Alcoholism

DESCRIPTION
* Alcoholism can have three components. The primary one is alcohol addiction (inability to discontinue drinking). The second is "problem drinking," in which alcohol interferes with the activities of daily living. The third is the use of alcoholic beverages to alleviate stress or emotional problems.


SYPTOMS
* Tolerance to the effects of alcohol
* Withdrawal symptoms when alcohol intake is interrupted
* Impairment in social and occupational function
* Depression
* Blackouts
* Frequent unexplained accidents (e.g., falls and injuries)

CAUSE
* Partial genetic Predisposition -- higher rate in twins and adopted children with alcoholic birth parents
* Abnormalities in the brain neurotransmitters or chemical enzymes may play a role.
* Depression
* Anxiety
* Addictive personality

HOW THE DIAGNOSIS IS MADE
* Alcohol on breath
* Red bulbous nose
* Red Eyes
* Memory difficulties
* Signs of alcoholic liver disease:
* Yellow eyes or skin
* Ascites (swollen abdomen)
* Palmar erythema (pink/red hands)
* Tremor
* Laboratory tests:

1. Elevated liver function tests, especially AST twice ALT value
2. Elevated mean corpuscular volume
3. Elevated Uric acid
4. Elevated triglycerides
5. Toxicology screen (ethanol level)

* Psychological screening tests such as Michigan Alcohol Screening Test (MAST), or Short MAST are sometimes used.

TREATMENT
* Alcohol recovery programs
* Alcoholics anonymous
* Religious/spiritual support
* Treatment of Depression, if present:

1. Psychotherapy
2. Antidepressants

* Disulfiram (Antabuse) -- an aversion medication that causes nausea/vomiting if one drinks alcoholic beverages
* Naltrexone -- a medication that helps with alcohol craving
* Ondansetron -- a medication that helps with alcohol craving
* Treatment of alcohol withdrawal if it occurs
* Treating Depression and social problems
* Treatment goal

- Complete Abstinence (and not "controlled drinking")

SIMILAR CONDITIONS
* Alcoholic Hepatitis
* Cirrhosis
* Drug addiction
* Alcohol withdrawal
* Wernicke's Encephalopathy
* Korsakoff's Psychosis
* Depression

MISCELLANEOUS
* Social Implications of Alcoholism

1. Major factor in rape, sexual abuse, assault, and murder
2. Higher rate of suicide
3. Major cause of automobile fatalities
4. Dysfunctional homes
5. Major cause of missed work