Alcoholism is the physical and emotional dependency on the use of alcohol, the removal of which causes physical and emotional withdrawal symptoms.
Although two-thirds of American men and one-half of American women drink alcohol, three-fourths of drinkers experience no serious consequences from alcohol use.
Repeated studies of alcoholics have confirmed that it is almost invariably fear which drives an alcoholic to seek help; fear for his safety, health, or sanity; fear of loss of love, family, home or job. An event ferocious enough, frightening enough, appalling enough, or humiliating enough happens to breech his denial system. But the defenses of the mind are like those of the body; they rush to wall off, to localize and repair damage. No sooner has the alcoholic faced the magnitude and malignancy of his drinking problem than the denial begins to build again and he begins to temporize. As paradoxical as it seems, therefore, the first phase in any treatment approach to the alcoholic, even the alcoholic who has specifically presented himself to obtain help with his drinking problem, must center on his being confronted with the inescapable fact of his alcoholism. He must be repeatedly reminded he is an alcoholic, that he is no different from other alcoholics in his vulnerability to alcohol, and that his feelings of imperviousness to relapse are not justified. Even with persistent confrontations, it may take 3-6 months before the alcoholic's efforts to rebuild his denial system taper off, and this will be the time of greatest danger that he will drop back out of treatment.
Population surveys demonstrate that between 12% and 14% of adults have a current alcohol use disorder [Arch Gen Psychiatry 64:pp830-42, 2007] and that 29% have had such a disorder at some point in their lifetime [Ann Intern Med 164:1-16, 2016].
The physical dependence element develops at different rates for different individuals and effects vary widely. Any human who drinks enough alcohol over enough time will become alcoholic. For some, it takes large quantities and long periods and for others, small quantities and short periods. It is difficult to predict where any given individual may be on that scale.
Genetic predisposition to easy development of alcoholism is evidenced in differing proportions in differing ethnic groups.
There are many symptoms of chronic alcoholism. The main ones include:
Amongst those who abuse alcohol, many reduce their drinking without formal treatment after personal reflection about negative consequences. However, the recovery rate is often poor even among people who seek help.
Rhinophyma (an enlarged nose) has been associated with several causes including the over-consumption of alcohol. Men are 12 times more likely to have this problem than women.
Alcoholics as well as the elderly suffer gradual loss of acetylcholine, a vital neurotransmitter. The brain compensates for this change by heightening the sensitivity of the receptors carrying memory messages, but because of the acetylcholine shortage, the transmission cannot be completed and short-term recall is poor.
Alcohol impairs wound healing and increases the likelihood of wound infection. Alcohol impairs the early inflammatory response; it inhibits wound closure, development of new blood vessels, and collagen production; it alters the protease balance at the wound site, which is needed to remove foreign matter and dead tissue; it decreases resistance to infectious microorganisms.
Many sufferers report that alcohol is an important trigger during a cluster period, but not during remission periods.
To many people, cirrhosis of the liver is synonymous with chronic alcoholism. It is a major cause, but nevertheless one of several. Alcoholic cirrhosis usually develops after more than a decade of heavy drinking. The amount of alcohol that can injure the liver varies from person to person. In women, as few as two to three drinks per day have been linked with cirrhosis and in men, as few as three to four drinks per day. Alcohol seems to injure the liver by blocking the normal metabolism of protein, fats and carbohydrates.
Since the original recommendation regarding alcohol was published, researchers at the Harvard Medical School found that even 3 drinks a week put women at increased risk for breast cancer. Women who had one or more drinks a day were found to be at 60% higher risk than women who did not drink.
If you are a smoker then heavy alcohol consumption can increase risk of esophageal cancer by 25% to 50%.
Elevated levels of HDL cholesterol are generally considered to have a protective effect against cardiovascular disease. However, very elevated levels can be a result of liver disease or chronic intoxication.
Cardiomyopathy occurs with greater frequency in people who drink too much alcohol. The risk of developing DCM is greater for female than for male alcoholics [JAMA 1995;274(2): pp.149-54]. Alcoholics can develop a form of thiamine deficiency called wet beri beri or Shoshin beri beri, which frequently includes cardiomyopathy.
People who abuse alcohol are at high risk for magnesium deficiency because alcohol increases urinary excretion of magnesium. Low blood levels of magnesium occur in 30-60% of alcoholics, and in nearly 90% of patients experiencing alcohol withdrawal. In addition, alcoholics who substitute alcohol for food will usually have lower magnesium intakes. Medical doctors routinely evaluate the need for extra magnesium in this population.
