alcohol dependence
The definitions used in this glossary of terminology either have been provided by the authors of the articles, or have been extracted wholly or in part, or paraphrased from the following sources: The American Medical Association Encyclopedia of Medicine, Charles B. Clayman, MD, Medical Editor, Random House, New York, 1989; Biotechnology from A to Z, 2d Edition, William Bains, Oxford University Press, New York, New York, 2002; A Dictionary of Genetics, 6th Edition, Robert C. King and William D. Stansfield, Oxford University Press, New York, New York, 2002; Dorland's Illustrated Medical Dictionary, 29th and 30th Editions, W. B. Saunders Company, Philadelphia, 2000, 2003; Genes VII, Benjamin Lewin, Oxford University Press, New York, New York, 2000; The Gale Encyclopedia of Genetic Disorders, Volumes I and II, Stacey L. Blachford, Ed., Thomson Learning, New York, New York, 2002; The Merriam-Webster Dictionary, Merriam-Webster, Inc., Springfield, Massachusetts, 1997; Molecular Biology of the Cell, 3rd Edition, Bruce Alberts, et al., Garland Publishing, 1994; The Random House Dictionary of the English Language, Unabridged Edition, 1966; Webster's Ninth New Collegiate Dictionary, 1991.
DEFINITION:
- alcohol dependence
-
An illness characterized by habitual, compulsive, long-term, heavy consumption of alcohol and the development of withdrawal symptoms when drinking has stopped suddenly. The description "alcohol dependence" is generally preferred medically to "alcoholism," but the terms are virtually synonymous.
Causes
There is no single cause of alcohol dependence. Three causative factors interact in the development of the illness: personality, environment, and the addictive nature of the agent (i.e., the drug alcohol). Thus, if all other factors (such as the availability of alcohol) are equal, then inadequate, insecure, or immature personalities are more at risk than more emotionally mature individuals.
Inherited, genetic factors probably play a part in causing dependence in some cases but it is now widely believed that any person, irrespective of environment, genetic background, or personality, can become alcoholic if he or she drinks heavily for a prolonged period.
Environmental factors are important, especially the ready availability, affordability, and widespread social acceptance of alcohol in the individual's national culture and among the people he or she associates with at work and during leisure hours. Thus alcoholism is much more common in certain countries, occupations, and social groups than in others.
Stress is another important factor. Many formerly moderate drinkers begin to drink excessively at times of bereavement. Women may turn to drink when their adolescent children leave home. Hormonal factors may also play a role in heavy drinking among women.
Once social and/or psychological factors have induced heavy drinking, the discovery that taking alcohol in the morning relieves the withdrawal symptoms induced by the previous night's drinking tends to accelerate the development of dependence.
Development of Dependence
The development of alcohol dependence can be divided into four main stages, which merge imperceptibly. The time scale of these changes may be from five to 25 years, although the average is about 10 years.
In the first phase, tolerance (being able to drink more alcohol before experiencing its ill effects) develops in the heavy social drinker. Entering the second phase, the drinker experiences memory lapses relating to events occurring during the drinking episodes. The third phase is characterized by loss, or lack, of control over alcohol; the drinker can no longer be certain of discontinuing drinking whenever he or she wants to. The final phase starts with prolonged binges of intoxication, with the drinker suffering observable mental or physical complications.
Some people halt their consumption, temporarily or permanently, during one of the first three phases.
Symptoms and Effects
Behavioral symptoms are varied and can include any combination of the following: furtive behavior (such as hiding bottles); aggressive or grandiose behavior; personality changes (such as irritability, jealousy, uncontrolled anger, selfishness); frequent change of jobs; constant promises to self and others to give up drinking; changes in drinking pattern (for example, switching to early-morning drinking, or changing from beer to spirits); neglect of food intake and personal appearance; and lengthy periods of intoxication.
Physical symptoms can also be varied. The drinker may exhibit any of the following: nausea, vomiting, or shaking in the morning; abdominal pain; cramps; numbness or tingling; weakness in the legs and hands; irregular pulse; redness and enlarged capillaries in the face; unsteadiness; confusion; poor memory; and incontinence. After sudden withdrawal of alcohol, the dependent person may experience delirium tremens (severe shakes, hallucinations, and convulsions).
In addition, alcohol-dependent persons are more susceptible than others to a wide variety of specific physical and mental diseases and disorders. (For example, cancer, liver damage and disease, nervous system disorders, heart and circulatory disorders, gastritis, pancreatitis, and peptic ulcer have all been associated with alcohol dependency. In pregnant women, heavy drinking carries a risk of the baby being born with fetal alcohol syndrome. Psychiatric illnesses include anxiety, depression, paranoia, and dementia. The incidence of suicide attempts and actual suicide is also higher among alcoholics.)
Treatment
Many alcoholics require detoxification (medical help in getting over their physical withdrawal symptoms when they stop drinking). Detoxification is followed by long-term treatment. No single form of treatment is best for all alcoholics. Sometimes psychological, social, and physical treatments may be combined.
Psychological treatments involve psychotherapy and are now commonly and more reasonably carried out in groups. There are various types of group therapy, using different techniques.
Social treatments include help with problems at work and, in particular, the inclusion of family members in the treatment process.
Physical treatment is needed only by some alcoholics. It generally includes the use of disulfiram, a drug that sensitizes the drinker to alcohol so that he or she is afraid to drink because of unpleasant symptoms.
Alcoholics are strongly advised to use the self-help fellowship of organizations (i.e., Alcoholics Anonymous), where the alcoholics greatly benefit from meeting fellow sufferers who share their experiences.
Used in 2 Term definitions
Used in 2 Term definitions