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...

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The Potential Benefits of Moderate Alcohol Consumption

In 1992, French scientists published a report that indicated that cardiovascular mortality was much less among predominantly wine-drinking residents of the Mediterranean southern provinces of France than in northern provinces where wine is less frequently preferred, in spite of similar overall dietary components and rates of consumption of alcoholic beverages (Table 1). This report on the 'French paradox' was assumed to confer specific cardiopro-tective benefit to wine, but was soon tempered by in vitro studies, which showed that the protective effect of wine on the oxidation of low-density lipoprotein could be mimicked by constitutive antioxidant fla-vonoids present not only in grapes but in many other fruits and vegetables. Another epidemiological study concluded that the lower mortality risk among wine drinkers compared to non-wine drinkers could be attributed in large part to a better life style, including less smoking, more exercise, and better diet. Subsequent population studies...

Benzodiazepines in Alcoholics

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.

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. Valmier, J., Touchon, J., Zanca, M., Fauchere, V., Bories, P. and Baldy-Moulinier, M., Correlations between cerebral grey matter flow and hepatic histology in alcoholism. Eur. Neurol. 25 428-435, 1986. Martin, P. R., Rio, D., Adinoff, B., Johnson, J. L., Bisserbe, J. C., Rawlings, R. R., Rohrbaugh, J. W., Stapleton, J. M. and Eckardt, M. J., Regional cerebral glucose utilization in chronic organic mental disorders associated with alcoholism. J. Neuropsychiatry Clin. Neurosci. 4 159-167, 1992. Berglund, M. and Ingvar, D. H., Cerebral blood flow and its regional distribution in alcoholism and in Korsakoff's psychosis. J. Stud. Alcohol 37 586-597, 1976.

Benzodiazepines and Alcoholism

D., Gacinovic, S., Suckling, J., Busatto, G. F., Boddington, S. J., Bullmore, E., Woodruff, P. W., Costa, D. C., Pilowsky, L. S., Ell, P. J., Marshall, E. J. and Kerwin, R. W., Reduced levels of GABA-benzodiazepine receptor in alcohol dependency in the absence of grey matter atrophy. Br. J. Psychiatry 173 116-122, 1998. Streeter, C. C., Ciraulo, D. A., Harris, G. J., Kaufman, M. J., Lewis, R. F., Knapp, C. M., Ciraulo, A. M., Maas, L. C., Ungeheuer, M., Szulewski, S. and Renshaw, P. F., Functional magnetic resonance imaging of alprazolam-induced changes in humans with familial alcoholism. Psychiatry Res. 82 69-82, 1998.

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). Preliminary...

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. Many have thought of this distribution as occurring in two parts. First, there is the great mass of normal drinkers their drinking might be plotted as a bell-shaped curve, with a few people drinking no more than a sip in a year, an increasing number drinking greater amounts than a sip but less than the average amount, and then a declining number drinking more than the average amount, until the graph reaches the normal drinkers who drink much more than the average and these are relatively few in number. Second, there is a much smaller number of abnormal drinkers their drinking distribution also might be plotted as a bell-shaped curve, but this curve is shifted to the right of...

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...

Family History of Alcoholism

Elmasian, R., Neville, H., Woods, D., Schuckit, M. and Bloom, F., Event-related brain potentials are different in individuals at high and low risk for developing alcoholism. Proc. Natl. Acad. Sci. USA 79 7900-7903, 1982. Pollock, V. E., Volavka, J., Goodwin, D. W., Mednick, S. A., Gabrielli, W. F., Knop, J. and Schulsinger, F., The EEG after alcohol administration in men at risk for alcoholism. Arch. Gen. Psychiatry 40 857-861, 1983. Begleiter, H., Porjesz, B., Bihari, B. and Kissin, B., Event-related brain potentials in boys at risk for alcoholism. Science 225 1493-1496, 1984. Begleiter, H., Porjesz, B., Rawlings, R. and Eckardt, M., Auditory recovery function and P3 in boys at high risk for alcoholism. Alcohol 4 315-321, 1987. Ehlers, C. L. and Schuckit, M. A., EEG response to ethanol in sons of alcoholics. Psychopharmacol. Bull. 24 434-437, 1988. Kaplan, R. F., Hesselbrock, V. M., O'Connor, S. and DePalma, N., Behavioral and EEG responses to alcohol in nonalcoholic men with a...

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.

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...

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...

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

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...

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...

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 situations in which drinking will take place. The second phase occurs when the drinker begins to suffer blackouts. He or she seems to be functioning, but later has no memory of what happened. He or she may sneak an extra drink before a party or quickly gulp the first drink or two. The third phase Jellinek described as the crucial phase a time when the individual can control whether he or she takes a drink, but once drinking begins the individual cannot stop. The fourth and final stage is the chronic phase, a period during which drinking occurs almost every day, almost all day long.

