Alcohol Addiction: Causes, and Treatment

Identification of the problem 

Alcohol addiction is a disease in which individuals continue to crave alcoholic drinks despite the existence of repeated alcohol-related issues. The signs of alcohol addiction and alcohol abuse have a high level of similarity, with the only variance being the degree of severance and intensity (Cargiulo, 2017). Usually, individuals with alcohol addiction are the last ones to identify that they have a problem. Some signs of alcohol addiction involve drinking along, and the inability of the individual affected to limit their level of alcohol consumption. Moreover, the addicted individual may lose interest in or altogether abandon hobbies and activities that they enjoyed before the addictions. 

Alcohol is one of the most extensively used drug substances across the world. Most individuals consume a small or moderate quality of alcohol with the purpose of relaxation or the enhancement of their social activities (Simmons et al., 2015). The use of alcohol in this way has no impact on most individuals. However, for particular consumers, the consumption of alcohol may have a negative effect on their daily activities and their social lives. This includes a decrease or deterioration of their health, relationships, work, and study (World Health Organization, 2019). When this occurs, an individual is identified as having an alcohol problem. This problem may vary in the level of intensity from mild to severe. A severe alcohol problem usually signified alcohol addiction. It can be characterized by the number of individual consumers, and the amount of time that they can go without feeling the need to consume alcohol. 

Alcohol is a liquid with a strong, pungent state and inflammable qualities. It has intoxicating elements, usually in fermented or distilled liquor. Alcohol forms one of the largest groups of sedatives and drugs with the inclusion of bromide and chloroform. Seductive drugs are chemical which results in sleepiness in the consumer when taken in large quantities. There are no established chemical or biological reasons as to why alcohol addiction occurs in some individuals and not in others (Jacubczyk et al., 2012). Alcohol addiction has become a significant problem not only for adults but as well as for the younger population. Currently, the consumption of alcohol and the prevalence of alcohol addiction is very high in college students. This has resulted in public health concern on the effects that this addiction has on younger consumers. 

Based on the World Health Organization (WHO), alcohol addiction is the most significant cause of severe disorders (World Health Organization, 2019). It can be identified by behavioral and other responses, which include the need for consuming alcohol consistently and periodically to experience its psychological effects. Due to the severe complications and medical and social implications that alcohol addiction has on the individual and the people around them, it essential that an assessment of the disorder be assessed. This paper has been structured to provide a brief introduction to the problem, followed by an evaluation of the background and significance of the issue. This will include a clear description of the disorder and a comparison of the prevalence of rates of the disease. Current surveillance methods on the chronic condition will be identified, followed by epidemiological analysis of alcohol addiction. Lastly, an integrative plan will be presented on how a nurse can address alcohol addiction in a patient. 

Background and Significance 

Alcohol addiction, also referred to as alcoholism, is a chronic condition in which excessive dependence of alcohol beverages results in shifts in the brain and neurochemistry of the individual involved. This condition affects all individuals, despite their sex, race, and socioeconomic background (World Health Organization, 2019). Alcohol addiction can be presented in several ways. Its severity, the frequency of consumption, and the level of alcohol they consume, also changes from one individual to the other. Some individuals drink heavily in a day, while other individuals binge drink and practice soberness for some time. 

Alcohol addiction may be difficult to identify. Unlike other illegal drugs, there is a high availability of alcohol as it is widely accepted in several cultures. Alcohol can be commonly found at the center of a social situation and is intricately connected to a majority of interactions (Connor et al., 2016). This makes it challenging to identify the distinction between an individual that just likes to have a few drinks as opposed to an individual that is addicted. 

Some symptoms of alcohol addiction include the increased amount of frequent use of alcohol along with a high tolerance for alcohol. Typically, after the consumption of large amounts of alcohol, the body showcases low levels of tolerance through symptoms such as nausea and headaches (Becker, 2008). However, an individual with alcohol addiction has a high level of alcohol tolerance, which results in a lack of body responses, usually referred to as 'hangover' symptoms. Individuals with an addiction problem may also exhibit consumption of the drug at inappropriate times. As already mentioned, alcohol is typically consumed during social situations. However, an individual with this chronic condition has been identified as engaging in consumption in cases outside social interactions such as during work hours or immediately when they wake up. Social withdrawal also acts as a significant sign of alcohol addiction (Connor et al., 2016). This is because alcohol addicts tend to avoid contact with loved ones and prefer to be solitary with their drinking habits. 

Individuals that have an alcohol addiction problem usually have a high dependence on alcohol for the individual to function in daily activities. They cannot engage in normal activities such as going to work without the sedative effects of alcohol. They also exhibit lethargy, depression, or other emotional issues that they did not have before their consumption of alcohol. This affects how they interact and communicate with those around them. It may also result in problems such as absenteeism and disregard for existing societal and legal rules. Hence, it is common for alcohol addicts to experience legal or professional issues such as multiple arrests or even losing their job. Alcohol addiction tends to worsen with time, which makes it essential for healthcare providers and family members of an individual to make early identification and support early treatment. 

