Diseases Associated with Alcohol Abuse.
Alcohol has been
shown to be directly toxic to the liver. Approximately 90 to 100 percent of
heavy drinkers show evidence of fatty liver, an estimated 10 to 35 percent
develop alcoholic hepatitis, and 10 to 20 percent develop cirrhosis. Fatty liver
is reversible with abstinence, alcoholic hepatitis is usually reversible upon
abstinence, and while alcoholic cirrhosis is often progressive and fatal, it can
stabilize with abstinence. In addition to liver disease, heavy alcohol
consumption causes chronic pancreatitis and malabsorption of nutrients.
Alcohol-induced heart damage appears to increase with lifetime dose of alcohol. Alcohol can damage the brain in many ways. The most serious effect is
Korsakoff's syndrome, characterized in part by an inability to remember recent
events or to learn new information. The incidence of alcohol-related brain
damage is approximately 10 percent of adult dementias in the United States.
Milder attention and memory deficits may improve gradually with abstinence.
Additional diseases strongly linked to alcohol consumption include failure of
reproductive function and cancers of the mouth, larynx, and esophagus.
Hospitalized alcoholics have also been found to have an increased prevalence of
dental problems, compared with nonalcoholic psychiatric patients, including
missing teeth and nonrestorable teeth. Psychiatric disorders.
Brain and Behavior
Mental illness is associated with alcohol and other drug abuse. One third
of abusers have a mental illness. Alcohol abuse increases the risk for legal
troubles, social and occupational impairment, domestic abuse, and a higher
likelihood of attempting and committing suicide. Alcohol abuse causes a wide
range of psychiatric conditions, including mood, anxiety, psychotic, sleep,
sexual, delirious, and amnestic disorders.
A study published in
Neurology in 2014 found that middle-aged men who drink more than 2.5 drinks
daily are more likely to undergo faster decline in all cognitive
areas—particularly memory—over a period of 10 years.
The UK Whitehall
study followed patients for 30 years found surprising negative effects on
the brain.. Moderate drinking is associated with pathologic findings in the
brain, including hippocampal atrophy. Higher alcohol intake predicted faster
decline in cognitive measures of lexical fluency. People who drank during
the 30 years had higher odds of hippocampal atrophy compared with those who
did not drink. The risk was dose dependent, with those who consumed more
than 30 units of alcohol per week having the highest risk compared with
abstainers. The risk was also higher among people who drank moderately (from
7 to fewer than 14 units per week). These individuals had 3 times the odds
of right-sided hippocampal atrophy. There was no protective effect in
reducing the odds of atrophy of light drinking, defined as 1 to fewer than 7
units per week, over abstinence. (Shivani R, Goldsmith RJ, Anthenelli RM.
Alcoholism and psychiatric disorders. National Institute on Alcohol Abuse
and Alcoholism. November 2002.NIH Publications
Accessed February 7, 2014. Collins M. Neuroinflammatory PARP
pathways in ethanol-dependent neurodegeneration: suppression by omega-3
fatty acid. Proceedings and abstracts of the 14th Congress of the European
Society for Biomedical Research on Alcoholism; September 8-11, 2013; Warsaw,
Poland. Abstract 01.2.)
The strongest correlate of alcoholism documented in the ECA is
antisocial personality disorder (ASPD). Comorbid ASPD has prognostic and
treatment implications for alcoholics. Patients with ASPD have an earlier age of
onset of alcohol and other drug abuse and a more rapid and serious course of
illness. Bulimia is an eating disorder in which patients, usually female,
binge on sugar- and fat-rich meals, and purge regularly, as by self-induced
vomiting. This disorder is characterized by craving, preoccupation with binge
eating, loss of control during binges, an emphasis on short-term gratification,
and ambivalence about treatment--symptoms that resemble those of addictive
disorders. Bulimics commonly exhibit multiple drug use disorders and have high
rates of alcoholism. Between 33 and 83 percent of bulimics may have a
first-degree relative suffering from alcohol abuse or alcoholism.
it has been suggested that alcoholism and depression are manifestations of the
same underlying illness, the results of family, twin, and adoption studies
suggest that alcoholism and mood disorder are probably distinct illnesses with
different prognoses and treatments. However, symptoms of depression are likely
to develop during the course of alcoholism, and some patients with mood
disorders may increase their drinking when undergoing a mood change, fulfilling
criteria for secondary alcoholism. When depressive symptoms are secondary to
alcoholism, they are likely to disappear within a few weeks of
abstinence, as withdrawal symptoms subside. /p>
Studies (not using
ECA data) indicate that approximately 10 to 30 percent of alcoholics have panic
disorder, and about 20 percent of persons with anxiety disorders abuse alcohol.
Among alcoholics entering treatment, about two-thirds have symptoms that
resemble anxiety disorders. Several studies indicate that anxious patients may
use alcohol or other drugs to self-medicate, despite the fact that such use may
ultimately exacerbate their condition. The strongest correlation between
alcoholism and severe anxiety symptoms occurs in the context of alcohol
withdrawal. The severe tremors, feelings of tension, restlessness, and insomnia
associated with withdrawal begin to subside after 4 or 5 days, although a
vulnerability to panic attacks and to generalized anxiety may continue for
months. Because these symptoms decrease with abstinence, they are unlikely to
represent an independent anxiety disorder. Other drug abuse.
Other drug abuse.
ECA data, alcoholics are 35 times more likely than nonalcoholics to also use
cocaine. Similar odds ratios for other types of drugs are: sedatives, 17.0
times; opioids, 13.0 times; hallucinogens, 12.0; stimulants, 11.0; and marijuana
and related drugs, 6.0. Surveys of indicate that up to 90 percent of
alcoholics are nicotine dependent.
( Statistics originated with the USA Epidemiologic
Catchment Area (ECA) program of the National Institute of Mental Health. In the early 80's, the ECA surveyed more than 20,000
respondents residing in households, group homes, and long-term institutions in
five sites across the United States. Their data tell us about the prevalence
and incidence of psychiatric disorders, as well as issues related to treatment.)
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