Apa Journal Article Citation
Apa Journal Article Citation
Alcoholism
Classification
Alcohol and Health
Short-term effects of alcohol
Long-term effects of alcohol
Alcohol and cardiovascular disease
Alcoholic liver disease
Alcoholic hepatitis
Alcohol and cancer
Alcohol and weight
Fetal alcohol syndrome
Fetal Alcohol Spectrum Disorder
Alcoholism
Blackout (alcohol related amnesia)
Wernicke-Korsakoff syndrome
Recommended maximum intake
Wine and Health
The definitions of alcoholism and related terminology vary significantly between the medical community, treatment programs and the general public.
Medical definitions
The National Council on alcoholism and drug use and American Society of Addiction Medicine defines alcoholism as "a primary, chronic disease characterized by impaired control over drinking, preoccupation with substance alcohol, use of alcohol despite adverse consequences, and distortions in thinking. "DSM-IV (the dominant diagnostic manual of psychiatry and psychology) defines alcohol abuse as repeated use despite recurrent adverse consequences. It further defines alcohol dependence as alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink. (See DSM diagnosis below.) Within psychology and psychiatry, alcoholism is the popular term for alcohol dependence.
Terminology
Many concepts used for a drink the alcohol. Use, misuse, heavy use, abuse, dependence, and dependence are all common labels used to describe drinking habits, but the real meaning of these words may vary widely depending on the context in which they are used. Even within the medical field, the definition can vary between areas of specialization. Because alcoholism is often used in a derogatory meaning in politics and religion, the meanings of the words around it are often imprecise.
Use refers to ordinary use of a substance. A person who drinks an alcoholic beverage use of alcohol. Misuse, problem use, abuse and heavy use refers to the abuse of alcohol can cause physical, social or moral harm to drink.
Moderate use is defined in the Dietary Guidelines for Americans as no more than two alcoholic drinks per day for men and no more than one alcoholic beverage per day for women.
Risk Factors
About 40 percent of those who start drinking alcohol before 14 years of developing alcohol dependency, while only 10 percent of those who did not start drinking until 20 years or older developed an alcohol problem later in life, although it should be remembered that the Correlation Table does not involve causation. Alcohol abuse during adolescence can lead to long-term changes in the brain, which leaves them at increased risk of alcoholism in recent years, genetic factors also influence the age onset of alcohol abuse and risk for alcoholism.
Age onset of drinking as well as genetic factors are associated with an increased risk of developing alcoholism. People who have an existing vulnerability to alcoholism are also more likely to start drinking earlier than average. The risk behavior associated with adolescence promotes binge drinking. Age and genetic factors influence the risk of developing alcohol-related neurotoxicity. Genetic properties affecting the risk of developing alcoholism is associated with a family history of alcoholism. An article published has found that use of alcohol at an early age may even direct influence on the risk of developing alcoholism by affecting expression of genes that increase risk for alcohol dependence. It has been hypothesized that this increased risk may be due to the highly sensitive developing young brain, which results in modulating the genetic state of the brain, which in turn primes the young increased risk for alcohol dependence. Approximately 40 percent of alcoholics were drinking excessively in the late teen years. Most alcoholics develop alcoholism in adolescence or young adults. Severe childhood trauma is also associated with an increased risk for alcohol or other drug problems. There is evidence that a complex combination of genetic factors and environmental factors such as stressful childhood events affects the risk of developing alcoholism. Genes affecting the metabolism of alcohol also affect the risk of alcoholism. Good peer and family support is associated with a reduced risk of developing alcoholism.
Signs and symptoms
Effects of long term alcohol abuse
Main article: Long-term effects of alcohol
Most important of the possible long-term effects of ethanol. Moreover, in pregnant women that causes the fetal alcohol syndrome.
The primary effect of alcoholism is to encourage the sufferer to drink at times and in amounts that are harmful to health. The secondary damage caused by an inability to control his drinking manifests in many ways. Alcoholism also has significant social costs for both the alcoholic and their family and friends. Alcoholism can have adverse effects on mental health causes mental disorders to develop. Approximately 18 percent of alcoholics commit suicide. Research has shown that over fifty percent of all suicides are linked to alcohol or drug abuse. In adolescents, the figure is higher with alcohol or drug abuse play a role in up to 70 percent of suicides.
