Alcohol is one of the most consumed substances in the world. It has come to be considered recreational while it also has effects on the mental states of people by altering the central nervous systems (Grant et al., 2015). In many cases, the people who take alcohol become dependent on it and thus experience an addiction. Its purchase and consumption are legal in many countries and it is even used for recreation (Kenna & Leggio, 2017). The substance has the largest consumption level in the world with 65 percent of US citizens will take a drink that has alcohol sometime in their life. In the UK, the number is even higher as it accounts for 92 percent in men and 86 percent in women.
According to WHO (2014), the patterns of drinking in the UK has been seen to be increasingly problematic and it could be termed as a disorder. Hazard drinking in this country takes about 26 percent of the population (Davey, 2015). In other words, the males consume five or more standard drinks while the women take three or more in a single drinking day. The rate of binge drinking is also on a rise over the past 45 years (WHO, 2014; Davey, 2015). This paper will analyze the effects of combining alcohol and what its addiction can cause in the long term. Also, this article provides the cause, etiology, treatment, and prognosis.
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Epidemiology and Prevalence of Alcohol Use
The definition of binge drinking is not as direct in every country. However, in the UK, it is defined as consuming 8 units in males and six units in females on a single drinking day. One in every five men takes eight units at least one day in a week (Davey, 2015). In this population, twenty-four percent are taken with the men between 16 and 24 years while 65 years and over only accounts for five percent. In case of females, thirteen percent take more than six units of alcohol on at least one day of the week (Davey, 2015). Of this group, twenty-four percent are aged between sixteen and twenty-four while only two percent are aged sixty-five and above. However, the consumption prevalence among the youth has fallen since for the last two decades. In 2010, the prevalence in young men was found to be 24 percent while that in young women was seventeen which was a record low (Davey, 2015). The prevalence is even lower in people of advanced age (WHO, 2014). The overall prevalence with respect to gender sees males on the higher percentage than females.
Clinical Presentation
Alcohol is a substance that causes both physical and psychological effects when the main component, ethyl alcohol, is absorbed into the bloodstream through the gut lining. When it reaches the brain and the central nervous system (CNS), it creates a relaxing effect on the individual. The chemical mainly binds to specific sites on GABA-sensitive ion points in the CNS that makes the inhibitory function in the neurotransmitter (Kenna & Leggio, 2017). When it prevents the continuous firing of neurons, the person becomes relaxed. The initial effect makes the individual’s confidence to rise and then becomes talkative, happy, and friendly.
Continuous absorption of ethyl alcohol in the CNS makes the person move to the second stage of intoxication which is characterized by the reduced ability to make a judgment. They become less coherent in their speech and it affects their memory also (Davey, 2015). This stage sees the individual transition from being happy and friendly to being aggressive and emotional. The physical effects of alcohol comprise of difficulties in motor coordination, in walking and balance, blurred vision, and slowed reaction time. This effect of alcohol intoxication process is known as biphasic as it involves two stages.
The first stage is where the individual becomes stimulated (happy and active) while the second stage acts as a depressant (negative emotions and sluggish reaction). The initial effect is the rationale behind alcohol being loved by many people and they overlook the real effects that come later. Most people use the substance to suppress stress after a busy day and increase sociability and the like. However, these perceived effects are mythical and are just results of the expectations of the individual about the effects of the alcohol rather than focusing on the actual ones that come later (Litten et al., 2015).
Due to the short-term physical and psychological benefits that the drinker perceives and the expectations that have been seen building around alcohol consumption makes it one of the ways of relieving pressure and alleviating tension from societal problems (Davey, 2015). The universal availability and the affordability make people consume alcohol to a point where the individual begins to experience significant negative impacts on psychological and physical health. Due to increased intake, the body becomes more tolerant and the individual has to continue taking more before they can achieve the same results (Davey, 2015). This leads to long-term effects that include withdrawal symptoms when there is a deprivation of alcohol.
The signs include muscle tremors, anxiety and depression, inability to sleep, restlessness, and rise in temperatures and blood pressure. Prolonged withdrawal for heavy drinkers may lead to the person experiencing delirium tremens (DTs) (Davey, 2015). In this case, the victim experiences hostile hallucinations, becomes delirious, and shows muscle tremors and shaking. The negative physical symptoms may worsen as the years advance due to uncontrolled heavy drinking. They may lead to early dementia, brain damage (the frontal lobes shrink), liver cirrhosis, cancer, stomach ulcers, heart failure, and hypertension (Kenna & Leggio, 2017). Long-term dependence on alcohol can cause symptoms that are similar to malnutrition. Even though it contains calories, it lacks the essential nutrients entirely.
Thus, a drinker may feel full but has not taken any diet or takes little. This leads to mineral and vitamin deficiencies which can result in memory disorders like Korsakoff’s syndrome and dementia (Davey, 2015). In women, alcohol can lead to a physiological disorder known as fetal alcohol syndrome. In this regard, heavy alcohol consumption and dependence by the mother during pregnancy can lead to a spectrum of physical and psychological abnormalities in the baby. They may include learning difficulties, hyperactivity, stunted growth, heart problems, and physical deformities. The discussed long-term effects reduce the life expectancy of drinkers as the deaths related to alcohol have more than doubled from 1979 to 2000 (Davey, 2015). This makes the chronic drinking a concern to the health sector and the nation at large. Etiology
The causes of abuse and dependence of alcohol are not entirely clear as it is with addiction to other drugs (McLellan et al., 2016). This disorder is a complex one as it has many pathways leading to its development. However, it is speculated that a combination of factors can lead to a person beginning the usage of the substance. First, genetics plays a vital role in the addiction of alcohol. Studies involving family pedigree, individuals who is raised away from their alcoholic parents and monozygotic and fraternal twins show a connection between genetics and vulnerability of developing alcohol dependence and addiction (Grant et al., 2015).
