Alcohol abuse, as described in the DSM-IV, is a psychiatric diagnosis describing the recurring use of alcoholic beverages despite negative consequences.[1] Alcohol abuse is sometimes referred to by the less specific term alcoholism. However, many definitions of alcoholism exist, and only some are compatible with alcohol abuse. There are two types of alcoholics: those who have anti social and pleasure-seeking tendencies, and those who are anxiety-ridden- people who are able to go without drinking for long periods of time but are unable to control themselves once they start.[2] Binge drinking is another form of alcohol abuse. Frequent binge drinking or getting severely drunk more than twice is classed as alcohol misuse.[3]
Alcohol abuse is a pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work. According to Gelder, Mayou & Geddes (2005) alcohol abuse is linked with suicide. They state the risk of suicide is high in older men who have a history of drinking, also if a person is suffering from depression. Certain manifestations of alcohol abuse include failure to fulfill responsibilities at work, school or home; drinking in dangerous situations, such as while driving; legal problems associated with alcohol use; and continued drinking despite problems that are caused or worsened by drinking. Alcohol abuse can lead to alcohol dependence.[4] Proposed changes to the DSM-IV to the DSM-V are expected to combine alcohol abuse with alcohol dependence to create one unified disorder, alcohol use disorder (AUD), that would include graded clinical severity from moderate to severe with at least 2 criteria to make diagnoses.[5] For adolescents, the DSM-V proposes that diagnoses meeting 2 or 3 criteria would be similar to alcohol abuse while meeting over 4 criteria would be equivalent to alcohol dependence when compared to the DSM-IV.
Alcohol abuse has both short-term and long-term risks. If a person has driven while drunk or regularly binge drinks (more than 5 standard drinks in one drinking session), they are considered to have been involved in alcohol abuse. Short-term abuses of alcohol include, but are not limited to, violence, injuries, unprotected sexual activities and, additionally, social and financial problems.[3]
Main article:
Binge drinkingIn the USA, binge drinking is defined as consuming more than 5 units in men and 4 units in women. It increases chances for vandalism, fights, violent behaviours, injuries, drunk driving, trouble with police, negative health, social, economic, or legal consequences to occur.[6] Binge drinking is also associated with neurocognitive deficits of frontal lobe processing and impaired working memory as well as delayed auditory and verbal memory deficits.[6]
Binge drinking combined with the stress of returning to work is a contributing factor to Monday deaths from heart attacks.[7]
Symptoms are the defining characteristic of alcohol abuse and are reviewed above in Definitions. Patient will often complain of difficulty with interpersonal relationships, problems at work or school, and legal problems. Additionally patients do complain of irritability and insomnia.
Signs of alcohol abuse are related to alcohol's effects on organ systems. However, while these findings are often present, they are not necessary to make a diagnosis of alcohol abuse. Signs of alcohol's effects on the central nervous system acutely include inebriation and poor judgment; chronic anxiety, irritability, and insomnia. Alcohol's effects on the liver include elevated liver function tests (classically AST is at least twice as high as ALT). Prolonged use leads to cirrhosis and failure of the liver. With cirrhosis, patients develop an inability to process hormones and toxins. The skin of a patient with alcoholic cirrhosis can feature cherry angiomas, palmar erythema and - in fulminent liver failure - jaundice and ascities. The derrangements of the endocrine system lead to gynecomastia. Inability to process toxins leads to hepatic encephalopathy.
