ALCOHOLISM – A CHRONIC DISEASE

Alcoholism or Alcohol Dependence - chronic disease marked by a craving for alcohol. People who suffer from this illness are known as alcoholics. They cannot control their drinking even when it becomes the underlying cause of serious harm, including medical disorders, marital difficulties, job loss, or automobile crashes. Medical science has yet to identify the exact cause of alcoholism, but research suggests that genetic, psychological, and social factors influence its development. Alcoholism cannot be cured yet, but various treatment options can help an alcoholic avoid drinking and regain a healthy life.

People tend to equate any kind of excessive drinking with alcoholism. But doctors and scientists recognize that disorders related to alcohol use lie along a continuum of severity. They prefer to use the term alcohol dependence instead of alcoholism to designate the most severe of the alcohol-use disorders. The terms alcohol abuse and problem drinking designate less severe disorders resulting from immoderate drinking.

Alcohol dependence develops differently in each individual. But certain symptoms characterize the illness, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a United States government agency that is part of the National Institutes of Health. Alcoholics develop a craving, or a strong urge, to drink despite awareness that drinking is creating problems in their lives. They suffer from impaired control, an inability to stop drinking once they have begun. Alcoholics also become physically dependent on alcohol. When they stop drinking after a period of heavy alcohol use, they suffer unpleasant physical ailments, known as withdrawal symptoms, that include nausea, sweating, shakiness, and anxiety. Alcoholics develop a greater tolerance for alcohol—that is, they need to drink increasing amounts of alcohol to reach intoxication. The World Health Organization (WHO) notes that other behaviors common in people who are alcohol dependent include seeking out opportunities to drink alcoholic beverages—often to the exclusion of other activities—and rapidly returning to established drinking patterns following periods of abstinence.

HEALTH CONSEQUENCES OF ALCOHOLISM

While some studies have found that moderate use of alcohol has beneficial health effects, including protection from coronary heart disease, heavy and prolonged intake of alcohol can seriously disturb body chemistry. Heavy drinkers lose their appetite and tend to obtain calories from alcohol rather than from ordinary foods. Alcohol is rich in calories and can provide substantial amounts of energy. However, if it constitutes the primary source of calories in place of food, the body will lack vitamins, minerals, and other essential nutrients.

Prolonged use of large amounts of alcohol may cause serious liver damage. In the first stage of liver disease caused by alcohol, fat accumulates in the liver. This stage of the disease is known as fatty liver. Most people do not notice symptoms of fatty liver, although in some people the liver becomes enlarged and tender. Some people with fatty liver develop hepatitis, which inflames and kills liver cells. Hepatitis is marked by jaundice, which gives a yellowish tint to the eyes and skin. Others may develop cirrhosis, an irreversible condition in which normal liver tissue is replaced by scar tissue. The scarring prevents blood from traveling freely through the liver, building blood pressure in the veins that run from the intestine to the liver. Consequently, the liver can no longer process toxins efficiently, causing poisons to build up in the blood. This buildup can be fatal.

Heavy drinking also damages heart muscle. Nearly half of all cases of cardiomyopathy are caused by alcohol abuse. In this heart disease, the heart muscles, particularly the right and left ventricles, enlarge and become flabby, reducing the heart’s blood-pumping efficiency. This inefficiency reduces the flow of blood through the kidneys, which normally filter excess salts and water out of the blood. Eventually the blood volume rises, causing a potentially fatal backup of fluid in the lungs.

Alcoholics tend to have high blood levels of the hormone epinephrine and deficiencies of the mineral magnesium. This combination produces severe arrhythmias, or heartbeat irregularities, a common cause of sudden death in heavy drinkers. Chronic drinkers typically develop hypertension, a leading cause of stroke.

In some cases, alcohol withdrawal may lead to delirium tremens (DTs), which produces increasing confusion, sleeplessness, depression, and terrifying hallucinations. As this delirium progresses, the hands develop a persistent and uncontrollable shaking that may extend to the head and body.

Women who drink excessive amounts of alcohol while pregnant run a high risk of having a baby born with fetal alcohol syndrome (FAS), the leading known cause of birth defects. FAS results in a combination of mental and physical defects, such as retardation, a small head, and poor muscle tone. Some babies exposed to alcohol during fetal maturation develop fetal alcohol effect (FAE), which produce more subtle symptoms, including behavioral problems, difficulty paying attention, or the inability to think abstractly.

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