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Drink, Drugs And Dependence: From Science To Clinical Practice - Isbn:9780415279017

Category: Psychology

  • Book Title: Drink, Drugs and Dependence: From Science to Clinical Practice
  • ISBN 13: 9780415279017
  • ISBN 10: 0415279011
  • Author: Woody Caan, J. De Belleroche
  • Category: Psychology
  • Category (general): Psychology
  • Publisher: Psychology Press
  • Format & Number of pages: 303 pages, book
  • Synopsis: In order to understand substance use and substance users, no single discipline can provide all the answers. In a novel way, this book integrates biological science, social science and clinical experience.

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ISBN: 0415278910 - Drink, Drugs And Dependence: From Science To Clinical Practice - OPENISBN Project: Download Book Data

Drink, Drugs And Dependence: From Science To Clinical Practice

At a world level addiction and the fall-out from substance use is affecting more and more lives. Professionals are increasingly being confronted with puzzling, multifaceted aspects of substance use, whether they work in a clinic, the laboratory or the community.
If you are a member of any caring profession, sooner or later you will encounter problems caused by drugs, alcohol and tobacco. In order to understand substance use and substance users, no single discipline can provide all the answers. In a novel way, this book integrates biological science, social science and clinical experience. It draws together contributions from experts in these diverse and rapidly growing fields, providing the reader with a deeper capacity to engage with problems effectively.
Drink, Drugs and Dependence includes thought-provoking examples, illustrations and test questions to support problem-based learning. Designed to be read consecutively or as a reference text, it will be a welcome resource for all those working in the field of addiction.

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Drink, drugs and dependence

Drink, drugs and dependence: from science to clinical practice Classification Book Details
  • Language: eng
  • Physical Description: xix, 303, [2] p. of plates. ill. (some col.) ; 24 cm.
  • Edition Info: (pbk.)
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Download Drink, Drugs and Dependence: From Science to Clinical Practice - Woody Caan, Jackie De Belleroche - Download free academic books pdf

Download Drink, Drugs and Dependence: From Science to Clinical Practice - Woody Caan, Jackie De Belleroche

At a world level addiction and the fall-out from substance use is affecting more and more lives. Professionals are increasingly being confronted with puzzling, multifaceted aspects of substance use, whether they work in a clinic, the laboratory or the community.
If you are a member of any caring profession, sooner or later you will encounter problems caused by drugs, alcohol and tobacco. In order to understand substance use and substance users, no single discipline can provide all the answers. In a novel way, this book integrates biological science, social science and clinical experience. It draws together contributions from experts in these diverse and rapidly growing fields, providing the reader with a deeper capacity to engage with problems effectively.
Drink, Drugs and Dependence includes thought-provoking examples, illustrations and test questions to support problem-based learning. Designed to be read consecutively or as a reference text, it will be a welcome resource for all those working in the field of addiction.

Author: Woody Caan, Jackie De Belleroche
Pages: 332 pages
Format: PDF
Size: 37.05 Mb Download

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Translation of Addictions Science Into Practice, 1st Edition

Translation of Addictions Science Into Practice, 1st Edition Key Features

*Provides a much needed resource for translating current research into clinical practice
*Focuses upon alcohol, tobacco, and substance abuse addictions
*Addresses method of research and best dissemination techniques

Description

Recent advances in the understanding of the genetic, neurochemical, behavioral and cultural underpinnings of addiction have led to rapid advances in the understanding of addiction as a disease. In fact, advances in basic science and the development of new pharmacological and behavioral therapies associated with them are appearing faster than can be assimilated not only by clinical researchers but practitioners and policy makers as well. Translation of science-based addictions knowledge into improved prevention, assessment and treatment, and communication of these changes to researchers and practitioners are significant challenges to the field.

The general aim of this book is to summarize current and potential linkages between advances in addiction science and innovations in clinical practice. Whilst this book is primarily focused on translation, it also encompasses some scientific advances that are relevant to dissemination, and the book is itself a tool for disseminating innovative thinking.

The goal is to generate interest in application opportunities from both recent research and theoretical advances.

Researchers in addiction, academic clinical researchers in addiction, practitioners and policy makers who are committed to a scientist-practitioner model and are interested in advances in their field.

Peter Miller

Peter M. Miller, Ph.D. is a clinical psychologist and Professor of Psychiatry and Behavioral Sciences in the Center for Drug and Alcohol Programs at the Medical University of South Carolina. He is Editor-in-Chief of the journal Addictive Behaviors and an experienced researcher and clinician in the field of alcohol use disorders.

Affiliations and Expertise

Medical University of South Carolina, Charleston, USA

Translation of Addictions Science Into Practice, 1st Edition

TRANSLATION OF ADDICTIONS SCIENCE INTO PRACTICE:
UPDATE AND FUTURE DIRECTIONS

Peter M. Miller and David J. Kavanagh

List of Contributors
Preface

SECTION I: GENETICS AND NEUROSCIENCE

Chapter 1
The Interplay between Genotype and Gene Expression in Human Brain: What Can It Teach Us about Alcohol Dependence? (Dodd)

Chapter 2
Common Genetic Influences on Antisociality and Addictions: Implications for Clinical Science and Practice (King)

Chapter 3
Opioids, Pain and Addiction: Cause and Consequence
(White and Hay)

Chapter 4
Imbalance between Neuroexcitatory and Neuroinhibitory Amino Acids Causes Craving for Ethanol: From Animal to Human Studies (DeWitte)

Chapter 5
Cannabis and the Brain: Implications of Recent Research (Sundram and Castle)

SECTION II. PHARMACOTHERAPY

Chapter 6
The Plasticity of Alcohol Addiction Suggests Novel Approaches to Pharmacological Intervention (Mulholland And Chandler)

Chapter 7
Pharmacotherapies for the Treatment of Alcohol Dependence: Current and on the Horizon (Wright, Baros, Anton)

Chapter 8
Agonist Treatment for Stimulant Abuse and Dependence
(Herin and Grabowski)

Chapter 9
Topiramate-Induced Neuromodulation of Cortico-Mesolimbic Dopamine: Implications for the Treatment of Nicotine and Alcohol Dependence (Johnson)

SECTION III. PSYCHOLOGY AND SOCIOLOGY

Chapter 10
Advances in the Scientific Study of Craving for Alcohol and Tobacco (MacKillop and Monti)

Chapter 11
Advances in the Treatment of Craving for Alcohol and Tobacco (Monti and MacKillop)

Chapter 12
Cognitive, Affective and Motivational Effects of Smoking (Powell and Dawkins)

Chapter 13
Therapeutic Outcome Research and Dissemination of Empirically Based Treatment for Alcohol Use Disorders (Wilbourne)

Chapter 14
Implications of Research on Comorbidity for the Nature and Management of Substance Misuse(Mueser, Kavanagh, & Brunette)