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...

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.

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 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

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 (

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. Giancola, P. R., Zeichner, A., Yarnell, J. E. and Dickson, K. E., Relation between executive cognitive functioning and the adverse consequences of alcohol use in social drinkers. Alcohol. Clin. Exp. Res. 20 1094-1098, 1996. Deckel, A. W., Tests of executive functioning predict scores on the MacAndrew Alcoholism Scale. Prog. Neuropsychopharmacol. Biol. Psychiatry 23 209-223, 1999.

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...

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...

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...

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.,...

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...

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

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.

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...

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...

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...

Alcoholism

Liver damage may develop into hepatitis or cirrhosis, a chronic inflammatory disease of the liver. Excessive alcohol use also affects the cardiovascular and nervous systems. Oral effects shown in alcoholics include bleeding gums and easy bruising. Individuals who drink excessively usually have poor oral hygiene habits. Remedies Have professional cleanings frequently. Take vitamins and try to eat properly. Drink plenty of water and reduce your alcohol consumption. Seek counseling for help in reducing alcohol abuse.

Alcohol Abuse

In the late 1980s, serotonin-uptake inhibitors were tested in various animal models of alcoholism including selectively bred alcohol-preferring rats given a choice between water and an alcohol solution and showed consistent decreases in the self-administration of alcohol in a dose-dependent manner. The results of these preclinical studies led to research in human alcohol abusers. In four placebo-controlled, double-blind, randomized clinical trials, serotonin-uptake inhibitors decreased short-term (1 to 4 weeks) alcohol intake by averages of 14 to 20 percent, as compared with pretreatment. No other treatment or advice was given. The effect developed rapidly after a serotonin-uptake inhibitor was administered and disappeared rapidly after discontinuation. All subjects had had mild or moderate (not severe) alcohol dependence but no current or past depression, anxiety, other psychiatric disorder, or other substance-abuse disorder. No aversive interactions with alcohol or changes in...

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...

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 is...

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...

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...

Wernicke and Korsakoffs Syndromes

Wernicke's encephalopathy and Korsakoff's psychosis, or the Wernicke-Korsakoff syndrome, result from nutritional deficiencies, particularly thiamine deficiencies. The syndrome can be precipitated by glucose administration to thiamine-deficient alcoholics. These syndromes are not exclusive to alcoholism, having been documented with MR imaging in nonalcoholic individuals with severe nutritional deficiencies (Doraiswamy et al., 1994) and in patients with thalamic lesions not resulting from alcoholism (Cole et al., 1992). Early studies of alcoholic Korsakoff's syndrome patients indicated increased whole brain and frontal white matter T1 values (Christie et al., 1988 Besson et al., 1989). T1 increases also have been described in several other brain regions in Korsakoff's patients including parietal white matter, caudate nucleus, and thalamus (Emsley et al., 1996). The anatomical change most widely associated with the Wernicke-Korsakoff syndrome is mamillary body atrophy (Fig. 5). This...

Central Pontine Myelinolysis

Central pontine myelinolysis (CPM) is a rarely occurring demyelination syndrome that is characterized by symmetric pontine lesions. It is typically though not exclusively detected in alcoholics. It has been postulated that CPM is induced by rapid correction of the electrolyte imbalance occurring in severe hyponatremia (Brunner et al., 1990). However, CPM occurs in normonatremic or partially hypernatremic patients, and it has been suggested that hypokalaemia may be significant (Bahr et al., 1990). DeWitt et al. (1984) reported the first case of CPM diagnosed with MR imaging, which was characterized by abnormal pontine signals that partially resolved during treatment. Extrapontine lesions have been found in CPM patients in the cerebellar peduncles (Steller et al., 1988), the basal ganglia (Price et al., 1987 Demaerel et al., 1992 Tien et al., 1992) and the thalamus (Rippe et al., 1987 Koci et al., 1990 Demaerel et al., 1992 Tien et al., 1992 Mascalchi et al., 1993). One report...

Cognitivebehavioral Therapy

Cognitive-behavioral treatments represent a group of approaches, grounded in social learning theories of substance abuse, that hold that lack of effective coping skills may be one factor underlying the development or perpetuation of substance use disorders. Cognitive behavioral treatments have been among the most well defined and rigorously studied of the psychosocial treatments for substance abuse and dependence, and have a comparatively high level of empirical support across the addictions. For example, in their review of cost and effectiveness data for treatments for alcohol use disorders, Holder and colleagues (1991) included social skills training, self-control training, stress management training, and the Community Reinforcement Approach (Azrin et al., 1976), all broad-spectrum CBT approaches, as having good empirical evidence of effectiveness. Recent meta-analyses (Irvin et al., 1999) and reviews of the effectiveness of treatments for substance abuse (APA Workgroup on Substance...

