Alcohol Treatment

How to Beat Addiction and Quit Alcoholism Easily

How to beat addiction and quit alcoholism is a collection of 6 eBooks that are all specifically crafted to help people leave addiction and alcoholism. These books were put down by a group of former alcoholics and addicts and hence you can trust them to help you along the way. The three authors that were involved are: Wendy Wilken, Martin Gouws and Stephen Steenkamp. They have all fought a war of alcoholism and addiction successfully and that's why they thought they should help you along the way. The books also come with various bonuses upon purchase. This means that if you purchase any of the books, you will get a special bonus. To successfully quit alcohol and beat addiction, you have to make use of all the books combined. Each of them introduces you to a certain perspective of addiction and alcoholism and hence all of them should be combined to come up with a significant outcome. The book is perfectly fit for alcoholics and drug addicts of all ages, race, social status and levels of addiction. More here...

How to Beat Addiction and Quit Alcoholism Easily Summary


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Alcoholism Versus Unwise Drinking

The available literature on the role of alcoholism as opposed to unwise drinking in injury occurrence suggests that problem drinkers and those diagnosed as alcoholics are at a greater risk of both fatal and nonfatal injuries than those in the general population who may drink prior to an accident. Alcoholics and problem drinkers are significantly more likely to be drinking and to be drinking heavily prior to an accident than others. Haberman and Baden (1978) found among fatalities from all causes that alcoholics and heavy drinkers were more than twice as likely as nonproblem drinkers to have a BAL at the legal limit. Alcoholics have also been found to experience higher rates of both fatal and nonfatal accidents, even when sober. Analysis of national mortality data found that those who died of injury drank more frequently and more heavily than those who died of disease, and that daily drinking, binge drinking (consuming 5 or more drinks per occasion), and heavier drinking (14 or more...

Validity of Alcohol Intake

Reporting bias by high-intake or low-intake consumers could, to some extent, explain the apparent lower mortality among light to moderate drinkers. In the type of studies included in this review,- with an emphasis on prospective population studies, one obvious source of bias is misclassification of subjects according to their self-reported alcohol intake. Studies of the validity of self-reported total alcohol intake have mainly concentrated on validating total alcohol intake in suspected alcoholics, whereas intake validity among low-intake consumers in the general population is poorly studied. No reference of alcohol intake (sales reports, collateral information, biological markers, etc.) has been identified. Some biochemical markers of alcohol intake have been suggested, such as 7-glutamyl transferase, high-density lipoprotein, and carbohydrate-deficient transferrin, the latter being one of the most promising. However, in a study from Copenhagen, it was shown that...

Effects of Alcohol Consumption on the Diet

Alcohol is consumed by about two-thirds of adult Americans, and the estimated per capita annual consumption of alcohol exceeds 2 gallons for each US citizen over age 14 years. In the US, young adults between 18 and 25 years of age consume more alcohol than any other age group, and the preferred beverages are wine, beer, and spirits in that order. Men and teenage boys consume about 3 times more alcohol than teenage girls and adult women. Among alcohol consumers, most are moderate drinkers, while about 10 are heavy drinkers at risk of addiction and organ damage. Moderate drinking can be defined as no more than 2 drinks per day for men or 1 drink per day for women, where 1 drink is equivalent to 12-15 g of alcohol. Heavy drinking is defined as consuming more than 5 drinks on any given day per week in men or 4 drinks on any given day per week for women. Chronic alcoholics are addicts who typically consume excessive amounts of alcohol on a daily basis. Binge drinkers are chronic alcoholics...

The risks of Excessive Alcohol Consumption

Unlike other abused drugs, chronic alcohol in excess affects many different organ systems, which include the liver, pancreas, heart, and brain (Table 1). Excessive chronic alcohol use also increases the risk of certain cancers. While these risks are apparent among the 7 of US citizens over aged 14 who abuse alcohol, their prevalence is generally no less in countries such as France, Italy, and Spain where drinking wine with meals is considered part of the culture. The organ damage from chronic alcoholism may impact on processes of nutrient assimilation and metabolism, as is the case with chronic liver and pancreatic disease, or may be modulated in large part by nutrient deficiencies, as with thiamine and brain function. This section will consider specific effects of alcohol abuse on certain organs as a

Adult Children Of Alcoholics

Carry an increased risk of severe alcohol problems themselves (a probability of two to four times that of children of nonalcoholics). Probabilities also indicate that they are not more vulnerable to severe psychiatric disorders (such as schizophrenia or manic depressive disease) and that they do not carry a heightened risk for severe problems with some drugs of abuse (such as heroin). Nevertheless, it is possible that when children of alcoholics reach adolescence or adulthood, they might be slightly more likely to have problems with marijuana-type drugs or with stimulants (such as cocaine or amphetamines). It has also been observed that if their childhood home has been disrupted by alcohol-related problems in either or both parents, the children may have greater difficulties with a variety of areas of life adjustment as they mature or go off on their own. The label Adult Children of Alcoholics has been given to a self-help group, often abbreviated as ACOA. Within the group, people...

The Costs Of Alcoholism

In the United States alcoholism is the most widespread form of drug abuse, affecting at least five million persons. In 1995, according to the Substance Abuse and Mental Health Services Administration, alcohol abuse and alcoholism cost an estimated 166.5 billion, while drug abuse dependence cost 109.8 billion. More than 100,000 deaths each year are related to alcohol abuse. Coalition for the Prevention of Alcohol Problems. Frank, G., and Wilcox, G. (1988). Journal of Advertising, 16(3), 22-30. Grube, J. W. (1995). National Institute on Alcohol Abuse and Alcoholism. Research Monograph, 28. Harvard School of Public Health (1999). Survey. Lastovicka, J. L. (1995). National Institute on Alcohol Abuse and Alcoholism. Research Monograph, 28. Lieberman, L. R. and Orlandi, M. A. (1987). Alcohol Williams, G. D., et al., (1992). National Institute on Alcohol Abuse and Alcoholism. Surveillance Report, No. 23.

Treatment For Alcohol Dependence

The first step in treating alcoholics is to remove the ethanol from the system, a process called detoxification. Since rapid termination of ethanol (or any other central nervous system depressant) can be life threatening, people who have been using high doses should be slowly weaned from the ethanol by giving a less toxic substitute depressant. Ethanol itself cannot be used because it is eliminated from the body too rapidly, making it difficult to control the treatment. Although barbiturates were once employed in this capacity, the safer benzodiazepines have become the drugs of choice. Not only do they prevent the development of the potentially fatal convulsions, but they reduce anxiety and help promote sleep during the withdrawal phase. New medications are constantly being tested for their abilities to aid in the treatment of alcohol withdrawal. Many support groups are available to help people remain abstinent. ALCOHOLICS ANONYMOUS (AA) is one of the most widely known and available...

Measurements ofalcohol intake

Alcohol consumption based on self-reported data consistently account for only 40-60 of alcohol purchases 43 , The greatest problem facing alcohol research is the lack of a reference standard with which to validate self-reported drinking. Collateral reports by significant others do not necessarily provide better information 43 , Biochemical markers, which are useful in the diagnosis of alcoholism and recent drinking, cannot be used to estimate absolute alcohol intake at an individual level. Most observational studies ask the respondents to recall their usual intake over a long period of time, say 1 month or 1 year. This approach is likely to yield information about modal frequencies and quantities and thus underestimate average intake. On the other hand, recalling the actual intake during all actual drinking occasions over a short period of time (e.g., 24 hours) ignores the day-to-day variations in alcohol consumption. Among the five main methods used to assess alcohol intake i.e.,...

Abstinence versus Controlled Drinking

The position of ALCOHOLICS ANONYMOUS (AA) and the dominant view among therapists who treat alcoholism in the United States is that the goal of treatment for those who have been dependent on alcohol is total, complete, and permanent abstinence from alcohol. Although temperance originally meant moderation, the nineteenth-century TEMPERANCE Movement's emphasis on complete abstinence from alcohol and the mid-twentieth century's experience of the ALCOHOLICS ANONYMOUS movement have strongly influenced alcohol- and drug-abuse treatment goals in the United States. Moral and clinical issues, however, have been irrevocably mixed. The disease model of alcoholism and drug addiction, which insists on abstinence, has incorporated new areas of compulsive behavior such as

Alcoholism In Women And Incidence Of Ahmd

Compared to men, women drink less and experience less alcohol-related medical problems 6 , However, one third of all alcoholics in the United States are women 6 , Over the last two decades, there is no evidence of any major increase in total alcohol consumption by women, however there has been an important change in the drinking patterns and prevalence of alcohol usage among women 7J. With regard to drinking patterns, younger women report frequent heavy drinking and frequent bouts of intoxication 8 , In addition, alcohol usage has increased among women who are employed full-time in nontraditional settings and among those who are unemployed and divorced 9 , This is of concern, because of the increase in the number of women in the work force as well as the number of women who are unemployed and divorced. Therefore, in the future, more women may experience alcohol-related medical problems. In the United States, long-term excessive alcohol consumption (of any beverage type) in both sexes...

Are Female Animal Models Of Alcoholism Helpful In Evaluating The Adverse Effects Of Alcohol

Female animal models of alcoholism should be used to study the effects oflong-term alcohol exposure. However, investigators need to consider variables such as the level concentration of ethanol intake, the pattern of weight gain as well as the absolute weight gain, and hormone levels. As noted above, we have found that female rodents drink less alcohol than male rodents (Table 4.6). Our findings differ from those of others, who have reported that female rodents drink more than male rodents 38,39 , In addition, the pattern of drinking appears to be different between cohorts of female animals (Figure 4.4). Lieber DeCarli liquid diet intake is shown in Figure 4.4 for two different cohorts of female rats one group drank for 5 months (preliminary data above) and another drank for 8 months (ongoing studies). Similar to others, we found that in both cohorts of female rats the average daily amount of diet consumed was variable 39 , However, the average daily ethanol intake (gm day) in the...