Chapter 15
The Role of Impulsive Personality Traits in the Initiation, Development and Treatment of Substance Misuse Problems (Dawe, Loxton, Gullo, Staiger, Kambouropoulos, Perdon, and Wood)

Chapter 16
Translational Research Involving Adolescent Substance Abuse (Cornelius and Clark)

SECTION IV: PRACTICE AND POLICY

Chapter 17
Dissemination of Evidence-Based Treatment into Substance Abuse Clinical Practice (Sorensen, Hettema, and Chen)

Chapter 18
Alcohol Screening and Intervention in Medical and Surgical Settings (Stewart and Miller)

Chapter 19
Internet-Based Interventions for Alcohol, Tobacco and Other Substances of Abuse (Cunningham)

Chapter 20
Alcohol Use among Undergraduate Students: From Brief Interventions to Behavioral Economics (Henslee, Irons, and Correia)

Chapter 21
Ethical and Policy Issues in the Translation of Genetic and Neuroscience Research on Addiction (Carter and Hall)

SECTION V: CONCLUSION

Chapter 22
Pathways to Innovation in Addiction Practice (Kavanagh and Miller)

Source:

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Alcoholism Facts for Kids

Alcoholism

A drawing from 1883, showing the problems of alcoholism; the drawing is called at her feet

Alcoholism is the medical condition of people who often drink too much alcohol. Some people who suffer from alcoholism feel that they have to drink alcohol, even when it causes health and social problems. Alcoholism means addiction to alcohol. People who suffer from it are called alcoholics. As the condition goes on, those who suffer from it change their habits: obtaining alcohol and consuming it becomes more important. Very often, other interests disappear. Many alcoholics do not think they have a problem with drinking alcohol. With time, they better support bigger quantities, and their personality changes.

Medically, there are two different conditions:

  1. Drinking too much alcohol, and seeing the negative effects of this behaviour
  2. Being dependent on alcohol

According to the World Health Oranization. there are approximately 140 million people with alcoholism worldwide. [1] [2] In the United States and Western Europe, ten to twenty percent of men and five to ten percent of women at some point in their lives will meet criteria for alcoholism. [3]

Alcoholism is called a "dual disease": There are both mental and physical components. [4] The biological mechanisms that cause alcoholism are not well understood. Social environment. stress. [5] mental health. family history. age, ethnic group, and gender all influence the risk for the condition. [6] [7] Consuming large amounts of alcohol produces changes in the brain's structure and chemistry. Some changes occur very early, even when small amountas of alcohol are consumed, in a short time. Examples are tolerance and physical dependence. Because of the changes, it is very difficult for an alcoholic to stop drinking, as this would result in alcohol withdrawal syndrome if the person stops. [8] Alcohol damages almost every organ in the body, including the brain. Chronic alcohol abuse can cause both medical and psychiatric problems. [9]

Alcoholism is a condition with a social stigma. As a result, people suffering from it, avoid being diagnosed or treated, as this may be shameful, or have social consequences. The evaluation responses to a group of standardized questioning is a common method for diagnosing alcoholism. These can be used to identify harmful drinking patterns, including alcoholism. [10] In general, problem drinking is considered alcoholism when the person continues to drink despite experiencing social or health problems caused by drinking. [11]

Contents

The drunkards progress, an illustrationfrom 1846: The stages:
Step 1. A glass with a friend.
Step 2. A glass to keep the cold out.
Step 3. A glass too much.
Step 4. Drunk and riotous.
Step 5. The summit attained. Jolly companions. A confirmed drunkard.
Step 6. Poverty and disease.
Step 7. Forsaken by Friends.
Step 8. Desperation and crime.
Step 9. Death by suicide.

Generally, there are different stages to alcoholism.

  1. Drinking alcohol starts in a social setting, on occasion, together with friends. With time progressing, the potential alcoholic feels relieved when he drinks. This relief is usually attributed to the situation, or the people, not the alcohol. With the time people seek out occasions where "social drinking" occurs. People also develop tolerance. This means over time, they need a larger quantity of alcohol to get the same feeling of relief.
  2. In the next phase, the drinker has problems remembering things. The alcoholic may be completely normal, but they cannot remember certain events, or how certain events occurred. This is independent of a feeling of drunkenness. The patient also begins to see that he drinks more alcohol than other people. For this reason, drinking is often done in secret. The first glasses are consumed more quickly; this is done so as to not stand out, and to get the feeling quicker. There are feelings of guilt; the patient tries to avoid talking about alcohol for this reason.
  3. The alcoholic is no longer able to control his drinking. He may not drink for a long time, but once he gets a tiny bit of alcohol, he is unable to stop until he is either drunk, or too sick to continue; this is called craving. The patient thinks this is just a lack of resolve, but in truth he is dependent on alcohol. Excuses are found for the drinking habit. To the patient it is important to be able to explain, because except for alcohol, there are no other solutions to problems. Because of this behaviour there are problems with the rest of his family. There are whole families who get isolated, because they try to hide the drinking problem of a family member. This is called co-dependence .

The overuse of alcohol has different causes, and there are different forms of treatment available. Some of these treatments are:

  • Detoxification. Alcohol use is stopped abruptly. The alcohol is sometimes replaced with other drugs that have similar effects, to prevent withdrawal symptoms.
  • Therapy. Various therapies are available.
  • Moderation. Alcohol use is lowered and lowered.
  • Drugs. Some drugs can help the transition to drinking less, or are very dangerous if they are consumed with alcohol.

Treatment of alcoholism takes several steps. Direct withdrawal leads to medical problems. For this reason, the process of withdrawal needs to be controlled carefully. Alcohol detoxification often involves the use of special drugs ; benzodiazepines such as diazepam are used frequently. [12] Sometimes, people with alcoholism also have other addictions. Benzodiazepines are addictive. If the person is addicted to both alcohol, and benzodiazepines, this step gets more complicated. [13] After detoxification, other support such as group therapy or self-help groups are used to help the person remain sober. [14] [15] Thombs (1999) states according to behavioural sciences alcoholism is described as a “maladaptive behaviour”. He explains this must not be confused with “misbehaviour”. Behavioural scientists explain that addicts have a behaviour pattern that may lead to destructive consequences for themselves, their families and society. This does not label addicts as bad or irresponsible. [16] Compared with men, women are more sensitive to alcohol's harmful physical, cerebral, and mental effects.

