Professional Documents
Culture Documents
ALCOHOLISM
ALCOHOLISM
Submitted by:
Richelle M. Santos
Submitted to:
Mrs. Baltazar
Alcoholism
Alcoholism is a disabling addictive disorder. It is characterized by
compulsive and uncontrolled consumption of alcohol despite its negative effects
on the drinker's health, relationships, and social standing. Like other
drug addictions, alcoholism is medically defined as a treatable disease. The
term alcoholism is widely used, and was first coined in 1849 by Magnus Huss,
but in medicine the term was replaced by the concepts of "alcohol abuse" and
"alcohol dependence" in the 1980s DSM III. (The term alcohol dependence is
sometimes used as a synonym for alcoholism, sometimes in a narrower sense.)
Similarly in 1979 an expert World Health Organization committee disfavored the
use of "alcoholism" as a diagnostic entity, preferring the category of "alcohol
dependence syndrome". In the nineteenth and early twentieth centuries, alcohol
dependence was called dipsomania before the term "alcoholism" replaced it.
PHILIPPINES (THE)
Sources: FAO (Food and Agriculture Organization of the United Nations), World Drink Trends
2003
Lifetime abstainers
Data from the 2003 World
Health
Survey. Total sample size n
= 10
034; males n = 4639 and
females
n = 5395. Sample population
aged 18 years and above.
Estimates from key alcohol experts show that the proportion of adult males and
females who had been abstaining (last year before the survey) was 10% (males)
and 70% (females). Data is for after year 1995.
According to the 2003 World Health Survey (total sample size n = 4951; males
n = 3430 and females n = 1521), the mean value (in grams) of pure alcohol
consumed per day among drinkers was 4.8 (total), 6.1 (males) and 2.0
(Females).
Heavy episodic drinkers
A 2001 survey (sub sample size of drinkers n = 3529; age group 15 to 74 years
old) found that among drinkers 4.8% were heavy drinkers. 6.6% of male drinkers
and 1.3% of female drinkers were heavy drinkers. Heavy drinking was defined as
having more than 12 drinks on an average drinking day.
A 2001 survey (total sample size n = 1105; age group 15 to 19 years old) found
that 24.3% of the total population sampled were current drinkers. 42.4% of males
and 11.1% of females were reported to be currently drinking alcohol.
Youth survey interviewed a national sample of 5266 men and 5612 women aged
15 to 24 in 1994. Data for age group 15 to 19 years old show that the rate of
current drinkers among males was 47% and 12% among females.
A 2001 survey (total sample size n = 1105; age group 15 to 19 years old) found
that 2.6% of the total population sampled were heavy drinkers. Heavy drinking
was defined as having more than 12 drinks on an average drinking day.
Mortality rates from selected death causes where alcohol is one of the
underlying risk factors
The data represent all the deaths occurring in a country irrespective of whether alcohol was a direct or
indirect contributor.
Chronic mortality
Physical
Psychiatric
Long term misuse of alcohol can cause a wide range of mental health
problems. Severe cognitive problems are not uncommon; approximately 10
percent of all dementia cases are related to alcohol consumption, making it the
second leading cause of dementia. Excessive alcohol use causes damage to
brain function, and psychological health can be increasingly affected over time.
Social effects
The social problems arising from alcoholism are serious, caused by the
pathological changes in the brain and the intoxicating effects of alcohol. Alcohol
abuse is associated with an increased risk of committing criminal offences,
including child abuse, violence, rape, burglary and assault. Alcoholism is
associated with loss of employment,[64] which can lead to financial problems.
Drinking at inappropriate times and behavior caused by reduced judgment, can
lead to legal consequences, such as criminal charges for driving or public
disorder, or civil penalties for tortious behavior, and may lead to a criminal
sentence.
