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Alcoholism
Other namesAlcohol dependence syndrome, alcohol use disorder (AUD)[1]
"King Alcohol and His Prime Minister" c. 1820
SpecialtyPsychiatry, toxicology, addiction medicine
SymptomsDrinking large amounts of alcohol over a long period, difficulty cutting down, acquiring and drinking alcohol taking up a lot of time, usage resulting in problems, withdrawal occurring when stopping[2]
ComplicationsMental illness, delirium, Wernicke–Korsakoff syndrome, irregular heartbeat, cirrhosis of the liver, cancer, fetal alcohol spectrum disorder, suicide[3][4][5][6]
DurationLong term[2]
CausesEnvironmental and genetic factors[4]
Risk factorsStress, anxiety, inexpensive, easy access[4][7]
Diagnostic methodQuestionnaires, blood tests[4]
TreatmentAlcohol detoxification typically with benzodiazepines, counselling, acamprosate, disulfiram, naltrexone[8][9][10]
Frequency208 million / 4.1% adults (2010)[11][12]
Deaths3.3 million / 5.9%[13]

Alcoholism, also known as alcohol use disorder (AUD),[1] is, broadly, any drinking of alcohol that results in mental or physical health problems.[14][2][4] The disorder was previously divided into two types: alcohol abuse and alcohol dependence.[2][15] 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.[2] Alcohol use can affect all parts of the body, but it particularly affects the brain, heart, liver, pancreas and immune system.[4][5] Alcoholism can result in mental illness, delirium tremens, Wernicke–Korsakoff syndrome, irregular heartbeat, an impaired immune response, liver cirrhosis and increased cancer risk.[4][5][16] Drinking during pregnancy can result in fetal alcohol spectrum disorders.[3] Women are generally more sensitive than men to the harmful effects of alcohol, primarily due to their smaller body weight, lower capacity to metabolize alcohol, and higher proportion of body fat.[11]

Environmental factors and genetics are two components associated with alcoholism, with about half the risk attributed to each.[4] Someone with a parent or sibling with alcoholism is three to four times more likely to become an alcoholic themselves.[4] Environmental factors include social, cultural and behavioral influences.[17] High stress levels and anxiety, as well as alcohol's inexpensive cost and easy accessibility, increase the risk.[4][7] People may continue to drink partly to prevent or improve symptoms of withdrawal.[4] After a person stops drinking alcohol, they may experience a low level of withdrawal lasting for months.[4] Medically, alcoholism is considered both a physical and mental illness.[18][19] Questionnaires and certain blood tests may detect possible alcoholism.[4][20] Further information is then collected to confirm the diagnosis.[4] Recommendations include no more than 2 drinks per week.[21]

Prevention of alcoholism may be attempted by regulating and limiting the sale of alcohol, taxing alcohol to increase its cost, and providing inexpensive treatment.[22] Treatment of alcoholism may take several forms.[9] Due to medical problems that can occur during withdrawal, alcohol detoxification should be carefully controlled.[9] One common method involves the use of benzodiazepine medications, such as diazepam.[9] These can be either given while admitted to a health care institution or occasionally while a person remains in the community with close supervision.[9] Mental illness or other addictions may complicate treatment.[23] After detoxification, group therapy or support groups are used to help keep a person from returning to drinking.[8][24] One commonly used form of support is the group Alcoholics Anonymous.[25] The medications acamprosate, disulfiram or naltrexone may also be used to help prevent further drinking.[10]

