ALCOHOLISM

Basic Definition
Also known as alcohol dependence.
It is by nature an addictive disorder characterized
by uncontrolled and compulsive abuse of alcohol.
Similar to other drug addictions, it is treatable as a
disease.
In the early 19th and 20th centuries Alcoholism was
known as
DIPSOMANIA, before the word Alcoholism
replaced it.
Alcoholism is the cyclic presence of tolerance,
withdrawal and excessive use.
Medical Definition

“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.”
The DSM-IV (a dominant psychology & psychiatry
manual) describes alcohol abuse as repeated use
despite recurrent adverse consequences.
The WHO defines alcoholism similarly as chronic
alcohol use characterised by a lack of control and
preoccupation with alcohol despite adverse
consequences on health.
The World Health Organisation uses the term
alcohol dependence syndrome rather than
alcoholism.
Terminology
There are different terms describing a drinker’s
relation with alcohol.
Use, misuse, heavy use, abuse, addiction,
dependence
are the common terms used to describe drinking
habits.
But the actual meaning can vary greatly depending
on the context of use.
Alcohol use refers to the simple use of the
substance.
Misuse, problem use, abuse, and heavy use refers
to improper use of alcohol which may cause
physical, social, or moral harm to the drinker.
Moderate Use is defined as no more than two
 Long term usage of alcohol produces physiological
alterations in brain.

 The result: Withdrawal symptoms upon discontinuation.

 Alcohol detoxification and rehabilitation is conducted to
treat patients

 Therapy includes group therapy, self-help groups to
prevent relapse

 WHO estimates that there are 140 million alcoholics
worldwide.



 Immediate
Effects
BAC stands for Blood Alcohol Concentration.
It is the measure of concentration of alcohol in a
person’s blood.
Commonly used as a metric of intoxication for legal
or medical purposes.
As measurement must be cheap and accurate
there are several methods employed to
approximate the true ppm measure in the blood
stream.
1.Volume of alcohol per volume of exhaled breath,
2.Mass of alcohol per mass of body.
Blood Alcohol Concentration
Blood Alcohol Stage Clinical symptoms
Concentration (BAC)
(g/100 ml of blood)
0.01 - 0.05 Subclinical Behavior nearly normal by ordinary observation
0.03 - 0.12 Euphoria Mild euphoria, sociability, talkitiveness, Increased self-confidence;
decreased inhibitions, Beginning of sensory-motor impairment, Loss
of efficiency in finer performance tests

0.09 - 0.25 Excitement Emotional instability; loss of critical judgment, Impairment of

perception, memory and comprehension, Reduced visual acuity;
peripheral vision and glare recovery, Sensory-motor incoordination;
impaired balance
0.18 - 0.30 Confusion Disorientation, mental confusion; dizziness, Exaggerated emotional
states, Increased pain threshold, Increased muscular incoordination;
staggering gait; slurred speech, Apathy, lethargy

0.25 - 0.40 Stupor General inertia; approaching loss of motor functions, Marked
muscular incoordination; inability to stand or walk, Vomiting;
incontinence, Impaired consciousness; sleep or stupor

0.35 - 0.50 Coma Complete unconsciousness, depressed or abolished reflexes,

Subnormal body temperature, Incontinence, Impairment of circulation
and respiration, Possible death

0.45 + Death Death from respiratory arrest

Long Term Effects
§ Physical
§ Mental
§ Social
Physical Effects
Cirrhosis of liver
Pancreatitis
Epilepsy
Alcohol Dementia
Polyneuropathy
Cognitive Problems
Damage to Nervous System
Malabsorption
Nutritional Deficiencies
Cancer
Cardiovascular Disease
Mental Effects
Psychiatric disorders
Anxiety

Psychosis

Confusion

Schizophrenia

Panic Disorder

Depression

 18% of alcoholics commit suicide

 50% of suicide cases involve alcohol/drug

abuse

Social Effects
Domestic Violence
Child abuse

 Causes lasting damage to the emotional

development of the child
 Unemployment
 Financial problems causing loss of living
quarters
 Criminal Charges
 Burglaries
 Assaults
 Drunk Driving
 Isolation from family and friends
LONG TERM EFFECTS
INTRODUCTION
The long term effects of alcohol range from
possible health benefits for low levels of alcohol
consumption to severe detrimental effects in
cases of chronical alcohol abuse.
Historically doctors and alcohol industry have

promoted alcohol for its perceived health

benefits.
Whether alcohol consumption should actually be

recommended is still controversial.

Adverse effects of long -term excessive use of

alcohol are similar to those seen with other

sedative-hypnotic drugs.
Cardiovascular Brain damage
disease Oesophagal Cancer

Phobias Cancers of

Panic disorder Respiratory,

Neurological deficits digestive systems,
Suicidal Tendencies
liver
Hypertension
etc.

Cirrhosis

Pancreatitis


ALCOHOL RELATED
DEATHS
 RUSSIA :

Half of all the deaths at ages 15-54 yrs.


UNITED KINGDOM :


8,724 alcohol related deaths(13.3 per

1,00,000) in 2007, double the 4,144(6.9
per 1,00,000) recorded in 1991.
9,000 people (approx.) died in 2009.
UNITED STATES :


79,000 deaths annually were recorded from 2001-

2005
Excessive alcohol use is 3rd leading lifestyle related
cause of death.


INDIA :


4.5 per 1,00,000 alcohol related deaths.