An individual that comes from a first-degree family which has a history of alcoholism may have a higher risk of developing the disorder as compared to the general public. Monozygotic twins show a higher prevalence than their dizygotic counterparts (McLellan et al., 2016).
On the case of adoption, the child of alcoholic parents, even though raised in a non-alcoholic family, has a higher chance of developing alcoholism later in life as compared to adopted children whose parents are not alcoholic. Whereas there is no guarantee that a person would become an addict as a result of environmental factors, genetics becomes the dominating correlation factor. Culture also plays a role in the habit as contemporary living motivates the usage of drugs. The youths seek to look cool among their peers and hence are easily swayed by the use of alcohol and other stimulants (WHO, 2014).
Some studies have linked childhood psychopathology and temperament to alcoholism. A person who has problems with behavior when young has a higher risk of developing alcoholism during adolescence and adulthood (Kenna & Leggio, 2015).
Diagnosis
The DMS-V has indicated several criteria used in diagnosing alcohol use disorder. The disorder is characterized by a collection of physical and behavioral symptoms that include tolerance and withdrawal symptoms within a period of four to twelve hours after controlled ingestion (Grant et al., 2015). It is imperative to note that some individuals do not exhibit the withdrawal after a compulsive drinking is initiated. The minimum requirement is that alcohol is regular and problematic (Litten et al., 2015).
The physician can ask whether there is a difficulty in cutting drinking, driving while drunk, or missing work due to drinking. When diagnosing abuse, the clinician checks the adverse consequences and while diagnosing dependence, includes behavioral factors that indicate loss of control, compulsive consumption, and psychological tolerance (Davey, 2015). The fact that many heavy drinkers do not meet the dependence criteria makes a rationale for the need of another criterion that looks into the continuum of alcohol use. Apart from the DSM-V criteria, the new approach takes into consideration the frequency and quantity of intake (Saha et al., 2006).
Comorbidity
Alcohol use is highly comorbid with other psychiatric disorders. It also includes abuse of other drugs. In fact, alcohol is used as a means of coping with challenging or adverse life experiences such as depression and anxiety disorders (Davey, 2015).
Prognosis
The aforementioned effects of alcohol use can reduce the life expectancy of an individual while also making them vulnerable to social misbehavior. Increased crime rate and accidents are the major ones (Davey, 2015). Besides alcohol is dangerous to health, it can cause death through behavior. Drink driving is a major cause of death through accidents, claiming lives of non-victims as well.
Treatment
Alcohol use disorder is treated through the management of the withdrawal symptoms that result from compulsive drinking. The withdrawal needs to be supervised by a qualified physician, which always begins with a detoxification program in a hospital (Davey, 2015). An inpatient rehabilitation program then follows after the completion of detoxification. This includes individual therapy from a psychologist or a group one. Aftercare plan, or outpatient rehabilitation, is essential for most addicts to enable them to readjust back to daily life and support them in their life goals (Litten et al., 2015).
In conclusion, the addiction to alcohol can be devastating despite the expectation that it may give beneficial effects. The consumption can lead to a heightened impact which can reduce the functionality of the CNS. The cause of the addiction is not entirely known but a combination of factors is connected to its etiology. However, with proper management of the victim, the addictive ordeal can be managed, and the person can go back to healthy living.
References
Davey, G. (2015). Psychopathology. John Wiley & Sons, Inc. New Jersey. 290-295
Grant, B. F., Goldstein, R. B., Saha, T. D., Chou, S. P., Jung, J., Zhang, H., ... & Hasin, D. S. (2015). Epidemiology of DSM-5 alcohol use disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA psychiatry , 72 (8), 757-766.
Kenna, G. A., & Leggio, L. (2017). Alcohol Use Disorder. Integrating Psychological and Pharmacological Treatments for Addictive Disorders: An Evidence-Based Guide , 77.
Litten, R. Z., Ryan, M. L., Falk, D. E., Reilly, M., Fertig, J. B., & Koob, G. F. (2015). Heterogeneity of alcohol use disorder: understanding mechanisms to advance personalized treatment. Alcoholism: Clinical and Experimental Research , 39 (4), 579-584.
McLellan, A. T., Woody, G. E., & OBRIEN, C. P. (2016). Drug abuse and psychiatric disorders: examinations of some specific relationships. Drogue et Civilisation: Refus Social ou Acceptation: Entretiens de Rueil, 246.
Saha, T. D., Chou, S. P., & Grant, B. F. (2006). Toward an alcohol use disorder continuum using item response theory: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological medicine , 36 (7), 931-941.
World Health Organization: Management of Substance Abuse Unit. (2014). Global status report on alcohol and health, 2014. World Health Organization.
