Alcoholism: DR Cynthia El Hajj

Alcoholism
Dr Cynthia El Hajj
What is Alcoholism ?
• Alcoholism or alcohol use disorder (AUD) is a chronic
relapsing disease characterized by denial and inability to
discontinue its use despite knowing its adverse consequences
• The disorder was previously divided into two types:

alcohol abuse and alcohol dependence
• Alcoholism  two or more of the following conditions are

present: a person drinks large amounts of alcohol over a long
time period & has difficulty cutting down
• A person is considered to suffer from chronic alcoholism if his

use of alcohol is interfering with successful physical, social
functioning and professional life
Harmful effects of Alcohol
Alcohol is strongly desired, usage results in:
- not fulfilling responsibilities
- in social problems
- in health problems
- in risky situations e.g.: drinking and driving
- Alcohol use can affect all parts of the body, but it particularly affects the brain, heart, liver, pancreas
and immune system.
- This can result in mental illness, irregular heartbeat, an impaired immune response, liver cirrhosis
and increased cancer risk, among other diseases.
- Drinking during pregnancy can cause damage to the baby resulting in
fetal alcohol spectrum disorders. Women are generally more sensitive than men to the harmful
physical and mental effects of alcohol.
Terms to remember…
• Abuse: if often used to refer to illegal use of any substance, use of

prescription medications in excess of the prescribed dosage, and
sometimes refers to use that results in long-term health problems.
• Alcohol intoxication: drinking excess alcohol leads to inappropriate

behavior and impaired judgment.
Terms to remember…
• Alcohol use disorder: medical term for alcohol addiction or what most people
think of as alcoholism
• Mild to severe alcoholism is defined as two or more of the following

problems:
• Taking alcohol in larger amounts or for a longer time than intended

• Wish they could cut down on alcohol, but they cant
• Most of the time, they try to obtain, use, or recover from alcohol
Alcoholic People
• Crave or have a strong desire or urge to drink
• Fail repeatedly to meet obligations at work, home, or school because of alcohol.
• Continue to use alcohol despite having recurrent social or interpersonal problems
• Continue to use alcohol despite having a physical (eg, liver disease) or mental
disorder (e, depression) caused or worsened by alcohol
• Stop or cut back an important social event , work, or fun activities they used to
do
Alcoholic People
• Keep drinking even in situations where it is dangerous to do so (such as while
driving)
• Lack tolerance
• Have a withdraw symptoms: Sweating, racing heart, shaking, insomnia, nausea or

vomiting hallucinations, anxiety, seizures
Risk factors for Alcoholism
• Steady drinking over time: binge drinking on a regular basis
• Age: drinking at an early age, and especially in a binge fashion
• Family history: higher for people who have a parent or other close relative
who has problems with alcohol
• Depression
• Social and cultural factors: friends or a close partner who drinks

regularly - media also may send the message that it's OK to drink too much
Psychological risk factors
• Poor stress management skills, loneliness, desire to escape from reality, a
sense of adventure, pleasure seeking.
• Emotionally immature, need for praise and appreciation
• Low frustration tolerance, feelings of inadequacy
• Psychological trauma during childhood as disturbed parent child relationship
• Inferiority, low self esteem, poor impulse control

What is one drink??
Are you?
 Moderate drinkers
 Heavy drinkers
 Binge drinkers
Five stages through which a person has to pass till he becomes complete
disorganized personality
1. Morning drinking: Person starts drinking alcohol in morning and he feels it is

necessary to push him throughout the day.
2. Escape drinking: It starts, when a person is not able to face reality of problems
without the help of alcohol
3. Increasing consumption : Consumption of alcohol increases in amount
leading to personal disorganization and decreased social value and feels that he
cannot survive without alcohol.
4. Drinking and social functions: Drinking becomes absolute necessity in social
gathering.
5. Extreme behavior: drinks excessively and behave indiscriminately, e.g.:
Fighting, abusing, throwing away things, beating wife and children, absurd and
dangerous behavior etc.
Identifying the alcoholics
Red palms and red nose