Different types of alcoholics

Elvin Morton Jellinek identified different types of people drinking alcohol: [17]

  • Alpha-type. these people drink alcohol to cope with difficult situations. The amount of alcohol consumed mainly depends how difficult the situation is perceived. Alpha-types are not alcoholics, but they run they risk of psychical addiction.
  • Beta type. Given the right occasion, these people drink a large quantity of alcohol. Socially and psychically speaking, they usually do not get noticed easily. They simply have a lifestyle which often gives the opportunities to drink. They suffer some consequences from their frequent alcohol consumption. They are neither psychically nor physically dependent, but often at risk of becoming so.
  • Gamma-type. These people have longer phases of being abstinent. These phases alternate with phases of being very drunk. One of the characteristic of people o this type is the loss of control: Such people cannot stop drinking, even when they have the feeling to have drunk enough. They feel safe because of the longer phases of not drinking alcohol, but they are in fact alcohol-dependent.
  • Delta-type. People of this type try to keep a "level" of alcohol during the day, and the night. The level is usually quite low, but increases as the illness progresses. This is also because a kind of tolerance develops; in other words, the same amount of alcohol will not have the same effect, after some time. For a long time, addicts can function in society, because they rarely "look drunk". There is a strong physical dependence; these people need to constantly drink alcohol to counter withdrawal symptoms. There are health problems related to the constant drinking. Delta types are not capable of being without alcohol, and of alcohol-dependent.
  • Epsilon-type. These people drink alcohol excessively, in irregular intervals. When drinking, they lose control. These intervals can last days to months. Between two intervals, usually no alcohol is consumed. Epsilon-types are alcohol dependent.
  • Type-I. Also called milieu -determined alcoholism: Sufferers can be of either sex. Alcohol abuse can be mild or heavy. The illness usually gets wors rapidly. People with a lower social status suffer more markedly. Those who suffer try to "keep harm away", they are dependent on a "reward". Usually, people suffer from Clinical depression and phobias. which they try to fight with drinking alcohol. There is little genetic disposition towards alcohol-dependence.
  • Type-II. This type only affects men. Alcohol abuse is moderate, but shows early. Mothers of such alcoholics tend to be non-nondescript, but their fathers usually developed alcohol dependence before they turned 25. In addition, such people are often criminals. Those affected often show antisocial behavior; they also like to take risks. Usually they use alcohol to get euphoric, but often also have a problem with other drugs. Probably genetic dispostion is more important in this type, than social factors.

S. Y. Hill added a third type in 1992: [19]

  • Type-III. Very much influenced by genetic disposition, as Type II. Unlike Type II, Type III does not show antisocial behavior.

Source:

www.kidzsearch.com

Drink, Drugs and Dependence: From Science to Clinical Practice - ISBN:9780415279017

Alcoholism

Alcoholism is a broad term for problems with alcohol. and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages. usually to the detriment of the drinker's health, personal relationships, and social standing. It is medically considered a disease. specifically a neurological disorder. and in medicine several other terms are used, specifically "alcohol abuse " and "alcohol dependence " which have more specific definitions. [ 1 ] In 1979 an expert World Health Organisation committee discouraged the use of "alcoholism" in medicine, preferring the category of "alcohol dependence syndrome". [ 2 ] In the 19th and early 20th centuries, alcohol dependence in general was called dipsomania. but that term now has a much more specific meaning. [ 3 ] People suffering from alcoholism are often called "alcoholics". Many other terms, some of them insulting or informal. have been used throughout history. The World Health Organization estimates that there are 140 million people with alcoholism worldwide. [ 4 ] [ 5 ]

Alcoholism is called a "dual disease" since it includes both mental and physical components. [ 6 ] The biological mechanisms that cause alcoholism are not well understood. Social environment. stress. [ 7 ] mental health. family history. age, ethnic group, and gender all influence the risk for the condition. [ 8 ] [ 9 ] Long-term alcohol abuse produces changes in the brain's structure and chemistry such as tolerance and physical dependence. These changes maintain the person with alcoholism's compulsive inability to stop drinking and result in alcohol withdrawal syndrome if the person stops. [ 10 ] Alcohol damages almost every organ in the body, including the brain. The cumulative toxic effects of chronic alcohol abuse can cause both medical and psychiatric problems. [ 11 ]

Identifying alcoholism is difficult because of the social stigma associated with the disease that causes people with alcoholism to avoid diagnosis and treatment for fear of shame or social consequences. A common method for diagnosing alcoholism is evaluating responses to a group of standardized questions. These can be used to identify harmful drinking patterns, including alcoholism. [ 12 ] In general, problem drinking is considered alcoholism when the person continues to drink when they want to stop because of social or health problems caused by drinking. [ 13 ]

Treatment of alcoholism takes several steps. Because of the medical problems that can be caused by withdrawal, alcohol detoxification is carefully controlled and may involve medications such as benzodiazepines such as diazepam (Valium). [ 14 ] People with alcoholism also sometimes have other addictions, including addictions to benzodiazepines, which may complicate this step. [ 15 ] After detoxification, other support such as group therapy or self-help groups are used to help the person remain sober. [ 16 ] [ 17 ] Thombs (1999) states according to behavioural sciences alcoholism is described as a “maladaptive behaviour”. He explains this must not be confused with “misbehaviour”. Behavioural scientists explain that addicts have a behaviour pattern that may lead to destructive consequences for themselves, their families and society. This does not label addicts as bad or irresponsible. [ 18 ] Compared with men, women are more sensitive to alcohol's harmful physical, cerebral, and mental effects. [ 19 ] [ 20 ]

Contents Terminology

Misuse, problem use, abuse, and heavy use refer to improper use of alcohol which may cause physical, social, or moral harm to the drinker. [ 21 ] Moderate use is defined by The Dietary Guidelines for Americans as no more than two alcoholic beverages a day for men and no more than one alcoholic beverage a day for women. [ 22 ] Some drinkers may drink more than 600 ml of alcohol per day during a heavy drinking period. [ 23 ]

The term "alcoholism" is commonly used, but poorly defined. The WHO calls alcoholism "a term of long-standing use and variable meaning", and use of the term was disfavored by a 1979 WHO Expert Committee. The Big Book (from Alcoholics Anonymous ) states that once a person is an alcoholic, they are always an alcoholic, but does not define what is meant by the term "alcoholic" in this context. In 1960, Bill W.. co-founder of Alcoholics Anonymous (AA), said:

We have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments, or combinations of them. It is something like that with alcoholism. Therefore we did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Therefore we always called it an illness. or a malady—a far safer term for us to use. [ 24 ]

In professional and research contexts, the term "alcoholism" sometimes encompasses both alcohol abuse and alcohol dependence, [ 25 ] and sometimes is considered equivalent to alcohol dependence. Talbot (1989) observes that alcoholism in the classical disease model follows a progressive course: if a person continues to drink, their condition will worsen. This will lead to harmful consequences in their life, physically, mentally, emotionally and socially. [ 26 ]

Johnson (1980) explores the emotional progression of the addict’s response to alcohol. He looks at this in four phases. The first two are considered “normal” drinking and the last two are viewed as "typical" alcoholic drinking. [ 27 ] [ 28 ] Johnson's four phases consist of:

  1. Learning the mood swing. A person is introduced to alcohol (in some cultures this can happen at a relatively young age), and the person enjoys the happy feeling it produces. At this stage there is no emotional cost.
  2. Seeking the mood swing. A person will drink to regain that feeling of euphoria experienced in phase 1; the drinking will increase as more intoxication is required to achieve the same effect. Again at this stage, there are no significant consequences.
  3. At the third stage there are physical and social consequences, i.e. hangovers, family problems, work problems, etc. A person will continue to drink excessively, disregarding the problems.
  4. The fourth stage can be detrimental, as Johnson cites it as a risk for premature death. As a person now drinks to feel normal, they block out the feelings of overwhelming guilt, remorse, anxiety, and shame they experience when sober. [ 29 ]

Other theorists such as Milam & Ketcham (1983) focus on the physical deterioration of alcohol. They describe the process in three stages:

  1. Adaptive stage - The person will not experience any negative symptoms, and believe they have capacity for alcohol. Physiological changes are happening with the increase in tolerance, but this will not be noticeable to the drinker or others.
  2. Dependent stage - At this stage, symptoms build gradually. Hangover symptoms may be confused with withdrawal symptoms. Many addicts will maintain their drinking to avoid withdrawal sickness, drinking small amounts frequently. They will try and hide their problem from others, and will avoid gross intoxication.
  3. Deterioration stage - Various organs are damaged due to long-term drinking. Medical treatment will be required; otherwise the pathological changes will cause death.

In psychology and psychiatry, the DSM is the most common global standard, while in medicine, the standard is ICD. The terms they recommend are similar but not identical.

  • alcohol abuse = repeated use despite recurrent adverse consequences. [ 30 ]
  • alcohol dependence = alcohol abuse combined with tolerance. withdrawal. and an uncontrollable drive to drink. [ 30 ]

The term "alcoholism" was split into "alcohol abuse" and "alcohol dependence" in 1980's DSM-III, and in 1987's DSM-III-R behavioral symptoms were moved from "abuse" to "dependence". [ 1 ] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry, [ 31 ] named "alcohol-use disorder". [ 32 ]

"alcohol harmful use" and "alcohol dependence syndrome"

Definitions are similar to that of the DSM-IV. The World Health Organisation uses the term "alcohol dependence syndrome" rather than alcoholism. [ 2 ] The concept of "harmful use" (as opposed to "abuse") was introduced in 1992's ICD-10 to minimize underreporting of damage in the absence of dependence. [ 1 ] The term "alcoholism" was removed from ICD between ICD-8/ICDA-8 and ICD-9. [ 33 ]

Despite the imprecision inherent in the term, there have been attempts to define how the word "alcoholism" should be interpreted when encountered. In 1992, it was defined by the NCADD and ASAM as "a primary, chronic disease characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking." [ 34 ] MeSH has had an entry for "alcoholism" since 1999, and references the 1992 definition. [ 35 ]

AA describes alcoholism as an illness that involves a physical allergy [ 36 ] :28 (where "allergy" has a different meaning than that used in modern medicine. [ 37 ] ) and a mental obsession. [ 36 ] :23 [ 38 ] The doctor and addiction specialist Dr. William D. Silkworth M.D. writes on behalf of AA that "Alcoholics suffer from a "(physical) craving beyond mental control". [ 36 ] :XXVI

A 1960 study by E. Morton Jellinek is considered the foundation of the modern disease theory of alcoholism. [ 39 ] Jellinek's definition restricted the use of the word "alcoholism" to those showing a particular natural history. The modern medical definition of alcoholism has been revised numerous times since then. The American Medical Association currently uses the word alcoholism to refer to a particular chronic primary disease. [ 40 ]

Signs and symptoms Long-term misuse

Some of the possible long-term effects of ethanol an individual may develop. Additionally, in pregnant women, alcohol can cause fetal alcohol syndrome .

Alcoholism is characterised by an increased tolerance of and physical dependence on alcohol, affecting an individual's ability to control alcohol consumption safely. These characteristics are believed to play a role in impeding an alcoholic's ability to stop drinking. [ 10 ] Alcoholism can have adverse effects on mental health, causing psychiatric disorders to develop and an increased risk of suicide. The onset of depression is a common symptom. [ 41 ] [ 42 ]

Physical

Women develop long-term complications of alcohol dependence more rapidly than do men. Additionally, women have a higher mortality rate from alcoholism than men. [ 45 ] Examples of long-term complications include brain, heart, and liver damage [ 20 ] and an increased risk of breast cancer. Additionally, heavy drinking over time has been found to have a negative effect on reproductive functioning in women. This results in reproductive dysfunction such as anovulation. decreased ovarian mass, problems or irregularity of the menstrual cycle. and early menopause. [ 45 ] Alcoholic ketoacidosis can occur in individuals who chronically abuse alcohol and have a recent history of binge drinking. [ 46 ] [ 47 ]

Psychiatric

Long-term misuse of alcohol can cause a wide range of mental health problems. Severe cognitive problems are common; approximately 10 percent of all dementia cases are related to alcohol consumption, making it the second leading cause of dementia. [ 48 ] Excessive alcohol use causes damage to brain function, and psychological health can be increasingly affected over time. [ 49 ]

Psychiatric disorders are common in alcoholics, with as many as 25 percent suffering severe psychiatric disturbances. The most prevalent psychiatric symptoms are anxiety and depression disorders. Psychiatric symptoms usually initially worsen during alcohol withdrawal, but typically improve or disappear with continued abstinence. [ 50 ] Psychosis. confusion, and organic brain syndrome may be caused by alcohol misuse, which can lead to a misdiagnosis such as schizophrenia. [ 51 ] Panic disorder can develop or worsen as a direct result of long-term alcohol misuse. [ 52 ] [ 53 ]

The co-occurrence of major depressive disorder and alcoholism is well documented. [ 54 ] [ 55 ] [ 56 ] Among those with comorbid occurrences, a distinction is commonly made between depressive episodes that remit with alcohol abstinence ("substance-induced"), and depressive episodes that are primary and do not remit with abstinence ("independent" episodes). [ 57 ] [ 58 ] [ 59 ] Additional use of other drugs may increase the risk of depression. [ 60 ]

Psychiatric disorders differ depending on gender. Women who have alcohol-use disorders often have a co-occurring psychiatric diagnosis such as major depression, anxiety, panic disorder, bulimia, post-traumatic stress disorder (PTSD), or borderline personality disorder. Men with alcohol-use disorders more often have a co-occurring diagnosis of narcissistic or antisocial personality disorder. bipolar disorder. schizophrenia, impulse disorders or attention deficit/hyperactivity disorder. [ 61 ] Women with alcoholism are more likely to have a history of physical or sexual assault, abuse and domestic violence than those in the general population, [ 61 ] which can lead to higher instances of psychiatric disorders and greater dependence on alcohol.