Pathology Of Alcohol Abuse

Alcohol abuse affects all organs of the body (Lieber, 1992a). It atrophies many tissues, including the brain and the endocrine glands. Indeed, altered hepatic (liver) metabolism plays a key role in a variety of endocrinological imbalances (such as go-nadal dysfunctions and reproductive problems). Alcohol also exerts toxic effects on the bone marrow and alters hematological status (e.g., macrocytic anemias), and it scars the heart and other muscles. This article focuses mainly on the liver and gastrointestinal tract, since this is where alcohol penetrates into the body and has its most vicious effects this focus will also allow exemplification of the insights and possible benefits that can be derived from the application of newly acquired knowledge in biochemistry, pathology, and molecular biology. Liver disease, one of the most devastating complications of alcoholism, was formerly attributed exclusively to the malnutrition associated with ALCOHOLISM. Indeed, nutritional deficiencies...

Alcoholism And Mood Disorders

The rate of depression in individuals with alcoholism and rate of alcoholism in individuals affected with mood disorders (depression and mania) varies greatly accord The effect that the means of assessment has upon psychiatric comorbidity is well illustrated by depression. Different rates of depression in alcoholics are seen if one uses standard clinical interviews, structured research interviews or self-report measures. Such methodological differences have led to widely differing conclusions regarding both comorbidity rates and comorbid influence. However, recent estimates from a number of sources suggests that 40 percent of all alcoholics in the U.S. are also battling depression (Larson, 1998). The critical importance of the timing of the psychiatric assessment and its relationship to comorbidity is demonstrated by studies from the Alcohol Research Center in San Diego (Brown, 1988 Schuckit, 1990). Symptoms of depression in 191 alcoholics were recorded...

Antisocial Personality and Alcoholism A

Great deal is known regarding the relationship of antisocial personality disorder and alcoholism. This diagnostic combination is estimated to involve as many as 2 percent of the male population of the United States. Most studies of this combination of illnesses indicate that the antisocial alcoholic has an earlier onset of drinking difficulties, more family history of alcoholism, more social complications of alcoholism, and a greater number of symptoms of other psychiatric disturbances, e.g., drug abuse, depression, mania, schizophrenia, and psychotic symptoms. Antisocial alcoholics have also been reported to attempt suicide more frequently. In addition to these more severe symptoms at the time of initial evaluation, antisocial personality disorder influences the natural history of the substance use disorders and alcoholism. This change in course is demonstrated by the following studies. Schuckit (1985) utilized standardized research criteria to divide a group of 541 alcoholics into...

Maternal Alcohol Consumption

Several laboratories have investigated the effects of sustained maternal alcohol consumption on the offspring's metabolic health. Alcohol consumption during pregnancy can lead to abnormal fetal development and a subsequent reduction in birth weight. Increased offspring morbidity may also be linked to gestational alcohol consumption. It has been previously documented that female rats fed a gestational diet supplemented with alcohol tended to have a higher number of pups die in early postnatal life. Of those alcohol-exposed offspring that survived, the reduced rate of prenatal growth and development has been linked to abnormalities in the offspring's glucose and insulin homeosta-sis. Both glucose intolerance and insulin resistance are evident in the rat offspring exposed during in utero life to maternal alcohol. Phenotypic abnormalities, Consumption of alcohol is quite common among breast-feeding mothers as studies have shown ethanol to aid in the promotion of lactation. Establishing...

Economic Costs Of Alcohol Abuse And Alcohol Dependence

Alcohol abuse and alcohol dependence continue to be major health problems in the United States. The terms alcohol abuse and alcohol dependence are based on the diagnostic criteria as stated in the American Psychiatric Association's DIAGNOSTIC and Statistical Manual of Mental Disorders, Third Edition, Revised (1987). As such, they cost the nation billions of dollars in health-care costs and reduced or lost productivity each year. Since the mid-1980s, researchers have issued studies that estimate the economic costs associated with alcohol and alcohol abuse in the United States. In 1985, alcohol abuse and dependence cost an estimated 70.3 billion dollars and in 1988 an estimated 85.8 billion dollars (Rice et al., 1990, 1991). In 1998, the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse (NIAAA), which are parts of the National Institutes of Health (NIH), released a study on these costs based on 1992 survey data. This report, which also analyzed drug...

Alcohol Consumption And The Risk Of Stroke

There is plenty of evidence that heavy drinking (> 60 g day) is related to increased risk ofboth hemorrhagic 19 and ischemic strokes 1,3,7,8,10-12 . In contrast, light ( 24 g day for men and 12 g day for women) and moderate (25-60 g day for men and 13-48 g day for women) drinking does not seem to increase and may even decrease the risk of stroke compared with non-drinking 7,13,14 . However, in order to understand the relationship between alcohol and the risk of stroke, one has to separately examine the effects of alcohol on each stroke subtype (i.e., subarachnoid and intracerebral hemorrhage, and cerebral infarction), the dose-response curve most probably differing from one subtype to another. The risk of subarachnoid hemorrhage seems to increase steeply with increasing alcohol consumption 7,15 , The relationship between alcohol and the risk of intracerebral hemorrhage is poorly known but may be U-shaped with lowest risk among light to moderate drinkers 7-9 , and that of ischemic...

Special Syndromes Associated with Alcoholism

Johannesson, G., Berglund, M. and Ingvar, D. H., Reduction of blood flow in cerebral white matter in alcoholics related to hepatic function. Acta Neurol. Scand. 65 190-202, 1982. Boroojerdi, B., Hungs, M., Biniek, R. and Noth, J., Subacute encephalopathy with epileptic seizures in a patient with chronic alcoholism. Nervenarzt 69 162-165, 1998. Case Report German Chan, Y. W., McLeod, J. G., Tuck, R. R., Walsh, J. C. and Feary, P. A., Visual evoked responses in chronic alcoholics. J. Neurol. Neurosurg. Psychiatry 49 945-950, 1986.

Benzodiazepines and Alcoholism

Saletu, M., Saletu, B., Grunberger, J., Mader, R. and Karobath, M., Clinical symptomatology and computer analyzed EEG before, during and after anxiolytic therapy of alcohol withdrawal patients. Neuropsychobiology 9 119-134, 1983. Bauer, L. O., Gross, J. B., Meyer, R. E. and Greenblatt, D. J., Chronic alcohol abuse and the acute sedative and neurophysiologic effects of midazolam. Psychopharmacology (Berl.) 133 293-299, 1997.

Military Drug And Alcohol Abuse In The United States Drug and

Similar to drug use, heavy drinking in the military has been an accepted custom and tradition (Bryant, 1979 Schuckit, 1977). In the past, alcohol was thought to be a necessary item for subsistence and morale and, as such, was provided as a daily ration to sailors and soldiers. Within the predominantly male U.S. military population, heavy drinking and being able to ''hold one's liquor'' have served as tests ''of suitability for the demanding masculine military role'' (Bryant, 1974). A common stereotype has been to characterize hard-fighting soldiers as hard-drinking soldiers. Alcoholic beverages have been available to military personnel at reduced prices at military outlets and until recently during ''happy hours'' at clubs on military installations (Bryant, 1974 Wertsch, 1991). In addition, alcohol has been used in the military to reward hard work, to ease interpersonal tensions, and to promote unit cohesion and camaraderie (Ingraham, 1984). Drug and alcohol abuse are strongly opposed...

Alcohol Abuse And Cardiovascular Disease

Although there is considerable evidence that moderate drinking protects against mortality and morbidity from coronary heart disease 21,22 , heavy consumption is shown to have deleterious cardiovascular effects. It exerts its adverse effects by increasing the risks of cardiomyopathy, hypertension, and stroke 23 , Chronic ethanol consumption has been linked to the prevalence of hypertension, which contributes to an increased incidence of stroke. Heavy drinkers have alO mmHg higher systolic blood pressure than non-drinkers even though the relationship may differ between men and women 24 , Stroke is a leading cause of death and morbidity. Alcohol may increase the risk of stroke through various mechanisms that include hypertension, hypercoagulable states, cardiac arrhythmias, and cerebral blood flow reductions 25 , Hypertension, including borderline hypertension, is probably the most important stroke risk factor based on degree of risk and prevalence. Furthermore, cardiac morbidity,...

Four Stages Of Alcoholism

Jellinek, one of the earliest researchers to focus on the study of alcohol and alcoholism, outlined four stages that mark the progress of alcoholism. According to Jellinek, alcoholism begins with what he called a prealcoholic phase a time when drinking takes place during social occasions. Drinking brings stress relief, and soon the individual begins to look for

What is the relapse rate in the first year after alcohol detoxification

An alcohol withdrawal syndrome with hallucinations, altered mental status, and seizures accompanied by vital sign abnormalities (tachycardia, hypertension, fever). Vital sign abnormalities may be the first clue to diagnosis. DT may lead to death. Vitamins (particularly thiamine) to treat underlying vitamin deficiencies seen in long-term alcoholism Antihypertensives to suppress underlying hypertension that can be made worse by the physiologic withdrawal process

Excessive Alcohol Consumption during Pregnancy

Chronic alcohol abuse may result in a wide spectrum of secondary disturbances of the absorption and utilisation of many nutrients, including glucose, amino acids, fat, sodium, and some vitamins (especially thia-min, vitamin B12, and folate). The inhibition of folate Both alcohol and its primary metabolite, acetaldehyde, are teratogenic. Excessive alcohol consumption (> 80 g of ethanol or 10 units per day) during pregnancy can result in a child being born with a specific combination of physical and mental disabilities known as fetal alcohol syndrome (FAS). Such fetuses usually survive until birth but are growth retarded and display a characteristic range of clinical features, principally craniofa-cial abnormalities and neurological damage (Table 3). FAS is only seen in infants born to women who are excessive drinkers, but it is not an inevitable result of heavy drinking in pregnancy, and even children born to mothers who are active alcoholics may not show it. This differing...