Increase of alcohol consumption in last 2 decades
by 106%.
95% of women and 80% of men in India refrain
from drinking Alcohol



CARDIOVASCULAR
SYSTEM
Heart Attack or Stroke – Increased risk of heart
failure, Hypertriglyceridemia, Hypertension.


Cardiomyopathy (Holiday heart syndrome)



Hematologic Diseases (Anemia)

NERVOUS SYSTEM
Brain strokes .


Impairing of Brain development.



Cognition and Dementia.



Insomnia.
MENTAL HEALTH
EFFECTS
Major depressive disorder.
Cravings and irritability.

Antisocial Behavior.

Delusion.


DIGESTIVE SYSTEM & WEIGHT
GAIN
Alcoholic liver disease
Alcoholic hepatitis

Cirrhosis

Gastritis

Gall Bladder Effect

Pancreatitis
Cirrhosis of Liver
WITHDRAWAL SYNDROME
INTRODUCTION
Symptoms which seen when an individual
reduces or stops alcohol consumption after
prolonged periods of excessive alcohol intake.
Occurs upon declining blood levels of alcohol.
Largely due to Central Nervous system being in
hyper-excited state.
Alcohol withdrawal can be fatal.

WITHDRAWAL
SYMPTOMS
Agitation Diarrhoea
Alcoholic hallucinosis Gastrointestinal upset
Anorexia Hypertension
Anxiety and panic Insomnia
attacks
Catatonia Nausea and vomiting
Confusion Palpitation
Delirium tremens Psychosis
Depression Rebound REM sleep
Derealization Tachycardia
Diaphoresis Hyperthermia

 TREATMENT
aried because there are multiple perspectives for the condition itself.

heir alcohol intake, followed up with life training and/or social suppor

ourage a person to continue drinking, they must all be addressed in ord

2. DETOXIFICATION

Alcohol detoxification or 'detox' for alcoholics is an abrupt stop
of alcohol drinking coupled with the substitution of drugs, such
as benzodiazepines.

These drugs 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
3. GROUP THERAPY
 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.


4. RATIONING AND MODERATION

Rationing and moderation programs such as Moderation
Management and DrinkWise do not mandate complete abstinence.

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
5.CURRENT MEDICATION
a.
b.Antabuse (disulfiram)
c.Temposil (calcium carbimide)
d.Naltrexone
e.Acamprosate
f.Benzodiazepines
g.

6. EXPERIMENTAL MEDICATION
a. Topiramate
 ALCOHOL
REHABILITATION
 NEED OF ALCOHOL REHABILITATION.


 WHAT IS ALCOHOL REHABILITATION?

 It is a complex process which often not only
deals with a blanket approach to treating
the addiction but also co -occurring mental
disorders.

STEPS FOR ALCOHOL
REHABILITATION.
 STEP 1:
 Alcohol Intervention.
 Alcohol detox.


 STEP 2:
 Improvement.
 Counselling.



STATISTICS
 0
2
4
6
8
10
12
14
16
18
Luxembourg:

France:

Ireland:

Hungary:

Czech Republic:
Spain:

Denmark:

Portugal:

United Kingdom:

Austria:

Switzerland:

Belgium:

Germany:

Australia:

Netherlands:

Finland:
Korea, South:

Greece:

New Zealand:

United States:

Poland:

Italy:

Canada:

Japan:

Slovakia:

Sweden:
Iceland:

Norway:

Mexico:

Turkey:

Weighted average:
Series1
Legal Limits

 Zero tolerance (illegal to have any amount of alcohol in blood in these

nations):


 Saudi Arabia
 Slovakia
 United Arab Emirates
 Brazil
 Bangladesh
 Czech Republic
 Hungary
 Romania



 0.02%


 China
 Estonia
 Poland
 Norway
 Sweden
 Puerto Rico (for drivers 18-20 years old)


 0.03%


 India (note: In the State of Kerala, a policy of zero tolerance has

developed.)
 Japan
 Russia
 Uruguay (0.00% for truck/taxi/bus drivers)


 0.04%


 Lithuania (0.02% for drivers in their first two years after gaining a
driving license)
 Canada: Saskatchewan- provincial offence.

 0.05%


 Australia
 Austria
 Belarus
 Belgium
 Bulgaria
 Canada: British Columbia, Ontario, Manitoba, Newfoundland, Nova
Scotia, Quebec - provincial offence
 Costa Rica
 Croatia
 Denmark
 Finland Argentina (0.02% for motorbikes, 0.00% for truck/taxi/bus
drivers)

 France(0.025% for bus drivers)
 Germany (0.00% for learner drivers, all drivers 18-21 and newly
licensed drivers of any age for first two years of licence)
 Greece
 Hong Kong
 Iceland
CONCLUSIONS AND
RECOMMENDATIONS
Recommendations
Implementation of classroom programs.
Education of parents
Counseling and treatment to prevent child
and domestic abuse
Community treatment programs
Heavy taxes
Ban on illicit liquor trade
Youth programs