Social effects

The social problems arising from alcoholism are serious, caused by the pathological changes in the brain and the intoxicating effects of alcohol. [ 48 ] [ 62 ] Alcohol abuse is associated with an increased risk of committing criminal offences, including child abuse. domestic violence. rape. burglary and assault. [ 63 ] Alcoholism is associated with loss of employment. [ 64 ] which can lead to financial problems. Drinking at inappropriate times, and behavior caused by reduced judgment, can lead to legal consequences, such as criminal charges for drunk driving [ 65 ] or public disorder, or civil penalties for tortious behavior, and may lead to a criminal sentence.

An alcoholic's behavior and mental impairment, while drunk, can profoundly affect those surrounding them and lead to isolation from family and friends. This isolation can lead to marital conflict and divorce. or contribute to domestic violence. Alcoholism can also lead to child neglect. with subsequent lasting damage to the emotional development of the alcoholic's children. [ 66 ]

Alcohol withdrawal

As with similar substances with a sedative-hypnotic mechanism, such as barbiturates and benzodiazepines, withdrawal from alcohol dependence can be fatal if it is not properly managed. [ 62 ] [ 67 ] Alcohol's primary effect is the increase in stimulation of the GABAA receptor. promoting central nervous system depression. With repeated heavy consumption of alcohol, these receptors are desensitized and reduced in number, resulting in tolerance and physical dependence. When alcohol consumption is stopped too abruptly, the person's nervous system suffers from uncontrolled synapse firing. This can result in symptoms that include anxiety. life threatening seizures. delirium tremens. hallucinations, shakes and possible heart failure. [ 68 ] [ 69 ] Other neurotransmitter systems are also involved, especially dopamine. NMDA and glutamate. [ 10 ] [ 70 ]

Acute withdrawal symptoms tend to subside after one to three weeks. Less severe symptoms (e.g. insomnia and anxiety, anhedonia ) may continue as part of a post withdrawal syndrome gradually improving with abstinence for a year or more. [ 71 ] [ 72 ] [ 73 ] Withdrawal symptoms begin to subside as the body and central nervous system restore alcohol tolerance and GABA functioning towards normal. [ 74 ] [ 75 ]

Causes

A complex mixture of genetic and environmental factors influences the risk of the development of alcoholism. [ 76 ] Genes that influence the metabolism of alcohol also influence the risk of alcoholism, and may be indicated by a family history of alcoholism. [ 77 ] One paper has found that alcohol use at an early age may influence the expression of genes which increase the risk of alcohol dependence. [ 78 ] Individuals who have a genetic disposition to alcoholism are also more likely to begin drinking at an earlier age than average. [ 79 ] Also, a younger age of onset of drinking is associated with an increased risk of the development of alcoholism, [ 79 ] and about 40 percent of alcoholics will drink excessively by their late adolescence. It is not entirely clear whether this association is causal, and some researchers have been known to disagree with this view. [ 80 ] A high testosterone concentration during pregnancy may be a risk factor for later development of alcohol dependence. [ 81 ]


Severe childhood trauma is also associated with a general increase in the risk of drug dependency. [ 76 ] Lack of peer and family support is associated with an increased risk of alcoholism developing. [ 76 ] Genetics and adolescence are associated with an increased sensitivity to the neurotoxic effects of chronic alcohol abuse. Cortical degeneration due to the neurotoxic effects increases impulsive behaviour, which may contribute to the development, persistence and severity of alcohol use disorders. There is evidence that with abstinence, there is a reversal of at least some of the alcohol induced central nervous system damage. [ 82 ]

Genetic variation

Genetic differences exist between different racial groups which affect the risk of developing alcohol dependence. For example, there are differences between African, East Asian and Indo-racial groups in how they metabolize alcohol. These genetic factors are believed to, in part, explain the differing rates of alcohol dependence among racial groups. [ 83 ] [ 84 ] The alcohol dehydrogenase allele ADH1 B*3 causes a more rapid metabolism of alcohol. The allele ADH1 B*3 is only found in those of African descent and certain Native American tribes. African Americans and Native Americans with this allele have a reduced risk of developing alcoholism. [ 85 ] Native Americans however, have a significantly higher rate of alcoholism than average; it is unclear why this is the case. [ 86 ] Other risk factors such as cultural environmental effects e.g. trauma have been proposed to explain the higher rates of alcoholism among Native Americans compared to alcoholism levels in caucasians. [ 87 ] [ 88 ]

Pathophysiology

Alcohol's primary effect is the increase in stimulation of the GABAA receptor. promoting central nervous system depression. With repeated heavy consumption of alcohol, these receptors are desensitized and reduced in number, resulting in tolerance and physical dependence. [ 68 ] The amount of alcohol that can be biologically processed and its effects differ between sexes. Equal dosages of alcohol consumed by men and women generally result in women having higher blood alcohol concentrations (BACs). [ 61 ] This can be attributed to many reasons, the main being that women have less body water than men do. A given amount of alcohol, therefore becomes more highly concentrated in a woman's body. A given amount of alcohol causes greater intoxication for women due to different hormone release compared to men. [ 20 ]

Diagnosis Social barriers

Attitudes and social stereotypes can create barriers to the detection and treatment of alcohol abuse. This is more of a barrier for women than men. Fear of stigmatization may lead women to deny that they are suffering from a medical condition, to hide their drinking, and to drink alone. This pattern, in turn, leads family, physicians, and others to be less likely to suspect that a woman they know is an alcoholic. [ 45 ] In contrast, reduced fear of stigma may lead men to admit that they are suffering from a medical condition, to display their drinking publicly, and to drink in groups. This pattern, in turn, leads family, physicians, and others to be more likely to suspect that a man they know is an alcoholic. [ 61 ]

Screening

Several tools may be used to detect a loss of control of alcohol use. These tools are mostly self-reports in questionnaire form. Another common theme is a score or tally that sums up the general severity of alcohol use. [ 12 ]

The CAGE questionnaire. named for its four questions, is one such example that may be used to screen patients quickly in a doctor's office.

Two "yes" responses indicate that the respondent should be investigated further. The questionnaire asks the following questions:

  1. Have you ever felt you needed to C ut down on your drinking?
  2. Have people A nnoyed you by criticizing your drinking?
  3. Have you ever felt G uilty about drinking?
  4. Have you ever felt you needed a drink first thing in the morning (E ye-opener) to steady your nerves or to get rid of a hangover? [ 89 ] [ 90 ]
The CAGE questionnaire has demonstrated a high effectiveness in detecting alcohol related problems; however, it has limitations in people with less severe alcohol related problems, white women and college students. [ 91 ]

Other tests are sometimes used for the detection of alcohol dependence, such as the Alcohol Dependence Data Questionnaire, which is a more sensitive diagnostic test than the CAGE questionnaire. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use. [ 92 ] The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses, [ 93 ] driving under the influence being the most common. The Alcohol Use Disorders Identification Test (AUDIT), a screening questionnaire developed by the World Health Organization. is unique in that it has been validated in six countries and is used internationally. Like the CAGE questionnaire. it uses a simple set of questions – a high score earning a deeper investigation. [ 94 ] The Paddington Alcohol Test (PAT) was designed to screen for alcohol related problems amongst those attending Accident and Emergency departments. It concords well with the AUDIT questionnaire but is administered in a fifth of the time. [ 95 ]