Binge Drinking and Social Alcohol Consumption during Pregnancy

Binge drinking, generally defined as the consumption of alcohol equivalent to five or more standard drinks per occasion, may be particularly harmful because it exposes the fetus to high blood alcohol concentrations over relatively short periods of time and may be associated with repeated withdrawal episodes. Animal studies have demonstrated binge-like exposure to alcohol to be as teratogeneic as long-term exposure throughout gestation, even if the overall alcohol amount consumed by binge drinking is less than intake during more continuous drinking patterns. However, the findings of human studies have been inconsistent, possibly because of the problems of recording binge drinking during pregnancy. The question of whether moderate or occasional alcohol consumption is safe during pregnancy has been widely debated. Currently, there is little evidence that modest drinking (< 10 units per week) has any harmful effects. Although there is general agreement that women should not drink...

Alcoholism Assessment

To appropriately assign an individual to treatment, his or her condition must be accurately evaluated. Management of alcoholism may be seen as involving a five-stage sequential process screening, diagnosis, triage, treatment planning, and treatment-outcome monitoring. Specific procedures exist to help inform clinical decisions at each of these stages (Allen, 1991). Screening tests help determine whether a drinking problem might exist. If this seems likely, formal and more lengthy diagnostic procedures are performed to specify the nature of the problem. If the diagnosis of alcoholism is established, determination of the type of treatment setting and intensity of care needed for detoxifying and treating the patient must be made next. Treatment planning can then be initiated to establish rehabilitation goals and strategies appropriate to the patient. Finally, outcome is monitored to determine if further treatment is needed or if a different treatment approach is advisable.

Agents To Treat Psychiatric Disorders Concomitant To Alcoholism

Alcoholism may be accompanied with various psychiatric problems including anxiety, depression, antisocial behavior, panic disorders, and phobias. Part of the problem in treatment is to determine if the psychiatric disorder developed before alcoholism (primary), or after (as a result of) alcoholism (secondary). Nevertheless, several studies have been conducted predominately with medications used to treat depression and anxiety. Agents to Treat Alcoholics with Depression. Depression has been associated with alcoholism, especially with relapse to drinking. A frequent pharmacologic treatment of depression is with a group of medications called tricyclic Antidepressants (desipramine, imipramine, amitriptyline, and doxepin). Their efficacy in treating alcoholics with depression is, however, largely unknown. This is in part because of poor methodological studies. A recent study of desipramine was conducted on alcoholics with and without secondary depression (Mason & Kocsis, 1991)....

Family History of Alcoholism

C., Cohen, M. J., Antick, J. and Caine, K., Visuospatial learning in elementary school children with and without a family history of alcoholism. J. Stud. Alcohol 49 538-545, 1988. Parsons, O. A., Schaeffer, K. W. and Glenn, S. W., Does neuropsychological test performance predict resumption of drinking in posttreatment alcoholics Addict. Behav. 15 297-307, 1990. Rodriguez, M., Cognitive functioning, family history of alcoholism, and antisocial behavior in female polydrug abusers. Psychol. Rep. 73 19-26, 1993. Rodriguez, M., Cognitive functioning in male polydrug abusers with and without family history of alcoholism. Percept. Mot. Skills 77 483-488, 1993. Deckel, A. W., Hesselbrock, V. and Bauer, L., Relationship between alcohol-related expectancies and anterior brain functioning in young men at risk for developing alcoholism. Alcohol. Clin. Exp. Res. 19 476-481, 1995. Drake, A. I., Butters, N., Shear, P. K., Smith, T. L., Bondi, M., Irwin, M. and...

Other Risk Factors for Alcoholism

W., Hesselbrock, V. and Bauer, L., Relationship between alcohol-related expectancies and anterior brain functioning in young men at risk for developing alcoholism. Alcohol. Clin. Exp. Res. 19 476-481, 1995. Deckel, A. W., Tests of executive functioning predict scores on the MacAndrew Alcoholism Scale. Prog. Neuropsychopharmacol. Biol. Psychiatry 23 209-223, 1999.

Alcoholism and Emotional Disturbance

One longitudinal study found that early personality predicts the later development of alcoholism and emotional disturbance (Conley & Angelides, 1984). Of the 233 men in the study, 40 were judged to develop a serious emotional problem or alcoholism. These 40 men had earlier been rated by their acquaintances as high on neuroticism. Specifi cally, they had neuroticism scores roughly three-fourths of a standard deviation higher than men who did not develop alcoholism or a serious emotional disturbance.

Prevention of Alcoholism The Ledermann Model of Consumption

Ledermann model of alcohol consumption is an important concept for anyone who wishes to understand the underpinnings of modern policy efforts to prevent heavy drinking and alcoholism. The point of departure for this concept is a set of observations about how alcohol consumption is distributed in human societies. Sully Ledermann, a French demographer, thought of this problem in relation to a single distribution that was not bell shaped or normal in its distribution. He imagined that drinking ought to be plotted in relation to a single curve, with a shape that is known as lognormal and without a categorical distinction between normal and abnormal drinkers. The shape is known as lognormal because the natural logarithms of individual consumption, rather than actual consumption values, are normally distributed. Assuming Ledermann is correct, the majority of individuals within a society will drink relatively modest amount of alcohol, and a small proportion will drink large quantities, but...

National Council On Alcoholism And Drug Dependence Ncadd

NCADD was established in 1944 as the National Committee for Education on Alcoholism. As the organization grew, its name and scope enlarged. It became the National Committee on Alcoholism in 1950, was renamed the National Council on Alcoholism in 1957, and assumed its present name in 1990. The NCADD was the idea of a single individual, Marty Mann she was its director until her retirement in 1968 and its guiding spirit until her death in 1980. Mrs. Mann was the first woman to recover from alcoholism through the fellowship of Alcoholics Anonymous (AA). During the early years of her recovery, she became increasingly aware that the United States was uninformed about the disease of ALCOHOLISM. The resulting stigma and prejudice kept alcoholics and their families from receiving the medical, social, and spiritual help they needed to recover. The structure and traditions of AA prevented it from becoming a public-health agency similar to those concerned with promoting prevention, treatment, and...

College Binge Drinking

Alcohol abuse is considered the most significant public health problem facing college students in the United States. It is estimated that more than 500,000 injuries and 70,000 cases of sexual assault a year result from alcohol abuse among students, and more than 1,400 students die each year as a result of their injuries. Two out of every five students report an episode of binge drinking which is usually defined as five or more drinks in a row in any given two-week period. During the 1990s, as government and health organizations be gan to recognize the magnitude of the problem, the U.S. Surgeon General set a goal of reducing binge drinking by 50 percent by the year 2010, and colleges sharply increased alcohol education programs and penalties for excessive or underage drinking. Nevertheless, the rate of binge drinking on college campuses remained virtually unchanged between 1993 and 2001, the year of the last comprehensive study.

Growth Of The Drug Addiction And Alcoholism Impairment Category

From the advent of SSI in January 1974, until March 1996, drug addiction and alcoholism (DA& A) were treated as potentially disabling impairments. The DI program adopted the more liberal SSI addiction standard in 1975. In Social Security lingo, beneficiaries who qualified on this basis were known as ''DA& As.'' In the SSI program, DA& As were obliged to be in treatment and to have a ''representative payee,'' a third party who received their checks and managed their funds. ''DA& As in the DI program were not subject to such requirements until 1994. This disparity reflected the historical reference tendency for American income maintenance programs to combine material aid and moral surveillance in welfare programs (WELFARE POLICY AND SUBSTANCE Abuse in the United States), but to treat the beneficiaries of the ''insurance-like'' programs as though they were the recipients of an insurance benefit for which they had paid premiums in full.

Aging And Alcoholism

Alcohol is an addictive drug for many individuals. Although its victims often do not recognize their alcoholism as a disease, it does meet the medical criteria for a disease it has definite symptoms it is chronic and it often progresses until it causes death but it is treatable. It destroys its victims not only physically but also mentally, emotionally, and spiritually. Many people with this disease die from physical complications, from accidents, even from suicide. In Western society, smoking cigarettes and excessive drinking of alcohol are two of the most insidious forms of drug abuse. Yet they are often considered socially acceptable. In the United States, two-thirds of all adults use alcohol occasionally. It is estimated that between 2 and 10 percent of persons over the age of sixty suffer from heavy drinking that interferes with their health and well-being. These persons by definition suffer from alcoholism (Jinks & Raschko, 1990). If cigarette smoking is excluded, alcoholism...

Controlled Drinking

By extension, for all those treated for alcohol abuse, including those with no dependence symptoms, moderation of drinking (termed controlled drinking, or CD) as a goal of treatment is rejected (Peele, 1992). Instead, providers claim, holding out such a goal to an alcoholic is detrimental, fostering a continuation of denial and delaying the alcoholic's need to accept the reality that he or she can never drink in moderation. One painful example of this is the case of Audrey Kishline, author of Moderate Drinking The New Option for Problem Drinkers, and founder of the group Moderation Management. In the summer of 2000, Kishline pleaded guilty to a vehicular homicide incident in which she killed a father and his twelve-year-old daughter when she drove the wrong way on a Washington State highway. Her blood alcohol level at the time of the accident was 0.26 three times the legal limit. In Britain and other European and Commonwealth countries, controlled-drinking therapy is widely available...


