ALCOHOL ABUSE

Alcoholism, also known as alcohol use disorder is a broad term for the consumption of alcohol that results in mental or physical health problems.

The World Health Organization estimates that as of 2010, there were 208 million people with alcoholism worldwide (41% of the population over 15 years of age). It’s more common among men and young adults and then becomes less common in the middle and old ages. It is least common in Africa at 1.1% and the highest rates are found in Eastern Europe at 11%. It was directly related to 139,000 deaths in 2013, up from 112,000 deaths in 1990. The figures shown for alcohol abuse disorder indicate a worsening trend that continues to soar.

The relaxed regulations on alcohol distribution in many parts of the world have compounded the problem. And the ease of accessibility to alcohol by underage populations has made it easy for the habit to develop at very young ages especially in areas where there is little or no oversight to ensure the right development channels for the younger generation.

Diagnosis of alcohol use disorder is usually done through questionnaires and blood tests; abnormally high amounts of alcohol in the blood for consistently long periods of time indicate a problem.

Medically, it’s usually known to exist when two or three of the conditions listed below are present. These parameters make up the biggest part of the diagnostic tool.

  • When a person drinks large amounts of alcohol over a long period of time and it becomes increasingly difficult to cut down the amount.
  • When acquiring and drinking alcohol takes up most of the person’s time.
  • When alcohol is strongly desired and leads to problems in the fulfillment of responsibilities.
  • When alcohol use results in health problems
  • When alcohol use results in overindulgence in risky behavior.
  • When withdrawal symptoms occur on stopping.
  • When alcohol tolerance has occurred with use.

Management

Medical emergencies as a result of high alcohol consumption are handled differently in different parts of the world, usually stemming from diagnostic tools that may vary widely i.e. the nature of questions on the questionnaire and interpretation of results may inadvertently be guided by the understanding of alcoholism as a medical condition. These factors affect the time taken to initiate treatment, progression of treatment, and follow-up of the treatment. Most treatments focus majorly on helping an individual halt the intake of alcohol and offering psychosocial support to patients.

Detoxification: Initiated by the abrupt halting of intake, and then followed by replacement with drugs in tapering doses to prevent withdrawal effects. These drugs are usually of the Benzodiazepine class.

Psychosocial support: Group therapy to address underlying psychological concerns that lead to high dependence on alcohol.

Medications: Only by prescription through assessment by duly qualified medical personnel. These medications may include Acamprosate, Naltrexone, Disulfrum, and many others.

References:

  1. Understanding and treating alcoholism Volume I: Litrell, Jill (2014)
  2. Alcohol use disorder: A comparison between DSM-IV and DSM-5 November 2013
  3. American Psychiatric Association 2013 Diagnostic and statistical manual on mental disorders pp 490-97
  4. Global status report on alcohol and health 2014 World Health Organization. 2014


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