Alcoholism: Difference between revisions

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[[Image:Mri alcohol.gif|right|thumb|350px|{{#ifexist:Template:Mri alcohol.gif/credit|{{Mri alcohol.gif/credit}}<br/>|}}Images of a 61-year-old healthy man (upper images) and a 60-year-old alcoholic man (lower images). Note on the MRI the thinner corpus callosum displaced upward by enlarged ventricles and, on the DTI, less well delineated white matter tracts in the alcoholic man compared with the healthy man.]]
{{Image|Mri alcohol.gif|right|350px|Images of a 61-year-old healthy man (upper images) and a 60-year-old alcoholic man (lower images). Note on the MRI the thinner corpus callosum displaced upward by enlarged ventricles and, on the DTI, less well delineated white matter tracts in the alcoholic man compared with the healthy man.}}
'''Alcoholism''' is a chronic condition, the development and presentation of which is influenced by [[genetic]], [[psychosocial]], and [[environment|environmental]] factors.  As a [[disease]] process, it is often progressive, and sometimes [[death|fatal]].  Alcholism is typically characterized by impaired [[impulse control]], preoccupation with [[alcohol (drug)|alcohol]], continued use of alcohol despite adverse consequences, and a generalized distortion in thinking.  While the condition itself is considered chronic, the symptom profile may present either continuously or periodically." <ref name="title">{{cite web |url=http://www.nlm.nih.gov/cgi/mesh/2007/MB_cgi?term=Alcoholism |title=Alcoholism |author=National Library of Medicine |accessdate=2007-12-06 |format= |work=}}</ref>
'''Alcoholism''' is a chronic condition, the development and presentation of which is influenced by [[genetic]], [[psychosocial]], and [[environment|environmental]] factors.  As a [[disease]] process, it is often progressive, and sometimes [[death|fatal]].  Alcholism is typically characterized by impaired [[impulse control]], preoccupation with [[alcohol (drug)|alcohol]], continued use of alcohol despite adverse consequences, and a generalized distortion in thinking.  While the condition itself is considered chronic, the symptom profile may present either continuously or periodically." <ref name="title">{{cite web |url=http://www.nlm.nih.gov/cgi/mesh/2007/MB_cgi?term=Alcoholism |title=Alcoholism |author=National Library of Medicine |accessdate=2007-12-06 |format= |work=}}</ref>



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(PD) Image: National Institute on Alcohol Abuse and Alcoholism
Images of a 61-year-old healthy man (upper images) and a 60-year-old alcoholic man (lower images). Note on the MRI the thinner corpus callosum displaced upward by enlarged ventricles and, on the DTI, less well delineated white matter tracts in the alcoholic man compared with the healthy man.

Alcoholism is a chronic condition, the development and presentation of which is influenced by genetic, psychosocial, and environmental factors. As a disease process, it is often progressive, and sometimes fatal. Alcholism is typically characterized by impaired impulse control, preoccupation with alcohol, continued use of alcohol despite adverse consequences, and a generalized distortion in thinking. While the condition itself is considered chronic, the symptom profile may present either continuously or periodically." [1]

Etiology / cause

Alcoholism is "probably a multifactorial, genetically influenced disorder" and twin studies show a "55% or higher concordance rate in monozygotic twins with only a 28% rate for like-sex dizygotic twins."[2]

Alcoholic styles

Chronic drinking

Maintenance drinking

Binge drinking

Blackout drinking

Recovery styles

The 'dry drunk'

In recovery

Post-recovery

Diagnosis

A systematic review concluded "full AUDIT may be superior to the AUDIT-C."[3]

Hair analysis

Hair analysis can detect alcohol consumption by measuring fatty acid ethyl esters and ethyl glucuronide that are metabolites of ethanol.[4][5]

Treatment

Medications

Baclofen

Baclofen is a a selective GABA B-receptor agonist that in a single trial of patients with alcoholic cirrhosis improved abstinence rates (71% versus 29%) over three months.[6]

Disulfiram

A randomized controlled trial showed benefit from disulfiram [7]

Topiramate

A randomized controlled trial of volunteers showed benefit from topiramate.[6]

Naltrexone

Randomized controlled trials show conflicting benefit from naltrexone with benefit among recent abstainers[8] and no benefit from chronic users[9].

See also

Alcohol (drug)

References

  1. National Library of Medicine. Alcoholism. Retrieved on 2007-12-06.
  2. Alcohol Dependence. (Online Mendelian Inheritance in Man, OMIM®. Johns Hopkins University, Baltimore, MD. MIM Number: 103780. World Wide Web URL: http://omim.org/.)
  3. Kriston L, Hölzel L, Weiser AK, Berner MM, Härter M (December 2008). "Meta-analysis: are 3 questions enough to detect unhealthy alcohol use?". Ann. Intern. Med. 149 (12): 879–88. PMID 19075207[e]
  4. Pragst F, Balikova MA (August 2006). "State of the art in hair analysis for detection of drug and alcohol abuse". Clin. Chim. Acta 370 (1-2): 17–49. DOI:10.1016/j.cca.2006.02.019. PMID 16624267. Research Blogging.
  5. Pragst F, Yegles M (April 2008). "Determination of fatty acid ethyl esters (FAEE) and ethyl glucuronide (EtG) in hair: a promising way for retrospective detection of alcohol abuse during pregnancy?". Ther Drug Monit 30 (2): 255–63. DOI:10.1097/FTD.0b013e318167d602. PMID 18367991. Research Blogging.
  6. 6.0 6.1 2007. Lancet Cite error: Invalid <ref> tag; name "pmidpending" defined multiple times with different content
  7. Fuller RK, Branchey L, Brightwell DR, et al (1986). "Disulfiram treatment of alcoholism. A Veterans Administration cooperative study". JAMA 256 (11): 1449–55. PMID 3528541[e]
  8. Anton RF, O'Malley SS, Ciraulo DA, et al (2006). "Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial". JAMA 295 (17): 2003–17. DOI:10.1001/jama.295.17.2003. PMID 16670409. Research Blogging.
  9. Krystal JH, Cramer JA, Krol WF, Kirk GF, Rosenheck RA (2001). "Naltrexone in the treatment of alcohol dependence". N. Engl. J. Med. 345 (24): 1734–9. DOI:10.1056/NEJMoa011127. PMID 11742047. Research Blogging.