Alcoholism is defined as the addiction of consumption of alcoholic drinks, in terms of,
- Taking alcohol frequently since long time.
- Cannot control drinking once it has begun.
- Physical dependence manifest as withdrawal symptoms when a person tries to stop drinking as anxiety, confusion, tremors, palpitation, nausea, vomiting, sleeplessness.
- Tolerance or need to consume more quantity alcohol to achieve the same effects.
- A variety of social and/or legal problems arising from alcohol use.
Alcohol abuse in India
India once had a reputation as having a culture that promoted abstinence towards drugs like alcohol. Things have changed and there is now serious problems arising due to alcohol abuse, 15 people die every day – or one every 96 minutes – from the effects of drinking alcohol, reveals an India Spend analysis of 2013 National Crime Records Bureau (NCRB) data, the latest available.
The per capita consumption of alcohol in India increased 38 percent, from 1.6 litres in 2003-05 to 2.2 liters in 2010-12, according to a World Health Organization (WHO) report, which also revealed that more than 11 percent of Indians were binge drinkers, against the global average of 16 percent.
Why people become addicted to alcohol?
Cause of Alcoholism
Alcoholism is a result of a combination of genetic, psychological, environmental and social factors.
Alcoholism and genes
There are lots of studies suggests that certainly there is a link between genetics and alcoholism. People having family history of alcohol consumptions are more prone to have alcohol addiction even they are grown up in the non-alcoholic environment. However, the connection of an actual gene is yet to be verified as one of the main causes of alcoholism.
Alcoholism and families
Other similar scientific studies have shown that children of alcoholics are more likely to develop alcohol problems compared to the general population. The prevalence of alcoholism in first-degree relatives is three to four times more compared to the general population. Even if a person has a long family history of alcoholism it does not mean that he or she will become an alcoholic. Alcoholism remains to be a result of environmental and genetic factors. Genetics only increased the risk of being one but it doesn’t have to shape a person’s destiny.
Alcoholism and youngsters
Usually youngsters start drinking alcohol because their friends drink. By adapting friend’s habit they feel that they are adapting the environment. So peer pressure is the strong cause of alcoholism in young people.
Alcoholism and stress
In recent scenario lifestyles generated psychological disorder like stress, anxiety and depression also play significant role to make a person alcoholic. As alcohol produces depressive state and euphoria, it gives temporary relaxation from their psychological symptoms.
What alcohol does in your body?
As soon as alcohol enters onto blood stream it crosses blood brain barrier.The blood-brain barrier (it is a highly selective semi permeable membrane barrier that separates the circulating blood from the brain, prevents many toxins from entering in brain) does not prevent alcohol from entering the brain, so the brain alcohol level will quickly become equivalent to the blood alcohol level. Alcohol potentially affects the entire brain, all at once.
Alcohol interferes with the actions of various neurotransmitters. Neurotransmitters are the chemical present in neurons by which signals from the brain transmitted to the target organ. There are basically two types of neurotransmitter one which transmit signal to increase target organ’s activity are called ‘excitatory’ neurotransmitter, another which transmit signal to decrease the target organ’s activity called ‘inhibitory’ neurotransmitter.
Now when you take alcohol as soon as it crosses blood brain barrier it inhibits activity and action of excitatory neurotransmitter and increases activity and action of inhibitory neurotransmitter result in state of euphoria.
Euphoria is an affective state in which a person experiences pleasure or excitement and intense feelings of well-being and happiness. That has been reported during the early (10–15 min) phase of alcohol consumption.
90% or more of the alcohol a person drinks is metabolized by the body, mainly metabolized in the liver and a little bit in the stomach. The rest is excreted unchanged by the kidneys into urine, by sweat glands, and by the lungs as a person breathes out.
How people become addicted to alcohol
Neuroadaptation refers to changes or ‘adaptations’ that occur in the brain for repeated stimuli.
In context of alcohol or any drug, when it is used in excessive quantity beyond body’s need, brain start developing tolerance or adaptation for the chemistry of that substance to offset that drug effect.