Although there is a debate among experts over whether alcoholism should be considered a disease, the National Institute on Alcohol Abuse and Alcoholism recognizes alcoholism as a disease. The risk for developing alcoholism is influenced by a person's genes and lifestyle behaviors. Alcoholism is a chronic disease that lasts for a lifetime. If diagnosed and treated early, however, alcoholism may be completely cured and severe complications prevented. Chronic alcohol abuse increases a person's risk for developing serious health problems, such as liver disease, high blood pressure, heart disease, stroke, cancer (especially cancer of the esophagus, mouth, and throat), and pancreatitis. Approximately two million Americans suffer from liver damage caused by alcohol abuse. About 10 to 20 percent of heavy drinkers will develop cirrhosis of the liver, which is characterized by scarring of the liver and causes irreversible damage. If heavy drinkers do not stop drinking, cirrhosis can cause poor...

Alcohol Abuse

ALCOHOLISM is mainly a problem of chronic abuse by adults over the age of 40. It is mainly a problem in northern Italy. Since the 1980s, however, increasing numbers of young people are abusing liquors and beer. Alcoholism has also become complicated by the combining of alcohol with psychotropics (e.g., tranquilizers), especially by women over 40.

Alcoholism Treatment

The influence of Alcoholics Anonymous can hardly be exaggerated. Whatever its therapeutic success a point of warm debate among scholars AA has profoundly affected the treatment of people now regularly known as alcoholics. AA's impact has been both ideological and institutional that is, its promotion of ''disease theory'' within the mutual-aid tradition has changed how recent generations think about excessive or problem-causing alcohol consumption and treatment methods, and the penetration of policymaking bodies and treatment institutions by people recovering from alcoholism has shaped the funding and practices of treatment. AA's impact was facilitated by the growing influence of the mental hygiene movement during the 1920s and 1930s, for AA provided the critical therapeutic bridge between the segregating institution and the community at large. This was recognized quickly by men like Clinton Duffy, the great reform warden of San Quentin, who encouraged the establishment of AA groups in...

Alcohol Dependence

Alcohol abuse becomes alcohol dependence when effects on one's life become more global and tolerance and withdrawal symptoms develop. The alco-holically dependent patient drinks larger amounts over longer periods of time than intended, spends a great deal of time attempting to obtain alcohol, and reduces participation in or eliminates important social, occupational, or recreational activities because of alcohol. In alcohol dependence, there also is a persistent desire or unsuccessful ef forts to cut down or control alcohol intake. The percentage of Americans who abuse alcohol is thought to be high. Two thirds of Americans drink occasionally 12 are heavy drinkers, drinking almost every day and becoming intoxicated several times a month. The Epidemiological Catchment Area study found a lifetime prevalence of alcohol dependence of 14 . The male-female prevalence ratio for alcohol dependence is 4 1. The etiology of alcohol dependence is unknown. Adoption studies and monozygotic twin...

Consumption of Alcohol

In the NDNS, alcohol was consumed by 10 of 1114 year olds and 37-46 of 15-18 year olds with older boys most likely to drink alcohol. Other European surveys have found higher proportions (6090 in 14-18-year-old males), while US surveys have found similar proportions to the UK. The average contribution of alcohol to energy intakes in the NDNS was just over 1 , with higher contributions reported by Danish and Irish studies (around 2-5 energy). Excess alcohol intake can increase micro-nutrient requirements but few younger adolescents fall into this category. However, binge drinking in the 15-18-year-old age group is a concern. One US study found that 20 of adolescents could be classed as problem drinkers, while 7 could be classed as alcoholics. Regular moderate consumption of alcohol can contribute to obesity since the energy provided by alcoholic drinks rarely displaces energy from other food sources. This is likely to increase overall daily energy intakes and could lead to a positive...

Alcohol and Nutrition

The nutritional status of alcoholics is often impaired. Some of the pathophysiological changes seen in alcoholics are direct consequences of malnutrition. However, in the 1960s, Charles Lieber demonstrated that many alcohol-induced pathologies, including alcoholic hepatitis, cirrhosis, and myopathy, are reproducible in animals fed a nutritionally adequate diet. Consequently, the concept that all alcohol-induced pathologies are due to nutritional deficiencies is outdated and incorrect. Myopathy is a direct consequence of alcohol or acetaldehyde on muscle and is not necessarily associated with malnutrition. Assessment of nutritional status in chronic alcoholics using anthropometric measures (e.g., limb circumference and muscle mass) may be misleading in the presence of myopathy.

Effects of Alcohol on the Cardiovascular System

The beneficial, cardioprotective effects of alcohol consumption have been broadcast widely. This observation is based on population studies of mortality due to ischemic heart disease, case-control studies, and animal experiments. However, there is no evidence from randomised controlled trials. The apparent protective effect of alcohol may therefore result from a confounding factor. Furthermore, on the population level, the burden of alcohol-induced morbidity and mortality far outweighs any possible cardiovascular benefit.

Alcohol and Mortality Amount of Alcohol

Several large prospective population studies from many countries have described the impact of alcohol intake on mortality as J-shaped, indicating both the beneficial effect of a light to moderate alcohol intake and a detrimental effect of a high alcohol intake (Figure 1). Some have explained the J shape as an artefact due to misclassification or confounding. Prevailing beliefs among these researchers is that abstainers comprise a mix of former heavy drinkers, underreporting drinkers, ill people who have stopped drinking, and people with an especially unhealthy lifestyle apart from abstaining. However, most researchers attribute the 'J' to a combination of beneficial and harmful effects of ethanol. This is based on findings from population studies of alcohol-related morbidity and cause-specific mortality that show a decreased relative risk of coronary heart disease, and an increased risk of certain cancers and cirrhosis, with increased alcohol intake. Further evidence derives from...

Economic Costs Of Substance Abuse

Rice et al. (1990) produced what is probably the most authoritative work currently available on this topic The Economic Costs of Alcohol and Drug Abuse and Mental Illness 198.5. Among the multiple objectives of the study were the following to estimate as precisely as possible the economic costs to society of alcohol abuse, drug abuse, and mental illness (ADM) for 1985, the most recent year for which reliable data were available to update previous cost estimates, using new data sources and a revised methodology and to develop an improved approach to deal with the issues of COMORBIDITY (the tendency for cases to overlap, that is, for individuals to have problems in more than one ADM category). Briefly, Rice et al. produced ADM cost estimates for 1980, 1985, and 1988. Estimated costs for illicit drug problems (in billions of dollars) were 1980, 46.9 1985, 44.1 1988, 58.3.

Benefits Coronary Heart Disease

A large number of investigators have studied the relation between alcohol intake and coronary heart disease. Studies indicate that the descending leg of the curve is mainly attributable to death from coronary heart disease, as mentioned previously. The lowest risk seems to be among subjects reporting an Alcohol consumption, drinks day Figure 1 Relative risk of death from all causes according to total alcohol intake. Relative risk is set at 1.00 among nondrinkers (0 drinks week). (Reproduced with permission from Boffetta P and Garfinkel L (1990) Alcohol drinking and mortality among men enrolled in an American Cancer Society prospective study. Epidemiology 1 342-348.) Alcohol consumption, drinks day Figure 1 Relative risk of death from all causes according to total alcohol intake. Relative risk is set at 1.00 among nondrinkers (0 drinks week). (Reproduced with permission from Boffetta P and Garfinkel L (1990) Alcohol drinking and mortality among men enrolled in an American Cancer...

Risks Large Number of Somatic Diseases

At the other end of the range of intake, the ascending leg has been explained by the increased risk of cirrhosis and development of certain types of cancers with a high alcohol intake. The mechanisms by which alcohol induces cirrhosis have been intensively studied but sparsely enlightened. It is well documented that women, most likely due to smaller size and different distribution of body fat and water, are at higher risk of developing cirrhosis than men, but other risk factors for alcoholic cirrhosis are not well established (Figure 2). Alcohol consumption, drinks wk Figure 2 Relative risk of alcohol-induced cirrhosis according to sex and alcohol intake. Relative risk is set at 1.00 among nondrinkers (< 1 drink week). (Reproduced with permission from Becker U et al. (1996) Prediction of risk of liver disease in relation to alcohol intake, sex and age A prospective population study. Hepatology 23 1025-1029.) Alcohol consumption, drinks wk Figure 2 Relative risk of alcohol-induced...

Beverage Specific Reporting Bias

Differential beverage-specific reporting bias by high-intake or low-intake consumers using the frequency questionnaire may, to some extent, explain the apparent lower mortality among wine drinkers than among beer and spirits drinkers. A few validation studies have shown the correlation between total alcohol consumption reported by questionnaire and interview to be 0.8. With regard to type of beverage, there was an overall agreement between frequency questionnaire and dietary interview. Thus, most subjects in one consumption category of any type of beverage according to the frequency questionnaire also responded to this category in the interview. Mean differences between intake of all three types of beverages were very small or zero, and there were no systematic differences at different levels of average intakes of any of the types of beverages. These are not true validation studies because neither of the two methods can be considered as reference or 'gold standard.' Thus, alcohol...

