Conceptual study on alcoholism

Introduction

An alcohol beverage is a drink which contains a substantial amount of the psychoactive drug ethanol (alcohol); drinking plays an important social role in most cultures, alcohol has potential for abuse and physical dependence, almost all countries have laws regulating their production, sale and consumption (Minimum Age Limits Worldwide, 2009).

An alcoholic consumer is a person who consumes an amount of alcohol capable of producing pathological changes; the concentration of alcohol in blood is measured via blood alcohol content (BAC). The amount of alcohol and consequence of consumption play a large part in determining the extent of intoxication, for example, eating heavy meal before alcohol consumption causes alcohol to absorb more slowly (Horwitz, Maddox, and Bochner, 1989). Hydration plays a role especially in determining the extent of hangovers which is the experience of various unpleasant physiological and psychological effects following consumption of alcohol which can last for more than 24 hours.

Typical symptoms of hangover may includes headache, drowsiness, concentration problems, dry mouth, dizziness, fatigue, gastrointestinal distress, absence of hunger, sweating, nausea, hyper-excitability and anxiety (Stephens, Ling, Heffman, Heather and Jones, 2008). After excessive drinking, unconsciousness can occur and extreme level of consumption can lead to alcohol poisoning and death (a concentration in the blood stream of 0.40% will kill half of those affected). Alcohol may also cause death indirectly by suffocation from vomit (Fiege, Scall, Honyak, Gann and Riemaan, 2007)

Alcohol also known as alcohol use disorder (AUD) and alcohol dependence syndrome is a broad term for any drinking of alcohol that results in problems (Jill, 2015). It was previously divided into two main types alcohol abuse and alcohol dependence (Hasin, 2015). In a medical context, alcoholism is said to exist when two or more of the following is present a person drinks large amount over a long period of time, has difficulty cutting down, acquiring and drinking alcohol is strongly desired usage results in health problem, usage result in risky situations, withdrawal occurs when stopping and tolerance has occurred to use (Alcohol Use Disorder, 2015). Alcohol use can affect the brain, heart, liver, pancreas and immune system. This can result in mental illness, an irregular heartbeat, liver failure and an increase in the risk of cancer among other diseases.

Drinking during pregnancy can cause damage to baby resulting in fetal alcohol syndrome (Fetal Alcohol Exposure, 2015). Generally women are more sensitive to alcohol’s harmful physical and mental effects than men (Global Status Report on Alcohol and Health, 2014).

Both environmental factors and genetics are involved in causing alcoholism with about half the risk attributed to each, a person with a parent or sibling with alcoholism are three or four times more likely to be Alcoholic themselves. (Association, American Psychiatric, 2013). High stress levels, anxiety as well as an inexpensive easily accessible alcohol increases risk (Moonach and Pandey, 2012) people may continue to drink partly to prevent or improve symptoms of withdrawal. A low level of withdrawal may last for months following stopping (Association, American psychiatric, 2013).  Medically alcoholism is considered both a physical and mental illness (Mersy, 2003).

Prevention of alcoholism is possible by regulating and limiting the sale of alcohol, taxing alcohol to increase its cost and providing inexpensive treatment (World Health Organisation, 2015). Treatment may take several steps because of the medical problems that can occur during withdrawal, alcohol detoxification should be carefully controlled. One common method involves the use of benzodiazepine medications such as diazepam. This can be given when admitted to a health care institution or occasionally while a person remains in the community with close supervision by close family and friends (Blondel, 2005). Other additions or mental illness may complicate treatment (Davido and Weiss, 2012). After detoxification, support such as group therapy or self help groups is used to help keep a person returning to drinking. (Morgan-Lopez and Fats-Stewart, 2006)  One commonly used form of support is the group Alcoholics Anonymous (Tusa and Burghozer, 2013). The medications acamprosate, disulfiram or naltrexone may also be used to help prevent further drinking (Testino, Leone and Borro, 2014).

The World Health Organization estimates that as of 2010, there were 208 million people with alcoholism Worldwide (4.1% of the population over 15 years of age). (Global Status Report on Alcohol and Health, 2014).

In the United States, about 17 million (7%) of adults and 7 million (2.8%) of those age 12 to 17 years of age are affected. (Alcohol Facts and Statistics, 2015) It is more common among males and young adults, becoming less common in the middle and old age. (Association, American Psychiatric, 2013). It is the least common on Africa at 1.1% and has the highest rates in Eastern Europe at 11% (Association, American Psychiatric, 2013),alcoholism resulted in 139,000 deaths in 2013 up from 112,000 deaths in 1990 (GBD, 2014) a total of 3.4 million deaths (5.9% of all deaths) are believed to be due to alcohol (Alcohol, facts and Statistic, 2015). Many terms, some insulting and other informal have been used to refer to people affected by alcoholism including tippler, drunkard, dipsomaniac (a condition of uncontrollable craving for alcohol) and souse (Chambers English thesaurus). In 1979 the World Health Organisation discouraged the use of alcoholism due to its inexact meaning, preferring “alcohol” dependence syndrome (World Health Organization, 2015).

Sign and symptoms of alcoholism

Early sign: The risk of alcohol dependence begins at low levels of drinking and increase directly of drinking and increase directly with both the volume of alcohol consumed and a pattern of drinking larger amounts on an occasion.  Young adults are particularly at risk.

Long term misuse: Alcoholism is characterised by an increased tolerance and physical dependence on alcohol, affecting an individual’s ability to control consumption. These characteristics play a role in decreasing an alcoholics ability to stop drinking. (Hoffman and Tabakoff, 1996) Alcoholism can have adverse effects on mental health, causing psychiatric disorders and increasing ability to stop drinking (Hoffman and Tabakoff, 1996). Alcoholism can have adverse effects on mental health, causing psychiatric disorders and increasing the risk of suicide. A depressed mood is a common symptom (Wilson, Rechard, Kolander and Cheryl, 2015).

