Alcohol-dependent persons are more
susceptible than others to a variety of
physical and mental disorders (see
Many problem drinkers require medical
withdrawal symptoms (detoxification)
when they stop drinking alcohol, fol-
lowed by long-term treatment. There
which may be combined.
Psychological treatments for alcohol
commonly carried out as
practical help, such as with problems at
work, and tend to involve family mem-
bers in the process. Physical treatment
includes the use of
, a drug
that sensitizes the drinker to alcohol so
that he or she experiences unpleasant
side effects when drinking, or acam-
prosate, which helps to reduce craving.
and other self-
help organizations can provide support
an antiseptic and a solvent.
also known as methyl alcohol, is a rela-
ted, highly toxic, substance.
Alcohol is a drug and produces a wide
range of mental and physical effects.
The effect of alcohol on the
(the brain and spinal
cord) is as a depressant, decreasing its
activity and thereby reducing anxiety,
tension, and inhibitions. In moderate
amounts, alcohol produces a feeling of
relaxation, confidence, and sociability.
However, alcohol slows reactions, and
the more that is drunk, the greater
the impairment of concentration and
alcohol results in poisoning or acute
with effects ranging
from euphoria to unconsciousness.
Short-term physical effects include peri-
(widening of small
blood vessels), causing flushing and
increased flow of gastric juices, which
stimulates the appetite. Alcohol increa-
ses sexual confidence, but high levels
Alcohol also acts as
a diuretic, increasing urine output.
In the long term, regular excessive
consumption of alcohol can cause
(inflammation and ulceration of
the stomach lining) and can lead to
in the long term may also lead to
However, individuals who
drink regular, small amounts of alcohol,
(1-2 units (see
alcohol, unit of)
seem to have lower rates of
than those who
The consumption of alcohol during
pregnancy may result in
fetal alcohol syn-
or a disruption in
normal fetal development.
An illness characterized by habitual,
compulsive, long-term, heavy alcohol
consumption and the development of
withdrawal symptoms when drinking is
Causative factors that interact in the
include: personality, environment, and
the addictive nature of alcohol. People
of an inadequate, insecure, or immature
personality are at greater risk. Environ-
mental factors are important, especially
the ready availability, affordability, and
widespread social acceptance of alco-
hol. Genetic factors may play a part in
causing alcohol dependence in some
cases, but it is now widely believed that
anyone, irrespective of personality, envi-
capable of becoming dependent. Stress
is often a major factor in precipitating
DEVELOPMENT OF DEPENDENCE
Alcohol dependence usually develops in
four main stages that occur over a num-
ber of years and merge imperceptibly.
In the first phase, tolerance (being able
to drink more alcohol before experienc-
ing its effects) develops in the heavy
social drinker. In the second phase, the
relating to events during the drinking
episodes. In the third phase, there is loss
of control over alcohol consumption.
The final phase is characterized by pro-
mental or physical complications.
SYMPTOMS AND EFFECTS
dependence are varied, and they can
include grandiose, aggressive, or furtive
behaviour; personality changes (such as
anger); neglect of food intake and per-
sonal appearance; and lengthy periods
Physical symptoms of the condition
may include nausea, vomiting, or shak-
ing in the morning; abdominal pain;
cramps; numbness or tingling; weak-
ness in the legs and hands; enlarged
pulse; unsteadiness; confusion; memory
lapses; and incontinence. Sudden with-
(severe shakes, halluci-
nations, and convulsions).
organization that is operated locally by
people working on a voluntary basis to
held in which
members are encouraged to help one
another to stay sober by sharing their
openly and by
support and advice.
The condition that results from consum-
ing an excessive amount of
often over a relatively short period.
The damage to a fetus by alcohol intake
during pregnancy has been recognized only
recently. Intake of more that two units (see
alcohol, unit of
per day increases the risk of
fetal alcohol syndrome
abnormalities such as
cleft lip and palate
heart defects, abnormal limb development,
and lower-than-average intelligence). The
risk of miscarriage is also increased. Binge
drinking can have the same effect, even if
the mother drinks little otherwise. Because
a proportion of the alcohol reaches the
baby, there is a risk that even small
amounts can disrupt normal development
(causing, for example, low birth weight).
Fetal alcohol syndrome
An affected baby is abnormally small, with small
eyes and a small jaw. He or she may also suffer
from heart defects or a cleft lip and palate, may
suckle poorly, sleep badly, and be irritable.