Pancreatitis and Pancreatic Insufficiency

Pancreatitis occurs less frequently than liver disease in chronic alcoholics, and is characterized by severe attacks of abdominal pain due to pancreatic inflammation, while pancreatic insufficiency is due to the eventual destruction of pancreatic cells that secrete digestive enzymes and insulin. This destructive process is associated with progressive scarring of the pancreas together with distortion and partial blockage of the pancreatic ducts, which promote recurrent episodes of acute inflammatory pancreatitis. Since the pancreas is the site of production of proteases and lipases for protein and lipid digestion, destruction of more than 90 of the pancreas results in significant malabsorption of these major dietary constituents, as well as diabetes secondary to reduced insulin secretion. Consequently, patients with pancreatic insufficiency exhibit severe loss of body fat and muscle protein. Since the absorption of fat-soluble vitamins is dependent upon pancreatic lipase for...

Body Weight and Energy Balance

The effects of alcohol on body weight are dependent upon the timing and amount of alcohol consumption in relation to meals and on the presence or absence of organ damage, in particular alcoholic liver disease (Table 2). Whereas body weight is usually unaffected by moderate alcohol consumption, chronic alcoholics who drink daily while substituting alcohol for other dietary constituents lose weight due to the energy neutral effect of alcohol in the diet. Moderate drinkers on weight loss regimens are less likely to lose weight while consuming alcohol with their meals since one effect of alcohol is to decrease restraint over food intake. At the same time, those who consume alcohol with high-fat meals are more likely to gain weight due to an acute effect of alcohol on reducing the oxidation of fat at the same time as it promotes its storage. Increase weight Heavy drinking

Addictive Personality The term

Addictive personality has been used in various ways, most commonly to refer to a recurrent pattern observed in many alcoholics and other substance abusers impulsivity, immaturity (dependency and neediness), poor frustration tolerance, anxiety, and depression. Many of these features disappear during extended periods of abstinence, however, suggesting that they may be either related directly to the drug use, to the life it imposes, or to social response, rather than to personality. Addictive personality more accurately preaddictive personality has also been used to refer to personality characteristics presumed to predate drug use and as such are predictive of such use. These aspects of personality are likely to include early difficulties in impulse control and submission to authority and sensitivity to anxiety and depresssion. ings and methodological issues (pp. 101-113). Washington, DC Hemisphere Publishing. Vaillant, G. E. (1983). The natural history of alcoholism. Cambridge Harvard...

Alcohol Use By Americans

In a survey conducted in 1996, 109 million Americans age 12 and older had used alcohol in the previous month (51 of the population). About 32 million people (15.5 ) engaged in binge drinking, defined as five or more drinks on the same occasion. Of these, about 11 million Americans (5.4 ) were heavy drinkers, defined as five or more drinks on the same occasion on at least five different days in the past month. The percentage of college freshmen who say they drink beer frequently or occasionally was 51.8 percent in 1998. Among all college students, the overall binge-drinking rate has stayed constant between 1993 and 1999 at 44 percent, but frequent binge drinkers rose from 20 percent in 1993 to 23 percent in 1999. The Bureau of Alcohol, Tobacco and Firearms (ATF), in 2000, estimated that 14 million U.S. residents suffer from alcohol abuse and dependence, and 76 million are affected by the alcoholism of a family member. Another cause for concern is that the level of alcohol use in 1996...

Beverage Alcohol Per Capita Consumption

From 1980 to 1989, there was a 12 percent decrease in per capita ethanol (drinking alcohol) consumption the only sustained decrease since Prohibition down to 2.43 gallons per person. The greatest decrease was seen in the consumption of distilled spirits. The U.S. Department of Health and Human Services has an objective for the year 2000 To reduce the per capita alcohol consumption to no more than two gallons of etha-nol (drinking alcohol) per person annually.

Socioemotional Well Being

African-American male adolescents are more likely than their European-American counterparts to be labeled conduct disordered or antisocial to be disciplined, suspended, or expelled from junior high and high school and to be arrested and incarcerated. Some of these differences appear to reflect racial bias resulting in more harsh treatment of African-American adolescents for comparable offenses. Generally, studies of self-reported delinquency find no race differences. For several decades, however, the rate of death from homicide has been higher for African-American male adolescents than European-American adolescents. In annual national surveys conducted since the early 1980s, African-American adolescents, compared to European-American and Hispanic adolescents, consistently reported the lowest level of marijuana use, the lowest prevalence of alcohol use and binge drinking, and the lowest level of cigarette smoking. School-based surveys probably underestimate drug use by African-American...

Alcohol and CHD mortality

The observed relationship between alcohol intake and CHD death has been reported to be linear (direct or inverse), L-shaped, U-shaped, or showing no relation. In the 5-year follow-up study of 4,532 middle-aged Finnish men 30 , non-drinkers had the lowest CHD mortality. Increased alcohol intake was associated with increased age-adjusted CHD mortality, especially in men with prior CHD. The opposite was reported in the post-trial follow-up of the Multiple Risk Factor Intervention Trial 25 , The original 5-year trial was to determine the effects of multifactor intervention on death from CHD in a population of high-risk men randomly assigned either to a special intervention program or to their usual sources of medical care in the community. The post-trial follow-up was conducted in 11,488 men who did not develop CHD and survived to the end of the trial. A reverse dose-response relationship between alcohol intake and CHD death rate was found 25 , Many studies have found an L-shaped pattern...

Fightor Flight Response

Alcohol lowers levels of serotonin in the brain, and many alcoholics have dreamless sleep, devoid of rapid eye movement activity. When alcoholics withdraw from alcohol, many experience delirium tremens (DTs), manifest by shaking, sweating profusely, anxiety, and hallucinations. Alcohol depletes the brain of serotonin, the levels of which may rise to higher than normal levels with the withdrawal of alcohol. Excessive production of serotonin is thought to cause the hallucinations, which characterize DTs. Serotonin deficiency is related to a broad array of emotional and behavioral problems, ranging from depression, premenstrual syndrome, anxiety, alcoholism, insomnia, violence, aggression, suicide, and compulsive gambling.

Alcohol And Its Complications In The Elderly

Health-care costs for a family with an alcoholic member are typically twice those for other families, and up to half of all emergency-room admissions are alcohol-related. Alcohol abuse contributes to the high health-care costs of elderly beneficiaries of government-supported health programs. In general, the medical complications of alcohol abuse observed in older individuals are the same as those found in younger alcoholics. They include alcoholic liver disease, acute and chronic inflammation of the pancreas, gastrointestinal (affecting the stomach and intestines) bleeding and other GI-tract diseases, an increased risk of infections, and disturbances in metabolism. The elderly tolerate GI bleeding and infection less well than do younger persons. They are particularly prone to vitamin deficiencies, malnutrition (that is to getting too few calories overall and consuming too little protein on a daily basis), anemia, loss of bone mass (lighter, weaker bones are more apt to break),...

Alcohol and sudden cardiac death

Evidence for a strong association between alcohol and sudden death has been reported among problem drinkers 37,38 , Findings among population studies published in the 1980s were, however, inconsistent. A positive association between alcohol consumption and the incidence of sudden coronary death was detected in the cohort of 4,532 Finnish men with or without prior CHD 30 , No association was found in the Puerto Rico Heart Health Program 10 , the Yugoslavia Cardiovascular Disease Study 11 , and the Framingham Heart Study 39 , The numbers of sudden deaths were small in these reports, however. In the Physicians Health Study, men who consumed light-to-moderate amounts of alcohol (2-6 drinks per week) had a significantly reduced risk of sudden cardiac death compared with those who rarely or never consumed alcohol 16 . Only 3 of the physicians drank 2 or more drinks per day. Men in this open-end category had neither an increase nor a reduction in risk. About 11 of men in the British Regional...

Precautions While Using Alcohol

Patients with liver disease and GI ulcers should not use alcohol. Alcohol should be avoided by patients with damage, caused by previous drinking, to the heart muscle or other muscles. Clearly, it should be taken only in strict moderation or not at all. For older individuals who have no medical reasons to the contrary and who take no drugs (prescription or over-the-counter or illegal) that interact with alcohol, one drink a day is a prudent level of alcohol consumption. In general, the use of alcohol in the presence of any particular disease or medication is a matter that the physician and patient must decide.

Alcohol And Drug Abuse In The Elderly

It is very difficult to determine the actual incidence of combined drug and alcohol use by the elderly, but it is likely to be reasonably high for the following reasons the average adult over sixty-five takes two to seven prescription medicines daily in addition to over-the-counter medications most elderly persons do not view alcohol as a drug and therefore falsely assume that modest amounts of alcoholic beverages can do little harm to an already aged body and few elderly persons hold to the traditional notion that mixing alcohol and medications will have bad consequences. Certainly not every medication reacts dangerously with alcohol however, a variety of drugs interact consistently. The most dangerous of these reactions occurs when alcohol is combined with another CNS depressant. Since alcohol itself is a potent CNS depressant, its use with antihistamines, barbiturates, sedative-hypnotics, or other mind-altering drugs adds to and reinforces synergistic CNS-depressant effects,...

Treatment of Folate Deficiency

If the deficiency is nutritional it is usually treated in the first instance with dietary supplements. In the past, daily supplements of 5.0mgday_1 have been used but more recent evidence suggests that such high levels would only be appropriate for the immediate treatment of an overt deficiency. More long-term treatment would recommend dietary changes to improve folate intake. In practice, to achieve effective changes is very difficult so the recommendation might be to improve intake through foods fortified with the synthetic form of the vitamin, namely folic acid, or the use of supplements of folic acid. In both of these instances the aim is to achieve a maximum increased intake via folic acid of 400 mgday-1. Long-term ingestion of larger amounts are not recommended because of their ability to mask the diagnosis of vitamin B12 deficiencies (discussed above). Other causes of folate deficiency are treated by removing the cause, e.g., alcohol abuse.

