Early detection of alcohol dependence

One of the disadvantages of early detection of alcohol dependence is that it makes medical personnel think of physical damage first, where as social problems such as marital breakdown or loss of job are earlier indicators. These are often followed by psychological difficulties such as depression, anxiety or change in personality. Physical disorders generally occur later. Alcohol induced gastritis, ulcer pain, vomiting of blood and cirrhosis are the common medical problems. Alcohol related problems may occur singly but the more and longer an individual drinks the more problems he risks. An alcohol dependent person displays the following main features:

* The dependent drinker drinks to reliever or avoid withdrawal symptoms and drinking increasingly takes priority over other activities.

* The development of tolerance is shown by the dependent person being able to sustain an alcohol intake which would incapacitate the average man. For example, blood alcohol concentration of 300 mg% does not indicate a person’s manly ability to hold his drink, but rather his pathological tolerance.

* The dependent drinker becomes liable to withdrawal symptoms after 8-12 hours of abstinence. Each morning he may experience tremors, which varies from shaking of the hands to the whole body, nausea or vomiting, sweating, itching, muscle cramps and mood disorders.

* These withdrawal symptoms are temporarily ‘cured’ by drinking more alcohol. The drinker finds he can no longer control his drinking or be sure of stopping once he has started and drinking after abstinence is likely to lead to reinstatement of the entire episode.

Because of the relatively poor results of treating the established and heavily dependent drinker, emphasis has recently turned towards prevention and early detection. Alcohol related problems are caused by many causes and research has implicated a variety of predisposing factors such as heredity, personality and occupation.

Overall, per capita consumption is related to the price and availability of alcohol. Wherever alcohol is relatively cheap and widely available (as in Sri Lanka), the per capita consumption is high and alcohol related problems are common. Since governments control the price and availability of alcohol, the prevalence of alcoholism is both a medical but political problem. Psychologists and doctors are increasingly confronted with the social, psychological and physical consequences of excessive alcohol consumption

It is not difficult to diagnose the pot-bellied person who shakes as he breathes stale alcohol, but it is difficult to recognise the excessive drinker decades earlier.

There are at risk factors to recognise an alcoholic dependent person.

* Marital problems e.g. Violence towards the family.

* Problems at work; repeated absence on Mondays.

* Problem drinkers are much more liable to accidents at home, at work and on the roads.

* A relative with alcoholism-alcoholism is a family disease.

* High risk occupation; commercial travellers, company directors, entertainers, journalists, soldiers, and doctors.

* Mental disorders anxiety, depression and attempted suicide.

* Physical disorders; gastritis, liver disease.There are some blood tests which will show whether a patient is alcohol dependent.

There are psychological treatment such as aversive therapy and behavioural modification therapy to treat alcohol dependents. These therapies are effective, but takes a long time to produce the expected results.

source: The Island