Neuroadaption has multiple stages, once neuroadaptation has occurred, removal of alcohol from the organism leads to a withdrawal syndrome.
Steps of Neuroadaption
Sensitization is learning process in which repeated administration of a stimulus results in the progressive increase of a response. In terms of alcoholism sensitization is the first step when you start taking alcohol as liking, due to the repeated exposure of the stimuli (liking) turns into wanting. Following repeated drug exposure, this wanting becomes stronger and transforms into pathological craving for the drug.
A person who is chronically exposed to alcohol develops tolerance to its effect on brain and body. Once tolerance to the pleasurable effects of alcohol develops, the person requires gradually more quantity of alcohol to produce the same effect previously experienced at less quantity.
After long and chronic exposure to the alcohol person become so dependent that if he tries to stop or cutoff the quantity he develops set of symptoms labeled as withdrawal symptoms.
Symptoms are classified into three stages depending on the time of their onset.
- Stage 1 (mild) develops after 6 to 7 hours of last drink:
Anxiety, insomnia, nausea, abdominal pain and/or vomiting, loss of appetite, fatigue, tremors, depression, foggy thinking, mood swings, and heart palpitations
- Stage 2 (moderate) develops after 12 to 24 hours of last drink:
Increased blood pressure, body temperature and respiration, irregular heart rate, mental confusion, sweating, irritability, and heightened mood disturbances
- Stage 3 (severe/delirium tremens) develops in first one or two days of last drink:
Hallucinations, fever, seizures, severe confusion, and agitation
Withdrawal symptoms are the major cause for relapse to alcohol-seeking behavior.
Effects of alcohol addiction
Acute or immediate effects
In the brain, alcohol interacts with various neurotransmitters to alter nerve function. Alcohol’s depressive effects result in
- Difficulty walking,
- Poor balance,
- Slurring of speech,
- Poor coordination
- Impairment of peripheral vision.
- At higher alcohol levels, a person’s breathing and heart rates may be slowed and vomiting may occur (with a high risk of the vomit being breathed into the lungs, potentially resulting in aspiration pneumonia.)
- Still higher alcohol levels may result in coma and death.
Effects of long-term (chronic) alcoholism
Long-term use of alcohol affects virtually every organ system of the body:
- Alcohol causes sleep disturbances, sleep quality is diminished.
- Numbness and tingling may occur in the arms and legs.
- Wernicke’s syndrome and Korsakoff’s syndrome, which can occur together or separately, are due to the low thiamine (vitamin B-1) levels because alcohal prevents vitamin B-1 absorption and storage. Which is characterized by mental confusion, amnesia (a permanent gap in memory), and impaired short-term memory. Other symptoms include ataxia (weakness in limbs or lack of muscle coordination, unsteady gait), slow walking, rapid, tremor-like eye movements, and paralysis of eye muscles. Fine motor function (e.g., hand or finger movements) may be diminished, and sense of smell also may be affected. In the advanced stages, coma can occur.
- Inflammation of stomach, may lead to ulcers and hemorrhage in advance stages.
- Acid reflux from stomach to food pipe (esophagus)
- Dilatation of blood vessels of lower end of food pipe (esophagus) may cause uncontrollable hemorrhage (esophageal varices)
- Inflammation of pancrease (Pancreatitis)
- Malabsorption leads to malnutrition
- Liver complaints such as fatty liver (enlarge and fill with fat), inflammation (hepatitis) or cirrhosis (fibrous scar tissue develops in liver)
Blood and immunity–
Alcohol may cause changes to all the types of blood cells. Red blood cells become abnormally large. White blood cells (important for fighting infections) decrease in number, resulting in a weakened immune system. This places alcohol-dependent individuals at increased risk for infections and may account in part for the increased risk of cancer faced by people with alcoholism. Platelets and blood clotting factors are affected, causing an increased risk of bleeding.
