Definition of chronic alcoholic liver disease Medical definition of chronic alcoholism Definition of chronic alcoholism Definition of a chronic alcoholic. Alcoholism: Facts on Alcoholic Symptoms & Treatment

Alcohol problems vary in severity from mild to life threatening and affect the individual, the person's family, and society in numerous adverse ways. Despite the focus on illegal drugs of abuse such as cocaine, alcohol remains the number-one drug problem in the United States. Nearly 17 million adults in the U.S. are dependent on alcohol or have other alcohol-related problems, and about 88,000 people die from preventable alcohol-related causes. Definition of chronic alcoholism.

In teenagers, alcohol is the most commonly abused drug. Thirty-five percent of teens have had at least one drink by age 15. Even though it is illegal, about 8.7 million people 12 to 20 years of age have had a drink in the past month, and this age group accounted for 11% of all alcohol consumed in the U.S. Among underaged youth, alcohol is responsible for about 189,000 emergency-room visits and 4,300 deaths annually.

Withdrawal, for those physically dependent on alcohol, is much more dangerous than withdrawal from heroin or other narcotic drugs. Alcohol abuse and alcohol dependence are now grouped together under the diagnosis of alcohol use disorder.

What was formerly called alcohol abuse refers to excessive or problematic use with one or more of the following:

Failure to fulfill major obligations at work, school, or home

Recurrent use in situations where it is hazardous (such as driving a car or operating machinery)

Continued use of alcohol despite having medical, social, family, or interpersonal problems caused by or worsened by drinking

Despite negative outcomes resulting from drinking, the alcoholic continues to drink to try to attain the feeling of euphoria they first experienced when they started drinking.

Previously called alcohol dependence, this aspect of alcohol use disorder refers to a more serious kind of alcohol use disorder and involves excessive or maladaptive use leading to three or more of the following:

Tolerance (need for more to achieve the desired effect, or achieving the effect with greater amounts of alcohol)

Withdrawal symptoms following a reduction or cessation of drinking (such as sweating, rapid pulse, tremors, insomnia, nausea, vomiting, hallucinations, agitation, dizziness, shaking, anxiety, or seizures ) or using alcohol to avoid withdrawal symptoms (for example, early morning drinking or drinking throughout the day)

Drinking more alcohol or drinking over a longer period of time than intended (loss of control)

Inability to cut down or stop

Spending a great deal of time drinking or recovering from its effects

Giving up important social, occupational, or recreational activities in favor or using alcohol

Definition of chronic alcoholic liver disease Medical definition of chronic alcoholism Definition of chronic alcoholism Definition of a chronic alcoholic

Continuing to drink despite knowing alcohol use has caused or worsened problems

Binge drinking (consuming several drinks over a short period of time) can occur at any level of alcohol use disorder.

The cause of alcoholism is not well-established. There is growing evidence for genetic and biologic predispositions for this disease. First-degree relatives of individuals with alcohol use disorder are four to seven times more likely to develop alcoholism than the general population. Research has implicated a gene (D2 dopamine receptor gene) that, when inherited in a specific form, might increase a person's chance of developing alcoholism.

Usually, a variety of factors contribute to the development of a problem with alcohol. Social factors such as the influence of family, peers, and society, and the availability of alcohol, and psychological factors such as elevated levels of stress, inadequate coping mechanisms, and reinforcement of alcohol use from other drinkers can contribute to alcoholism. Also, the factors contributing to initial alcohol use may vary from those maintaining it, once the disease develops.

While it may not be causative, twice as many men are alcohol dependent. One study showed one-third of men age 18-24 met the criteria for alcohol dependence, and those who start drinking before age 15 are four times more likely to develop alcohol dependence. Men are more likely to engage in binge drinking or heavy drinking. They are also more likely to be involved in behaviors that harm themselves or others such as alcohol-related violence, using other drugs such as marijuana and cocaine, having sex with six or more partners, and earning mostly Ds and Fs in school grades.

People who drink alcohol to the point it interferes with their social life, professional life, or with their medical or mental health should contact a doctor to discuss the problem. The great difficulty lies in the fact that denial plays a large part in alcoholism. Consequently, alcoholics rarely seek professional help voluntarily.

Often a family member or employer convinces or forces the person with alcoholism to seek medical treatment. Even if an alcoholism sufferer accepts treatment because of pressure from family, an employer, or a medical professional, he or she can benefit from it. Treatment may help this person develop motivation to change the alcohol problem.

Alcohol is involved in 40% of motor-vehicle fatalities, 70% of drownings, 50% of suicides, and up to 40% of violent crimes, including homicide, rape, assault, and child and spousal abuse.

It is imperative emergency care be sought immediately when alcohol has contributed to an injury. This is important because someone who is intoxicated may not be able to reliably assess the severity of the injury they have sustained or inflicted. An intoxicated person may, for example, not notice they have a fractured neck vertebra (broken neck) until it is too late and paralysis has occurred.

Several alcohol-related conditions require immediate evaluation in a hospital's emergency department.

Alcohol withdrawal requires emergency treatment. When withdrawing from alcohol, a person classically goes through four phases: tremulousness (the shakes), seizures, hallucinations, and delirium tremens (DTs). These stages are described in further detail:

During the tremulous stage, the person will exhibit a tremor (shakiness) of his or her hands and legs. This can be seen if the person extends his or her hand and tries to hold it still. This symptom is often accompanied by anxiety and restlessness.