Genetic predisposition testing

Psychiatric geneticists John I. Nurnberger, Jr. and Laura Jean Bierut suggest that alcoholism does not have a single cause—including genetic—but that genes do play an important role "by affecting processes in the body and brain that interact with one another and with an individual's life experiences to produce protection or susceptibility". They also report that fewer than a dozen alcoholism-related genes have been identified, but that more likely await discovery. [ 96 ]

At least one genetic test exists for an allele that is correlated to alcoholism and opiate addiction. [ 97 ] Human dopamine receptor genes have a detectable variation referred to as the DRD2 TaqI polymorphism. Those who possess the A1 allele (variation) of this polymorphism have a small but significant tendency towards addiction to opiates and endorphin-releasing drugs like alcohol. [ 98 ] Although this allele is slightly more common in alcoholics and opiate addicts, it is not by itself an adequate predictor of alcoholism, and some researchers argue that evidence for DRD2 is contradictory. [ 96 ]

DSM diagnosis

The DSM-IV diagnosis of alcohol dependence represents one approach to the definition of alcoholism. In part this is to assist in the development of research protocols in which findings can be compared to one another. According to the DSM-IV, an alcohol dependence diagnosis is: [ 13 ]

 maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae .

Urine and blood tests

There are reliable tests for the actual use of alcohol, one common test being that of blood alcohol content (BAC). [ 99 ] These tests do not differentiate alcoholics from non-alcoholics; however, long-term heavy drinking does have a few recognizable effects on the body, including: [ 100 ]

However, none of these blood tests for biological markers is as sensitive as screening questionnaires.

Prevention

The World Health Organization. the European Union and other regional bodies, national governments and parliaments have formed alcohol policies in order to reduce the harm of alcoholism. [ 101 ] [ 102 ] Targeting adolescents and young adults is regarded as an important step to reduce the harm of alcohol abuse. Increasing the age at which licit drugs of abuse such as alcohol can be purchased, the banning or restricting advertising of alcohol has been recommended as additional ways of reducing the harm of alcohol dependence and abuse. Credible, evidence based educational campaigns in the mass media about the consequences of alcohol abuse have been recommended. Guidelines for parents to prevent alcohol abuse amongst adolescents, and for helping young people with mental health problems have also been suggested. [ 103 ]

Management

Treatments are varied because there are multiple perspectives of alcoholism. Those who approach alcoholism as a medical condition or disease recommend differing treatments than, for instance, those who approach the condition as one of social choice. Most treatments focus on helping people discontinue their alcohol intake, followed up with life training and/or social support in order to help them resist a return to alcohol use. Since alcoholism involves multiple factors which encourage a person to continue drinking, they must all be addressed in order to successfully prevent a relapse. An example of this kind of treatment is detoxification followed by a combination of supportive therapy, attendance at self-help groups, and ongoing development of coping mechanisms. The treatment community for alcoholism typically supports an abstinence-based zero tolerance approach; however, some prefer a harm-reduction approach. [ 104 ]

Detoxification

Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol drinking coupled with the substitution of drugs, such as benzodiazepines, that have similar effects to prevent alcohol withdrawal. Individuals who are only at risk of mild to moderate withdrawal symptoms can be detoxified as outpatients. Individuals at risk of a severe withdrawal syndrome as well as those who have significant or acute comorbid conditions are generally treated as inpatients. Detoxification does not actually treat alcoholism, and it is necessary to follow-up detoxification with an appropriate treatment program for alcohol dependence or abuse in order to reduce the risk of relapse. [ 14 ]

Psychological

Various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues that are related to alcohol addiction, as well as provide relapse prevention skills. The mutual-help group-counseling approach is one of the most common ways of helping alcoholics maintain sobriety. [ 16 ] [ 17 ] Alcoholics Anonymous was one of the first organizations formed to provide mutual, nonprofessional counseling, and it is still the largest. Others include LifeRing Secular Recovery. SMART Recovery. Women For Sobriety, and Secular Organizations for Sobriety .


Rationing and moderation programs such as Moderation Management and DrinkWise do not mandate complete abstinence. While most alcoholics are unable to limit their drinking in this way, some return to moderate drinking. A 2002 U.S. study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7 percent of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. This group, however, showed fewer initial symptoms of dependency. [ 105 ] A follow-up study, using the same subjects that were judged to be in remission in 2001–2002, examined the rates of return to problem drinking in 2004–2005. The study found abstinence from alcohol was the most stable form of remission for recovering alcoholics. [ 106 ] A long-term (60 year) follow-up of two groups of alcoholic men concluded that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence." [ 107 ]

Medications

A variety of medications may be prescribed as part of treatment for alcoholism.

  • Disulfiram (Antabuse) prevents the elimination of acetaldehyde. a chemical the body produces when breaking down ethanol. Acetaldehyde itself is the cause of many hangover symptoms from alcohol use. The overall effect is severe discomfort when alcohol is ingested: an extremely fast-acting and long-lasting uncomfortable hangover. This discourages an alcoholic from drinking in significant amounts while they take the medicine. A recent nine-year study found that incorporation of supervised disulfiram and the related compound carbimide into a comprehensive treatment program resulted in an abstinence rate of over 50 percent. [ 108 ]
  • Calcium carbimide (Temposil) works in the same way as Antabuse; it has an advantage in that the occasional adverse effects of disulfiram, hepatotoxicity and drowsiness, do not occur with calcium carbimide. [ 108 ] [ 109 ]
  • Naltrexone is a competitive antagonist for opioid receptors, effectively blocking the effects of endorphins and opiates. Naltrexone is used to decrease cravings for alcohol and encourage abstinence. Alcohol causes the body to release endorphins, which in turn release dopamine and activate the reward pathways; hence when naltrexone is in the body there is a reduction in the pleasurable effects from consuming alcohol. [ 110 ] Naltrexone is also used in an alcoholism treatment method called the Sinclair Method. which treats patients through a combination of Naltrexone and continued drinking. [ 111 ]
  • Acamprosate (Campral) stabilises the brain chemistry that is altered due to alcohol dependence via antagonising the actions of glutamate, a neurotransmitter which is hyperactive in the post-withdrawal phase. [ 112 ] A 2010 review of medical studies demonstrated that acamprosate reduces the incidence of relapse amongst alcohol dependent persons. [ 113 ]

A study of a large number (>27,000) of alcohol dependence-related insurance claims suggested that healthcare utilization, such as the number of inpatient detoxification days, alcoholism-related inpatient days, and alcoholism-related emergency department visits was significantly reduced in the patient population receiving alcoholism medications (naltrexone, naltrexone XR [an injectable sustained-release form of naltrexone], disulfiram [Antabuse], acomprosate) when compared to the patient population that did not take any medications. [ 114 ]