What Have Animal Models Taught Us

Animal models of alcoholism have revealed that long-term alcohol consumption is associated with numerous histological and cellular changes in the myocyte. Specific histological changes include myocyte loss and disarray, interstitial and perivascular fibrosis, deposition of lipids with the myocardial tissue, accumulation of fatty acid ethyl esters within intracellular organelles, and mitochondrial and sarcoplasmic reticulum disorganization 22-27 , In terms of cell function, there are reports of altered mitochondrial and sarcoplasmic reticulum function, decreased myofibrillar ATPase activity and decreased calcium sensitivity of the myofilaments 28-32 , In animal models, these changes often precede changes in cardiac structure and function. These studies have been exclusively performed in male animal models. The only exceptions are the studies reported by Lochner and colleagues and Brown and colleagues 33,34 , Therefore, the effects of both acute and chronic alcohol consumption on the...

Ongoing Research In Female Rats

Our laboratory has been studying the effects oflong-term alcohol consumption in both female and male rats. Presented below is preliminary data from our laboratory. The primary aim has been to describe in an animal model (male and female rats) the evolution of alcohol-induced changes in cardiac structure (hypertrophy and dilation) that lead to the development of a cardiomyopathy. The second aim has been to determine if these changes are associated with activation of specific peptide and neurohormonal systems. Preliminary experiments were conducted in male (n 5) and female (n 5) Sprague-Dawley rats which received the Lieber DeCarli liquid diet for 5 months 35 , In brief and as previously described by this laboratory, control (CON) and ethanol (ETOH) groups received the nutritionally complete control or ethanol liquid Lieber-DeCarli diet 31,32 , The males received an ethanol diet (9 v v), which provided up to 42 of their total daily caloric intake orl3.0 gm ethanol kg day. However, the...

Predisposing Factors for Heat Illness

Certain segments of the population are at greater risk for dehydration and subsequent heat illness than others (Table 5). The predisposing factors for dehydration and heat illness in these populations are obesity (extra exertion, heat production, and sweating are required to move a larger mass), insufficient heat acclimation (associated with reduced sweating and evaporative cooling and increased cardiovascular and renal stress), socioeconomic barriers to cooling methods (fans, air conditioners, etc.), pyrexial illness (fever), drug and alcohol abuse (interferes with fluid balance and thermoregulation), physical work in environments that contribute to dehydration (heat sweating cold respiratory water loss and diuresis altitude respiratory water loss and Alcoholics

Content of a Single Lexical Entry

Subcategory information is information that divides syntactic categories into subclasses. This sort of information may be usefully separated into two types, contextual features and inherent features. The former are features that may be defined in terms of the contexts in which a given lexical entry may occur. Subcategorization information marks the local legitimate context for a word to appear in a syntactic structure. For example, the verb devour is never intransitive in English and requires a direct object hence the lexicon tags the verb with a subcategorization requiring an NP object. Another type of context encoding is collocational information, where patterns that are not fully productive in the grammar can be tagged. For example, the adjective heavy as applied to drinker and smoker is collocational and not freely productive in nature.

Carbohydrate Metabolism

Tered alcohol may result in a reversible and mild resistance to the glucose-lowering effects of insulin, perhaps explaining the observations of a rise in glucose following alcohol use. In fasting individuals, alcohol administration can lead to severe depressions of serum glucose, primarily by reducing the liver's production of glucose. Serum-glucose levels are also lower in chronic alcohol users with concurrent alcohol-related liver disease. Nevertheless, serum levels are elevated in alcoholics with concurrent alcohol-related destruction of the pancreas. Even without other concurrent diseases, alcohol consumption may result in either no changes or in minimal to mild elevations or reductions in serum glucose.

Alcohol Use And Abuse Among Adolescents

Another significant reason for concern about alcohol ingestion by adolescents is the close association of alcohol abuse with the use of other drugs. There is considerable evidence that alcohol use tends to precede use of illicit drugs, and some researchers argue that, based on long-term studies, alcohol serves as a ''gate-way'' to the use of illicit substances. As early as the eighth grade, alcohol users were found to have a significantly higher prevalence of cigarette smoking, and use of marijuana and cocaine than non-users of alcohol. This difference persists through grade 12 and thereafter (Kandel and Yamaguchi, 1993).

