‫‪Chronic Alcohol Abuse and‬‬

‫‪Alcoholism‬‬
‫اعداد الطالب‬
‫أنس فارس مزعل‬
‫رحمة ياسر ابراهيم‬
‫باسم صالح جبر‬
‫اسماعيل خليل عيدو‬
‫رياض احمد دحام‬
 Alcohol Abuse and
Alcohol Dependence
According to health professionals, alcohol abuse is defined
in terms of
persistent physical, social, or occupational
problems that have become associated with
alcohol use
recurring use of alcohol in physically hazardous
situations
 Alcohol Abuse and
Alcohol Dependence
Alcohol dependence is defined in terms of
uncontrolled alcohol intake, unsuccessful efforts
to reduce alcohol use, life problems, and
alcohol tolerance and withdrawal.
According to criteria set by the American
Psychiatric Association, an estimated 8.5
percent of U.S. adults can be classified either
as alcohol abusers or as alcohol dependent.
 Alcoholism: Stereotypes,
Definitions, and Criteria

The National Institutes of Health defines alcoholism as

“a physical addiction to alcohol in which people
continue to drink even though the drinking causes
physical, mental and social problems, including
problems with job responsibilities and relationships”
 Physiological Effects of Chronic
Alcohol Abuse
Excessive, chronic alcohol use increases the
risk of
liver disease
cardiovascular disease
cancer
pancreatitis
Type II diabetes
neurological disorders
most severely, Korsakoff’s syndrome
 Physiological Effects of Chronic
Alcohol Abuse
A particular concern is the development of fetal alcohol
syndrome (FAS) in the offspring of alcoholic mothers.
10–15% of pregnant women in the U.S. report having
recently drunk alcohol, and up to 30% drink alcohol at
some point during pregnancy
There is no amount of alcohol that is known to be safe
Total abstinence during pregnancy is ideal, and FAS is
100% preventable.
 Fetal Alcohol Syndrome
Facial features are a good
diagnostic for underlying brain
damage.
The greater the facial
abnormalities, the greater the
underlying damage. upturned nose

The exact degree and nature

of deficits depends on timing, flat face
small head
length and severity of
exposure, in addition to
individual differences in fetal
sensitivity to alcohol.
 Fetal Alcohol Syndrome
Shorter-than-average height
Low body weight
Poor coordination
Small head size
Hyperactive behavior
Difficulty paying attention
Poor memory
Difficulty in school (especially with math)
Learning disabilities
Speech and language delays
Intellectual disability or low IQ
Poor reasoning and judgment skills
Sleep and sucking problems as a baby
Vision or hearing problems
Problems with the heart, kidney, or bones
 Fetal Alcohol Syndrome
Anatomical Changes in the Brain
reduction in gross brain size
especially frontal and parietal lobes
agenesis of the corpus callosum
abnormal cerebellar development
reduced size of the caudate nucleus

Functionally
lower cerebral blood flow
reduced glucose utilization
reduced caudate and frontal lobe activation on
spatial memory tasks
Fetal alcohol syndrome
A. is not a concern unless the mother is an alcoholic
B. is unavoidable because it results from abnormal
metabolic activity of the fetus
C. can be avoided by drinking only beer and wine
during pregnancy
D. can be a product of changes in sperm of an
alcoholic father
E. can only be avoided with certainty if the mother
abstains from alcohol completely
 The Concept of Alcoholism as
a Disease
The majority position with respect to alcoholism
is that it should be considered a disease and
that alcoholics should be treated rather than
punished.
In 1956, the American Medical Association
adopted the disease model of alcoholism.
Calling alcoholism a disease was a bonanza
that quickly poured many billions of dollars into
the pockets of physicians, hospitals
and pharmaceutical companies and continues
 The Concept of Alcoholism as
a Disease
1992 JAMA article, the Joint Committee of the National
Council on Alcoholism and Drug Dependence, Inc. (NCADD)
and the American Society of Addiction Medicine (ASAM)
published this definition for alcoholism:
“Alcoholism is a primary chronic disease with genetic,
psychosocial and environmental factors influencing its
development and manifestations. The disease is often
progressive and fatal. It is characterized by impaired control
over drinking, preoccupation with the drug alcohol, use of
alcohol despite adverse consequences, and distortions in
thinking, mostly denial. Each of these symptoms may be
continuous or periodic.”
 The Concept of Alcoholism as
a Disease
Alcoholism does not fit the classic definitions of a
disease in that it is in part defined by attitudes of the
afflicted toward the drinking problem itself, e.g. denial,
or consequences of the drinking problem, an alcoholic
will
“continue to drink even though the drinking causes
physical, mental and social problems, including
problems with job responsibilities and relationships”
 The Concept of Alcoholism as
a Disease
It is the only disease that is generally diagnosed by the
sufferer rather than by a health professional
Recent surveys of primary care physicians indicate that
the medical profession is frequently ill prepared to
diagnose alcoholism or supervise effective treatment.
 The Concept of Alcoholism as
a Disease
Naming it as a disease may also give the illusion of
explanation,

“I can’t control my drinking because I am an alcoholic”

(but, alcoholism is defined by that same drinking)

That’s like saying

“I’m hypertensive because I have high blood pressure”.
 The Concept of Alcoholism as
a Disease
The disease concept makes certain assumptions and
has far-reaching implications for understanding,
treatment and legal treatment of alcoholics.
Heavy problem drinkers show a single distinctive
pattern of ever greater alcohol use leading to ever
greater bodily, mental, and social deterioration.
The condition, once it appears, persists involuntarily:
the craving is irresistible and the drinking is
uncontrollable once it has begun.
 The Concept of Alcoholism as
a Disease
Medical expertise is needed to understand and relieve
the condition (“cure the disease”) or at least ameliorate
its symptoms.
If alcoholism is a disease, then alcoholics are no more
responsible legally or morally for their drinking and its
consequences than epileptics are responsible for the
consequences of their movements during seizures, or
someone with a brain tumor, diagnosed as
schizophrenic, etc.
 The Concept of Alcoholism as a
Disease
The disease model also diverts attention away from
the social and cultural contributions to the problem
 Approaches to Treatment
for Alcoholism
Approaches include behaviorally and
psychologically based treatments (e.g.,
cognitive behavioral therapy, contingency
management) and spiritually based treatments
(e.g., Alcoholics Anonymous).
It is curious to note that although AA embraces
the disease concept of alcoholism, it embraces
a spiritual rather than a scientific or medical
approach to its treatment.
 Approaches to Treatment for
Alcoholism
Other self-help programs, such as Moderation
Management (MM) and SMART Recovery, have
been devised to appeal to those who cannot
accept a spiritual approach or the total abstinence
required in the AA program
 Approaches to Treatment for
Alcoholism
Moderation Management (MM)
Non-profit, supported by voluntary donations
Alcoholism is a learned behavior, not a disease
For those concerned about drinking habits but
not dependent or are in early-stage
dependency
Controlled drinking,
Self-Management not total
and Recovery abstinence
Training (SMART)
Non-profit organization, recognized by NIDA
A Cognitive/Behavioral Therapy approach
Self-empowering and teaches self-reliance
Total abstinence, controlled drinking up to the individual
Physiological Effects of Chronic
Alcohol Abuse
Physical effects of alcoholism include tolerance
and withdrawal, liver disease, cardiovascular
disease, cancer, and neurological disorders
such as Wernicke-Korsakoff syndrome.
A particular concern is the development of fetal
alcohol syndrome (FAS) in the offspring of
alcoholic mothers.