Physical health effects
The physical health effects associated with alcohol consumption may include cirrhosis, pancreatitis, epilepsy, polyneuropathy, alcoholic dementia, heart disease, increased chance of cancer, nutritional deficiencies, sexual dysfunction, and death from many sources. Severe cognitive problems are not uncommon among alcoholics. Approximately 10% of all cases of dementia, alcohol-related does second alcohol most common cause of dementia. Other adverse effects on physical health include an increased risk of developing cardiovascular disease, malabsorption, alcoholic liver diseases and cancer. Damage to the central nervous system and peripheral nervous system can occur from continuous alcohol consumption.
Mental health effects
Prolonged abuse of alcohol can cause a wide range of psychological effects. Alcohol abuse is not only toxic to the body, but also for brain function and thus psychological well being can be adversely affected by the long-term effects of abuse. Psychiatric disorders are common in alcoholics, especially anxiety and depression disorders, with as many as 25% of alcoholics presenting with severe psychiatric disorders. Typically these psychiatric symptoms caused by alcohol misuse initially worsen during alcohol withdrawal but with abstinence these psychiatric symptoms typical gradually improve or disappear altogether. Psychosis, confusion and organic brain syndrome may be induced by chronic alcohol abuse can lead to a misdiagnosis of major mental disorders such as schizophrenia. Panic disorder can develop as a direct consequence of prolonged alcohol abuse. Panic disorder may also worsen or occur as part of the alcohol withdrawal symptoms. Chronic alcoholism can cause panic disorder to develop or worsen an underlying panic disorder through diversion of neurochemical systems in the brain.
The simultaneous incidence of moderate to severe depression and alcoholism is well documented. Among those with comorbid events, a distinction generally between depressive episodes, which are secondary to the pharmacological or toxic effects of heavy alcohol use and functions of abstinence and depressive episodes, which are primary and not the task of abstinence. Additional use of other drugs may increase the risk of depression in alcoholics. Depressive episodes with an onset of heavy drinking or those who continue in the absence of drinking is typically referred to as "Independent" episodes, while those who appear to be etiologically related to heavy drinking are called "drug-induced." There is a high level of suicide In chronic alcoholics with the risk of suicide increased the longer a person drinks. The causes are believed to cause the increased risk of suicide in alcoholics includes long Abuse of alcohol causes physiological distortion of brain chemistry and social isolation, as is common in alcoholics. Suicide is also very common in young alcohol addicts with one in four suicides in adolescents being related to alcohol abuse.
Social Impact
The social problems caused by alcoholism can be massive and partly due to because of the severe pathological changes induced in the brain from prolonged alcohol abuse and partly because of the intoxicating effects of alcohol. Alcohol abuse is also associated with increased risk of committing criminal offenses, including child abuse, domestic violence, rape, burglary and assault. Alcoholism is associated with loss of jobs which can lead to economic problems, including loss of habitation. Drinking at inappropriate times, and behavior caused by impaired judgments may lead to legal consequences, such as charge for drunk driving or public disorder, or civil penalties for tortious behavior. An alcoholic's behavior and mental suffering, while drunk deeply can affect surrounding them and lead to isolation from family and friends, can lead to marital conflict and divorce, or contributing to violence home. This may contribute to loss of self esteem and even lead to imprisonment. Alcoholism can also lead to neglect, with subsequent permanent damage to the emotional development alcoholic's children, even after they reach adulthood.
Alcohol withdrawal
Main article: Alcohol withdrawal symptoms
Alcohol withdrawal differs from most other drugs in that it can be directly fatal. For example, it is extremely rare for heroin withdrawal is fatal. When people dies of heroin or cocaine withdrawal they typically have serious underlying health problems, exacerbated by the strain of acute withdrawal. An alcoholic, but do not have serious health problems have a significant risk of dying from the direct effects of withdrawal, if not properly managed. Sedative-hypnotic medications such as barbiturates and benzodiazepines, which have a similar mechanism of alcohol (which is also a sedative-hypnotic) also have a similar risk of causing death during withdrawal.
Alcohol primary effect is the increase in stimulation of GABAA receptor, promoting central nervous system depression. With repeated high consumption of alcohol, these receptors are desensitized and reduced in number, resulting in tolerance and physical dependence. Thus when alcohol is stopped, especially abruptly, the person's nervous system suffering from uncontrolled synapse firing. This can result in symptoms that include anxiety, life-threatening seizures, delirium tremens and hallucinations, shakes and possible heart failure.