Substance Abuse And Other Anxiety Disorders

Individuals with anxiety disorders (e.g., generalized anxiety disorder, panic disorder, phobic disorders, obsessive-compulsive disorder) find that alcohol provides temporary relief from some of their anxiety symptoms. Large community studies of individuals with phobias suggest over a twofold increase in alcoholism risk. Panic disorder patients have rates of alcoholism approaching 20 percent, and male relatives of individuals with panic disorder have a two to three times increased rate of alcoholism when compared to controls, further suggesting a relationship between alcoholism and anxiety disorders. Another known fact is that anxiety symptoms are experienced during withdrawal. Schuckit (1990), in a study of anxiety symptoms during withdrawal, evaluated 171 alcoholics for anxiety and panic symptoms. Nearly all subjects had at least one anxiety symptom during heavy drinking, or upon abrupt discontinuation of drinking, but only 4 percent fulfilled DSM-III-R criteria...

Substance Abuse And Schizophrenia

Only recently has the high prevalence of alcoholism in schizophrenia been noted. Likewise, the recognition of high rates of other substance abuse in the schizophrenic population was not appreciated until the 1980s. A review of published estimates of the prevalence of alcohol abuse in schizophrenia reported a range of 8.4 to 47 percent (Mueser, 1990). Stimulant abuse in this review was reported between 4 and 15 percent. The question of whether substance abuse induces a chronic schizophrenic-like psychosis even after the drugs are stopped is still open to debate. It is generally held, however, that individuals who develop schizophrenia coupled with drug abuse would most likely have developed schizophrenia regardless, but the abuse may have caused an earlier onset. The early drug use may represent efforts at self-treatment. Treatment of the schizophrenic with drug abuse presents a major clinical challenge. Such patients tend to be disruptive, prone to frequent relapse of psychosis and...

Substance Abuse And Eating Disorders

Eating disorders who seek psychiatric treatment, as many as 35 percent have a significant substance-abuse history. Alcoholism, particularly in bulimia and bulimic anorectic patients, appears to be common. Substance abuse in eating disorders is generally thought to convey a poor prognosis for recovery.

Substance Abuse And Attention Deficit Disorder

Children with attention deficit hyperactivity disorder (ADHD) have been noted to be at risk for development of alcoholism and cocaine abuse as they grow into adolescence and adulthood. Family studies of children with ADHD and alcoholism have demonstrated higher rates of alcoholism in family members than that seen in the general population. Goodwin (1975) compared previously hyperactive adult adoptees with and without alcoholism. As children, these alcoholics were hyperactive, truant, shy, aggressive, disobedient, and friendless. In these adoptees, those with alcoholism clearly had an excess of alcoholism in their biological parents. No alcoholism was found among the biological parents of the nonalcoholic hyperactive adoptees. These findings suggest that in the case of alcoholism and hyperactivity, the risk for alcoholism comes from a genetic basis and not necessarily from just having ADHD.

Substance Abuse And Other Complications

Alcoholics have a 15 percent lifetime risk of SUICIDE. Alcohol is involved in at least 50 percent of successful suicides. Substance abusers are also recognized to have an elevated risk of suicide, and it has been reported that 70 percent of suicides in young people are associated with sub Brown, S. A., & Schuckit, M. A. (1988). Changes in depression among abstinent alcoholics. Journal of the Study of Alcohol, 49, 412-417. COOK, B. L., ET AL. (1991). Depression and previous alcoholism in the elderly. British Journal of Psychiatry, 158, 72-75. Goodwin, D., ET AL. (1975). Alcoholism and the hyperactive child syndrome. Journal of Nervous and Mental Disorders, 160, 349-353. Keeler, M. H., Taylor, C. I., & Miller, W. C. (1979). Are all recently detoxified alcoholics depressed American Journal of Psychiatry, 136, 586-588. Larson, J. (1998). Alcoholism The Biochemical Connection. Women in Engineering and Science News. Liskow, B., Powell, B. J., & Nickel, E. (1991). Diagnostic...

Alcohol Acute Effects

A binge of heavy drinking can lead to MEMORY lapses or alcoholic blackouts, in which the individual is unable to recollect events that took place during the period of intoxication even though he or she may have seemed normal to observers at the time. Although the pathogenesis of these episodes is not yet defined, it appears that the mechanisms underlying memory storage are temporarily disrupted during the blackout. Less severe difficulties with storage of new information can be seen even when drinking is below the legal limit of intoxication.

Alcohol Tolerance And Withdrawal

Alcohol tolerance also show cross-tolerance to other CNS depressants, including general anesthetics. Loss of tolerance appears to occur in the ELDERLY and in alcoholics who have developed organic brain impairments due to alcohol use or other factors, such as head injury. However, tolerance does not appear to develop to the direct neurotoxic effects of long-term alcohol abuse. Following heavy drinking, many alcoholics experience a tremulous-hyperexcitable withdrawal syndrome, which is characterized by postural tremor, agitation, confusion, and ataxia. Generalized seizures can also appear in withdrawal, typically 10 to 48 hours after cessation of drinking. It has been hypothesized that long-term alcohol use may establish an epileptogenic state of the brain that becomes manifest upon alcohol withdrawal. For this reason, it has become common practice in many treatment facilities to guard against withdrawal seizures in patients with known susceptibility by giving prophylactic...