Alcohol And Aids Alcohol and AIDS

Neuroimmune effects of alcohol and its role in AIDS. Advances In Neu-roimmunology 3 (1993) 151-162. Watson, R. R. et al. Alcohol, immunomodulation, and disease. Alcohol and Alcoholism 29 (1996) 131-139. Watson, R. R., ed. Nutrition and AIDS II. CRC Press in Press, 2000.

Environmental Factors

Additional variables have been associated with an increased risk of ovarian cancer. An example is saturated fat consumption (OR 1.20 for each 10 g day of intake 95 CI 1.03 to 1.40 P .008).35 Clinical and epidemiologic studies have conflicting views on an association between ovarian carcinoma and talcum powder use.36,37 Coffee and tobacco consumption has not been found to be associated with an increased risk.38 Obesity is a risk factor for several hormone-related cancers, but evidence of an effect on risk of epithelial ovarian cancer remains inconclusive. Some studies have shown a positive correlation between early adulthood obesity and ovarian cancer.39 Alcohol consumption has not been associated with increased risk.40,41 A history of pelvic inflammatory disease and endometriosis (endometrioid and clear cell histologies) has been associated with ovarian cancer.42,43

Tolerance Dependence And Abuse

Like tolerance, dependence on ethanol can develop after only a few weeks of consistent intake. The degree of dependence can be assessed only by measuring the severity of the withdrawal signs and symptoms observed when ethanol intake is terminated. Victor and Adams (1953) provided perhaps one of the best descriptions of the clinical aspects of ethanol dependence. Patients typically arrive at the hospital with the ''shakes,'' sometimes so severe that they cannot perform simple tasks by themselves. During the next twenty-four hours of their stay in the hospital, an alcoholic might experience hallucinations, which typically are not too distressing. Convulsions, however, which resemble those in people with epilepsy, may occur in susceptible individuals about a day after the last drink. Convulsions usually occur only in those who have been drinking extremely large amounts of ethanol. If the convulsions are severe, the individual may die. Many somatic effects, such as nausea, vomiting,...

Inherent weakness in observational studies

Consistency is often cited as one of the criteria making an observed association more likely to be causal. However, results from studies with the same design can be wrong or artefactual and remain consistent. Most population studies rely on volunteers. This may bias the study samples toward cooperative persons, who are, perhaps, more health conscious than nonparticipants. The heaviest drinkers are not likely to be included in the large cohort studies and this may diminish the role ofheavier drinking in the overall results. Studies on the highly educated and health conscious groups 12-19,29,35 are more likely to miss the up-turn of a J-shaped relationship between alcohol and outcome. The most fundamental weakness in the observational studies is that the preference and quantity of alcohol intake are entirely self-determined by the participants. Hence, all reports on the benefit of small-to-moderate alcohol consumption to cardiovascular disease reduction are referenced to those who are...

Ethanol Absorption and Metabolism

Because the ethanol molecule has a hydroxyl group, its metabolism involves dehydrogenase enzymes. After some metabolism in the stomach and intestine, it is transported to the liver for further metabolism. Alcohol dehydrogenase produces acetalde-hyde, which causes many of the indirect effects attributed to ethanol. Because females metabolize alcohol less efficiently in the stomach wall than males, their exposure can be higher, with more direct consequences, from the same amount of alcohol consumption. Ethanol is also metabolized by the liver cells' MEOS system. Ethanol also affects the transportation of proteins across membranes in the cell. Thus aldehyde dehydrogenase's transportation into the mitochondria from the cell's cytoplasm is retarded. This reduces the oxidation of acetaldehyde to acetic acid, and increases ethanol's Cocaethylene and Drug Metabolism. When alcohol and cocaine are ingested together, the ''high'' is accentuated. Ethanol can react with COCAINE via the enzyme...

The Twentieth Century

World War I prompted national austerity programs in many countries that curtailed the diversion of foodstuffs to alcoholic beverages but didn't quite reach the full prohibition for which the United States became famous. Absinthe was thought to be medically so dangerous that it was banned in several European countries, and Iceland banned beer but not wine or liquor. Sweden experimented with rationing, and the czar again tried prohibition in Russia. The worldwide economic depression of the 1930s appears to have slowed the growth of alcohol consumption, which grew rapidly during the economic boom that followed World War II. The Scandinavian countries, beset by a pattern of binge drinking, often accompanied by violence, tried a variety of systems of regulation, including state monopolies, high taxation, and severely restricted places and times of sale, before turning to large-scale social research. In the middle decades of the twentieth century, a number of alcoholics formed a mutual-help...

Negative Consequences

In the early 1990s, it was estimated that between 7 and 10 percent of all individuals drinking alcoholic beverages will experience some degree of negative consequences as a result of their drinking pattern. Most people believe that chronic excessive drinking results in a variety of behavioral consequences, including poor work school performance and inappropriate social behavior. These two behavioral criteria are used in most diagnostic protocols when determining if a drinking problem exists. Several surveys have found that heavy chronic drinking does produce a variety of school- and job-related problems. A survey of personnel in the U.S. armed services found that for individuals considered heavy drinkers, 22 percent showed job-performance problems. Health professionals also show high rates of alcohol problems, with a late 1980s British survey indicating that physicians experience such problems at a rate of 3.8 times that of the general population. A variety of surveys have...

Utility of Event Related Potentials in Substance Abuse Research

Because many of the illnesses believed to have genetic components are characterized by some type of abnormal brain function, it has been postulated that abnormalities in latency, amplitude or topography of ERP components could serve as markers of genetic vulnerabilities. To date, most of the data supporting this notion in substance abuse is in the area of alcoholism. The P300 is a good candidate as a biological marker because there is ample evidence to indicate that its generation is genetically determined (Begleiter et al., 1998) and a number of studies have found that young children with a family history of alcoholism have significantly reduced P300 amplitudes before ever being exposed to alcohol compared with children without such a history (Begleiter et al., 1984, 1987 Porjesz and Begleiter, 1990). In addition, findings of reduced P300 amplitudes in chronic (Porjesz et al., 1980) and recovering (Porjesz et al., 1987) alcoholics further support the notion that that P300 amplitude...

The Process Of Affiliation

Affiliation is a process, not a single, unitary happening within AA. Its elements and phases act to select and make ready certain alcoholics and problem drinkers for affiliation, leaving behind others with less readiness. The process begins before the problem drinker ever goes to a meeting (Trice, 1957). If the person has heard favorable hearsay about AA if long-time drinking friendships have faded if no will-power models of self-quitting have existed in the immediate background and if the drinker has formed a habit of often sharing troubles with others the stage is set for affiliation. It is further enhanced if, upon first attending meetings, the person has had experiences leading to the decision that the troubles associated with drinking far outweigh the pleasures of drinking (i.e., ''hitting bottom''). Typically, this means that affiliates, contrasted with nonaffiliates, had a longer and more severe history of alcoholism and those with more severe alcohol problems are more likely...

Therapeutic Mechanisms

As with psychotherapies in general, the effectiveness of AA has not been convincingly established. For example, some problem drinkers drop out after the first two or three AA meetings. Nevertheless, for those who remain, AA has unique and distinctive features that contribute to its therapeutic effectiveness. By definition, as problem drinkers move into addiction, alcohol comes to be central to their lives. How can this centrality be reduced and a new conception of alcohol be put in its place AA experiences provide a new orientation, not only to alcohol, but to self and to others. ''One of A.A.'s great strengths lies in the quality of its social environment the empathetic understanding, the acceptance and concern which alcoholics experience there which, along with other qualities, make it easier to internalize new ways of feeling, thinking, and doing'' (Maxwell, 1982). Even brief exposure to AA introduces the alcoholic to the idea that self-regulation seems to be rarely achieved alone...

Adaptation Of Aa To Other Disorders

(SEE ALSO Alcoholism Gambling as an Addiction Treatment) Alcoholics Anonymous. (1939, 1955, 1976). Alcoholics Anonymous The story of how many thousands of men and women have recovered from alcoholism. New York Alcoholics Anonymous World Service. Alcoholics Anonymous World Service. (1993). A.A. directory, 1992-1993. New York Author. Emerick, C. (1989a). Overview Alcoholics Anonymous. In M. Galanter (Ed.). Recent developments in alcoholism Treatment research. Vol. 7. New York Plenum. Emerick, C. (1989b). Alcoholics Anonymous Membership characteristics and effectiveness as treatment. In M. Galanter (Ed.), Recent developments in alcoholism Treatment and research. Vol. 7. New York Plenum. KhantZIAN, E. J., & Mack, J. E. (1989). Alcoholics Anonymous and contemporary psychodynamic theory. In M. Galanter (Ed.) Recent developments in alcoholism Treatment research. New York Plenum. Maxwell, M. (1982). Alcoholics Anonymous. In E. Gomberg, H. R. White, & A. Carpenter (Eds.), Alcohol,...

Stanton Peele Revised by Kimberly A McGrath

Origin of the Term The term alcoholism is of relatively recent date knowledge of the adverse effects of heavy alcohol (ethanol) consumption is not. A proverb describes alcohol as ''both mankind's oldest friend and oldest enemy.'' Alcohol occurs in nature, and humans have long known how to ferment plants to create it both its moderate and excessive use have therefore occurred since prehistory. The Bible cautions ''Do not look at wine when it is red, when it sparkles in the cup and goes down smoothly. At the end it bites like a serpent and stings like an adder'' (Proverbs 23 3132). A drunken Noah (Genesis 9 20-28) is one of a long line of such literary descriptions. In the classical era of the Greeks and the Romans we have drunks in the Character Sketches of Theophrastus, in the Satyricon of Petronius Arbiter, and in the Epistles of Seneca. In the 1600s, we have Shakespeare's porter in Macbeth (Act II, Scene 3) and others. Viewing the long-term adverse effects of alcohol as a disease is...