Physical effects of alcoholism

Long term alcohol dependence can cause a number of physical symptoms, including cirrhosis of the liver, pancritisis, epilepsy, heart disease, peptic ulcer, nutritional deficiencies (American Medical Association, 2003).

The amount of alcohol that can be biologically processed and its effects between sexes; equal dosages of alcohol consumed by men and women generally result in women having blood alcohol concentration, since women generally have a higher percentage of body fat and therefore a lower volume of distribution for alcohol than men and because the stomach of men tend to metabolize alcohol more quickly (Cederbaum, 2012).

Social effects of alcoholism

The social problems arising from alcoholism are serious, caused by the pathological changes in the brain and intoxicating effects of alcohol (McCully and Chris, 2004); Alcohol abuse is associated with an increased risk of committing criminal offences, including child abuse, domestic violence, rape, burglary and assault (Isralowitz and Richard, 2004).  Alcoholism is associated with loss of employment (Lang-dana and Farrokh, 2009) which can lead to lead to financial problems. It could also lead to marital conflict and divorce or contribute to child neglect with subsequent lasting damage to the emotional development of the alcoholic’s children (Schade and Johannes, 2006). For this reason children of alcoholic parents can develop number of emotional problems. For example, they can become afraid of their parents because of their unstable mood behaviours. In addition they can develop wretched self-images which can lead to depression.

Management of alcoholism

Treatments are varied because there are multiple perspective of alcoholism. Detoxification could be done with the use of drugs such as benzodiazepines that have similar effects to prevent alcohol withdrawal. Patients who are at risk to mild or moderate withdrawal symptom can be treated as outpatients while those of severe withdrawal symptoms are detoxified as inpatients. Detoxification does not necessarily treat alcoholism, it should be followed up with treatment medications such as Acamprosate, disulfiram, etc. Group therapy plays a great role in management of alcoholism psychologically.

Laboratory diagnosis

Blood alcohol concentration is most commonly used as a metric of alcohol intoxication for legal or medical purposes. It is usually expressed as a percentage of ethanol in the blood in units of mass of alcohol per mass of blood.

A test for blood alcohol level is done to:

• Check the amount of alcohol in the blood when a person is suspected of being legally drunk (intoxicated). Symptoms of alcohol intoxication include confusion, lack of coordination, unsteadiness that makes it hard to stand or walk, or erratic or unsafe driving.
• Find the cause of altered mental status, such as unclear thinking, confusion, or coma.
• Check to see whether alcohol is present in the blood at times when the consumption of alcohol is prohibited—for example, in underage people suspected of drinking or in people enrolled in an alcohol treatment program.

Pretest preparation

• No special preparation is needed before having a blood alcohol test.
• Many medicines may change the results of this test. Be sure to tell your doctor about all the nonprescription and prescription medicines you take.

Procedure for sample collection

• Wrap a tourniquet around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
• Clean the needle site with a non-alcohol solution such as povidone-iodine or antiseptic soap.
• Put the needle into the vein. More than one needle stick may be needed.
• Attach a tube to the needle to fill it with blood.
• Remove the band from your arm when enough blood is collected.
• Put a gauze pad or cotton ball over the needle site as the needle is removed.
• Put pressure on the site and then put on a bandage.

A blood alcohol test measures the amount of alcohol (ethanol) in your body. Some states have no set limit for legal intoxication. But the National Highway Traffic Safety Administration (NHTSA) recommends that all states set the legal definition of intoxication as the point when the blood alcohol concentration (BAC) exceeds 0.08 (which is equivalent to 80 mg/dL or 17 mmol/L).

Result

Legal intoxication is defined as having a blood alcohol concentration (BAC) of 0.08 or greater. But the legal blood alcohol concentration (BAC) limit for people under age 18 may be lower, such as 0.02.

Effects of alcohol intake

Having any amount of alcohol in the blood can cause poor judgment and slowed reflexes. BAC and the effects of drinking alcohol vary from person to person and depend upon body weight, the amount of food eaten while drinking, and each person’s ability to tolerate alcohol.

Precautions

Reasons you may not be able to have the test or why the results may not be helpful include:

• Using rubbing alcohol to clean the skin before inserting a needle to draw blood.
• You have high blood ketones, as in diabetic ketoacidosis.
• Taking cough medicines that contain alcohol or herbal supplements, such as kava or ginseng.
• Drinking other alcohols, such as isopropyl alcohol or methanol.

Many medicines may change the results of this test. Be sure to tell your doctor about all the non-prescription and prescription medicines you take. Things that affect how quickly the blood alcohol level rises in the body include:

• The number of drinks per hour. As you increase the number of drinks per hour, your blood alcohol level steadily increases.
• The strength of alcohol (proof or percentage) in the drink.
• Your weight. The more you weigh, the more water is present in your body, which dilutes the alcohol and lowers the blood alcohol level.
• Your sex. Women’s bodies usually have less water and more fat than men’s bodies. Alcohol does not go into fat cells as well as other cells, so women tend to keep more alcohol in their blood than men do. Also, a woman’s hormones may affect the breakdown of alcohol.
• Your age. One drink raises the blood alcohol level of an older adult more than it does for a young adult.
• Eating: Food in the stomach absorbs some of the alcohol. The blood alcohol level will be higher if you do not eat before or during drinking.

Conclusion

From knowledge gotten from different events and article around the world, alcohol has proven to have more negative effects than positive in human health.

Recommendations

The more alcohol a person consumes the more intoxicated and impaired they become. Laws should be created to control alcohol intake and age range. Also taxing alcohol to increase its cost, inexpensive treatment should be provided for alcoholics.

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