Alcohol Recovery Of Function

When alcoholics stop drinking, their presenting neurocognitive impairment can often show marked recovery over weeks to months with maintained abstinence. Substantial recovery has been demonstrated in only a minority of patients with WKS, given appropriate thiamin treatment and abstinence from alcohol use. In 1978, Carlen and colleagues were the first to report reversibility in measured cerebral atrophy on computerized tomography (CT) scans in chronic alcoholics after several months of abstinence. This reversibility has been replicated by several other research groups. Many studies have also reported recovery in the cognitive performance deficits for a majority of patients, with improvements depending critically on abstinence. In general, the more novel, complex, and rapid the information-processing requirements of the task, the longer the time for recovery to normal levels of function. As of the mid-1990s, only modest correlations between the measures of brain atrophy and cognitive...

Other Cns Depressants

Can be associated with adverse behavioral changes, particularly in older individuals. In acute administration, they can cause impaired memory, slowing of reaction time and decision making, and disrupted attention. These effects are similar to those produced by drinking alcohol, and the effects of these two drugs taken together can be additive. Although patients appear to develop some tolerance to the sedating effects of benzodiazepines when they are administered for long periods, new evidence suggests that memory and cognitive impairments can remain or even increase with chronic administration. At present, it does not appear that these drugs have direct toxic effects on brain structures, so that their effects on behavior are likely mediated by a temporary and reversible pharmacological blocking of normal routes of neural information processing.

Violence and Aggression

Beatings, gunshot wounds, and stabbings are clearly related to drugs and alcohol abuse. Drug traffickers and street dealers will go to any length, no matter how violent their behavior, to make money. Social factors include the prevalence of hostile environments, where children raise themselves on the streets, and view society as miserable and violent. They must be taught to accept responsibilities, and be respectful of authorities in order to escape the world of constant fear, terror, ignorance and envy. Without moral principles, they can never be free.

Delirium Tremens Dts This

Clinical disorder is a DELIRIUM that occurs after abrupt cessation of, or reduction in, ALCOHOL consumption in an individual who has been a heavy drinker for many years. It represents the most severe form of the alcohol WITHDRAWAL state and is not very common. It is associated, however, with a significant mortality rate of those who develop it (10-15 ), if left untreated. Goodwin, D. W. (1989). Alcoholism. In H. I. Kaplan & B.J. Sadock (Eds.), Comprehensive textbook ofpsy-chiatry, 5th ed., vol. 1. Baltimore Williams & Wil-kins.

Classification Systems

Alcoholism and drug Addiction have been variously defined as medical diseases, mental disorders, social problems, and behavioral conditions. In some cases, they are considered the symptom of an underlying mental disorder (Babor, 1992). Some of these definitions permit the classification of alcoholism and drug dependence within standard nomenclatures such as the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders. The recent revisions of both of these diagnostic systems has resulted in a high degree of compatibility between the classification criteria used in the United States and those used internationally. Both systems now diagnose dependence according to the elements first proposed by Edwards and Gross (1976). They also include a residual category (harmful alcohol use ICD-10 alcohol abuse DSM-III-R ) that allows classification of psychological, social, and medical consequences directly related to substance use.

Daniel X Freedman R N Pechnick

DISEASE CONCEPT OF ALCOHOLISM AND DRUG ABUSE Throughout most of recorded history, excessive use of ALCOHOL was viewed as a willful act leading to intoxication and other sinful behaviors. The Bible warns against drunkenness Islam bans alcohol use entirely. Since the early nineteenth century, the moral perspective has competed with a conceptualization of excessive use of alcohol as a disease or disorder, not necessarily a moral failing. The disease (or disorder) concept has, in turn, been evolving with considerable Among the first to propose that excessive alcohol use might be a disorder, rather than willful or sinful behavior, were the physicians Benjamin Rush, in the United States, and Thomas Trotter, in Great Britain. Both Rush and Trotter believed that some individuals developed a pernicious habit of drinking and that it was necessary to undo the habit to restore those individuals to health. Words such as habit and disease were used to convey interwoven notions. Trotter saw the...