The World Health Organization has estimated that as of 2010, there were 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age).[11][12] As of 2015 in the United States, about 17 million (7%) of adults and 0.7 million (2.8%) of those age 12 to 17 years of age are affected.[13] Alcoholism is most common among males and young adults, and is less common in middle and old age.[4] Geographically, it is least common in Africa (1.1% of the population) and has the highest rates in Eastern Europe (11%).[4] Alcoholism directly resulted in 139,000 deaths in 2013, up from 112,000 deaths in 1990.[26] A total of 3.3 million deaths (5.9% of all deaths) are believed to be due to alcohol.[13] Alcoholism reduces a person's life expectancy by approximately ten years.[27] Many terms, some insulting and others informal, have been used to refer to people affected by alcoholism; the expressions include tippler, drunkard, dipsomaniac and souse.[28] In 1979, the World Health Organization discouraged the use of "alcoholism" due to its inexact meaning, preferring "alcohol dependence syndrome".[29]

References[edit]

  1. ^ a b "Alcoholism MeSH Descriptor Data 2020". meshb.nlm.nih.gov. Archived from the original on 23 June 2020. Retrieved 9 May 2020.
  2. ^ a b c d e "Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5". November 2013. Archived from the original on 18 May 2015. Retrieved 9 May 2015.
  3. ^ a b "Fetal Alcohol Exposure". 14 September 2011. Archived from the original on 4 April 2015. Retrieved 9 May 2015.
  4. ^ a b c d e f g h i j k l m n o p Association, American Psychiatric (2013). Diagnostic and statistical manual of mental disorders : DSM-5 (5 ed.). Washington, DC: American Psychiatric Association. pp. 490–97. ISBN 978-0-89042-554-1.
  5. ^ a b c "Alcohol's Effects on the Body". 14 September 2011. Archived from the original on 3 June 2015. Retrieved 9 May 2015.
  6. ^ Borges, G; Bagge, CL; Cherpitel, CJ; Conner, KR; Orozco, R; Rossow, I (April 2017). "A meta-analysis of acute use of alcohol and the risk of suicide attempt". Psychological Medicine. 47 (5): 949–957. doi:10.1017/S0033291716002841. PMC 5340592. PMID 27928972.
  7. ^ a b Moonat, S; Pandey, SC (2012). "Stress, epigenetics, and alcoholism". Alcohol Research : Current Reviews. 34 (4): 495–505. PMC 3860391. PMID 23584115.
  8. ^ a b Morgan-Lopez, AA; Fals-Stewart, W (May 2006). "Analytic complexities associated with group therapy in substance abuse treatment research: problems, recommendations, and future directions". Exp Clin Psychopharmacol. 14 (2): 265–73. doi:10.1037/1064-1297.14.2.265. PMC 4631029. PMID 16756430.
  9. ^ a b c d e Blondell, RD (February 2005). "Ambulatory detoxification of patients with alcohol dependence". Am Fam Physician. 71 (3): 495–502. PMID 15712624.
  10. ^ a b Testino, G; Leone, S; Borro, P (December 2014). "Treatment of alcohol dependence: recent progress and reduction of consumption". Minerva Medica. 105 (6): 447–66. PMID 25392958.
  11. ^ a b c Global status report on alcohol and health 2014 (PDF). World Health Organization. 2014. pp. 8, 51. ISBN 978-92-4-069276-3. Archived (PDF) from the original on 13 April 2015.
  12. ^ a b "Global Population Estimates by Age, 1950–2050". 30 January 2014. Archived from the original on 10 May 2015. Retrieved 10 May 2015.
  13. ^ a b c "Alcohol Facts and Statistics". Archived from the original on 18 May 2015. Retrieved 9 May 2015.
  14. ^ Littrell, Jill (2014). Understanding and Treating Alcoholism Volume I: An Empirically Based Clinician's Handbook for the Treatment of Alcoholism: Volume Ii: Biological, Psychological, and Social Aspects of Alcohol Consumption and Abuse. Hoboken: Taylor and Francis. p. 55. ISBN 978-1-317-78314-5. Archived from the original on 20 July 2017. The World Health Organization defines alcoholism as any drinking which results in problems