Drinking patterns and beverage types

Drinking patterns have been studied surprisingly little. Yet, drinking patterns vary and are of obvious health relevance. The frequency of drunkenness, the frequency ofhangover and morning drinking have been found to be related to mortality from several causes 54 , Changes in drinking between years may influence mortality 9,55 . Most reports classify participants using a total consumption variable (e.g., drinks per day) based on estimates of customary drinking frequency and amount of alcohol consumed on a typical occasion. This does not quantify variability in drinking frequency or amount consumed binge drinkers may be classified with controlled, regular drinkers on the basis of their common average daily alcohol intake. Because the health effects of moderate drinking may depend on drinking pattern, failure to differentiate between binge drinkers and regular drinkers may obscure real associations. Type ofbeverage may have a role even if the amount of ethyl alcohol imbibed is the same....

What is moderate drinking

While it is generally agreed that we should do all things in moderation 58 , there is less agreement about the precise definition of 'moderate' drinking. Use of different sets of drinking categories in different reports has resulted in different interpretations, and the number and boundaries of categories appears to be determined by the sample size available in the study. Classification of moderate alcohol consumption ranges from a half a drink per day (or less) in some studies, up to six drinks a day in others 59 , Data from the National Health Interview Survey 52 demonstrated that people with different drinking habits perceived 'moderate' drinking differently. Only 25 of men who drink 3 or more drinks per day, in comparison to 56 of other men, considered 2 or fewer drinks per occasion as moderate. Likewise, only 6 of the women who drink at least 2 drinks per day (vs. 27 of other women) perceived moderate drinking as 1 drink or less per occasion. The National Health and Medical...

Methodological Considerations

It is well known that energy intake is underreported in national surveys (Cook et al., 2000 Mertz et al., 1991 Schoeller et al., 1990). Estimates of underreporting of energy intake in the Third National Health and Nutrition Examination Survey were 18 percent of the adult men and 28 percent of the adult women participating (Briefel et al., 1997). Underreporters indicated that their fat intake was approximately 30.5 percent calories, whereas adequate reporters indicated a fat intake of 35 percent of calories. In addition, alcohol intake, which accounted for approximately 4 percent of the total energy intake in men and 2 percent in women, is thought to be routinely underreported as well (McDowell et al., 1994).

Some statistical issues

The non-continuous feature of the measures of drinking habit has limited studies on the alcohol-health relationship to categorical analyses. The categories selected, the number of categories, and the distance between the categories were determined by the available data, the sample sizes and number of outcome events. The clear demonstration of a U- or J-shaped relationship requires a much larger amount of data than is generally appreciated. Some studies have combined all cardiovascular diseases or all types of stroke as the endpoint. This is often necessary because of the small numbers of cases for some of the diagnostic endpoints, but might result in partial cancellation of positive and negative associations. Furthermore, as the result of a loss of power in the categorical analysis, many reports drew conclusions based on visual observation on the trends in relative risks by drinking categories and ignored the results of formal statistical tests. Another drawback of the categorical...

Alcohol and Substance Use Disorders

The very high comorbidity of these disorders with the bipolar spectrum cannot be explained away as the chance occurrence of two prevalent disorders 96, 224, 225 . This is particularly true for the high lifetime cooccurrence of bipolarity and alcohol abuse. Self-medication for subthreshold bipolar symptoms is insufficiently appreciated by both psychiatrists and substance use disorder experts. Whereas stimulants can be used to enhance hypomania 110, 226-228 , alcohol can both enhance or calm down excited mood states. The present author believes that a modest amount of daily alcohol may have some therapeutic value in a subgroup of bipolar patients. This can perhaps be inferred from the fact that bipolar disorder following alcohol abuse usually manifests a decade later than bipolar disorder without such abuse 97 however, one cannot rule out the possibility that the protracted use of alcohol may have played a formative influence on the bipolar disorder in such cases. Given the clinical...

Antisocial Personality Antisocial

A large percentage of alcohol and drug abusers meet criteria for ASP. For example, in one multisite study of 20,000 community respondents, 15 percent of the alcoholic participants compared to 2.6 percent of the population as a whole, met criteria for ASP. Comparable data from clinical samples indicate that from 16 percent to 49 percent of treated alcoholics met criteria for ASP. The course of alcohol or drug abuse is affected by ASP. Alcoholics with ASP have a more chronic and more severe course, an earlier onset of alcohol symptoms (for example, average age of onset of 20 compared to nearly 30 for those without ASP), as well as a significantly longer history of problem drinking. Furthermore, evidence is mounting that ASP alcoholics have poorer response to treatment relapsing much earlier than alcoholics without ASP and they may respond only to certain therapies. Antisocial behavior problems in childhood have been identified as an independent risk factor in the development of...

Genuine Alcoholic Cardiomyopathy Asymptomatic Type

There is ample evidence that acute or chronic alcohol ingestion may be a myocardial depressant. There is also evidence that acute or chronic alcohol ingestion may be a skeletal muscle depressant. In one study in asymptomatic alcoholics, almost one third of the men and half of the women showed histologic evidence of deltoid muscle myopathy with accompanying muscle weakness and depression of ejection fraction . Low doses of ethanol, even as little as two cocktails, have been shown to be able to decrease myocardial contractility in normal subjects 2-5 , If the subject is alcoholic or already has some cardiac muscle disease on which alcohol is superimposed, the depressant effect of acute alcohol ingestion is exaggerated 6,7 , Partly responsible for the deleterious effects of alcohol in patients who have cardiac disease is the finding that in such patients alcohol acts as a vasoconstrictor 8 , However, when a decreased afterload is necessary for improving the function of a heart in Class...

Assessment Of Substance Abuse Drug Abuse Screening Test Dast

The DAST was modeled after the widely used Michigan Alcoholism Screening Test (Selzer, 1971). Measurement properties of the DAST were initially evaluated using a clinical sample of 256 drug-alcohol-abuse clients (Skinner, 1982). The 20-item DAST has excellent internal consistency reliability (alpha) at 0.95 for total sample and 0.86 for the drug-abuse sample. Good discrimination is evident among clients classified by their reason for seeking

Abuse Of Tranquilizers

Only a few patients prescribed benzodiazepines push the dose up above recommended levels. If this happens, the user may become intoxicated, with slurred speech and incoordination. Some people with alcohol problems also abuse benzodiazepines. Intravenous (IV) injection of benzodiazepines and hypnotics has become an increasing problem and has led to controls on these drugs concerning manufacture and prescription in various countries, including the United States and the U.K. Some addicts abuse benzodiazepines alone others combine it with heroin-type drugs. Injection of benzodiazepines can result in clotting of the veins. It also carries the risk of getting infectious diseases from sharing dirty syringes, such as hepatitis and the human immunodeficiency virus (HIV or the AIDS virus).

British Regional Heart Study

In 1978-80, research nurses administered to each man a standard questionnaire which included questions on frequency, quantity and type of alcohol consumption, smoking habits and medical history. Several physical measurements were made, and blood samples (non-fasting) were taken for measurement of biochemical and haematological variables. All men were followed up for all-cause mortality and cardiovascular morbidity 21 Analysis was restricted to men with no recall of a doctor diagnosis of CHD or stroke (N 7272 men) in whom there were 901 major CHD events and 1308 deaths from all causes (595 cardiovascular and 713 non-cardiovascular) during a mean follow-up period ofl6.8 years. The men were classified into five groups according to their estimated reported weekly intake none, occasional (< 1 unit week), light (1-15 units week) moderate (16-42 units week) and heavy (> 42 units day). One UK unit of alcohol (one drink) is defined as half a pint ofbeer, a single measure of spirits, or a...

Causes of Birth Defects

Several birth defects can be traced to a mutation in a single gene or chromosome (e.g., neurofibromatosis type 1 and cystic fibrosis) or environmental influence (e.g., thalidomide, rubella virus, and ionizing irradiation), but most are due to a combination of these factors. This is referred to as multifactorial inheritance. Neural tube defects and orofacial clefts (cleft lip and cleft palate) are two types of anomalies that are thought to have a multifactorial cause in most instances. Cleft lip, which results from an incomplete development of the lip, and cleft palate, which is an incomplete development of the roof of the mouth, may occur singly or in combination with each other. Cleft lip with or without cleft palate occurs more often than cleft palate alone, but infants with cleft palate alone are much more likely to have birth defects that involve other organ systems and are more likely to have chromosomal anomalies. Although these conditions can be remedied through surgery, speech...

Consequences of Birth Defects

Have shown that families of children with birth defects may experience more distress, as measured by higher levels of mental health treatment, than families of children without birth defects. These families, however, are no more prone to divorce, social isolation, or alcohol problems than families without a child affected by a birth defect.

Skills Training For Young People

Trips, camps, foreign travel Problem solving (including contingency planning) What would do if your arthritis flared and you were away from home What might you do if your friends are drinking alcohol at a party and you are still taking methotrexate What would you do if you didn't get accepted to a university How would you disclose your condition to a potential employer Accessing advice from

Kenneth Silverman Roland R Griffiths

CALCIUM CARBIMIDE Citrated calcium carbimide is a mixture of two parts citric acid to one part calcium carbimide it slows the metabolism of ALCOHOL (ethanol) from acetaldehyde to acetate, so it is used in the treatment of ALCOHOLISM. It is also known as calcium cyanamide. As an antidipsotropic an antialcohol or alcohol-sensitizing medication, it has been used for treatment in Canada, the United Kingdom, and Europe since its introduction for clinical use in 1956. Its only therapeutic use is for the treatment of alcoholism. In Canada it is sold under the brand name Temposil. As of 2000, however, calcium carbimide is still not approved for use in the United States.