Acute withdrawal symptoms tend to subside after one to three weeks. Less severe symptoms (eg insomnia and anxiety, anhedonia) may continue as a part of a post-withdrawal symptoms gradually improved with abstinence in a year or more. Withdrawal symptoms begin to subside as the body and central nervous system makes adjustments to reverse tolerance and restore GABA function to normal. Other neurotransmitter systems are involved, especially glutamate and NMDA.
Diagnosis
Several tools are available for those who wish to implement screening for alcoholism. Identification involves an objective assessment of the damage that imbibing alcohol is not to drink life compared to the subjective benefits of drinking perceive from alcohol intake. While there are many cases where an alcoholic's life has been significantly and obviously damaged, there are always marginal cases that may be difficult to classify.
Addiction Medicine specialists have extensive training in diagnosis and treatment of patients with alcoholism.
Screening
More Tools can be used to detect a loss of control over alcohol consumption. These tools are mostly self reports in questionnaire form. Another common theme is a score or cast, which summarizes the overall severity of alcohol use.
The CAGE questionnaire, named for its four questions, is one such example that can 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 following questions:
Have you ever felt you needed to cut down on your drinking?
Have people annoyed you by criticizing your drinking?
Have you ever felt guilty about drinking?
Have you ever felt you needed a drink first thing in the morning (eye opener) to steady nerves or get rid of a hangover?
The CAGE questionnaire showed a high efficiency in the detection of alcohol-related problems, but it has its limitations in people with less severe alcohol-related problems, white women and college students.
For alcohol dependence data questionnaire is a more sensitive diagnostic test than the CAGE test. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol consumption.
The Michigan Alcohol Screening Test (MAST) is a screening for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses, driving under the influence is the most common.
The alcohol use disorders identification test (AUDIT) is a screening questionnaire developed by the World Health Organization. This test is unique because it has been validated in six countries and are used internationally. Like the CAGE questionnaire, it uses a simple set of questions – a high score serves a deeper investigation.
The Paddington Alcohol Test (PAT) was designed to screen for alcohol related problems amongst those attending Accident and emergency departments. The Concord well with the AUDIT questionnaire but administered in a fifth of the time.
Genetic predisposition testing
Psychiatric geneticists John I. Nürnberger, Jr., and Laura Jean Bierut indicate that alcoholism does not have a single causencluding geneticut that genes do not play an important role "by affecting processes in the body and brain that interact with each other and with a person's life experiences to to produce protection or susceptibility. "They also report that fewer than a dozen alcoholism-related genes have been identified, but more probably await discovery.
At least one genetic test exists for an allele that is correlated to alcoholism and opiate addiction. Human dopamine receptor genes have a detectable variation referred to as the DRD2 Taqi polymorphism. Those who have A1 allele (variation) of this polymorphism is a small but significant tendency for addiction to opiates and endorphin releasing drugs like alcohol. Although this allele is slightly more common in alcoholics and opiate addicts, it is not in itself an adequate predictor of alcoholism, and some researchers argue that evidence for DRD2 is contradictory.
DSM diagnosis
The DSM IV diagnosis of alcohol dependence represent one approach to the definition of alcoholism. Part of it is helping with the development of research protocols, the results can be compared with each other. According to DSM-IV, an alcohol dependence diagnosis is:
… Inappropriate alcohol with clinically significant deterioration manifested at least three of the following within a period of one year: tolerance, withdrawal, taken in larger amounts or over longer period than intended desire or unsuccessful attempts to cut down or control use; great time to collect, use or from use of social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or mental injury.
Urine and blood samples
There are reliable tests for the actual use of alcohol a common test is that of blood alcohol concentration (BAC). These tests do not differentiate alcoholics from non-alcoholics, but the long-term heavy drinking has a couple recognizable effects on the body, including:
Macrocytosis (enlarged MCV) 1
Elevated GGT
Moderate elevation of AST and ALT and an AST: ALT ratio of 2:1.
High carbohydrate deficient transferrin (CDT)
But none of these blood samples for biological markers as sensitive as screening questionnaires.
Prevention
Because alcohol use disorders perceived as affecting society as a whole, the World Health Organization, the European Union and other regional bodies, national governments and parliaments have formed alcohol policies to reduce the harmful effects of alcoholism.
