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Alcoholism - Highlights

Description

An in-depth report on the causes, diagnosis, and treatment of alcoholism.

Alternative Names

Alcohol dependence; Alcohol abuse

Highlights:

Complications of Alcoholism

Chronic alcoholism causes many severe health problems. These include:

Liver Disorders. The liver is particularly endangered by alcoholism. Between 10 - 20% of people who drink heavily (five or more drinks a day) develop cirrhosis, a progressive and irreversible scarring of the liver that can eventually be fatal.
Gastrointestinal Problems. Alcoholism increases the risk for inflammation of the esophagus (“food pipe”), and stomach ulcers. It can also lead to swollen veins (varices) in the esophagus. Violent vomiting can produce tears in the junction between the stomach and esophagus. Alcoholism can also cause serious acute and chronic inflammation of the pancreas.
Heart Disease. Excessive drinking has many negative effects on heart health. Alcohol is a toxin that damages the heart muscle. In fact, heart disease is one of the leading causes of death for alcoholics. Alcohol abuse increases levels of triglycerides (unhealthy fats) and increases the risks for high blood pressure, heart failure, and stroke.
Cancer. Alcoholism increases the risk for mouth, throat, esophageal, gastrointestinal, liver, colorectal, and breast cancers.
Neurological Problems. Chronic alcohol abuse can impair so-called "executive functions," which include problem solving, mental flexibility, memory, and attention. Vitamin B12 deficiencies can lead to peripheral neuropathy and other nerve damage.
Diabetes. Heavy drinking is associated with obesity, a risk factor for type 2 diabetes. In addition, alcohol can cause hypoglycemia, a drop in blood sugar.
Skin, Muscle, and Bone Disorders. Severe alcoholism is associated with osteoporosis (loss of bone density), muscular deterioration, skin sores, and itching.
Reproductive Problems. Alcoholism can contribute to erectile dysfunction in men and infertility in women. Even moderate amounts of alcohol can have damaging effects on a developing fetus.
Lung Problems. Patients who abuse alcoholism have a greater risk for developing severe pneumonia.

Resources

www.niaaa.nih.gov -- National Institute on Alcohol Abuse and Alcoholism
www.samhsa.gov -- Substance Abuse and Mental Health Services Administration
www.ncadi.samhsa.gov -- National Clearinghouse for Alcohol and Drug Information
www.aca-usa.org -- American Council on Alcoholism
www.ncadd.org -- National Council on Alcoholism
www.alcoholics-anonymous.org -- Alcoholics Anonymous
www.al-anon-alateen.org -- Al-Anon Family Group Headquarters
www.nofas.org -- National Organization on Fetal Alcohol Syndrome

References

Addolorato G, Leggio L, Ferrulli A, Cardone S, Vonghia L, Mirijello A, et al. Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: randomised, double-blind controlled study. Lancet. 2007 Dec 8;370(9603):1915-22.

Anton RF. Naltrexone for the management of alcohol dependence. N Engl J Med. 2008 Aug 14;359(7):715-21.

Anton RF, O'Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006 May 3;295(17):2003-17.

de Roux A, Cavalcanti M, Marcos MA, Garcia E, Ewig S, Mensa J, et al. Impact of alcohol abuse in the etiology and severity of community-acquired pneumonia. Chest. 2006 May;129(5):1219-25.

Hingson RW, Heeren T, Winter MR. Age at drinking onset and alcohol dependence: age at onset, duration, and severity. Arch Pediatr Adolesc Med. 2006 Jul;160(7):739-46.

Johnson BA, Rosenthal N, Capece JA, Wiegand F, Mao L, Beyers K, et al. Improvement of physical health and quality of life of alcohol-dependent individuals with topiramate treatment: US multisite randomized controlled trial. Arch Intern Med. 2008 Jun 9;168(11):1188-99.

Johnson C, Drgon T, Liu QR, Walther D, Edenberg H, Rice J, et al. Pooled association genome scanning for alcohol dependence using 104,268 SNPs: Validation and use to identify alcoholism vulnerability loci in unrelated individuals from the collaborative study on the genetics of alcoholism. Am J Med Genet B Neuropsychiatr Genet. 2006 Aug 7; [Epub ahead of print]

Kleber HD, Weiss RD, Anton RF Jr, George TP, Greenfield SF, Kosten TR, et al. Treatment of patients with substance use disorders, second edition. American Psychiatric Association. Am J Psychiatry. 2007 Apr;164(4 Suppl):5-123.

McKenna W. Diseases of the myocardium and endocardium. In: Goldman L and Ausiello DA, eds. Cecil Medicine. 23rd edition. Philadelphia, PA: Saunders Elsevier; 2007: chap 59.

O'Connor PG. Alcohol abuse and dependence. In: Goldman L and Ausiello DA, eds. Cecil Medicine. 23rd edition. Philadelphia, PA: Saunders Elsevier; 2007: chap 31.

Volkow ND, Wang GJ, Begleiter H, Porjesz B, Fowler JS, Telang F, et al. High levels of dopamine D2 receptors in unaffected members of alcoholic families: possible protective factors. Arch Gen Psychiatry. 2006 Sep;63(9):999-1008.

Reviewed last on: 1/22/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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