Alcohol withdrawal
Causes
A complex mixture of genetic and environmental factors influences
the risk of the development of alcoholism. Genes which influence the
metabolism of alcohol also influence the risk of alcoholism, and may
be indicated by a family history of alcoholism. One paper has found
that alcohol use at an early age may influence the expression of
genes which increase the risk of alcohol dependence. Individuals
who have a genetic disposition to alcoholism are also more likely to
begin drinking at an earlier age than average. Also, a younger age of
onset of drinking is associated with an increased risk of the
development of alcoholism, and about 40 percent of alcoholics will
drink excessively by their late adolescence. It is not entirely clear
whether this association is causal, and some researchers have been
known to disagree with this view.
Severe childhood trauma is also associated with an general increase
in the risk of drug dependency. Lack of peer and family support is
associated with a increased risk of alcoholism developing. Genetics
and adolescence are associated with an increased sensitivity to the
neurotoxic effects of chronic alcohol abuse. Cortical degeneration
due to the neurotoxic effects increases impulsive behavior, which
may contribute to the development, persistence and severity of
alcohol use disorders. There is evidence that with abstinence, there
is a reversal of at least some of the alcohol induced central nervous
system damage.
Genetic variation
Pathophysiology
Alcohol's primary effect is the increase in stimulation of
the GABAA receptor, promoting central nervous system depression.
With repeated heavy consumption of alcohol, these receptors are
desensitized and reduced in number, resulting
in tolerance and physical dependence. The amount of alcohol that
can be biologically processed and its effects differ between sexes.
Equal dosages of alcohol consumed by men and women generally
result in women having higher blood alcohol concentrations (BACs).
This can be attributed to many reasons, the main being that women
have less body water than men. A given amount of alcohol therefore
becomes more highly concentrated in a woman's body. A given
amount of alcohol causes greater intoxication for women due to
different hormone release compared to men.
Diagnosis
Social barriers
Screening
Several tools may be used to detect a loss of control of alcohol use.
These tools are mostly self reports in questionnaire form. Another
common theme is a score or tally that sums up the general severity
of alcohol use.
The CAGE questionnaire, named for its four questions, is one such
example that may be used to screen patients quickly in a doctor's office.
Two "yes" responses indicate that the respondent should be investigated further.
The questionnaire asks the following questions:
1. Have you ever felt you needed to Cut down on your drinking?
2. Have people Annoyed you by criticizing your drinking?
3. Have you ever felt Guilty about drinking?
4. Have you ever felt you needed a drink first thing in the morning
(Eye-opener) to steady your nerves or to get rid of a hangover?
Other tests are sometimes used for the detection of alcohol dependence,
such as the Alcohol Dependence Data Questionnaire, which is a more sensitive
diagnostic test than the CAGE questionnaire. It helps distinguish a diagnosis of
alcohol dependence from one of heavy alcohol use. The Michigan Alcohol
Screening Test (MAST) is a screening tool for alcoholism widely used by courts
to determine the appropriate sentencing for people convicted of alcohol-related
offenses, driving under the influence being the most common. The Alcohol Use
Disorders Identification Test (AUDIT), a screening questionnaire developed by
the World Health Organization, is unique in that it has been validated in six
countries and is used internationally. Like the CAGE questionnaire, it uses a
simple set of questions – a high score earning a deeper investigation.
The Paddington Alcohol Test (PAT) was designed to screen for alcohol related
problems amongst those attendingAccident and Emergency departments. It
concords well with the AUDIT questionnaire but is administered in a fifth of the
time.
There are reliable tests for the actual use of alcohol, one common
test being that of blood alcohol content (BAC). These tests do not
differentiate alcoholics from non-alcoholics; however, long-term heavy
drinking does have a few recognizable effects on the body, including:
Prevention
The World Health Organization, the European Union and other regional
bodies, national governments and parliaments have formed alcohol policies in
order to reduce the harm of alcoholism. Targeting adolescents and young adults
is regarded as an important step to reduce the harm of alcohol abuse. Increasing
the age at which licit drugs of abuse such as alcohol can be purchased, the
banning or restricting advertising of alcohol has been recommended as additional
ways of reducing the harm of alcohol dependence and abuse. Credible, evidence
based educational campaigns in the mass media about the consequences of
alcohol abuse have been recommended. Guidelines for parents to prevent
alcohol abuse amongst adolescents and for helping young people with mental
health problems have also been suggested.
