Alcoholism

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Alcoholism

Alcoholism is a chronic, often progressive disease in which a person continues to crave alcohol and drink despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. Alcoholism affects 10 to 20 percent of men and 3 to 10 percent of women. Nearly 14 million people in the United States—1 in every 13 adults—abuse alcohol or are alcoholic. This disease contributes to over 50 percent of car and industrial fatalities, drownings, and child or domestic abuse.

Signs and Symptoms

Alcoholism is often accompanied by the following signs and symptoms. Symptoms vary with the amount of alcohol taken and how long it has been abused.

	Craving for alcohol
	Inability to control drinking habits
	Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking
	Tolerance (the need for increasing amounts of alcohol in order to feel its effects)
	Psychological, social, occupational dysfunction
	Malnutrition, anorexia
	Cardiovascular symptoms (leading cause of death)
	Increased levels of cancer (second leading cause of death)
	Repeated infections—for example, tuberculosis, urinary tract infections
	Lung conditions—complicated by smoking; for example, respiratory failure, pneumonia
	Central nervous system disorders—unsteady gait or stance; cognitive impairment; psychiatric manifestations (for example, mood, anxiety, psychotic disorders); blackouts; coma; sleep disruptions
	Diarrhea, vomiting
	Gastrointestinal bleeding
	Men—increased sexual drive with decreased ability to maintain an erection
	Women—miscarriage, stopping of menstrual periods
	Inflammation of the pancreas
	Hepatitis (a disease of the liver)
	Poor wound healing
	Buildup of fluid in the body
	Swollen, painful muscles, paralysis, lack of reflexes
	Increased bone fractures
	Hypoglycemia (low blood sugar)
	Hypothermia (reduction of body temperature)

What Causes It?

Alcoholism is caused by chronic over-consumption of alcohol.

Who's Most At Risk?

People with the following conditions or characteristics are at a higher-than-average risk for developing alcoholism.

	Genetically predisposed
	Preexisting psychiatric disorder
	Began consuming alcohol at an early age
	Stress

What to Expect at Your Provider's Office

If you or someone you care for is experiencing symptoms associated with alcoholism, you should see your health care provider. He or she can help make a diagnosis and guide you in determining which treatment or combination of therapies will work best.

Your provider will take a history and do a physical exam to look for specific organ damage or trauma and to evaluate if your muscles are tender or weak. Laboratory tests will reveal any indicators of alcoholism, such as high blood alcohol. Imaging techniques may be used to diagnose alcohol-related disorders or to screen for repeated bone fractures.

Treatment Options

Prevention

The best prevention is to stop drinking alcohol completely. Medications are sometimes prescribed to curb alcohol cravings.

Treatment Plan

Treatment must address both medical issues and rehabilitation, such as motivational techniques for abstaining from drinking, psychotherapy, and Alcoholics Anonymous (or other support groups).

Drug Therapies

Your provider may prescribe the following medications.

	Tranquilizers called benzodiazepines, such as Valium^®, which are used during the first few days of treatment to help patients safely withdraw from alcohol
	Antipsychotic medications for people who do not respond to benzodiazepines
	Naltrexone (ReVia^TM), a recently approved medication to help people remain sober. When used in combination with counseling, this medication may lessen the craving for alcohol and help prevent a return to heavy drinking.
	Disulfiram (Antabuse^®), an older medication, which discourages drinking by causing nausea, vomiting, and other unpleasant physical reactions when alcohol is used
	Medications for specific organ damage or for symptoms associated with alcohol withdrawal

Complementary and Alternative Therapies

A comprehensive treatment plan for alcoholism may include a range of complementary and alternative therapies.

Nutrition

A well-balanced, nutritionally adequate diet helps to stabilize alcohol-induced blood-sugar fluctuations and decrease cravings. Following these tips can help reduce symptoms.

	Eliminate simple sugars.
	Increase complex carbohydrates.
	Consume adequate protein.
	Increase essential fatty acids.
	Decrease saturated fats and fried foods.
	Avoid caffeine.

Potentially beneficial nutrient supplements include the following.

	Vitamin A (25,000 IU a day)
	Vitamins B₁ (50 to 100 mg a day), B₂ (50 mg a day), B₃ (25 mg a day), B₅ (100 mg a day), B₆ (50 to 100 mg a day), B₁₂ (100 to 1,000 mcg a day)
	Vitamin C (1,000 mg two to three times a day)
	Vitamin E (400 IU a day) to protect the heart
	Magnesium (250 mg bid) to decrease withdrawal symptoms
	Selenium (200 mcg a day) to protect the liver
	Zinc (15 mg a day) to aid metabolism
	Amino acids: carnitine (500 mg two times a day) to protect the liver, glutamine (1 g a day) to decrease cravings, glutathione (300 mg a day) to protect liver and heart
	Chromium (250 to 500 mcg twice a day) helps reduce sugar cravings and reduces low blood sugar related to alcohol cravings.

Herbs

The use of certain herbal remedies may offer relief from symptoms.

	Milk thistle (Silybum marianum): 80 to 200 mg three times a day, to support the liver
	Dandelion (Taraxacum officinale): 2 to 8 g of root three times a day in tea, or 5 ml three times a day of leaf tincture helps detoxify the liver. Works well with milk thistle.
	Kudzu (Pueraria lobata) reduces cravings
	Skullcap (Scutellaria lateriflora): historic use for hysteria, tension, and nervous disorders, especially anxiety; a cup of tea before bed can help insomnia.
	Dessicated liver capsules (500 mg three times a day) help heal liver tissue.

Herbs are generally available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp../cup water steeped for 10 minutes (roots need 20 minutes). Herbal extracts made with alcohol should be avoided in alcoholics.

Homeopathy

An experienced homeopath can prescribe a regimen for treating alcoholism that is designed especially for you. Some of the most common acute remedies are listed below.

	Arsenicum album for anxiety and compulsiveness, with nausea, vomiting, and diarrhea
	Nux vomica for irritability and compulsiveness with constipation, nausea, and vomiting
	Lachesis for cravings for alcohol, headaches, and difficulty swallowing
	Lycopodium for low self-esteem, heartburn, impotence

Acute dose is three to five pellets of 12X to 30C every one to four hours until symptoms are relieved.

Acupuncture

Acupuncture may be very helpful at decreasing cravings and assisting with recovery. It can also be helpful for liver repair, reducing anxiety and depression, and alleviating tremors and fatigue related to alcohol withdrawal. Acupuncture helps maintain sobriety.

Prognosis/Possible Complications

Possible complications associated with alcoholism include mental confusion or delirium, severe amnesia, an unsteady gait, and loss of sperm cells, as well as ailments resulting from repeated, violent vomiting. Typically, there are periods of remission followed by periods of abuse. Life expectancy is decreased by about 15 years. About a fifth of alcoholics permanently abstain. During pregnancy, abstinence from alcohol is the only completely safe measure.

Following Up

After initial care, medical follow-up should continue for 6 to 12 months.

Supporting Research

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