Improper gait
Decreased sensation and weakness in legs
and feet.
Disorientation
Ring like opacity of cornea (Bilateral)
Clinical feature of an alcoholism
Physical signs
 Indigestion- anorexia
 Sweating
 Unsteady gait
 Malaise
 Weakness in feet and legs
 Pain in upper abdomen
Psychological signs
 Blackouts- amnesia of events
 Loss of self control
 Outburst of aggressive behavior
 Insomnia
What Happens When You Drink?
• When you take a drink, about 20 % of the alcohol is absorbed in your stomach
• Remaining 80 % is absorbed in the small intestine
• How quickly the alcohol is absorbed depends upon the concentration of the alcohol in the
drink and whether you've just eaten a big meal
• Vodka absorption is faster than beer

• Food slows down alcohol absorption.
• Kidneys and lungs remove about 10 % of alcohol---breath test

• Liver breaks down the rest of the alcohol
• Physical effects are related to the blood alcohol concentration (BAC).
Clinical feature of an alcoholism- Complications
A- Gastro-intestinal Tract
Gastritis Fatty degeneration of the liver,

Vomiting interferes with absorption of vitamin
B-complex
Peptic ulcer
Cirrhosis of liver
Cancer
Hepatitis, Jaundice
Reflex esophagitis
Liver cell carcinoma
Carcinoma of stomach and
oesophagus, larynx, liver, colon Acute and chronic
 pancreatitis
B-Cardiovascular System: D- Nervous System:
 Cardiomyopathy  Confusion, numbness of hands, feet,

 Hypertension disordered thinking,
Change in mood
 Heart failure or stroke
Excitement
 High risk for myocardial
infarction. Hallucination
 Depression, depresses vital centers of
the brain
C- Blood :
 Peripheral Neuropathy
Dementia
Anemia
 Epilepsy
Low immunity
 Head injury
 Cerebellar degeneration
Coma
Alcohol and the Brain
• Trouble with balance- judgment
-coordination
• Stumbling walk
• Slurred words
• Memory lapses
• React slowly to stimuli (Driving is
dangerous_
• Sexual urge may increase
• performance decrease
• Sleepiness
• Life threatening
• Slow breathing
• Lower body temperature
E- Hormonal : H- Reproductive System :
 Hypoglycemia Sexual dysfunction in male

Failure of ovulation in female
F-Muscle :
Peripheral muscle weakness Interruption in menstruation
Wasting of muscles
I- Pregnancy :
G- Bones :
Fetal abnormalities
Interferes with the production of Developmental disabilities- Mental
bones retardation, Growth retardation
Thinning of bones, osteoporosis Low birth weight
Fractures Still birth
Birth defects
Foetal alcohol syndrome
G-Nutritional Deficiency Diseases :
When to see a doctor???
• If you've ever wondered if your own alcohol consumption crosses the
line of abuse or dependence, ask yourself these questions:
Do you need a drink as soon as you get up?

Do you feel guilty about your drinking?
Do you think you need to cut back on your alcohol consumption?
Are you annoyed when other people comment on or criticize your
drinking habits?
Screening and diagnosis of Alcoholism
• Ask you several questions related to your drinking habits:

permission to speak with family members or friends-- confidentiality
• Perform a physical exam: ask questions about your health-many physical

signs that indicate complications of alcohol use
• Lab tests and imaging tests: no specific test to diagnose- test that show
damage to organs
• Complete a psychological evaluation: fill out a questionnaire

Surveys to Aid in the Diagnosis of Alcoholism
• There are several surveys designed to help medical professionals diagnose

alcoholism. One of the most widely used surveys is the CAGE test. The
survey asks four questions, and two affirmative answers may suggest that the
patient may be at risk:
• The “C” question asks if they felt the need to “cut” down on alcohol.
• The “A” question asks if they ever felt annoyed when others discussed their
heavy drinking.
• The “G” question asks if they have experienced guilt about drinking.
• The “E” question asks if they have used alcohol as an “eye-opener” to wake
up or cure a hangover in the morning.
Laboratory diagnosis
Urine and blood tests :One common test being that of blood alcohol
content (BAC).
Liver function tests:

AST (alanine transaminase),ALT (aspartate transaminase), GGT
(gamma-glutamyl transpeptidase), etc
What should you DO and NOT DO with Alcohol Poisoning
Do Dont
• Make sure they remain conscious • Tell them to sleep it off
• Keep them hydrated • Give them coffee—further
• Keep them warm dehydration
• Stay with them and never leave • Instruct them to walk around---
them alone fall/injuries
• Monitor their symptoms • Ask them to take a cold
• Ensure they lie on their side so they shower---colder then they
won't choke on their own vomit already feel --hypothermia
Management
• Detoxification and withdrawal
• Psychological counseling
• Oral medications: ex: Disulfiram (Antabuse)/Naltraxone
• Injected medication
• Continuing support
• Treatment for psychological disorders
• Medical treatment to other conditions
• Spiritual practice
Management
• Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol drinking coupled
with the substitution of drugs that have similar effects to prevent alcohol withdrawal.
• It treats the physical effects of prolonged use of alcohol, but does not actually treat alcoholism.
• relapse is likely without further treatment
• Usually take 2-7 days
• May need to take sedating medications to prevent withdrawal symptoms
• Usually done at an inpatient treatment center or a hospital
Lifestyle changes
• Consider your social situation: make it clear to your friends and

family that you're not drinking alcohol, support system of friends and
family
• Develop healthy habits: good sleep, regular physical activity,

managing stress more effectively and eating well
• Do things that don't involve alcohol

Benefits of living Alcohol-free
• Maintaining a healthy body
• Establishing healthy relationships
• Making healthy decisions
• Avoiding risky behavior
• Avoiding illegal activities
• Avoiding violence
• Achieving your goals

Alcoholism: DR Cynthia El Hajj

Uploaded by

Copyright:

Available Formats

Alcoholism: DR Cynthia El Hajj

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Alcoholism: DR Cynthia El Hajj

Uploaded by

Copyright:

Available Formats

Alcoholism

• The disorder was previously divided into two types:

• Alcoholism  two or more of the following conditions are

• A person is considered to suffer from chronic alcoholism if his

• Abuse: if often used to refer to illegal use of any substance, use of

• Alcohol intoxication: drinking excess alcohol leads to inappropriate

• Mild to severe alcoholism is defined as two or more of the following

• Taking alcohol in larger amounts or for a longer time than intended

• Fail repeatedly to meet obligations at work, home, or school because of alcohol.

• Continue to use alcohol despite having recurrent social or interpersonal problems

• Have a withdraw symptoms: Sweating, racing heart, shaking, insomnia, nausea or

• Age: drinking at an early age, and especially in a binge fashion

• Social and cultural factors: friends or a close partner who drinks

• Emotionally immature, need for praise and appreciation

• Low frustration tolerance, feelings of inadequacy

• Psychological trauma during childhood as disturbed parent child relationship

• Inferiority, low self esteem, poor impulse control

1. Morning drinking: Person starts drinking alcohol in morning and he feels it is

Red palms and red nose

• Remaining 80 % is absorbed in the small intestine

• Vodka absorption is faster than beer

• Kidneys and lungs remove about 10 % of alcohol---breath test

Gastritis Fatty degeneration of the liver,

 Cardiomyopathy  Confusion, numbness of hands, feet,

 Hypoglycemia Sexual dysfunction in male

Do you need a drink as soon as you get up?

• Ask you several questions related to your drinking habits:

• Perform a physical exam: ask questions about your health-many physical

• Complete a psychological evaluation: fill out a questionnaire

• There are several surveys designed to help medical professionals diagnose

Liver function tests:

• Consider your social situation: make it clear to your friends and

• Develop healthy habits: good sleep, regular physical activity,

• Do things that don't involve alcohol

You might also like