Alcohol Addiction. Clinical Aspects of Alcoholism

Alcoholism – is a pathological condition characterized by painful addiction to alcohol consumption and body damage caused by chronic alcohol intoxication.

Alcohol abuse prevalence

In Europe and America, alcohol consumption is the most common form of substance abuse. There is a direct correlation between the amount of absolute alcohol consumed per capita per year, and the prevalence of alcoholism in the community. In France, a country with the largest number of absolute alcohol consumed per capita (18.6 liters per year), number of chronic alcoholism is approximately 4% of the total population and 13% of the male population (20 to 55 years). In Canada, this number is closer to 1.6% of the total population. In Russia, in 2005 the prevalence of alcoholism was 1.7% (1650.1 cases per 100,000 population).

Etiology and pathogenesis of alcoholism addiction

Alcoholism is a form of addiction. At the heart of its development is the psychic and physical alcohol addiction.

Alcoholism can develop under the influence of both external and internal factors.

   The external factors include characteristics of education and human habitation, the traditions of the region, stressful situations. Intrinsic factors are genetic predisposition to the development of alcoholism. At the moment, the existence of such a predisposition is not a doubt. Family members of alcoholics have the risk of developing this disease about 7 times higher than in people whose families were not alcoholics. In connection with this there are two types of alcoholism:

• Alcoholism type I develops under the influence of both external and internal (genetic) factors. This type of disease is characterized by early onset (young or adolescence), occurs only in males, and runs hard.
• Alcoholism type II is developed exclusively by human genetic predisposition to this type of disease and, unlike alcoholism, I-type, starts later and is not accompanied by violent behavior and criminal propensities of patients.

Psychological addiction and withdrawal symptoms

Once in the body, alcohol stimulates the release of endogenous opioid substances – a group of peptide hormones, responsible for the formation of a sense of contentment and ease. Dutch researchers from Maastricht University have discovered a genetic mutation that causes a tendency to alcohol abuse. The mutation affects a gene that encodes the structure of the mu-opioid receptor cells responsive to beta-endorphin (opioid hormone controlling human behavioral responses associated with a sense of satisfaction) (2007). This point is essential in the formation of psychological alcohol addiction. In most cases, alcohol pursue such goals as getting rid of the sadness and care of pressing problems, facilitating communication with people, the acquisition of self-confidence.

Over time, alcohol is embedded in the metabolism of the body that determines the physical alcohol addiction, which is the main manifestation of withdrawal syndrome (hangover).

How ethyl alcohol affects the human body

Ethyl alcohol has a marked toxic potential in relation to various organs and tissues of the body. Disturbances caused by ethanol in the body are followed, on the one hand, by the toxic effect of the ethanol on living cells, on the other hand, by the toxic effect of the decay products of alcohol in the body. Ethyl alcohol is processed (oxidized), mainly in the liver. One of the intermediate products of its oxidation is acetaldehyde – a toxic substance that affects various organs and tissues. Direct ethanol disrupts the microcirculation, increasing the adherence of blood cells, which leads to the formation of microthrombi.

In the pathogenesis of psychosomatic disorders an important role lays poliavitaminosis that develops in consequence of the negative impact of alcohol on the gastrointestinal tract and liver.

In the later stages of alcoholism it is observed the inhibition of the hematopoietic system with the appearance of anemia, as well as inhibition of immune system function, which causes the development of serious infectious complications in chronic alcoholics.

Chronic alcohol consumption generates a picture of chronic poisoning with dysfunction of vital organs.

Classification of alcoholism

The simplest classification of alcoholism available, is prepared in accordance with the amount of alcohol consumed and the presence of signs of alcoholism include the following groups of people: those who use no alcohol, a group of people who moderately consume alcohol, and a group of people abusing alcohol.

This classification reflects some evolutionary aspects of alcoholism as a disease. Alcohol consumption varies over time from mild to chronic abuse, which in turn becomes the cause of the so-called chronic alcoholism – a pathological condition characterized by severe alcohol addiction and the presence of signs of internal organ involvement.

Chronic alcoholism causes and symptoms

For chronic alcoholism is characterized by signs of mental and somatic disorders caused by chronic alcohol abuse. The most striking manifestations of this condition are changes in sensitivity to alcohol, the disappearance of the protective reactions of the body when it is consumed large amount of alcohol (ex. vomiting), pathological craving for being in a state of intoxication, development of withdrawal symptoms after stopping alcohol consumption.

Diagnosing Alcohol Abuse

The diagnosis of alcoholism is established on the basis of evidence of chronic abuse of alcohol, the presence of classical symptoms of chronic alcoholism: the development of withdrawal symptoms, pathological craving for alcohol, changes in sensitivity to alcohol, and signs of internal organ involvement (psychosomatic disorders). It is necessary to distinguish alcoholism from some mental illness combined with alcohol abuse, but have completely different etiopathogenic basis (ex. schizophrenia).

Treatment of Alcoholism

Alcoholism treatment is carried out in stages:

• The first priority is the removal of the patient from a state of chronic intoxication (binge) and relief (removal) of withdrawal symptoms. For this purpose, there used a variety of psychotropic drugs, which have calming effect on patients. Parallel conduct measures to eliminate metabolic disorders caused by chronic alcoholism: vitamin A, restoring the function of the liver, drug normalizes water-salt balance and microcirculation.

• The next challenge is to overcome alcohol addiction and create aversion to alcohol, which is achieved by the methods of creating negative reflex reaction to alcohol. For this purpose, together with small doses of alcohol there given to the patient drugs causing vomiting (apomorphine, emetine).

But most important is the psychological rehabilitation of the patient through psychotherapy. This treatment can not only change the person’s attitude toward alcohol, but also restores him as a person. To prevent the recurrence, psychotherapy is conducted in parallel with the prescribed medical treatment.