Have you ever seen beggars lying on the footpath drunk? Or maybe read a headline about a drunken brawl? You might even know someone whose "behavior changes" when they get drunk. Alcoholism is a huge problem; It not only implicates the body but also has a psychological and cognitive impact and harms society and communities at large.
Alcohol-use disorders (AUD) are classified under substance-related and addictive disorders. It is defined by a cluster of behavioral and physical symptoms, such as withdrawal, tolerance, and craving. It is characterized by problematic patterns of alcohol use, which lead to significant impairment or distress. Several symptoms substantiate the current version of The Diagnostic and Statistical Manual of Mental Disorders (i.e., DSM-V-TR).
As evident, many symptoms can be indicative of AUD. However, the presence of all at the same time is not necessary. The presence of at least two symptoms occurring within 12 months can provide for a diagnosis of AUD.
Severity is based on the number of diagnostic criteria or symptoms endorsed, and change in severity is reflected by reduced frequency (days per month) or dose (number of drinks) of alcohol. It is judged based on an individual's self-report, report of knowledgeable others, clinician observations, and, when practical, biological testing like blood tests.
Individuals consuming alcohol may engage in heavy and extended periods of drinking. Once they stop, they may experience withdrawal symptoms. Withdrawal symptoms develop approximately 4–12 hours after the reduction of intake following a prolonged period of heavy alcohol intake. Withdrawal can be unpleasant and intense. As a result, people may try to avoid or relieve themselves by continuing to drink despite adverse consequences. Some withdrawal symptoms, like sleep problems, can persist at lower intensities for months and further contribute to relapse. Once a repetitive and intense cycle of use develops, individuals with AUD may spend considerable time obtaining and consuming alcoholic beverages.
Craving can be understood as a strong desire to drink. The desire is so strong that it is difficult to think of anything else, often leading to the onset of drinking. Consequently, various social and personal aspects of the individual's life may be affected by the after-effects of drinking or intoxication; School, workplace, and familial responsibilities may be implicated. Hazardous action done under the influence may cost human life. Individuals with AUD may continue to consume alcohol, knowing the dangerous effects it will have.
Poverty, discrimination, unemployment, low levels of education, the availability of alcohol (including price), cultural attitudes toward drinking, intoxication, acquired personal experiences with alcohol, and stress levels are some environmental risk factors that may push a person towards AUD. Peer substance use exaggerated positive expectations of the effects of alcohol, and suboptimal ways of coping with stress may also have an impact. On genetic levels, it has also been found that alcoholism may run in the family. Approximately 60% of AUD is heritable. Parents' drinking patterns may also influence the likelihood of a child developing an AUD. The personality trait of neuroticism (i.e., negative emotionality), impulsivity, and sensation-seeking are associated with risk for alcoholism. For adolescents, the level of peer-group drinking is the strongest correlate to alcohol consumption. On an individual level, age, gender, family circumstances, and socioeconomic status affect alcohol consumption. Although no single risk factor is dominant, the more vulnerabilities a person has, the more likely the person will develop alcohol-related problems due to alcohol consumption. Poorer people suffer more health and social consequences from alcohol consumption than those from a more affluent background.
Studies have linked suicide with alcohol use, suggesting that intoxication and chronic heavy alcohol use are associated with suicide. Additionally, extensive population-level data link alcohol with suicide, and there is evidence suggesting that restrictive alcohol policies may help prevent suicide on a general population level. AUD also has psychiatric comorbidity with bipolar disorders, schizophrenia, and antisocial personality disorder, and anxiety and depression are also associated with AUD.
Prolonged use of alcohol damages almost every tissue and organ of the body. Alcohol provides empty calories without any nutrients essential for health; This leads to lower food intake causing serious implications for the body. Older people who have abused alcohol have a deficiency of B-complex vitamins, which may result in amnestic syndrome. Long-time alcohol use may also lead to cirrhosis which may compromise the liver. Heavy drinking during pregnancy can slow down the fetus's growth and cause anomalies in limbs, face, and skull leading to a condition known as fetal alcohol syndrome (FAS). Even moderate drinking during pregnancy can have detrimental effects on the fetus. Damage to the endocrine glands and pancreas, heart failure, erectile dysfunction, hypertension, stroke, and capillary hemorrhages are other common changes that can happen in the body due to alcohol abuse. Severe and repeated alcohol intoxication may also predispose and increase cancer risk by suppressing immune mechanisms. Withdrawal from long-term chronic alcohol use can also lead to tremors, anxiety, nausea, transient hallucinations, agitation, insomnia, and, at its most extreme, withdrawal delirium (or delirium tremens—the DTs). Frightening hallucinations and body tremors characterize DT.
There are multiple treatment methods for AUD, including rehab and the 28th-day residential program. Many people think that rehab is the only effective treatment method for AUD. However, AUD might not always be helpful or even necessary. Medicine like Naltrexone, acamprosate, and disulfiram may be helpful in treatment. Other than this, cognitive behavior therapy (CBT) may also be employed. Behavioral treatments like talk therapy or counseling may also be provided to individuals. Brief intervention, reinforcement approaches, treatments that build motivation, teaching skills for coping and preventing relapse, and mindfulness-based therapy are all included in this treatment option. Mutual-support groups also provide peer support for stopping and reducing drinking. They are low-cost, available in most communities, and have time and location convenience.
Alcohol use caused 2.8 million deaths worldwide; AUD is estimated to affect 237 million men and 46 million women globally, with men having higher drinking and alcohol use disorder rates than women. However, as important as it is to talk about the negatives of alcohol, it is also important to talk about its positives. Light drinking has been associated with a lower risk for coronary heart disease and stroke. Low to moderate levels of wine consumption have been linked to lower bad cholesterol and higher good cholesterol levels. These positives could be due to physiological or psychological factors or the interaction of the two.
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National Institute on Alcohol Abuse and Alcoholism. Understanding Alcohol Use Disorder (URL - https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder)
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World Health Organization. Alcohol (URL - https://www.who.int/news-room/fact-sheets/detail/alcohol)
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