the brain. There it exerts a numbing effect. An individual may experience mild mood swings, or have trouble walking or maintaining balance. He or she may not be able to speak clearly and may lose coordination. The loss of coordination accounts for the high rate of accidents involving alcoholism.

As the level of alcohol in a person's blood increases, physical problems become more serious. Heart and respiration (breathing) rates slow down. At high enough alcohol levels, a person may fall into a coma and even die.

Alcoholism: Words to Know

Dependence:

A state in which a person requires a steady amount of a particular drug in order to avoid experiencing the symptoms of withdrawal.

Detoxification:

The phase of treatment during which a patient stops drinking, and harmful chemicals are removed from his or her system.

Tolerance:

The condition under which a drug user becomes physically accustomed to a particular quantity of a drug, such as alcohol.

Withdrawal:

Those signs and symptoms experienced by a person who has become physically dependent on a drug, exhibited when the drug's dosage is decreased or discontinued.

Chronic Effects of Alcohol Use

Long-term use of alcohol can affect virtually every organ system of the body:

• Blood. Alcohol can cause changes in all kinds of blood cells. It can reduce the production of white blood cells, for example, which weakens a person's immune system. This means that an individual loses the ability to fight off disease and infection. Blood platelets (pronounced PLATE-lit; blood cells that help blood clot) can also be damaged, increasing the risk of bleeding.
• Gastrointestinal system. Alcohol exerts its effects on nearly every part of the digestive system. It can damage muscles in the stomach lining, allowing stomach acid to flow upwards and back into the esophagus (pronounced ee-SAH-fuh-guss). This action causes pain and bleeding in the esophagus, which is the tubal passage through which food moves from the throat to the stomach.
• Heart. High levels of alcohol in the blood can cause a number of problems in the heart and circulatory system. Heart size tends to increase, heart muscles become weaker, and abnormal heart rhythms begin to appear. All of these changes increase the risk of stroke (the blocking of a brain blood vessel by means of a blood clot; see stroke entry).
• Liver. Alcohol interferes with a number of important chemical reactions that take place in the liver. In order to combat this problem, the liver begins to enlarge and fill in with fat and scar tissue. These materials interfere with the liver's normal function and result in the diseases cirrhosis (pronounced suh-RO-suss) and hepatitis (pronounced hep-uh-TIE-tuss; see hepatitis entry). Both conditions can be fatal.
• Nervous system. Heavy drinking can cause blackouts and loss of memory. By some estimates 30 to 40 percent of all men in their teens and twenties have experienced an alcoholic blackout. Over time, alcohol abuse can also cause sleep disturbances and numbness and tingling in the arms and legs. Two major diseases of the nervous system are associated with alcohol abuse: Wernicke's syndrome and Korsakoff's syndrome. Both are caused by low thiamine (pronouonced THIE-uh-min), or B-vitamin, levels produced by excessive consumption of alcohol.
• Reproductive system. Heavy drinking has a tendency to reduce the size of both testicles and ovaries, the reproductive organs in men and women, respectively. As a result, there is a reduction in the number of sperm and eggs produced, which makes becoming pregnant more difficult.

TREATMENT

Treatment of alcoholism takes place in two steps: detoxification and rehabilitation. Detoxification involves helping a person to stop drinking and ridding his or her body of the harmful (toxic) effects of alcohol.

Detoxification and Withdrawal

Detoxification is often difficult because a person's body becomes accustomed to the intake of alcohol. When alcohol is no longer available, the body goes through a period known as withdrawal. The ease and success of withdrawal depends on the person's prior drinking habits. The amount of alcohol consumed on a regular basis and the length of time the person has been drinking determines the difficulty of the withdrawal process.

Mild withdrawal symptoms may include nausea, achiness, diarrhea, difficulty in sleeping, excessive sweating, trembling, and anxiety. These symptoms often disappear in less than a week. Patients going through a mild withdrawal usually require no medical attention other than observation to see that their symptoms do not become worse.

An individual who has been dependent on alcohol for a long period of time may experience more serious withdrawal symptoms. Such symptoms include fever, increased heart rate, high blood pressure, seizures, and hallucinations, which may take the form of delirium tremens (DT). A person suffering from DT has uncontrollable shaking, panic attacks (see panic disorders entry), and severe hallucinations. DT usually begin about three to five days after the patient's last drink and may last up to a week. During this time, the patient must be monitored.

Patients going through serious withdrawal generally require medical attention. For example, they are often given sedatives to avoid the potentially life-threatening consequences of high blood pressure, rapid heart rate, and seizures.

Rehabilitation

Rehabilitation may involve the use of both medications and recovery programs. Some chemicals act as a deterrent to drinking because when they interact with alcohol they produce nausea, vomiting, and other unpleasant physical effects. One drug that has been used with some positive results is disulfiram (pronounced di-SUL-fuh-ram; trade name Antabuse). Drugs by themselves are often not very effective, however, since they do not deal with some of the reasons that may have contributed to a person becoming an alcoholic.

Recovery programs help alcoholics to understand why they abuse alcohol and to find ways to avoid drinking in the future. Some of the most effective rehabilitation programs involve peer groups in which recovering alcoholics meet regularly and provide support for each other. Perhaps the best known of these groups is Alcoholics Anonymous (AA). The AA recovery program is based on a 12-step model. These steps include the need to recognize the destructive power that alcohol has over an alcoholic's life, the damage that alcoholism has done to others involved personally or professionally with the alcoholic, and the need to turn to a higher power for help in overcoming the problem.

PREVENTION

Prevention must begin at an early age. In the vast majority of cases, alcoholics begin drinking during their teenage years. Educational programs need to be aimed especially at those known to be at risk—those whose parents or other relatives are alcoholics. Efforts to develop effective prevention programs of this kind continue to be an issue within the United States's educational system.

EFFECTS OF ALCOHOL