Small amounts of alcohol cause a drop in blood pressure, but with increased consumption, alcohol raises blood pressure into a dangerous range (hypertension). High levels of fats circulating in the bloodstream increase the risk of heart disease. Heavy drinking results in an increase in heart size, weakening of the heart muscle, abnormal heart rhythms, a risk of blood clots forming within the chambers of the heart, and a greatly increased risk of stroke due to a blood clot entering the circulatory system and blocking a brain blood vessel.
Reproductive system –
Heavy drinking has a negative effect on fertility in both men and women. It decreases testicle and ovary size and interferes with both sperm and egg production.
Pregnancy and Alcoholism
Maternal alcohol consumption during pregnancy contributes adversely to a fetus’s development. Abnormalities in infants and children associated with maternal alcohol consumption may include
- Prenatal and postnatal physical retardation,
- Neurological deficits (e.g., impaired attention control),
- Mental retardation,
- Behavioral problems (e.g., impulsivity),
- Cognitive difficulties (e.g., lower IQ scores, more learning problems, poorer short-term memory functioning)
- Skull or brain malformations and facial malformations (e.g., a thin upper lip and elongated flattened midface).
Check yourself are you Alcohol Addicted?
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a diagnostic tool for mental disorders issued from American Psychiatric Association.
It has 11 criteria for diagnosis of alcohol use disorder.
Alcohol use disorder (AUD) is a medical condition that doctors diagnose when a patient’s drinking causes distress or harm. The condition can range from mild to severe and is diagnosed when a patient answers “yes” to two or more of the following questions.
|The Diagnostic and Statistical Manual of Mental Disorders |
|1||Had times when you ended up drinking more, or longer, than you intended?|
|2||More than once wanted to cut down or stop drinking, or tried to, but couldn’t?|
|3||Spent a lot of time drinking? Or being sick or getting over other aftereffects?|
|4||Wanted a drink so badly you couldn’t think of anything else?|
|5||Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?|
|6||Continued to drink even though it was causing trouble with your family or friends?|
|7||Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?|
|8||More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?|
|9||Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?|
|10||Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?|
|11||Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?|
|The presence of at least 2 of these symptoms indicates an Alcohol Use Disorder (AUD). |
The severity of the AUD is defined as:
Mild: The presence of 2 to 3 symptoms
Moderate: The presence of 4 to 5 symptoms
Severe: The presence of 6 or more symptoms
Treatment for alcoholism
The person with alcoholism often resists that he or she has an alcohol problem and needs to stop drinking. Treatment cannot be forced on adults unless it is a condition imposed by a court of law.
The alcohol-dependent person will most likely develop withdrawal symptoms so first aim of the treatment is to relive withdrawal effects. Withdrawal will be different for different individuals, depending on the severity of the alcoholism as measured by the quantity of alcohol ingested daily and the length of time the patient has been alcohol dependent.
Types of Treatment
Aim of behavior treatment is to change drinking behavior through counseling also known as alcohol counseling. Behavioral treatments involve working with a health professional to identify and help change the behaviors that lead to heavy drinking. Behavioral treatments share certain features, which can include:
- Developing the skills needed to stop or reduce drinking
- Helping to build a strong social support system
- Working to set reachable goals
- Coping with or avoiding the triggers that might cause relapse
- Naltrexonecan help people reduce heavy drinking.
- Acamprosate makes it easier to maintain abstinence.
- Disulfiramblocks the breakdown (metabolism) of alcohol by the body, causing unpleasant symptoms such as nausea and flushing of the skin. Those unpleasant effects can help some people avoid drinking while taking disulfiram.
Not all people will respond to medications, but for a subset of individuals, they can be an important tool in overcoming alcohol dependence.
Homeopathy treatment of alcoholism
Homeopathy treatment is a natural form of medicine based on the principle of symptom similarity. Homeopathic remedies are derived from natural sources and are diluted and potentized to make them safe. Homeopathic literature says that when a remedy, which covers your symptoms very well, is administered, it is able to affect a cure rapidly and gently, even of long standing and inveterate cases.