ALCOHOL USE by Dr Winston Gopaul, SMO  – Substance Abuse Prevention and Treatment Center, Caura

Alcohol use is very common in our population. While some persons may be able to drink socially, others begin to experience problems related to their alcohol use. These include adverse effects on physical and mental health, marital/family problems, work-related issues (tardiness, absenteeism, poor work performance) and road traffic accidents.

Alcohol Use Disorders

Persons who develop an alcohol use disorder may experience:

• Loss of control over their alcohol use:  Drinking more than intended, unsuccessful efforts to cut down or control alcohol use.
• Craving: a strong desire or urge to use alcohol.
• Recurrent alcohol use affecting their ability to fulfill responsibilities at home and at work.
• Continued alcohol use despite experiencing problems associated with alcohol use.
• Tolerance: A need for increasing amounts of alcohol to achieve the same effect. Some persons may change their choice of alcoholic beverage to one with a greater alcohol concentration (e.g. from beer to rum to puncheon).

Alcohol Withdrawal

Alcohol withdrawal symptoms can occur with cessation or reduction of alcohol use. In mild cases, persons may experience tremor of hands, sweating, increased heart rate, nausea or vomiting. More severe withdrawal symptoms include confusion, hallucinations and seizures.

Medical Conditions 

Alcohol use contributes to the development of several medical conditions, most commonly liver disease including fatty liver, alcoholic hepatitis and cirrhosis. Other medical complications include disorders of the Gastrointestinal Tract (Gastritis, gastric ulcers, malabsorption syndromes, pancreatitis), Central Nervous System (Wernicke-Korsakoff Syndrome, Cerebellar Disease), Cardiovascular Disease (Cardiomyopathy). Alcohol use also increases the risk of several cancers including those of the stomach, oesophagus, liver, colon and kidney.

Psychiatric/Psychological Effects of Alcohol Use

• Alcohol intoxication can result in behavioural or psychological changes (e.g. inappropriate aggressive or sexual behaviour), slurred speech, poor coordination, unsteady gait.
• Other alcohol-related mental conditions include memory impairment, mood disorders (including depression and mania), anxiety disorders, sexual dysfunction and sleep disorders.
• Wernicke’s Syndrome, also called Alcoholic Encepalopathy, is an acute neurological disorder characterised by ataxia (unsteady gait), confusion and ocular motility abnormalities. It may clear spontaneously in a few days or weeks or it may progress into Korsakoff’s syndrome.  Korsakoff’s syndrome  is characterized by an anterograde amnesia (loss of ability to create new memories after the onset of the illness) and confabulation.

Alcohol Use and Road Traffic Accidents

Alcohol consumption increases the risk of involvement in road traffic accidents. Alcohol-impaired drivers account for approximately one-third of all fatal crashes.

The higher the blood alcohol level, the greater the impairment in the person’s ability to operate a vehicle.

Where can I find more information and get help? 

NADAPP- National Alcohol and Drug Abuse Prevention Programme

Substance Abuse Prevention Treatment Center, Caura Hospital

AA/NA Groups

References:

1) WHO Global Status Report on Alcohol-2004

2)  Centres for disease control and prevention (CDC); Alcohol and Public Health; Alcohol-Related Disease Impact (2006-2010)

3) Kaplan, H; Sadock,B.J.; Grebb, J.A.: Synopsis of Psychiatry p396-410.