To combat the health, social and educational underperformance, caused by alcohol or drugs targeting teens and young adults considered as an important step towards reducing the harmful effects of alcohol abuse. The age at which legal drugs of abuse such as alcohol can be purchased as well as to prohibit or restrict the advertising of alcohol has been recommended. Credible and evidence-based education drives in mass media about the consequences of alcohol and other drug abuse has also been recommended. Guidelines for parents on alcohol and drug use in adolescence and reach out to youth with mental health problems has also been suggested to prevent the harm of alcohol and other substance abuse.
Management
Treatments for alcoholism (antidipsotropic) is quite varied because there are multiple perspectives for the condition itself. Those who approach alcoholism as a medical condition or disease recommend various treatments than for example those who approach the condition as a social choice.
Most treatments focus on helping people discontinue their alcohol intake, followed up with life training and / or social support to help them resist a return to alcohol consumption. Since alcoholism involves multiple factors which encourage a person to continue to drink, they must all be addressed in order in order to prevent a relapse. An example of this form of treatment is detoxification followed by a combination of supportive care, participation in self-help groups and ongoing development of clear mechanisms. The treatment community for alcoholism typically supports an abstinence-based zero tolerance approach, but there are some who promote a harm reduction strategy as well.
Efficiency
When examining the effectiveness of treatment options, one must consider the success rate based on those who enter a program not only those who complete it. Since the completion of a program are skills for success, success among those who complete a program is generally near 100%. It is also important to consider not only the number of those reaching treatment goals but the number of these relapsed. Results should be compared to the approximately 5%, where people will leave on their own. A years after completing a rehab program, about a third of alcoholics are sober, an additional 40 percent are substantially improved but still drink heavily on occasion, and a quarter have completely relapsed.
Detoxification
Main article: Alcohol detoxification
Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol intake with the substitution of drugs that have similar effects to prevent alcohol withdrawal.
Detoxification treat the physical effects of long-term use of alcohol but does not actually treat alcoholism. After detox is complete, relapse is likely without further treatment. These rehabilitation (or "rehab ') May take place in a stationary or mobile.
Group therapy and psychotherapy
A regional service center for Alcoholics Anonymous.
After detoxification, various forms of group therapy or psychotherapy can be used to treat the underlying psychological problems related to alcohol dependence, 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. Many organizations have been formed for providing this service. Alcoholics Anonymous was the first group, and has more members than all other combined programs. Some others include Life Ring Secular Recovery, Rational Recovery, SMART Recovery, and Women for sobriety.
Rationing and moderation
Rationing and moderation programs such as Moderation Management and DrinkWise not mandate total abstinence. While most alcoholics are unable to restrict their water this way. some return to moderate intake of 2,002 American study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7% of people diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. This group showed, however, fewer first symptoms of dependence. A follow-up study with the same issues that were considered to be in remission in 2001-2002 studied return to problem drinking in 2004-2005. The study found abstinence from alcohol was the most stable form of remission for recovering alcoholics. A long-term (60 years) follow-up of two groups of alcoholic men concluded that the "return to controlled drinking rarely persisted for more than a decade without relapse or evolution into abstinence. "
Drug
A number of medications can be prescribed as part of treatment for alcoholism.
Medication in use
Antabuse (disulfiram) prevents removal of acetaldehyde, a chemical the body produces when breaking down ethanol. Acetaldehyde itself is the cause of many hangover symptoms from alcohol. The overall effect is severe discomfort when alcohol is consumed: an extremely fast acting and long lasting uncomfortable hangover. This hold an alcoholic from drinking in large quantities while taking this medicine. A recent nine-year study showed that the incorporation of monitoring disulfiram and a related compound carbamide in a comprehensive treatment program resulted in an abstinence of over 50%.
Temposil (calcium carbimide) works the same way as antabuse, but is weaker and safer [edit].
Naltrexone is a competitive antagonist of opioid receptor, effectively blocking our ability to use endorphins and opiates. Alcohol causes the body to release endorphins, and therefore when naltrexone is in the body drink no longer get any benefit from alcohol intake. Naltrexone used in two very different forms of treatment. The first treatment uses naltrexone to decrease cravings for alcohol and promoting abstinence. The second treatment, called pharmacological extinction, combines naltrexone with normal drinking habits in order to reverse the endorphin conditioning that causes alcohol dependence. This results in a reduced desire to drink, which persists after naltrexone use is interrupted, so long as the patient always taking naltrexone before drinking.