Early Models Of The Disease Concept

Central to the disease concept of alcoholism put forward by Jellinek were the roles of TOLERANCE and Physical Dependence, usually considered hallmarks of ADDICTION. Tolerance indicates that increased doses of a drug are required to produce effects previously attained at lower doses. Physical dependence refers to the occurrence of WITHDRAWAL symptoms following cessation of alcohol or other drug use. Although Jellinek recognized that alcohol problems could occur without alcohol addiction, addiction to alcohol moved to the center of scientific focus. Despite being couched in the language of science, the reemergence of the disease concept of alcoholism was not a result of new scientific findings. Jellinek believed it was necessary to see alcoholism as a disease in order to increase the availability of services for alcoholics within established medical facilities. He also recognized that efforts to prevent alcoholism would still have to address the complex cultural, demographic, political...

Problem Drinking As A Distinct Dimension

The importance of what can now be called the classic disease model'' of alcoholism as a primary focus for health programs was challenged in 1977 by a report of a WHO Expert Committee on alcohol-related disabilities. This report stressed that not everyone who develops a disability related to alcohol use exhibits alcohol dependence or addiction, nor would such an individual necessarily develop a dependence in the future. The report asserted that some alcohol-related disabilities represent a dimension of problem drinking distinct from the disease of alcoholism or alcohol dependence syndrome. This perspective provided support for policies aimed at reducing overall alcohol consumption, not just at promoting abstinence among vulnerable individuals. The report described the alcohol dependence syndrome itself as a learned phenomenon, not a disease state, which is either present or absent, but ''a condition which exists in degrees of severity.'' It is important to recognize that this syndrome...

From Psychic And Physical Dependence To Dependence Syndrome

The changing perspectives on the general concept of drug dependence, given momentum by the 1977 WHO report on alcohol and by other research, were ultimately reflected in changes in the definitions and other positions of the World Health Organization and in its 1980 International Classification of Diseases, 9th edition (ICD-9). With its publication, the concept of an alcohol dependence syndrome formally emerged at an international level. The ICD-9 concept of dependence was based on a 1976 proposal by researchers Griffith Edwards and Milton Gross, who defined seven characteristics of the alcohol dependence syndrome and proposed that there are certain implicit assumptions to the syndrome First, it is a symptom complex involving both biological processes and learning. Second, it should be defined along a continuum of severity, rather than as a discrete category. Third, dependence should be differentiated from alcohol-related disabilities. Both dependence and disabilities exist in degrees,...

Criteria For Diagnosis Of A Generic Dependence Disorder

The DSM-III-R conceptualization of dependence was controversial. Because for many years physical dependence and tolerance had been considered evidence of ''true disease,'' many clinicians believed that changing these criteria from the necessary and required status they had had in DSM-III was a mistake that erroneously broadened the category of drug dependence. Much of the focus in the development of DSM-IV, published in 1994, was on how to restore the primacy of these phenomena in the diagnosis of drug and alcohol dependence. DSM-IV defines seven generic criteria for alcohol and other drug dependence. Three are required for a diagnosis of alcohol or other drug dependence. Although tolerance and withdrawal are listed first, they are not required but the clinician must specify whether either is present. ICD-10 and DSM-IV share important characteristics that represent a further evolution in understanding drug and alcohol dependence syndromes. In contrast to some disease-oriented...

Challenges To The Disease Concept

The classic disease model of alcoholism and drug dependence has served as a challenge to some behavioral researchers and social scientists they have raised a number of questions about biologically based theories of such behaviors. Critics of the disease concept point to studies showing that some former alcoholics could apparently return to normal drinking. Such findings challenged the concept of alcoholism as a progressive disease. The concept of inevitable ''loss of control'' over drinking was also challenged by Merry's study (1966) in which alcoholics were given drinks containing either vodka or a placebo (no alcohol) on alternate days and reported having no more desire to drink after consuming the vodka than after the placebo. The results suggested that if ''loss of control'' did occur in alcoholics, it was not triggered as a biological response to alcohol but rather as a learned response with associated EXPECTANCIES concerning drinking behavior. Researchers Nancy Mello and Jack...

Interactions With Other Drugs

Psychiatric complications following disulfiram treatment. American Journal of Psychiatry, 144, 1310-1312. Fuller, R. K., et al. (1986). Disulfiram treatment of alcoholism A Veterans Administration cooperative study. Journal of the American Medical Association, 256, 1449-1455. Fuller, R. K., Lee, K. K., & Gordis, E. (1988). Validity of self-report in alcoholism research Results of a Veterans Administration cooperative study. Alcoholism Clinical and Experimental Research, 12, 201-205. Johnsen, J., ET AL. (1987). A double-blind placebo controlled study of male alcoholics given a subcutaneous disulfiram implantation. British Journal of Addiction, 82, 607-613.

Driving Alcohol And Drugs

Although the association between alcohol consumption and traffic accidents had been recognized by the beginning of the twentieth century, the magnitude of the problem did not capture public attention until the 1970s. Public tolerance of DRIVING Under the Influence of alcohol decreased sharply a shift in attitude that, combined with increased legal countermeasures, resulted in a significant decline in alcohol-related fatalities from a high of 57 percent in 1982 to 38 percent in 1998.

