Consultant Psychiatrist, Kalubowila Teaching Hospital Dr.Malika Weerasinghe speaks about alcohol addiction and its adverse health impacts. At present a large number of persons including school children have got addicted to alcohol and other substances. Symptoms of alcoholism.
Q: Who gets addicted to alcohol often, how and why?
A: Alcohol is a psychoactive substance with dependence properties. Alcohol acts on the brain and may cause addiction. Harmful use of alcohol causes diseases in almost all systems in the body. It also causes mental health issues, social and economic problems. Although many people use alcohol as a recreational substance, only some of them get addicted to alcohol. There is no single explanation for this. Multiple biological, mental and social factors interact with each other to cause this.
Having a family history of alcohol abuse and being male increases the risk. In other words, if a close relative (father/ mother/ brother etc.) had problems with alcohol addiction, one is more likely to have problems oneself. Mental health disorders like depression, anxiety, schizophrenia and bipolar disorder also increases the risk of addiction.
Lack of a positive parent-child relationship is linked to early age of drinking which increases risk of addiction later in life.
Living in an environment with easy accessibility to alcohol (bartender/ restaurant worker), where alcohol is accepted as part of life also increases the risk of addiction. However perceptions related to alcohol play a major part. People who take alcohol to get "drunk" are more likely to get addicted.
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Peer influence, relationship problems, low self - esteem, not having a purpose or satisfaction in life are other factors which further increase the risk of addiction.
A: Certain chemical changes occur in brain cells in people who are addicted to alcohol. As a result when alcohol consumption is reduced or stopped suddenly, body develops withdrawal symptoms. These include tremors, vomiting, increased heart rate, agitation and sweating. More serious complications like seizures (fits) and confusion can also occur. Therefore even if a person wants to stop alcohol they might find it difficult to do so.
Basic steps in treatment are motivating to seek help, managing withdrawal symptoms and maintaining abstinence. Education about negative consequences of their habit and counselling helps a person seek treatment. Medications are available to treat withdrawal symptoms. This can be done as an outpatient or inpatient depending on the degree of addiction and available supports.
Effective drug treatments are available to reduce craving and prevent relapse. Behavioral treatment methods can also be used to prevent relapses. Some may benefit from therapy at Day Centers or long term rehabilitation at Residential rehabilitation centers.
Q:What can be done if the alcoholic is not willing to get rid of his/her addiction?
A: Many continue to use alcohol despite knowing the harm due to physical dependence and unpleasant withdrawal symptoms. Some people again tend to use alcohol after remaining abstinent since they find it difficult to manage craving. A person may also relapse due to other psycho socio factors (influence of "bad friends"- a single "event" set back may bring on the previous state rapidly and also add to the low self- esteem.)
Success of treatment depends on person's willingness to change.
Alcohol cause significant medical problems. If a person is not willing to take treatment family members can initially take him to a doctor to check for medical problems. Most of the time addicted person will have changes in liver enzymes and changes in other blood reports. By seeking help for those physical complications and educating about the contribution of alcohol they can be motivated to seek help for alcohol abuse.
Q:What can be done by a healthy non addicted person to protect himself / herself from getting addicted to alcohol or any other substance?
A: A person should be aware of how high his/ her risk to develop dependence. If you are having risk factors, steps should be taken to minimize modifiable factors.
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For example if one is having mental problems like social anxiety, depression, or low self -esteem s/he should seek help since these factors can commonly lead to addictions. Learning to manage day to day stress effectively and practising healthy coping skills would prevent a person seeking solutions by using alcohol or drugs which in turn can develop in to an addiction.
People who are living or working in an environment where alcohol use is accepted as norm should also take steps to control their drinking pattern (eg. Substitute non- alcoholic beverages)
School based interventions like correcting misconceptions about alcohol use, teaching youth to say no to alcohol, promoting healthy life style and education about addictions also help in preventing addictions among youth.