Alcohol Dependence

Alcohol Dependence

Alcohol Dependence

AAlcohol use disorder (AUD) is, broadly speaking, any drinking of alcohol that results in mental and/or physical health problems. There can be plenty of confusion between the terms alcohol abuse, alcohol dependence, alcoholism, and AUD. AUD is often used interchangeably with alcoholism. AUD was previously divided into two types: alcohol abuse and alcohol dependence.

The following definitions are derived from the American Psychiatric Association Diagnostic and Statistical Manual Fourth Edition (DSM-4):

  1. Alcohol abuse = repeated alcohol use despite recurrent adverse consequences.
  2. Alcohol dependence = alcohol abuse + at least three of the following over a one-year period:
  • Tolerance – increasingly more amounts of alcohol needed to have the “hit”
  • Dependence
  • Physiological withdrawal – excessive sweating, vomiting, generalized aches and pains, and sleep disturbances
  • Drinking greater amounts of alcohol or over a longer period of time than originally intended
  • Unsuccessful attempts to reduce the amount of alcohol taken or an inability to control use
  • Great deal of time spent getting, drinking, or recovering from alcohol use
  • Social, occupational, or recreational activities given up or reduced – to the extent that one is unable to fulfil one’s responsibilities
  • Continued use despite knowledge of harmful physical or psychological consequences
  • An intense or strong drive to drink alcohol
  • Alcohol usage that results in risky situations

How much alcohol is too much?

NIAAA defines a standard drink as one 12-ounce bottle of beer, one 5-ounce glass of wine, or 1.5 ounces of distilled spirits. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), men may be at risk for alcohol-related problems if their alcohol consumption exceeds 14 standard drinks per week, and women may be at risk if they have more than 7 standard drinks per week.

Prevalence

In the United States, AUD affects approximately 7% of adults and 3% of people aged between 12 and 17 years, and it is more common in males than in females.

Causes of Alcohol abuse or dependency):

The exact cause of AUD remains unknown; however, genetic and environmental factors have both been implicated. A person with a first-degree relative — a parent or sibling — who has AUD is three to four times more likely to develop the condition him or herself.

Environmental factors include social, cultural, and behavioral influences. High stress levels and anxiety, as well as the low cost of alcohol and how easy it is to buy, are also factors that increase the risk of developing AUD.

Diagnosis of Alcohol Dependence Medication:

The CAGE questionnaire is a simple screening tool that can be used to identify potential problems with alcohol drinking and consists of the following four questions:

  • 1 – Have you ever felt you should Cut down on your drinking?
  • 2 – Have people annoyed you by criticizing your drinking habits?
  • 3 – Have you ever felt bad or Guilty about your drinking?
  • 4 – Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?

If the answer is yes to two or more of the questions above, or one if you are a female, than the amount of alcohol you are drinking may be problematic and you should seek professional help immediately.

Risk Factors for Alcohol Dependence:


AUD can result in mental illness like major depressive disorder, delirium tremens — seizures and hallucinations, Wernicke–Korsakoff syndrome — a condition characterized by the triad of memory problems, visual disturbances and changes in the way a person walks, irregular heartbeat, an impaired immune response, liver cirrhosis, and increased cancer risk. AUD also reduces a person’s life expectancy by approximately ten years.

Alcohol dependence treatment:

There are several treatment options available for people who have AUD.

  • Detox – Due to complications that can arise during alcohol withdrawal, alcohol detoxification must be closely monitored and carefully controlled by professional alcohol and drug addiction services.
  • Medication – A medicine that is commonly used for alcohol detoxification is chlordiazepoxide which belongs to the benzodiazepine family of drugs. These can be either given while admitted to a health care setting or while a person remains at home with 24-hour support by a family member and/or responsible adult.

    The medications acamprosate or naltrexone help to reduce craving of alcohol and may be used for relapse prevention purposes.

  • Therapy and support – Once alcohol detoxification is achieved, the individual receives aftercare as part of the goal to prevent relapse, stabilize, and develop harm reduction strategies. This includes attending group therapy or a support group such as Alcoholics Anonymous, which helps stop a person from returning to drinking.

Causes of abuse or dependency):

The exact cause of AUD remains unknown; however, genetic and environmental factors have both been implicated. A person with a first-degree relative — a parent or sibling — who has AUD is three to four times more likely to develop the condition him or herself.

Environmental factors include social, cultural, and behavioral influences. High stress levels and anxiety, as well as the low cost of alcohol and how easy it is to buy, are also factors that increase the risk of developing AUD.

Diagnosis of abuse or dependency:

The CAGE questionnaire is a simple screening tool that can be used to identify potential problems with alcohol drinking and consists of the following four questions:

  • 1 – Have you ever felt you should Cut down on your drinking?
  • 2 – Have people annoyed you by criticizing your drinking habits?
  • 3 – Have you ever felt bad or Guilty about your drinking?
  • 4 – Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?

If the answer is yes to two or more of the questions above, or one if you are a female, than the amount of alcohol you are drinking may be problematic and you should seek professional help immediately.

Risk Factors for Alcohol Dependency:

AUD can result in mental illness like major depressive disorder, delirium tremens — seizures and hallucinations, Wernicke–Korsakoff syndrome — a condition characterized by the triad of memory problems, visual disturbances and changes in the way a person walks, irregular heartbeat, an impaired immune response, liver cirrhosis, and increased cancer risk. AUD also reduces a person’s life expectancy by approximately ten years.

Alcohol dependence treatment:

There are several treatment options available for people who have AUD.

  • Detox – Due to complications that can arise during alcohol withdrawal, alcohol detoxification must be closely monitored and carefully controlled by professional alcohol and drug addiction services.
  • Medication – A medicine that is commonly used for alcohol detoxification is chlordiazepoxide which belongs to the benzodiazepine family of drugs. These can be either given while admitted to a health care setting or while a person remains at home with 24-hour support by a family member and/or responsible adult.

    The medications acamprosate or naltrexone help to reduce craving of alcohol and may be used for relapse prevention purposes.

  • Therapy and support – Once alcohol detoxification is achieved, the individual receives aftercare as part of the goal to prevent relapse, stabilize, and develop harm reduction strategies. This includes attending group therapy or a support group such as Alcoholics Anonymous, which helps stop a person from returning to drinking.