Naltrexone come in two forms. Oral naltrexone (initially, but no longer available as the brand ReVia) is a pill to be taken one hour before drinking to be effective. Vivi Trol is a time-release formulation is injected in the buttocks once a month.
Acamprosate (also known as Campral) is thought to stabilize the chemical balance in brain would otherwise be disrupted by alcoholism. The Food and Drug Administration (FDA) approved this drug in 2004, says "Although the mechanism of action is not fully understood, Campral is thought to act on the brain approaches to alcohol abuse … Campral shown superior to placebo in maintaining abstinence for a short period … " Combine the study failed to demonstrate efficacy for Acamprosate.
Experimental Medicine
Many experimental drugs are currently in clinical trials for the treatment of alcoholism. Promising results were obtained with anticonvulsants commonly used to treat epilepsy.
Topiramate (brand Topamax), a derivative of the naturally occurring sugar monosaccharide D-fructose, has been found effective in helping alcoholics stop or cut down on the amount they drink. In a study heavy users were six times more likely to remain abstinent for a month if they took medication, even in small doses. In another study, those who received topiramate fewer heavy drinking days, fewer drinks per day and several days of continuous abstinence than those receiving placebo. Suggests that topiramate antagonizes excitatory glutamate receptors, inhibits dopamine release and enhances inhibitory gamma-aminobutyric acid function. A 2008 review of effectiness of topiramate concluded that the results of published trials are promising, but currently the data are insufficient to support using topiramate in brief weekly compliance counseling as a first-line agent for alcohol dependence.
Medication which may worsen outcome
Benzodiazepines, while useful in the management of acute alcohol intoxication withdrawal, if used long term lead to a worse outcome in alcoholism. Alcoholics on chronic benzodiazepines have a lower rate to achieve abstinence from alcohol than those not taking benzodiazepines. This class of drugs commonly prescribed to alcoholics for insomnia or anxiety management. Launch of prescriptions of Benzodiazepines or sedative-hypnotics in individuals in recovery have a high relapse with one author reporting more than one quarter of people relapse after being required sedative-hypnotics. Patients often mistakenly believe that they are sober despite continuing to take benzodiazepines. Those who are long term users of benzodiazepines should not be withdrawn quickly, have tapered regimens 612 months proved to be the most successful, with less intensity of withdrawal.
Dual addictions
AMA definition of alcoholism refers to a disease unit involves compulsive use of alcohol despite social, physical and mental injury. [Edit]. DSM-IV definition of alcohol dependence refers to alcohol alone, and DSM-IV uses sedative dependence to refer to the disease entity involving non-alcohol-tranquilizers. [Citation needed]
Alcoholics may also require treatment of other psychoactive drug dependence. The most common dual addiction of alcohol dependence is a benzodiazepine dependence studies show 10-20% of alcohol dependent people who have problems with addiction and / or addictions of benzodiazepines. Alcohol itself is a sedative-hypnotic and cross-tolerant with other sedative-hypnotics such as barbiturates, benzodiazepines and nonbenzodiazepines. Dependence on other sedatives such as zolpidem and zopiclone and opiates and illicit drugs is common in alcoholics. Dependence and withdrawal from sedatives such as benzodiazepine withdrawal similar to alcohol and can be medically serious and include the risk of psychosis and seizures, if not managed properly. Benzodiazepines dependence requires careful reduction in dose to avoid a severe benzodiazepine withdrawal syndrome and health consequences. Benzodiazepines have the problem of rising cravings for alcohol in problem alcohol consumers. Benzodiazepines also increase the amount of alcohol consumed by problem drinkers.
Epidemiology
Disability-adjusted life years for alcohol-related illnesses per 100,000 inhabitants in 2002.
No data are less than 50 50-150 150-250 250-350 350-450 450-550 550-650 650-750 750-850 850-950 950-1050 More than 1,050
Total recorded alcohol per capita annual consumption (15 +), in liters of pure alcohol
Substance disorders are a major public health problem, as many countries. "The most general substance abuse / dependence in patients for treatment is alcohol. "In the United Kingdom that the number of 'dependent drinkers' was calculated as above 2.8 million in 2001. World Health Organization estimates that around 140 million people worldwide suffer from alcohol dependence. In the U.S. and Western Europe 10-20% of men and 50-10% of women at some point in their lives will meet criteria for alcoholism.