  15. ^ Hasin, Deborah (December 2003). "Classification of Alcohol Use Disorders". Alcohol Research & Health : The Journal of the National Institute on Alcohol Abuse and Alcoholism. 27 (1): 5–17. PMC 6676702. PMID 15301396. Archived from the original on 18 March 2015. Retrieved 28 February 2015.
  16. ^ Romeo, Javier; Wärnberg, Julia; Nova, Esther; Díaz, Ligia E.; Gómez-Martinez, Sonia; Marcos, Ascensión (October 2007). "Moderate alcohol consumption and the immune system: a review". The British Journal of Nutrition. 98 Suppl 1: S111–115. doi:10.1017/S0007114507838049. ISSN 0007-1145. PMID 17922947.
  17. ^ Agarwal-Kozlowski, K; Agarwal, DP (April 2000). "[Genetic predisposition for alcoholism]". Ther Umsch. 57 (4): 179–84. doi:10.1024/0040-5930.57.4.179. PMID 10804873.
  18. ^ Mersy, DJ (1 April 2003). "Recognition of alcohol and substance abuse". American Family Physician. 67 (7): 1529–32. PMID 12722853.
  19. ^ "Health and Ethics Policies of the AMA House of Delegates" (PDF). June 2008. p. 33. Archived (PDF) from the original on 20 March 2015. Retrieved 10 May 2015. H-30.997 Dual Disease Classification of Alcoholism: The AMA reaffirms its policy endorsing the dual classification of alcoholism under both the psychiatric and medical sections of the International Classification of Diseases. (Res. 22, I-79; Reaffirmed: CLRPD Rep. B, I-89; Reaffirmed: CLRPD Rep. B, I-90; Reaffirmed by CSA Rep. 14, A-97; Reaffirmed: CSAPH Rep. 3, A-07)
  20. ^ Higgins-Biddle, John C.; Babor, Thomas F. (2018). "A Review of the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and USAUDIT for Screening in the United States: Past Issues and Future Directions". The American Journal of Drug and Alcohol Abuse. 44 (6): 578–586. doi:10.1080/00952990.2018.1456545. ISSN 0095-2990. PMC 6217805. PMID 29723083.
  21. ^ "New guidance on alcohol and health from the Canadian Centre on Substance Use and Addiction | This Changed My Practice (TCMP) by UBC CPD". thischangedmypractice.com. Archived from the original on 27 March 2024. Retrieved 24 March 2024.
  22. ^ World Health Organization (January 2015). "Alcohol". Archived from the original on 23 May 2015. Retrieved 10 May 2015.
  23. ^ DeVido, JJ; Weiss, RD (December 2012). "Treatment of the depressed alcoholic patient". Current Psychiatry Reports. 14 (6): 610–08. doi:10.1007/s11920-012-0314-7. PMC 3712746. PMID 22907336.
  24. ^ Albanese, AP (November 2012). "Management of alcohol abuse". Clinics in Liver Disease. 16 (4): 737–62. doi:10.1016/j.cld.2012.08.006. PMID 23101980.
  25. ^ Tusa, AL; Burgholzer, JA (2013). "Came to believe: spirituality as a mechanism of change in alcoholics anonymous: a review of the literature from 1992 to 2012". Journal of Addictions Nursing. 24 (4): 237–46. doi:10.1097/jan.0000000000000003. PMID 24335771.
  26. ^ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442. {{cite journal}}: |first1= has generic name (help)CS1 maint: numeric names: authors list (link)
  27. ^ Schuckit, MA (27 November 2014). "Recognition and management of withdrawal delirium (delirium tremens)". The New England Journal of Medicine. 371 (22): 2109–13. doi:10.1056/NEJMra1407298. PMID 25427113. Archived from the original on 13 February 2020. Retrieved 26 June 2020.
  28. ^ Chambers English Thesaurus. Allied Publishers. p. 175. ISBN 978-81-86062-04-3. Archived from the original on 25 July 2020. Retrieved 26 June 2020.
  29. ^ WHO. "Lexicon of alcohol and drug terms published by the World Health Organization". World Health Organization. Archived from the original on 5 February 2013.
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