Alcoholism is a syndrome caused by a physical dependence on alcohol, to such an extent that sudden deprivation may cause withdrawal symptoms like tremor, anxiety, hallucinations and delusions. It is considered a chronic illness of undetermined cause, with a gradual onset that shows recognizable symptoms and signs proportional to severity. The risk of alcoholism to an individual and the incidence in society depend on the amount of alcohol consumed, i.e. in societies where heavy drinking is socially acceptable, the incidence of alcoholism is higher.

Signs and symptoms

  • An alcoholic is identified by a severe dependence or addiction and a cumulative pattern of behaviors associated with drinking.
  • Usually several years of drinking is needed for addiction to develop, but the range is 1 to 40 years.
  • Frequent intoxication is obvious and destructive; it interferes with the individual’s ability to socialize and to work as intellectual function, physical skills, memory and judgment are impaired. Social skills like conversation are preserved until a late stage.
  • The most common forms of specific organ damage seen in alcoholics are cirrhosis of the liver, damage to the peripheral nerves, damage to the heart muscle, gastritis and pancreatitis. Poor nutrition, which is secondary to alcoholism, aggravates damage to the liver and heart

Tolerance of alcohol

  • Individuals, who drink large amounts of alcohol regularly, become somewhat tolerant to its effects.
  • This phenomenon, also noted with other central nervous system depressants like barbiturates and opioids, is not based on a change in metabolism but caused by adaptation changes of the central nervous system cells. However, tolerance is incomplete and individuals always manifest some degree of intoxication.

Alcohol withdrawal syndrome

  • Symptoms of withdrawal usually begin 12-48 hours after the last drink.
  • The mild withdrawal syndrome includes tremor, weakness, sweating and gastro-intestinal symptoms.
  • Some individuals may suffer generalized grand mal seizures known as “alcoholic epilepsy” or “rum fits”.
  • Alcoholic hallucinosis follows prolonged excessive use of alcohol. The symptoms include auditory illusions and hallucinations which are frequently accusatory and threatening. The alcoholic is usually apprehensive and may be completely terrified.

Treatment

  • Treatment is difficult and usually given in a psychiatric hospital where the alcoholic is first “dried out” and then helped to understand the psychological pressures that led to the alcoholism. Drugs (oral or implants) may help in treatment.
  • Alcoholics Anonymous (AA): The best help an alcoholic can offer himself is to join AA. No other approach has been shown to benefit so many alcoholics as effectively as AA. The individual needs to find an AA group in which he is comfortable, preferably one in which he has common interests with the other members, in addition to his alcohol problem. These groups provide non-drinking friends who are always available, as well as a place to socialize away from the pub.
  • It is a long and hard road to recovery.

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