Within the medical and scientific community, there is broad agreement on 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. This is due to a complex interplay of biological vulnerability, environmental exposure and developmental factors (Eg phase brain maturity). "
Current data indicate that both men and women, alcoholism is 50-60% genetically determined, leaving 40-50% of environmental influences.
In the 2002 study by National Institute on Alcohol Abuse and Alcoholism surveyed a group of 4,422 adults who meet the criteria for alcohol dependence and found that after a year, some authors met the criteria for low risk drinking, although only 25.5% of the group received any treatment, broken down as follows:
25% still dependent
27.3% in partial remission (some symptoms persist)
11.8% asymptomatic drinkers (consumption increases chances of relapse)
35.9% fully recovered consists of 17.7% low risk drinking plus 18.2% abstainers.
In contrast, however, the results of a long-term (60 years) follow-up of two groups of alcoholic men by George Vaillant of Harvard Medical School, to "return to controlled drinking rarely persisted for more than a decade without relapse or evolution into abstinence. "Vaillant also noted that" return to controlled drinking, as reported in short term studies, is often a mirage. "
History
Etymology
1904 advertisement describes alcoholism as a disease.
The term "alcoholism" was first used in In 1849 by Swedish physician Magnus Huss to describe the systematic negative effects of alcohol.
In the U.S., use of the word "alcoholism" was largely popularized of the founding and growth of Alcoholics Anonymous in 1935 [citation needed]. AA's basic text, known as "Big Book" describes alcoholism as a disease involving a physical allergy: p.xxviii and a mental obsession.: p. 23 Note that the definition of "allergy" as used in this context is not the same as used in modern medicine. . The physician and addiction specialist Dr. William D. Silkworth MD writes on behalf of AA to Alcoholics suffer from a (physical) craving without mental control ".
A 1960 study by E. Morton Jellinek is considered the foundation for the modern disease theory of alcoholism. Jellinek's definition limited use of the word "Alcoholism" to those showing a particular natural history. The modern medical definition of alcoholism has been revised several times since then. American Medical Association currently uses the word alcoholism to refer to a particular chronic primary disease.
A minority opinion within the region, including recommended by Herbert Fingarette and Stanton Peele, argue against the existence of alcoholism as a disease. Critics of the disease model tend to use the term "heavy drinking" when discussing the negative effects of alcohol consumption.
Society and Culture
The various health related problems with long-term alcohol consumption are generally perceived as harmful 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 assault. Besides money, there is also the pain and suffering to the people besides alcoholic hit. For example, consumption of alcohol by a pregnant woman can cause fetal alcohol syndrome, an incurable and damaging condition.
Estimates of the economic costs of alcohol abuse collected, the World Health Organization, vary from one to six percent of a country GDP. One Australian estimate associated social costs of alcohol in 24 percent of all drug costs, a similar Canadian study concluded, alcohol percentage was 41 per cent.
A study quantified the cost to the UK of all forms of alcohol abuse as 18,520 billion annually (2001 figures).
Stereotypes
Representation of a wino or town drunk
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 portrayal of the Irish as excessive alcohol consumption.
Studies by social psychologists Stivers and Greeley attempt at documenting perceived prevalence of high alcohol consumption among the Irish in America.
Alcohol-related crime
See also: Narcotic Crime
This section may require cleanup to meet Wikipedia's quality standards. Please improve this section if you can. (July 2009)
Of the adult U.S. population at least 75% are drinkers, and about 6% of the total group of alcoholics. In groups, there are almost 100% drink, the alcoholism is about 8%. Many reports approximately 73% of felonies are alcohol related. A survey shows that about 67% of child-beating cases, 41% of forced rape cases, 80% of wife-abuse, 72% of Stabbing and 83% of homicide, either the attacker or victim or both had been drinking. "
In film and literature
In modern times, recovery is moving forward to more realistic depictions of problems resulting from heavy alcohol consumption. Authors such as Charles R. Jackson and Charles Bukowski describe their own alcohol addiction in their writings. The incoherent story by Patrick Hamilton's Hangover Square reflects alcoholism of his central character. A famous depiction of alcoholism, and psychology of an alcoholic, is in Malcolm Lowry's highly acclaimed novel The Volcano, which details the last days of the British Consul Geoffrey Firmin on days the Dead in Mexico in 1939 and his election to continue his extreme alcohol consumption in Instead of returning to the woman he loves.