In Florida, alcohol was the most commonly cited abused substance for the number of individuals admitted for addiction treatment. In 2016, about 53 percent of adults in the county drank alcohol at least each month ("Florida Alcohol and Drug Abuse Association/ Florida Behavioral Health Association", 2020). The rate of binge drinking was identified as a habit in about 16 percent of the county's population, with most individuals admitting to about six drinks during binge drinking. Excessive drinking was identified as having a Florida cost per capita of 815 dollars ("Florida Alcohol and Drug Abuse Association/ Florida Behavioral Health Association", 2020). The table below shows a comparison of the prevalence of alcohol addiction and treatment in the U.S.A to those of Florida County. 

Surveillance and Reporting 

Several surveillance methods exist for alcohol addiction. An example of this is the behavioral risk factor surveillance system (BRFSS) which a telephone survey that assesses health behaviors, and chronic disease among non-institutionalized adults in the U.S. Data collected through this method includes the number of days of alcohol consumption, the magnitude of drinks per social interaction, and the maximum number of drinks consumed per each interaction (Gonzales et al., 2017). It also assesses the existence of binge drinking. The Youth Risk Behavior Surveillance System (YRBSS) is a surveillance method that engages in monitoring six categories of priority health-risk behaviors in high school youth at the national, state and local levels (Kann et al., 2016). This survey engages in the specific collection of data on the age of first alcohol consumption, frequency of binge drinking, and drinking linked to other behaviors such as driving. 

The mandated reporting processes for alcohol addiction are primarily related to cases in which alcoholism results in child abuse or neglect. In eighteen states, all citizens are required to report any suspected abuse or neglect of children based on the alcohol addiction of the parents and guardians that are involved (Mudrick et al., 2017). Alcohol addiction treatment providers are also mandated by state laws to disclose any issues of alcohol addiction if child abuse or neglect is suspected. Some alcoholic parents and guardians are drawn into the child protection system during their treatment, while others are compelled into treatment by the system. 

Epidemiological Analysis 

The epidemiological analysis will involve an assessment of the 5W's concerning alcohol addiction. This will include an evaluation of the what, who, where, when, and why associated with alcohol addiction. Several factors influence alcoholism in individuals. Most individuals with this condition are exposed to determinants, such as family and home life and work environments. 

An individual's home life has a significant role in their struggle with alcohol addiction. If children have early exposure to alcohol, there is a high likelihood that they will later struggle with alcohol abuse in later stages of development. Individuals with alcohol consumption before the of five are five times more likely to develop alcoholism in their adulthood as opposed to individuals that start drinking at the age of 21 (Glantz et al., 2020). Hence, alcohol addiction is a chronic condition that mainly develops during the stages of adolescence and adulthood once an individual can freely access alcoholic substances. 

Traumatic experiences act as the main reason why individuals may develop an alcohol addiction. This refers to traumatic experiences experienced at any age of an individual's development, which, when not adequately reviewed and encountered, will result in the development of alcoholism later on. Adolescents and adults that receive alcohol addiction treatment report elevated rates of physical and sexual abuse as opposed to others. In a majority of the reported cases, alcoholism is developed after the abuse occurs. Peer pressure is a major deciding factor for adolescents that develop a drug addiction. Students that consuming alcohol may encourage their colleagues to join them. Moreover, students that poor social skills are at a higher risk of drinking alcohol as a way of fitting in. This usually acts as a way for them to fit into the social groups around them. 

Adults with stressful work environments or low income may also use alcohol as a form of relief, which usually result in alcoholism. This is typically attributed to a feeling of hopelessness associated with an individual's inability to be economically stable or to find employment. On the other hand, work-related stress has also been identified as being highly correlated with alcohol abuse (Berenz et al., 2017). Lastly, mental health illnesses act as a significant precursor for alcohol addiction. Round a third of individuals with mental illnesses have substance use disorders. When a substance disorder takes place in addition to a mental health disorder, it is referred to as co-occurring disorders. 

The social and economic costs of alcohol addiction affect not only the addicted individual but also those around them. The economic costs of alcoholism can be severe, particularly for individuals within the low-income bracket. Apart from the funds directed towards the purchase of alcohol, heavy drinkers may also have to deal with lower wages and loss of employment opportunities. There is also a related increase in medical and legal costs and decrease in eligibility for loans. 

Socially, the work performance of an individual with alcohol addiction is adversely impacted. This is because the condition usually results in the increased absence of the individual from their work environment, an increased rate of work accidents, and the decreased productivity of the individual. These effects can then result in the individual losing their jobs resulting in unemployment. Alcoholism can also affect how an individual relates to their family as a parent, parent, and their contribution to the functioning of the household (Glantz et al., 2020). Drinking outside the home may also result in less time being spent at home. For pregnant women, alcoholism may result in developmental disorders in the unborn child. Lastly, alcohol addiction has been linked to increased cases of domestic violence. Excessive alcoholic consumption results in the poor judgment of the individual, which may result in increased arguments with their domestic partners and even abusive behavior towards their spouses or significant others. 