An interesting study showed significantly decreased levels of anxiety among a group of alcoholics treated with megavitamins. Over a 21-day period, the group took approximately 3gm of vitamin C, 3gm of niacin, 600mg of B6, and 600 IU of vitamin E per day. A comparison group received only inert gelatin capsules. None of the subjects in either group took antidepressants or antianxiety drugs. Anxiety levels among both groups were measured three times over the 21 days. They fell dramatically only in the group on megavitamin therapy.
Zinc deficiency is frequently associated with alcoholism, due to a lower intake of food.
Depletion of tryptophan as a result of heavy drinking explains why alcoholics suffer from insomnia.
Cancer Research UK warned in August of 2009 that growing numbers of 40-somethings are developing mouth, lip and tongue cancer because they drink too much alcohol. Diagnoses of oral cancer have gone up by 28% among men in their 40s and 24% among women the same age since the mid-1990s. The charity says tobacco does not explain the rise, as it takes up to 30 years to cause cancer. Some 41% of cancers of the mouth could be prevented if no one drank, the World Cancer Research Fund estimated.
In a study where the average intake of uncooked food comprised 62% of calories ingested, 80% of those who drank alcohol abstained spontaneously. [South Med J 1985 Jul;78(7): pp.841-4]
Fasting makes it easier to overcome bad habits and addictions. Many people have overcome tobacco and alcohol addictions, and even drug addictions, by fasting. Fasting rapidly dissipates the craving for alcohol.
GHB shows great promise in the treatment of alcoholism. In Europe, one of its primary uses is to relieve withdrawal symptoms, cravings and anxiety among alcoholics.
In a rigorous, double-blind, placebo-controlled study conducted on alcoholics, "...nearly all withdrawal symptoms disappeared within 2-7 hours" after administration of GHB. On a severe-moderate-mild-or-none scale, withdrawal symptoms remained below moderate during the entire period. The only side-effect observed was slight, occasional and transient dizziness. The researchers concluded, "...the results clearly indicated that GHB is effective for the suppression of withdrawal symptoms in alcoholics" [Gallimberti, 1989].
It can be dangerous to drink if you are taking prescription or over-the-counter medications. Medication that slows you down or sedates you can be very dangerous when combined with alcohol. You might find you have difficulty breathing and a great deal of difficulty thinking clearly. You need to be careful with the following drugs:
Aspirin can prevent stomach enzymes from processing the alcohol. If taking aspirin, leave more time between drinks so the liver can cope.
Some antibiotics do not work well when combined with alcohol.
It is clear that brain zinc content changes during disease states and that brain zinc deficiency is possibly dynamically related to alcoholism. McLardy (1973) observed a 30% deficit in brain zinc levels amongst chronic alcoholics.
Low zinc status has been observed in 30% to 50% of alcoholics. Alcohol decreases the absorption of zinc and increases loss of zinc in urine. In addition, many alcoholics do not eat an acceptable variety or amount of food, so their dietary intake of zinc may be inadequate.
Alcoholics Anonymous, made up of recovering alcoholics, is as successful as any treatment program and there is no fee.
Alpha-lipoic acid should not be given in high doses to patients suspected of having a thiamine deficiency unless the thiamine deficiency is also corrected. Individuals who may be deficient in vitamin B1 (such as alcoholics) should supplement vitamin B1 along with alpha-lipoic acid.
Regular use of a quality high potency multiple vitamin may be important in alcoholism. Alcoholics are classically deficient in most of the B vitamins. These deficiencies result from a variety of mechanisms: low dietary intake, deactivation of the active form, impaired conversion to the active form by ethanol or acetaldehyde, impaired absorption, and decreased storage capacity. A thiamine deficiency is both the most common and the most serious of the B-vitamin deficiencies, since a deficiency causes beriberi and the Wernicke-Korsakoff Syndrome. A functional pyridoxine deficiency is also common in alcoholics, due not so much to inadequate intake as impaired conversion to its active form, pyridoxal-5-phosphate, and enhanced degradation.
A study published in the journal "Archives of Internal Medicine" in 2006 indicates that coffee may greatly reduce the risk of liver damage in those who consume alcohol regularly. Every daily cup of coffee reduced the incidence of cirrhosis, a condition that destroys liver tissue, by 22%, according to researchers at the Kaiser Permanente Medical Care Program. However, Dr. Arthur Klatsky, the leader of the study, said the results "should not be interpreted as giving a license to drink without worry, because of all the other problems connected with drinking." adding, "the only proper advice is to drink less."
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