Dropouts And Substance

As much is known about the substance use of those who become high school dropouts. Nonetheless, by putting together evidence from a variety of sources, including the NATIONAL HOUSEHOLD SURVEY ON DRUG Abuse and the Epidemiologic Catchment Area surveys sponsored by the U.S. government, it is possible to say that high school dropouts are much more likely to have started using TOBACCO, ALCOHOL, and other drugs, as compared with their peers who remained in school. There also is some evidence that dropping out of high school is associated with an increased risk of adult-onset alcohol-dependence syndromes, even among persons whose dropping out could not have been caused by the consequences of starting to drink during the adolescent years. Whether this conclusion also holds for adult-onset DEPENDENCE on other drugs such as Cocaine or Marijuana is not yet clear but is under study. In trying to understand how it might happen that dropouts are more likely to be substance users, the possibility...

Largeartery Atherosclerosis

It is generally thought that thromboembolic strokes are mainly caused by atherosclerotic disease. Atherosclerotic disease is less prevalent among populations regularly consuming alcohol than among binge-drinking populations. The high risk of stroke in a population with a high alcohol intake does not seem to be due to large-artery atherosclerosis 24 , but may be caused by other diseases promoting the onset of stroke, i. e., alcoholic cardiomyopathy. On the other hand, the age-adjusted relation between alcohol intake and carotid artery atherosclerosis has been reported to be U-shaped, with light drinkers facing a lower atherosclerosis risk than either abstainers or heavy drinkers 25 , A strong positive relation between alcohol consumption and the risk of mortality from stroke is apparent 26 , In the Scandinavian countries, binge drinking has been observed to associate with both an increased risk for ischemic stroke mortality 27 and the progression of atherosclerosis 28 , It is therefore...

Smallvessel Occlusion

Small-vessel occlusions, i.e., thrombosis of a single perforating cerebral artery, cause lacunar ischemic strokes. A lacunar infarct usually occurs in the internal capsule or thalamus and presents clinically as a pure motor stroke, pure sensory stroke, sensomotor stroke, dysarthria clumsy hand or ataxic hemiparesis. Patients with typical lacunar infarct syndromes account for approximately 20 of all ischemic strokes, and hypertensive small-vessel disease seems to be the most important etiology 29 , Because heavy drinking of alcohol is a frequent cause of arterial hypertension, it is assumed to associate with small-vessel occlusion as well. However, conflicting observations have also been reported. Some studies have not shown alcohol to be a significant risk factor 29-31 , whereas others have 9,32 , The study ofYou et al. included a rather large series of young adults with lacunar infarcts 33 . This study suggested that long-term heavy alcohol consumption is a risk factor for ischemic...

Cervical Arterial Dissection

Cervical arterial dissection is probably one of the most common causes of ischemic stroke in young subjects. It is diagnosed by imaging with conventional or MR angiography and typically occurs after major trauma, but may also occur spontaneously or after trivial injury. Needless to say, alcoholic intoxication is a major risk factor for all types of trauma. Therefore, it is not surprising that cervical arterial dissections have also been described to have occurred in connection with alcohol abuse 22,37 , Some reports have emphasized that extracranial vessel compression due to unusual posturing during alcoholic stupor or coma could also result in a brain infarct 38-40 , but it has remained unclear whether cervical arterial dissection is the underlying mechanism or not. In at least one of the reported cases dissection was excluded 40 , Surprisingly, case-control studies have not yet been able to prove alcohol as a risk factor for ischemic stroke caused by cervical arterial dissection 13...

The Crime Of Drunk Driving

At least since the early 1970s, the criminal justice system's processing of drunk drivers has been linked to alcohol-treatment programs. In many jurisdictions, all drunk-driving offenders are routinely screened for ALCOHOLISM and alcohol abuse. Alcoholics and abusers may be diverted from prosecution to TREATMENT. More likely, however, the judge will require the offender to participate in treatment as a condition of probation or in order to obtain a provisional or regular driver's license. In some jurisdictions, the criminal-justice system is the largest source of clients flowing into alcohol- treatment programs. Thus, enforcement of the drunk-driving laws is one of the major ways that alcohol abusers are brought into the alcohol-treatment matrix. In addition to the standard alcohol treatments, the attack on drunk driving has produced one unique kind of treatment the drinking-driver school, which several million people have passed through since the mid-1970s. States and localities that...