Screening and Guidelines 

The Alcohol Use Disorders Identification Test (AUDIT) was structured by the WHO in 1982 as a proper method of screening and identifying individuals at risk for the development of alcohol issues (Babor et al., 2016). The AUDIT test has its focus on the identification of the early symptoms of harmful drinks and slow dependency on alcohol. It is utilized for the detection of alcohol issues experienced within the last year for an individual. It has been identified as one of the most effect screening tests that exist and viewed as highly effective in the detection of hazardous and harmful drinking habits. 

As opposed to other alcohol screening tests, AUDIT can be used across diverse groups. The test is made up of 10 multiple choice questions on the amount and frequency of alcohol consumption (Weobong et al., 2019). These questions are also used to assess drinking behavior and alcohol-related issues or reactions. The responses or answers of the participant or respondent are graded based on a point system. A score that higher than eight acts as an indicator of an alcohol problem within an individual. 

The questions on the AUDIT can be divided into three separate categories; excessive alcohol use, dependency on alcohol, and harmful alcohol use. In the domain of excessive alcohol use, the first three questions assess the frequent consumption, typical quantity, and the frequency of heavy drinking. The second category of dependency on alcohol ranges from the fourth to the sixth question and involves the assessment of the prominence of drinking. The last category of harmful alcohol use is within the seventh to tenth question. It includes an evaluation of guilt after alcohol consumption, blackouts, alcohol-related injuries, and the case of other individuals exhibiting concern over the participant's alcohol consumption behaviors. 

The sensitivity and specificity of the selected test item are computed for multiple criteria, which include but are not limited to the average daily alcohol consumption, chronic intoxication, and the diagnosis of alcohol dependence. This criterion has elevated the level of sensitivity of the test, increasing its effectiveness in identifying the early stages of alcohol dependence. It has also increased the ability of the test to determine the existence of any negative cases. Several cut-off points in total scores have been established to enhance the predictive value of the test. This can be seen through the high rate of positive cases that the test was able to identify correctly. The test has a high range of validity, which is based on its composite diagnosis of harmful alcohol use and dependence. A cut-off value of 8 points is used to yield the sensitivity of the test (Blair et al., 2017). The AUDIT is different from other tests as it is founded on data from an extensive multi-national sample. It places priority on the identification of harmful drinking. With its primary focus on the symptoms that have occurred in the respondent’s recent past, its predictive value is very high. 

There are several guidelines established to ensure the receptivity of the patient to the questions and to ensure that the responses they provide are accurate (Babor et al., 2016). Some of these guidelines include that the interviewers or presenters have to be friendly, and the patients should not be intoxicated or require emergency treatment the test. The objective of the test should also be clearly expressed to the patients in regard to its relevance to their health. Lastly, assurance should be provided that the responses of the patients will remain confidential and their information protected. Hence, the AUDIT can be presented as an oral interview or written questionnaire. 

Intervention Plan 

For a nurse, the screening and brief intervention can be used for an individual with alcohol addiction. This entails 

Screening 

Screening is used for the identification of any individual that is at risk of having an alcohol addiction. The nurse involved should use AUDIT as the appropriate screening tool within the intervention due to its easy application across individuals from different backgrounds and ages (Woebong et al., 2019). The nurse should ensure the privacy of the patient at the time of screening. 

Provide feedback 

In this section, the nurse should review current drinking patterns based on the results and identify links between alcohol and any other health problems that the individual may possess (Ganz et al., 2018). The nurse can then provide comments to the patient based on the outcomes while respecting the opinions and feelings of the patients. 

Enhance Motivation 

The nurses should ten conduct the readiness of the patient to change. This should be followed by an effort to assist the client in identifying the difference between their present behavior and concerns. In this step, the nurse should practice reflexive learning to ensure proper communication. 

Negotiate and advise 

Lastly, the nurse should then take part in discussion with the nurse about the options that exist for them and how they can cut back on their drinking and decrease the harm that the addiction has had on them (Ganz et al., 2018). In this step, the nurse should present options with the permission of the patient. 

Conclusion 

Alcohol addiction is a significant problem in society today. It has high prevalence rates due to the commonality of alcohol consumption and acceptability in social situations. Some signs and symptoms of this condition include increased dependence on alcoholic substances and social withdrawal. In Florida, the rate of alcohol addiction has grown over the years and forms a significant portion of the prevalence of the condition in the country. Alcohol addiction is mainly influenced by the environment of an individual, such as the existence of mental illnesses of traumatic experiences. However, it is difficult at times to differentiate between alcohol use and dependence. Hence, the AUDIT test acts, which acts as one of the most significant tests for the screening of alcohol abuse, should be used for any suspected individuals. A four-step intervention plan can then be used for intervention following the screening of the patient. Based on the evidence, further education of the public should be conducted to spread awareness of the problem of alcohol addiction and its impact on society and the individuals involved. 

References 

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Cargiulo, T. (2007). Understanding the health impact of alcohol dependence. 

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Mudrick, N. R., & Smith, C. J. (2017). Mandatory reporting for child protection in health settings and the rights of parents with disabilities.  Disability and health journal ,  10 (2), 165-168. 

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