Film as Bad Santa, Barfly, Days of Wine and Roses, Ironweed, My Name Is Bill W., Withnail and I, Arthur, Leaving Las Vegas when a man Loves a Woman, Shattered Spirits, and The Lost Weekend chronicle similar stories of alcoholism.
Women and alcoholism
Alcoholism is a higher incidence among men, although in recent decades, the proportion of female alcoholics has increased. It is important to articulate the various biological and social ways alcoholism manifests in women to understand barriers to treatment and effective recovery strategies.
William Hogarth's Gin Lane, 1751st
Biological diversity and physiological effects
Biological women have symptom profiles from their use of alcohol, which differs in essential respects from men. They experience a telescoping of physiological effects from alcohol. Equal doses of alcohol consumed by men and women generally result in women who have higher blood alcohol content (BAC). This can be attributed to many reasons, including most important is that women have less body water than men. A given quantity of alcohol, thus becoming more concentrated in a woman's body. Besides this fact, even women are more intoxicated, due to different hormone release.
Women develop long-term complications of alcohol dependence more rapidly than do alcoholic men. In addition, women have a higher mortality rate of alcoholism than men. Examples of long-term complications include brain, heart and liver damage and an increased risk of breast cancer (See alcohol and breast cancer). Additionally, drinking sometimes shown to have a negative effect on reproductive function in women. This results in reproductive dysfunction such as anovulation decreased ovarian mass, irregular menstruation, amenorrhea, luteralfase dysfunction and premature menopause.
Psychological and emotional consequences
Psychiatric disorders are generally more prevalent among those with alcohol disorders. This applies to both men and women, however, disorders varies depending on gender. Women who have alcohol-use disorders often have co-occurring psychiatric diagnoses as major depression, anxiety, panic disorder, bulimia, post-traumatic stress disorder (PTSD), or borderline personality disorder. Men with alcohol disorders often have co-occurring diagnosis of narcissistic and antisocial personality disorder, bipolar disorder, schizophrenia, impulse disorders and attention deficit / hyperactivity disorder.
Women with alcoholism are also more likely to have a history of physical or sexual assault, abuse and violence at home than in the general population. This trauma can lead to higher instances of PTSD, depression, anxiety, and a greater dependence on alcohol.
Societal barriers to treatment
Attitudes and social stereotypes on women and alcohol can create barriers to detection and treatment of female alcohol abusers. Such beliefs stigmatize women who drink by classifying them as "both generally and sexually immoral" or "fallen women". Fear of stigma can lead women to deny that they suffer from a medical condition in order to hide their drinking, and drinking alone. This pattern, which in turn leads family physicians and others to be less inclined to suspect that a woman they know is an alcoholic.
In contrast, attitudes and social stereotypes about men and alcohol can lower the barriers the detection and treatment of male alcohol abusers. Such beliefs reward men who drink by classifying them as "both generally and sexually moral" or "grown men." Reduced fear of stigma can lead men to admit that they suffer from a medical condition that publicly display their drinking, and to drink in groups. This pattern, which in turn leads family physicians and others to be more inclined to believe that a man they know is an alcoholic. Women also has a tendency to have a greater fear that the negative effects of stigma will reflect poorly on their families. This can also keep them from seeking Help.
Implications for treatment
Research has shown a lack of adequate training for practitioners both problematic alcohol use in general and in relation to women's problems. The complexity of alcohol related disorders, particularly gender issues, shows that the need for practitioners' knowledge, insight and compassion is enormous. Better education and awareness about gender implications of alcoholism will help care providers to adequately treat women suffering from alcoholism. Early interference will also increase the likelihood of repayment.
See also
Wikiquote has a collection of quotations related to: Alcoholism
Wikimedia Commons has media related to: Alcoholism
Alcohol consumption and health
Alcoholism in family systems
Alcoholic dementia
Alcohol-related traffic crashes
Alcohol tolerance
Alcohol withdrawal syndrome
Alcoholic lung disease
Binge drinking
List of countries drinking
Alcohol Poisoning
E. Morton Jellinek
Ethanol Metabolism biochemical discussion of alcohol metabolism
Handbook on drug and alcohol abuse
Hangover
List of deaths through alcohol
Drug addiction
Self Medication
Wernicke-Korsakoff syndrome
Willingway Hospital
Medical diagnostic testing for alcohol
Alcohol Concentration blood
Full blood count
Liver Function Tests
Al-Anon and Alateen: Support for friends and families affected by alcoholism
References
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