Binge drinking is associated with individuals reporting fair to poor health compared to non-binge drinking individuals and which may progressively worsen over time.[6] Binge drinking is associated with alcohol poisoning, unintentional injuries, suicide, hypertension, pancreatitis, sexually transmitted diseases, and meningitis, among other disorders. Alcohol abuse is a pressing factor in many types of cancer. Liver and mouth cancer are both on the rise[where?] due to alcohol abuse.[citation needed] Alcohol is also the second highest (smoking being the first) risk causer for oral and digestive tract cancers. Other negative consequences include social costs (including interpersonal violence), drunk driving, and lost economic productivity. Impairments in neurophysiological and neurocognitive function can result from binge drinking. A substantial proportion of alcohol-related deaths are due to binge drinking. Someone is a binge drinker if they drink more than 5 drinks in one session.[8]
Children aged 16 and under who consume alcohol heavily display symptoms of conduct disorder. Its symptoms include troublesome behaviour in school, constantly lying, learning disabilities and social impairments.[9]
Peer pressure influences individuals to abuse alcohol; however most of the influence of peers is due to inaccurate perceptions of the risks of alcohol abuse.[10] According to Gelder, Mayou and Geddes (2005) easy accessibility of alcohol is one of the reasons people engage in alcohol abuse as this substance is easily obtained in shops. Another influencing factor among adolescents and college students are the perceptions of social norms for drinking; people will often drink more to keep up with their peers because they believe that their peers drink more than they actually do or that they expect to drink more given the context (e.g. sporting event, fraternity party, etc.).[11] This perception of norms results in higher alcohol consumption than is normal. Alcohol abuse is also associated with acculturation, because social and cultural factors such as an ethnic group’s norms and attitudes can influence alcohol abuse.[12] Drug abuse is associated to the neural circuit of the brain. The instantaneous effect of drugs release the neurotransmitter dopamine which act as reinforcement for the behavior.[2] Laboratory studies of ad-lib consumption of alcohol by alcoholics have of t en indicated that continued drinking is associated with self-reports of increased anxiety and depression [13]
The
United States Navy provides informative, in-depth training on alcohol and drug abuse prevention to soldiers and supervisors.
Preventing or reducing the harm has been called for via increased taxation of alcohol, stricter regulation of alcohol advertising and the provision of brief Interventions. Brief Interventions for alcohol abuse reduce the incidence of unsafe sex, sexual violence, unplanned pregnancy and, likely, STD transmission.[14] Information and education on social norms and the harms associated with alcohol abuse delivered either via the internet or face to face has been found to result in a decrease in harmful drinking behaviours in young people.[10]
Withdrawal of alcohol leads to over activity of neural function because the use of alcohol leads to the depression of the central nervous system. This results in hallucinations and seizures (Schreiber, 2001).[15]
An individual's need for alcohol can depend on their family's history status with the use of alcohol. For instance, if it is discovered that their family history with alcohol has a strong correlation, there might be a need for education to be set in place for the prevention of it so that it is less likely to occur in their family again (Powers, 2007).[16]
Alcohol abuse is said to be most common in people aged between 15 and 24 years:[10] however this particular study of 7275 college students in England collected no data about other age groups or other countries.
Causes of alcohol abuse are complex and are likely the combination of many factors from coping with stress to childhood development. The US Department of Health & Human Services identifies several factors influencing adolescent alcohol use such as risk-taking, expectancies, sensitivity and tolerance, personality and psychiatric comorbidity, hereditary factors, and environmental aspects.[17] Studies show that child maltreatment such as neglect, physical, and/or sexual abuse,[18] as well as having parents with alcohol abuse problems,[19] increases the likelihood of that child developing alcohol use disorders later in life. According to Shin, Edwards, Heeren, & Amodeo (2009) underage drinking is more prevalent among teens who experienced multiple types of childhood maltreatment regardless of parental alcohol abuse, putting them at a greater risk for alcohol use disorders.[20] Genetic and environmental factors play a role in the development of alcohol use disorders depending on age. The influence of genetic risk factors in developing alcohol use disorders increase with age[21] ranging from 28% in adolescence and 58% in adults.[22]
Alcohol abuse is associated with many accidents, fights, driving offenses and unprotected sex. Alcohol is responsible in the world for 1.8 million deaths and results in disability in approximately 58.3 million people. Approximately 40 percent of the 58.3 million people disabled through alcohol abuse are disabled due to alcohol related neuropsychiatric disorders.[10] In South Africa, where HIV infection is epidemic, alcohol abusers exposed themselves to double the risk of this infection. Additionally, alcohol abuse increases the risk of individuals either being the victim of sexual violence or perpetrating sexual violence.[14]