  • Benzodiazepines, whilst useful in the management of acute alcohol withdrawal, if used long-term cause a worse outcome in alcoholism. Alcoholics on chronic benzodiazepines have a lower rate of achieving abstinence from alcohol than those not taking benzodiazepines. This class of drugs is commonly prescribed to alcoholics for insomnia or anxiety management. [ 115 ] Initiating prescriptions of benzodiazepines or sedative-hypnotics in individuals in recovery has a high rate of relapse with one author reporting more than a quarter of people relapsed after being prescribed sedative-hypnotics. Those who are long-term users of benzodiazepines should not be withdrawn rapidly, as severe anxiety and panic may develop, which are known risk factors for relapse into alcohol abuse. Taper regimes of 6–12 months have been found to be the most successful, with reduced intensity of withdrawal. [ 116 ] [ 117 ]
Dual addictions

Alcoholics may also require treatment for other psychotropic drug addictions. The most common dual addiction in alcohol dependence is benzodiazepine dependence, with studies showing 10–20 percent of alcohol-dependent individuals had problems of dependence and/or misuse problems of benzodiazepines. Benzodiazepines increase cravings for alcohol and the volume of alcohol consumed by problem drinkers. [ 118 ] Benzodiazepine dependency requires careful reduction in dosage to avoid benzodiazepine withdrawal syndrome and other health consequences.

Dependence on other sedative hypnotics such as zolpidem and zopiclone as well as opiates and illegal drugs is common in alcoholics.

Alcohol itself is a sedative-hypnotic and is cross-tolerant with other sedative-hypnotics such as barbiturates. benzodiazepines and nonbenzodiazepines. Dependence upon and withdrawal from sedative hypnotics can be medically severe and, as with alcohol withdrawal, there is a risk of psychosis or seizures if not managed properly. [ 15 ]

Epidemiology

Total recorded yearly alcohol per capita consumption (15+), in litres of pure alcohol [ 119 ]

Substance use disorders are a major public health problem facing many countries. "The most common substance of abuse/dependence in patients presenting for treatment is alcohol." [ 104 ] In the United Kingdom. the number of 'dependent drinkers' was calculated as over 2.8 million in 2001. [ 120 ] About 12% of American adults have had an alcohol dependence problem at some time in their life. [ 121 ] The World Health Organization estimates that about 140 million people throughout the world suffer from alcohol dependence. [ 4 ] [ 5 ] In the United States and Western Europe, 10 to 20 percent of men and 5 to 10 percent of women at some point in their lives will meet criteria for alcoholism. [ 122 ]

Within the medical and scientific communities, there is broad consensus regarding alcoholism as a disease state. For example, the American Medical Association considers alcohol a drug and states that "drug addiction is a chronic, relapsing brain disease characterized by compulsive drug seeking and use despite often devastating consequences. It results from a complex interplay of biological vulnerability, environmental exposure, and developmental factors (e.g. stage of brain maturity)." [ 40 ]

Alcoholism has a higher prevalence among men, though in recent decades, the proportion of female alcoholics has increased. [ 20 ] Current evidence indicates that in both men and women, alcoholism is 50–60 percent genetically determined, leaving 40–50 percent for environmental influences. [ 123 ] Most alcoholics develop alcoholism during adolescence or young adulthood. [ 76 ]

Prognosis

A 2002 study by the National Institute on Alcohol Abuse and Alcoholism surveyed a group of 4,422 adults meeting the criteria for alcohol dependence and found that after one year, some met the authors' criteria for low-risk drinking, even though only 25.5 percent of the group received any treatment, with the breakdown as follows: 25 percent were found to be still dependent, 27.3 percent were in partial remission (some symptoms persist), 11.8 percent asymptomatic drinkers (consumption increases chances of relapse) and 35.9 percent were fully recovered — made up of 17.7 percent low-risk drinkers plus 18.2 percent abstainers. [ 124 ]

In contrast, however, the results of a long-term (60-year) follow-up of two groups of alcoholic men by George Vaillant at Harvard Medical School indicated that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence." [ 125 ] Vaillant also noted that "return-to-controlled drinking, as reported in short-term studies, is often a mirage."

The most common cause of death in alcoholics is from cardiovascular complications. [ 126 ] There is a high rate of suicide in chronic alcoholics, which increases the longer a person drinks. This is believed to be due to alcohol causing physiological distortion of brain chemistry, as well as social isolation. Suicide is also very common in adolescent alcohol abusers, with 25 percent of suicides in adolescents being related to alcohol abuse. [ 127 ] Approximately 18 percent of alcoholics commit suicide, [ 42 ] and research has found that over 50 percent of all suicides are associated with alcohol or drug dependence. The figure is higher for adolescents, with alcohol or drug misuse playing a role in up to 70 percent of suicides. [ 128 ]

History

1904 advertisement describing alcoholism as a disease.

Historically the name dipsomania was coined by German physician Dr. C. W. Hufeland in 1819 before it was superseded by alcoholism. [ 129 ] [ 130 ] The term "alcoholism" was first used in 1849 by the Swedish physician Magnus Huss to describe the systematic adverse effects of alcohol. [ 131 ]

Alcohol has a long history of use and misuse throughout recorded history. Biblical, Egyptian and Babylonian sources record the history of abuse and dependence on alcohol. In some ancient cultures alcohol was worshiped and in others its abuse was condemned. Excessive alcohol misuse and drunkenness were recognised as causing social problems even thousands of years ago. However, the defining of habitual drunkenness as it was then known as and its adverse consequences were not well established medically until the 18th century. In 1647 a Greek monk named Agapios was the first to document that chronic alcohol misuse was associated with toxicity to the nervous system and body which resulted in a range of medical disorders such as seizures, paralysis and internal bleeding. In 1920 the effects of alcohol abuse and chronic drunkenness led to the failed prohibition of alcohol being considered and eventually enforced briefly in America. In 2005 the cost of alcohol dependence and abuse was estimated to cost the USA economy approximately 220 billion dollars per year, more than cancer and obesity. [ 132 ]

Society and culture

The various health problems associated with long-term alcohol consumption are generally perceived as detrimental to society, for example, money due to lost labor-hours, medical costs, and secondary treatment costs. Alcohol use is a major contributing factor for head injuries. motor vehicle accidents, violence, and assaults. Beyond money, there are also significant social costs to both the alcoholic and their family and friends. [ 62 ] For instance, alcohol consumption by a pregnant woman can lead to fetal alcohol syndrome. [ 133 ] an incurable and damaging condition. [ 134 ]

Estimates of the economic costs of alcohol abuse, collected by the World Health Organization, vary from one to six percent of a country's GDP. [ 135 ] One Australian estimate pegged alcohol's social costs at 24% of all drug abuse costs; a similar Canadian study concluded alcohol's share was 41%. [ 136 ] One study quantified the cost to the UK of all forms of alcohol misuse in 2001 as £18.5–20 billion. [ 120 ] [ 137 ] All economic costs in the United States in 2006 have been estimated at $223.5 billion. [ 138 ]