Canada Drug And Alcohol

Tional survey found that 76.8 percent of Canadian adults aged 15 and over were current drinkers (who had consumed ALCOHOL at least once in the past year) an additional 13.5 percent said they were former drinkers, while only 9.7 percent said they never drank. Per-adult consumption was about 450 drinks per year (7.64 l) of absolute alcohol (ethanol). Overall alcohol consumption has decreased in Canada since the 1980s. High school students and street kids reported the use of numerous illegal drugs, such as LSD, HALLUCINOGENS, speed, heroin, glue and other INHALANTS, or made nonprescription use of stimulants, Barbiturates, and tranquilizers. Most indigenous youth smoke and have rates of alcohol problems and illicit drug use several times higher than the national average. Almost all street youth in Toronto used alcohol and one or more illicit drugs.

Drugs Of Abuse And Cancer

Between alcohol consumption and cancer of the digestive tract, primarily cancer of the oral cavity, the pharynx (nasopharynx excluded), and the larynx all two to five times more likely in alcoholics the esophagus two to four times more likely and the liver liver cancer was increased 50 percent, with primary liver cancer increasing twofold to threefold. These findings persisted, even after adjusting for the effects of smoking, with the relative risk for cancer increasing with the amount of alcohol consumed.

Causes Of Substance Abuse This

Section contains articles on some of the many factors thought to contribute to substance use, abuse, and dependence. It includes discussions of Drug Effects and Biological Responses, Genetics Learning, and an article on the Psychological (Psychoanalytic) Perspective. Sociocultural causes and Vulnerability, are discussed in several articles throughout the Encyclopedia, for example, Ethnicity and Drugs, Families and Drug Use, Poverty and Drugs. See also the article Disease Concept of Alcoholism and Drug Addiction and the section on Vulnerability.

Everett H Ellinwood G R King

Genetic Factors Why do some people become alcoholics or drug addicts, while others who try the same substances, even to excess, avoid the snare of dependence Could there be a genetic basis for such behavior Given the strong familial patterns of substance abuse that often occur, the answer may be yes in some cases. Evidence points toward at least one inheritable form of ALCOHOLISM a genetic vulnerability to drug abuse has not been confirmed by research, although it may exist. Researchers know that many environmental and psychological factors are implicated in addictions, including a dysfunctional family, poor academic performance, delinquent behavior, and perhaps most importantly, easy access to drugs. The abuser's personality is also a factor, and alcoholics, in particular, often exhibit similar traits an inability to handle frustration, extreme sensitivity, poor self-image, and isolation. While some of these qualities may be inherited, they do not prove a direct genetic link to...

Sample And Control Variables

Many factors affect a person's susceptibility to drug abuse, which makes studying the genetic bases for addiction difficult, particularly where drug addiction is concerned. Studies must match control and drug-abusing populations adequately, and the sample size must be large enough to detect small genotype changes from background influences. Individual variables (such as severity of dependence) need to be consistent between research groups. It's also difficult to determine whether an individual currently in the control group will express addictive behavior in the future. For these and other reasons, scientists have been unable to prove a definitive link between an individual's genetic makeup and a tendency to substance abuse, although they strongly suspect its existence, especially in the more severe forms of alcoholism and drug dependence. Hesselbrock, M. M., & Keener, J. (1985). Psychopa-thology in hospitalized alcoholics. Archives of General Psychiatry, 42, 1050-1055.

George R Uhl Revised by Amy Loerch Strumolo

Learning The role played by learning factors in drug and alcohol abuse has recently received much attention. Two basic learning mechanisms are thought to be activated when an organism repeatedly self-administers a psychoactive substance. First, classical conditioning processes are engaged when environmental stimuli signal the upcoming effects of the drug. Second, operant conditioning occurs as an organism learns that particular behaviors lead either to a drug reward or to punishment. The effects of these two processes presumably interact, and they are thought to influence repeated drug use and or relapse to drug use following a period of abstinence.

Selfregulation Vulnerabilities

Although the self-medication hypothesis has gained wide acceptance as an explanation for drug alcohol dependency, it is not without its critics and it fails to deal with at least two fundamental problems or observations that it does not explain or address. First, many individuals suffer with the painful feelings and emotions that substance abusers experience, but they do not become addicted or alcoholic. Secondly, the self-medication hypothesis fails to take into account that addicted and alcoholic individuals suffer as much if not more as a result of their drug alcohol use, and this might appear to contradict the hypothesis that substances are used to relieve suffering. Finally, deficits in self-care (again deriving from early-life developmental problems) make it likely that certain individuals will become involved with hazardous activities and relationships that lead to drug experimentation, use, and dependence. Self-care deficits refer to a major self-regulation problem, wherein...

Incidence And Prevalence Of Drug Abuse

Drug Abuse (NIDA), and the National Institute on Alcoholism and Alcohol Abuse (NIAAA). The Children of Alcoholics Foundation estimates that in the U.S. population about one in eight were raised in homes with one alcoholic parent. Studies suggest that as many as 11 percent of newborns are drug-exposed in utero. About six million women of childbearing age are marijuana users and 10,000 children per year are born to women using opiates. Polydrug use and frequent use of alcohol and other drugs by parents increases the difficulty of researching any causal relationships between a specific drug and child abuse.

Relationship Of Child Maltreatment And Atod Abuse

Do addicted parents abuse their children more Do both addicted and nonaddicted parents abuse their children more when using alcohol or drugs Unfortunately, clear empirical research is lacking on the relationship of child abuse and alcohol abuse or child abuse and drug abuse. The validity of existing research is threatened by problems, such as unclear definitions of ATOD abuse, lack of control groups or longitudinal causal studies, and inappropriate statistical and research design techniques for separating causation and coincidence (Bays, 1990). Nevertheless, a relationship does exist between child abuse and ATOD abuse and definitely between ATOD abuse and child neglect. Similar risk factors for child abuse exist for both child-abusing parents and substance-abusing parents, adult. In addition, infants can ingest alcohol, nicotine, and other drugs through breast milk. Passive inhalation of tobacco is recognized as a health hazard to children however, passive inhalation of CRACK...

Effectiveness of Self Regulatory Processes

The importance of identifying specific goals was examined peripherally in the meta-analytic review. Nonetheless, identifying specific goals can be expected to have a positive effect on outcome. This question has been addressed in the literature examining the effects of abstinent versus controlled drinking as target outcomes in individuals with alcohol abuse problems. If abstinence is a more specific goal than controlled drinking, studies that evaluate these two approaches should favor the former. In fact, however, outcomes vary depending on the study. Hodgins, Leigh, Milne, and Gerrish (1997) found that choosing an abstinence goal produced better results than choosing moderate drinking. Ojehagen and Berglund (1989), on the other hand, found that individuals with an abstinence goal drank more during heavy drinking days than patients with controlled drinking goals, an outcome explainable by the abstinence violation effect.

Richard F Catalano Tracy W Harachi

CHLORAL HYDRATE Chloral hydrate is one of the oldest sedative agents still in use. It was made by the German chemist Liebig in 1832 and introduced into general use in 1869 as a substitute for Laudanum, an alcoholic solution of Opium. Chloral hydrate differs from the BARBITURATES in that it is a simple molecule composed of two carbon atoms, three hydrogen atoms, two oxygen atoms, and three chloride atoms. It is the famous (or infamous) substance added to alcohol to make a Mickey Finn, a drink known to cause those who drink it to become unconscious. Because it shares many effects of other central nervous system depressants, it can be used to treat the alcohol withdrawal syndrome. Chloral hydrate was a popular sedative for elderly patients because its effects occur quickly, last only a short time, and leave no nagging hangover effect. However, it is inconvenient to use (up to 2 grams must be taken by mouth) and, after the introduction of the Benzodiazepines, its use has decreased.

Abstinence and Relapse

While most studies of chronic alcoholics have been conducted during the postalcohol period (e.g. during detoxification or abstinence), few studies have employed repeated MR measurements to document brain changes associated with prolonged abstinence or relapse. Several of these studies reported reversibilty of alcohol-induced ventricular enlargements (Schroth et al., 1988 Mann et al., 1989 Zipursky et al., 1989). The Zipursky study also demonstrated ventricular volume stability over time in controls, suggesting that ventricular volume normalization in abstinent alcoholics is associated with abstinence (Zipursky et al., 1989). A study of alcoholic women repeatedly scanned over a 6-week interval noted no ventricular volume changes however, baseline ventricular volumes in those women were nearly normal and abstinence-associated changes may have been too small to detect (Kroft et al., 1991). Subsequent longitudinal studies of abstinent alcoholics reported improved brain white matter,...

Hepatic Cirrhosis and Encephalopathy

Cerebral volume changes including frontal and parietal sulcal width increases were described in nonencephalopathic cirrhotic alcoholics (Moore et al., 1989). Cirrhotic alcoholics were found to have more frontal and parietal lobe morphologic abnormalities than noncirrhotic alcoholics (Barthauer et al., 1992). One study noted associations between brain atrophy and both memory and frontal-premotor function (Kulisevsky et al., 1992). In addition to cerebral volume abnormalities, symmetric globus pallidus T1 hyperintensites have been described in alcoholics with chronic hepatic encephalopathy (CHE) (Zeneroli et al., 1991). Additionally, correlations between pallidal signal intensity and plasma ammonia levels (Kulisevsky et al., 1992), severity of hepatic dysfunction (Pujol et al., 1993), and brain atrophy (Kulisevsky et al., 1993) have been identified. Reversibility of the T1 abnormality was confirmed by a study documenting the disappearance of pallidal T1 hyperintensites following liver...

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