Also, according to studies of present and former alcoholic drinkers in Canada, 20 % of them are aware that their drinking has negatively impacted their lives in various vital areas including finances, work and relationships.[23]
Alcohol misuse costs the National Health Service (UK) 3 billion pounds sterling per year and the cost to employers is 6.4 billion pounds sterling per year. These figures do not include the crime and social problems associated with alcohol misuse. The number of women regularly drinking alcohol has almost caught up with men.[24]
Alcohol abuse is related to pregnant women which caused their baby Fetal Alcohol Syndrome. Alcoholic baby's brain will develop slower than usual and possibly die for the alcoholic mother. After birth, sometimes it breathed a few times but subsequently died. However, the baby may be deformed even if it survives. They may have abnormal eyes, fissures, lips and incomplete cerebella. Some infants may develop lung disease. Experts suggest that pregnant women take no more than one unit of alcohol per day. However, other organizations advise complete abstinence from alcohol while pregnant.[25] It is even possible that the baby throughout pregnancy will develop heart defects such as ventricular septal defect or atrial septal defect [26]
Alcohol abuse during adolescence, especially early adolescence (i.e. before age 15), may lead to long-term changes in the brain which leaves them at increased risk of alcoholism in later years; genetic factors also influence age of onset of alcohol abuse and risk of alcoholism.[27] For example, about 40 percent of those who begin drinking alcohol before age 15 develop alcohol dependence in later life, whereas only 10 percent of those who did not begin drinking until 20 years or older developed an alcohol problem in later life.[28] It is not entirely clear whether this association is causal, and some researchers have been known to disagree with this view.[29]
College/university students who are heavy binge drinkers (3 or more times in the past 2 weeks) are 19 times more likely to be diagnosed with alcohol dependence, and 13 times more likely to be diagnosed with alcohol abuse compared to non-heavy episodic drinkers, though the direction of causality remains unclear. Occasional binge drinkers (one or two times in past 2 weeks), were found to be 4 times more likely to be diagnosed with alcohol abuse or dependence compared to non-heavy episodic drinkers.[6]
The introduction of alcopops, which are flavoured alcoholic drinks which have a sweet and pleasant taste was responsible in Sweden for half of the increase in alcohol abuse in 15-16 year olds in a survey. In the case of girls the alcopops, which disguise the taste of alcohol, were responsible for two thirds of the increase. The introduction of alcopops to Sweden was a result of Sweden joining the European Union and adopting the entire European Union law.[30] Alcohol abuse is highly associated with adolescent suicide. Adolescents who abuse alcohol are 17 times more likely to commit suicide than adolescents who don't drink.[31]
Alcohol abuse is significantly associated with suicide and violence. Alcohol is the most significant health concern in Native American communities because of very high rates of alcohol dependence and abuse; up to 80 percent of suicides and 60 percent of violent acts are a result of alcohol abuse in Native American communities.[32] However, abuse of alcohol can have a variety of effects and because its categorized as a depressant can create an individual angry. This is not to say that every angry individual will resort to violence.
The overuse of alcohol has led to 16% of intoxicated people that have abused children. Abusing children can also come in the form of verbal abuse while under the influence, as well as physical abuse. Alcohol can impair one's judgment and make emotions more easily emphasized, such as anger towards a minor topic, which can cause them[who?] to become extremely dangerous.
Treatment and interventions among youth should focus on eliminating or reducing the effects of adverse childhood experiences, like childhood maltreatment, since these are common risk factors contributing to the development of alcohol abuse.[18] Approaches like contingency management and motivational interviewing have shown to be effective means of treating substance abuse in impulsive adolescents by focusing on positive rewards and redirecting them towards healthier goals.[33] Educating youth about what is considered heavy drinking along with helping them focus on their own drinking behaviors has been shown to effectively change their perceptions of drinking and could potentially help them to avoid alcohol abuse.[34]
- ^ National Institute on Alcohol Abuse and Alcoholism. "Diagnostic Criteria for Alcohol Abuse and Dependence" Alcohol Alert, No. 30 PH 359, October 1995.
- ^ a b Neil R.Carlson, C.Donald Heth. "Psychology: The Science of Behaviour". Pearson Canada Inc,2010, p.572.
- ^ a b Michaud, PA. (Feb 2007). "[Alcohol misuse in adolescents - a challenge for general practitioners]". Ther Umsch 64 (2): 121–6. DOI:10.1024/0040-5930.64.2.121. PMID 17245680.
- ^ Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edition, Text Revision. Washington, DC: American Psychiatric Association; 2000.
- ^ "Proposed Revision - APA DSM-V". American Psychological Association. http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=247#. Retrieved 19 February 2012.