Stereotypes of alcoholics are often found in fiction and popular culture. The 'town drunk ' is a stock character in Western popular culture. Stereotypes of drunkenness may be based on racism or xenophobia. as in the depiction of the Irish as heavy drinkers. [ 139 ] Studies by social psychologists Stivers and Greeley attempt to document the perceived prevalence of high alcohol consumption amongst the Irish in America. [ 140 ]

Alcohol consumption is relatively similar between many European cultures, the United States, and Australia. In Asian countries that have a high gross domestic product, there is heightened drinking compared to other Asian countries, but it is nowhere near as high as it is in other countries like the United States. It also inversely seen, with countries that have very low gross domestic product showing high alcohol consumption. [ 141 ]

In a study done on Korean immigrants in Canada, they reported alcohol was even an integral part of their meal, and is the only time solo drinking should occur. They also believe alcohol is necessary at any social event as it helps conversations start. [ 142 ]

Caucasians have a much lower abstinence rate (11.8%) and much higher tolerance to symptoms (3.4±2.45 drinks) of alcohol than Chinese (33.4% and 2.2±1.78 drinks respectively). Also, the more acculturation there is between cultures, the more influenced the culture is to adopt Caucasians drinking practices. [ 143 ]

Peyote, a psychoactive agent, has even shown promise in treating alcoholism. This is interesting because alcohol replaced peyote as Native American’s psychoactive agent of choice in rituals when peyote was outlawed. [ 144 ]

Research
  • Topiramate. a derivative of the naturally occurring sugar monosaccharide D-fructose, has been found effective in helping alcoholics quit or cut back on the amount they drink. Evidence suggests that topiramate antagonizes excitatory glutamate receptors, inhibits dopamine release, and enhances inhibitory gamma-aminobutyric acid function. A 2008 review of the effectiveness of topiramate concluded that the results of published trials are promising, however as of 2008, data was insufficient to support using topiramate in conjunction with brief weekly compliance counseling as a first-line agent for alcohol dependence. [ 145 ] A 2010 review found that topiramate may be superior to existing alcohol pharmacotherapeutic options. Topiramate effectively reduces craving and alcohol withdrawal severity as well as improving quality-of-life-ratings. [ 146 ]
See also References Further reading
  • Galanter, Marc (2005). Alcohol Problems in Adolescents and Young Adults: Epidemiology, Neurobiology, Prevention, Treatment. New York, NY: Kluwer Academic/Plenum. ISBN  0-306-48625-3. OCLC  56653179 57724687 71290784 133155628 56653179 57724687 71290784.  
  • Hedblom, Jack H. (2007). Last Call: Alcoholism and Recovery. Baltimore, MD: Johns Hopkins University Press. ISBN  978-0-8018-8677-5. OCLC  77708730 237901552 77708730.  
  • National Institute on Alcohol Abuse and Alcoholism. "Etiology and Natural History of Alcoholism ".
  • The Online Resource for Addiction Recovery, Addiction Treatment & Addiction help. "Addiction Recovery ".
  • O'Farrell, Timothy J. and William Fals-Stewart (2006). Behavioral Couples Therapy for Alcoholism and Drug Abuse. New York, NY: Guilford Press. ISBN  1-59385-324-6. OCLC  64336035.  
  • Pence, Gregory, "Kant on Whether Alcoholism is a Disease," Ch. 2, The Elements of Bioethics. McGraw-Hill Books, 2007 ISBN 0-07-313277-2 .
  • Plant, Martin A. and Moira Plant (2006). Binge Britain: Alcohol and the National Response. Oxford, UK; New York, NY: Oxford University Press. ISBN  0-19-929940-4. OCLC  64554668 238809013 64554668.  
  • Smart, Lesley (2007). Alcohol and Human Health. Oxford, UK: Oxford University Press. ISBN  978-0-19-923735-7. OCLC  163616466.  
  • Sutton, Philip M. (2007). "Alcoholism and Drug Abuse". In Michael L. Coulter, Stephen M. Krason, Richard S. Myers, and Joseph A. Varacalli. Encyclopedia of Catholic Social Thought, Social Science, and Social Policy. Lanham, MD; Toronto, Canada; Plymouth, UK: Scarecrow Press. pp. 22–24. ISBN  978-0-8108-5906-7.  
  • Thompson, Warren, MD, FACP. "Alcoholism ." Emedicine.com, June 6, 2007. Retrieved 2007-09-02.
External links Look at other dictionaries:

Alcoholism — Alcoholism remains one of Russia’s main social problems, often bemoaned as “Russia’s curse.” The habitual consumption of large quantities of spirits impedes economic growth and cultural development, as well as having an especially pernicious… … Historical Dictionary of the Russian Federation

Alcoholism — • The term is understood to include all the changes that may occur in the human organism after the ingestion of any form of alcohol Catholic Encyclopedia. Kevin Knight. 2006. Alcoholism Alcoholism … Catholic encyclopedia

alcoholism — (n.) disease of alcohol addiction, 1852, from ALCOHOL (Cf. alcohol) + ISM (Cf. ism), or else from Mod.L. alcoholismus, coined in 1852 by Swedish professor of medicine Magnus Huss (1807 1890) to mean what we now would call alcohol poisoning. In… … Etymology dictionary

Alcoholism — Al co*hol*ism, n. [Cf. F. alcoolisme.] (Med.) A diseased condition of the system, brought about by the continued use of alcoholic liquors. [1913 Webster] … The Collaborative International Dictionary of English

alcoholism — index dipsomania, inebriation Burton s Legal Thesaurus. William C. Burton. 2006 … Law dictionary

alcoholism — [n] alcohol abuse addiction, alcohol addiction, alcohol dependence, crapulence, dipsomania, drunkenness, methomania, problem drinking, substance abuse, vinosity; concepts 20,316,709 … New thesaurus

alcoholism — ► NOUN ▪ addiction to alcoholic liquor … English terms dictionary

alcoholism — [al′kə hôl΄iz΄əm, al′kəhäl΄iz΄əm] n. 1. the habitual or compulsive consumption of alcoholic liquor to excess 2. a chronic diseased condition marked by psychological and nutritional disorders, caused by the compulsive consumption of and dependence … English World dictionary

alcoholism — /al keuh haw liz euhm, ho /, n. Pathol. a chronic disorder characterized by dependence on alcohol, repeated excessive use of alcoholic beverages, the development of withdrawal symptoms on reducing or ceasing intake, morbidity that may include… … Universalium

Alcoholism — (See also Substance Abuse.) Since the beginning of modern times, medicine has considered alcoholism a disease rather than a moral failing. In the nineteenth century, with the advent of inexpensive, industrially distilled alcohol, alcoholism … Historical dictionary of Psychiatry

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