Management
Detoxification
Medications
Experimental medications
Dual addictions
Epidemiology
Substance use disorders are a major public health problem facing many
countries. "The most common substance of abuse/dependence in patients
presenting for treatment is alcohol." In the United Kingdom, the number of
'dependent drinkers' was calculated as over 2.8 million in 2001.[119] About 12% of
American adults have had an alcohol dependence problem at some time in their
life. The World Health Organization estimates that about 140 million people
throughout the world suffer from alcohol dependence. In the United States and
Western Europe 10 to 20 percent of men and 5 to 10 percent of women at some
point in their lives will meet criteria for alcoholism.
Prognosis
In contrast, however, the results of a long term (60 year) follow-up of two
groups of alcoholic men by George Vaillant at Harvard Medical School indicated
that "return to controlled drinking rarely persisted for much more than a decade
without relapse or evolution into abstinence." Vaillant also noted that "return-to-
controlled drinking, as reported in short-term studies, is often a mirage."
The most common cause of death in alcoholics is from cardiovascular
complications. There is a high rate of suicide in chronic alcoholics, which
increases the longer a person drinks. This is believed to be due to alcohol
causing physiological distortion of brain chemistry, as well as social isolation.
Suicide is also very common in adolescent alcohol abusers, with 25 percent of
suicides in adolescents being related to alcohol abuse. Approximately 18 percent
of alcoholics commit suicide, and research has found that over 50 percent of all
suicides are associated with alcohol or drug dependence. The figure is higher for
adolescents, with alcohol or drug misuse playing a role in up to 70 percent of
suicides.
History
Alcohol has a long history of use and misuse throughout recorded history.
Biblical, Egyptian and Babylonian sources record history of abuse and
dependence on alcohol. In some ancient cultures alcohol was worshiped and in
others its abuse was condemned. Excessive alcohol misuse and drunkenness
were recognised as causing problems thousands of years ago. However, the
defining of habitual drunkenness as it was then known as and its adverse
consequences were not well established medically until the 18th century. In 1647
a Greek monk named Agapios was the first to document that chronic alcohol
misuse was associated with toxicity to the nervous system and body which
resulted in a range of medical disorders such as seizures, paralysis and internal
bleeding. In 1920 the effects of alcohol abuse and chronic drunkenness led to the
failed prohibition of alcohol being considered and eventually enforced briefly in
America. In 2005 the cost of alcohol dependence and abuse was estimated to
cost the USA economy approximately 220 billion dollars per year, more than
cancer and obesity.
Stereotypes of alcoholics are often found in fiction and popular culture. The 'town
drunk' is a stock character in Western popular culture. Stereotypes of
drunkenness may be based on racism orxenophobia, as in the depiction of
the Irish as heavy drinkers. Studies by social psychologists Stivers and Greeley
attempt to document the perceived prevalence of high alcohol consumption
amongst the Irish in America.
Alcoholism does not have uniform effects on all families. The levels of
dysfunction and resiliency of the non-alcoholic adults are important factors in
effects on children in the family. Children of untreated alcoholics score lower on
measures of family cohesion, intellectual-cultural orientation, active-recreational
orientation, and independence. They have higher levels of conflict within the
family, and many experience other family members as distant and non-
communicative. The cumulative effect of the family dysfunction may affect the
children in families with untreated alcoholics' ability to grow in developmentally
healthy ways.
The headings in this table are explained as follows. All columns refer to
2005 only, except Recorded and Total. Recorded refers to an average of
recorded consumption for 2003-2005. Unrecorded consumption was calculated
using empirical investigations and expert judgments. Total is the sum of the first
two columns. The last four columns are a breakdown of the (2005) recorded
alcohol consumption by type. Beer refers to malt beer, wine refers to grape wine,
spirits refers to all distilled beverages, and other refers to all other alchoholic
beverages. Values were corrected for tourism only in countries where the
number of tourists per year was at least equivalent to the number of inhabitants.