- ^ a b c d Courtney, Kelly E; Polich, John (January 2009). "Binge drinking in young adults: Data, definitions, and determinants". Psychological Bulletin 135 (1): 142–56. DOI:10.1037/a0014414. PMC 2748736. PMID 19210057. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2748736.
- ^ Phil Barker (7 October 2003). Psychiatric and mental health nursing: the craft of caring. London: Arnold. ISBN 978-0-340-81026-2. http://books.google.com/books?id=6qdoQgAACAAJ. Retrieved 17 December 2010.
- ^ Binge Drinking Facts
- ^ McArdle, Paul (27). "Alcohol abuse in adolescents". Archives of Disease in Childhood 93 (6): 524–527. http://adc.bmj.com.myaccess.library.utoronto.ca/content/93/6/524. Retrieved 27 November 2011.
- ^ a b c d Moreira, MT.; Smith, LA.; Foxcroft, D.; Moreira, Maria Teresa (2009). "Social norms interventions to reduce alcohol misuse in university or college students.". Cochrane Database Syst Rev (3): CD006748. DOI:10.1002/14651858.CD006748.pub2. PMID 19588402.
- ^ Lewis, Melissa; Litt, D. M., Blayney, J. A., Lostutter, T. W., Granato, H., Kilmer, J. R., & Lee, C. M. (2011). "They drink how much and where? Normative perceptions by drinking contexts and their association to college students' alcohol consumption.". Journal of Studies on Alcohol and Drugs 72 (5): 844–853.
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- ^ a b Chersich, MF.; Rees, HV. (Jan 2010). "Causal links between binge drinking patterns, unsafe sex and HIV in South Africa: its time to intervene.". Int J STD AIDS 21 (1): 2–7. DOI:10.1258/ijsa.2000.009432. PMID 20029060.
- ^ Schreiber, Andrea. "Alcoholism." AORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 92.2 (2001): 127. Print.
- ^ Powers A, Rebecca (2007). "Alcohol and Drug Abuse Prevention". A Journal of Continuing Psychiatric Education- Psychiatric Annals 37 (5): 349–358.
- ^ National Institute on Alcohol Abuse and Alcoholism. "Diagnostic Criteria for Alcohol Abuse and Dependence" Alcohol Alert, No. 30 PH 359, October 1995.
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- ^ Shin, Sunny Hyucksun; Edwards, Erika, Heeren, Timothy, Amodeo, Maryann (2009). "Relationship between Multiple Forms of Maltreatment by a Parent or Guardian and Adolescent Alcohol Use". American Journal on Addictions. pp. 226–234. DOI:10.1080/10550490902786959.
- ^ Brown, S. A.; McGue, M., Maggs, J., Schulenberg, J., Hingson, R., Swartzwelder, S., Martin, C., Chung, T., Tapert, S. F., Sher, K., Winters, K. C., Lowman, C., Murphy, S. (2008). "A Developmental Perspective on Alcohol and Youths 16 to 20 Years of Age". PEDIATRICS. pp. S290–S310. DOI:10.1542/peds.2007-2243D.
- ^ Beek, Jenny H. D. A.; Kendler, Kenneth S., Moor, Marleen H. M., Geels, Lot M., Bartels, Meike, Vink, Jacqueline M., Berg, Stéphanie M., Willemsen, Gonneke, Boomsma, Dorret I. (2012). "Stable Genetic Effects on Symptoms of Alcohol Abuse and Dependence from Adolescence into Early Adulthood". Behavior Genetics. pp. 40–56. DOI:10.1007/s10519-011-9488-8.
- ^ "Send Us a Message." Alcoholism in Canada. Web. 03 Apr. 2012. <http://www.ledgehill.com/resources/addiction-info/alcoholism-in-canada/>.
- ^ Dooldeniya, MD.; Khafagy, R.; Mashaly, H.; Browning, AJ.; Sundaram, SK.; Biyani, CS. (Nov 2007). "Lower abdominal pain in women after binge drinking.". BMJ 335 (7627): 992–3. DOI:10.1136/bmj.39247.454005.BE. PMC 2072017. PMID 17991983. http://www.bmj.com/cgi/content/extract/335/7627/992.
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- ^ "Early Age At First Drink May Modify Tween/Teen Risk For Alcohol Dependence". Medical News Today. 21 September 2009. http://www.medicalnewstoday.com/articles/164576.php.
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