Seizures can follow the tremulous stage. They are commonly generalized seizures during which the entire body shakes uncontrollably, the person loses consciousness and may lose control over their bladder or bowels. If you see someone having a seizure, first call 911. Then attempt to lay the person on one side so they don't inhale vomit or secretions into their lungs. If possible, protect the person's head or other body parts from knocking uncontrollably onto the floor or against other potentially harmful objects. Do not place anything inside the person's mouth while they are having a seizure.

Hallucinations affect many people undergoing the late stages of major alcohol withdrawal. Visual hallucinations are the most common type of hallucination experienced during alcohol withdrawal. People will classically "see" insects or worms crawling on walls or over their skin. Often this is associated with tactile (feeling) hallucinations in which alcoholics think they feel insects crawling on their skin. This phenomenon is called formication. Auditory ( hearing ) hallucinations can also occur during withdrawal, although less commonly than the other types of hallucinations.

Definition of chronic alcoholic liver disease Medical definition of chronic alcoholism Definition of chronic alcoholism Definition of a chronic alcoholic

The most dangerous stage of alcohol withdrawal is called delirium tremens (DTs) and it is a medical emergency. About 5% of people withdrawing from alcohol experience DTs. This condition usually occurs within 72 hours after drinking stops but can occur up to seven to 10 days later. The hallmark of this stage is profound delirium (confusion). People are awake but thoroughly confused. This is accompanied by agitation, delusions (beliefs that have no basis in reality), sweating, hallucinations, rapid heart rate, and high blood pressure. Even with appropriate medical treatment, this condition is associated with a 5% death rate.

Alcoholic ketoacidosis (AKA) is another alcohol related condition for which emergency medical treatment should be sought. AKA often starts within two to four days after an alcoholic has stopped consuming alcohol, fluids, and food, often because of gastritis or pancreatitis. Not uncommonly, AKA and alcohol withdrawal syndromes are seen at the same time. AKA is characterized by nausea, vomiting, abdominal pain, dehydration, and an acetone-like odor on the person's breath. This occurs when the alcohol dependent person has become depleted of carbohydrate fuel stores and water. The body begins to metabolize ("burn") fat and protein into ketone bodies for energy. Ketone bodies are acids that accumulate in the blood, increasing its acidity and causing the person to feel even sicker, thus perpetuating a vicious cycle.

Alcohol use disorder is often associated with other psychiatric disorders such as anxiety, depression, bipolar disorder, and psychosis. These psychiatric illnesses, often combined with a reduced level of sound judgment while intoxicated, leads to suicides and suicide attempts by people who are alcohol dependent. A person who has attempted suicide or is believed to be in serious or imminent danger of committing suicide should be taken quickly to the emergency department of a hospital.

Alcoholism is best treated by professionals trained in addiction medicine. Physicians and other health-care workers with such specialized training and experience are best suited to manage alcohol withdrawal and the medical and mental disorders associated with alcoholism.

Home therapy without supervision by a trained professional may be life threatening because of complications from alcohol withdrawal syndrome. Usually an alcoholic will begin to experience alcohol withdrawal six to eight hours after cutting down or stopping alcohol consumption.

Several levels of care are available to treat alcoholism. Medically managed hospital-based detoxification and rehabilitation programs are used for more severe cases of dependence that occur with medical and psychiatric complications. Medically monitored detoxification and rehabilitation programs are used for people who are dependent on alcohol and who do not require more closely supervised medical care. The purpose of detoxification is to safely withdraw the alcohol dependent person from alcohol and to help him or her enter a rehabilitation (rehab) treatment program. The purpose of a rehabilitation program is to help the individual with alcoholism accept that they have the disease, begin to develop skills for sober living, and get enrolled in ongoing treatment and self-help programs. Most detoxification programs last just a few days. Most medically managed or monitored rehabilitation programs last less than two weeks. Many alcoholic individuals benefit from longer-term rehabilitation programs, day treatment programs, or outpatient programs. These programs involve education, therapy, addressing problems contributing to or resulting from the alcoholism, and learning skills to manage the alcoholism over time.

These skills include, but are not limited to, the following:

Learning to identify and manage what leads to cravings for alcohol ("triggers")

Resisting social pressures to engage in substance use

Changing health-care habits and lifestyle (for example, improving diet and sleep hygiene, and avoiding high-risk people, places, and events)

Learning to challenge alcoholic thinking (thoughts such as, I need a drink to fit in, have fun, or deal with stress )

Developing a recovery support system and learning how to reach out for help and support from others (for example, from members of self-help programs)

Learning to deal with emotions (anger, anxiety, boredom, depression) and stressors without reliance on alcohol

Developing a healthy, secure self-image that no longer includes alcohol

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Identifying and managing relapse warning signs before alcohol is used

Anticipating the possibility of relapse and addressing high-risk relapse factors

Adult Children of Alcoholics World Service Organization

http://www.adultchildren.org/

Al-Anon Family Group Headquarters, Inc.

1600 Corporate Landing Parkway

Virginia Beach, VA 23454-5617

Call 888-4AL-ANON (888-425-2666) for meeting information

A.A. World Services, Inc., 11th Floor

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