Alcohol Dependence Syndrome or Alcohol Use Disorder (AUD), generically known as ‘Alcoholism’ can be defined as the unrestrained consumption of alcohol which leads to social, societal, and health problems.
From a medical context, alcoholism is a acknowledged if 2 or more of the following symptoms affect a subject:
- Large amounts of alcohol consumption over an extended time period,
- Difficulty in alcohol withdrawal or abstinence,
- Large amounts of time, money, and other personal resources are devoted to acquire and drink alcohol,
- Strong and constant desire to consume alcohol,
- Constant addiction to alcohol results in social problems,
- Constant consumption results in health issues or other risky situations,
- Development of alcohol tolerance due to constant use.
Health Implications of Alcoholism
Excessive and chronic consumption of alcohol has long been associated with major health problems based on worldwide collected medical evidence. Constant alcohol use has been medically proven to affect almost all parts of the body, especially the liver, heart, brain, pancreas, and the immune system. Such relentless abuse has been associated with millions of cases of liver failure, irregular cardiac functioning, mental illnesses, a statistically increased risk of cancer development, Wernicke-Korsakoff syndrome, and many other diseases.
Medical and Psychiatric Definition of Alcoholism
Alcoholism was commonly classified as two separate psychiatric conditions namely, Alcohol Abuse and Alcohol Dependence. More recently, in 2013 both alcohol abuse and alcohol dependence were reclassified as ‘Alcohol Use Disorder’ or plainly ‘Alcoholism’ according to the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (ICD).
Basically, alcohol abuse can be presented in two common forms where there are subjects who consume alcohol with anti-social, pleasure-seeking tendencies, and another section of alcoholics are driven by anxiety and stress if they haven’t consumed alcohol for extended periods of time. For instance, Binge Drinking is an instance of severe alcohol abuse that results in several casualties every year. According to statistics released by the WHO, in 2013 139,000 deaths occurred globally, which were directly linked to alcohol abuse and another 384,000 deaths occurred due to liver cirrhosis from excessive consumption of alcohol.
In another aspect of Alcoholism, Alcohol dependence is psychiatrically defined by a set of criteria according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). In short, a subject is said to be an ‘alcohol-dependent’ if 3 of the following 7 criteria are manifest over a 12-month period.
- Displays ‘Alcohol withdrawal syndrome’
- Alcohol consumption in larger amounts or longer periods than intended
- Tolerance
- Persistent desire, yet unsuccessful efforts to abstinence
- Majority of time is spent acquiring alcohol or recovering from its effects
- Occupational and recreational pursuits are lost due to alcohol use
- Alcohol use is continued despite knowledge of causing physical or psychological harm.
Detecting Alcoholism through Medical Approaches
The Blood Alcohol Count is a commonly used, highly reliable test to measure concentration levels of ethanol in one’s blood. However such tests are merely meant to pick up the physiological measure of alcohol in blood and not meant as a psychiatric test to define an “Alcoholic”. But still, medical studies have shown that long-term heavy alcohol drinking leaves recognizable bodily side-effects like:
- Enlarged Red Blood Cells (Macrocytosis)
- Elevated gamma-glutamyl transferase (GGT)
- High carbohydrate deficient transferrin (CDT)
- Moderate elevation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
- Liver function test – AST: ALT ratio of 2:1
However, none of these blood or urine tests to pick up biological markers on alcohol is as sensitive as a screening questionnaire commonly termed as the ‘CAGE test’ for alcoholism.
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