Extent Of The Problem

The economic cost to society from alcohol and drug abuse was 246 billion in 1992. Alcohol abuse and alcoholism cost an estimated 148 billion, while drug abuse and dependence cost an estimated 98 billion. When adjusted for inflation and population growth, the alcohol estimates for 1992 were very similar to cost estimates produced over the past 20 years. The 1992 estimates were significantly greater than the 1985 estimate for alcohol 42 percent higher for alcohol over and above increases due to population growth and inflation. Between 1985 and 1992, inflation accounted for about 37.5 percent and population growth for 7.1 percent increases. Over 80 percent of the increase in estimated costs of alcohol abuse was attributed to changes in data and methodology employed in the new study. This suggests that the previous study significantly underestimated the costs of alcohol abuse. In 1992, there were an estimated 107,400 alcohol-related deaths in the United States. Many of the alcohol-related...

Eighteenth Amendment

ELIMINATION OF THE DRUG ADDICTION AND ALCOHOLISM CATEGORY IN SOCIAL SECURITY DISABILITY PROGRAMS Since 1950, the federal government of the United States has provided income support by welfare or social insurance mechanisms to individuals with work disabilities unrelated to military service. Currently, the Social Security Administration operates two programs for the disabled Social Security Disability Insurance (DI) and Supplemental Security Income (SSI). The differences between them reflect a fundamental schism in the American welfare state, which is divided into ''tracks'' along the line of labor force attachment. As it name implies, DI is an ''insurance-like ' program Workers make payroll deductions that over time qualify them for benefits based on average lifetime earnings should they ever become disabled. SSI, on the other hand, is a ''welfare'' program designed for individuals with little history of employment and few resources. Whereas income and wealth are no bar to the receipt...

Effects Of Light Drinking

Several studies have shown regular light (10-20 g of ethanol daily) or moderate (less than 300 g of ethanol per week) drinking to associate with a decreased risk for ischemic stroke of atherothrombotic origin 43-45 , but the observations on the effects of light and moderate alcohol consumption on stroke mortality have been conflicting 27,46,47 , For example, one study showed light-to-moderate drinking to be associated with a 36 reduction in deaths from ischemic heart disease, but had no effect on death from stroke 47 , A recent study 48 reported that light-to-moderate alcohol consumption reduces the overall risk of stroke and the risk of ischemic stroke in men. The benefit was apparent with as little as one drink per week. More abundant consumption, up to one drink per day, did not increase the observed benefit. Several possible mechanisms have been proposed to explain the beneficial effect oflight-to-moderate alcohol consumption 49 , However, almost all of the proposed mechanisms are...

Epidemiology Of Drug Abuse

For a young adult living in the United States, what is the risk of developing the problem of alcohol abuse or dependence between one year and the next Is the risk for alcohol dependence greater for some young adults than for others Which subgroups of young adults are at especially high risk for alcohol dependence For those 18 to 29 living in the United States, the best available estimate for the risk of developing alcohol abuse or dependence between one year and the next is about 2 to 4 percent. The risk of succumbing to alcohol abuse or dependence for males aged 18 to 29 is an estimated 6 percent per year, as compared with about 1 percent per year for females aged 18 to 29. Males between the ages of 18 and 25 are at especially high risk of succumbing to alcohol abuse or dependence. sponsored National Comorbidity Survey. According to this survey, one in three tobacco smokers had tobacco problems, signs, and symptoms consistent with their having become dependent on tobacco and one in...

Thiamin Vitamers And Antagonists

Synthetic allithiamin derivatives, such as thiamin propyl and tetrahydro-furfuryl disulfides, have been used for the prevention and treatment of thiamin deficiency. Because they are lipid soluble, and are not subject to the normal control of thiamin absorption by saturation of the intestinal transport system, they have potential benefits in the treatment of thiamin-deficient alcoholics, whose absorption of thiamin is impaired.

Other Aspects Of Epidemiology As Applied To Drug Use And Drug Dependence

International databases on drug dependence. In L. Eisenberg & R. DesJarlais (Eds.), International behavioral and mental health A sourcebook. Cambridge Oxford University Press. Anthony, J. C., & Helzer, J. E. (1995). Epidemiology of drug dependency. In M. Tsuang, M. Tohen, & G. Zahner (Eds.). Textbook of psychiatric epidemiology. New York John Wiley and Sons. Anthony, J. C., Warner, L. A., & Kessler, R. C. (1994). Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalant drugs Basic findings from the National Comorbidity Survey. Experimental and Clinical Psychopharmaco-logy, 2, 1-24. Helzer, J. E., ET AL. (1990). Alcoholism North America and Asia. Archives of General Psychiatry, 47, 313-319.

Metabolism Of Thiamin

The absorption of thiamin is impaired in alcoholics, leading to thiamin deficiency (Section 6.4.4). In vitro, tissue preparations show normal uptake of the vitamin into the mucosal cells in the presence of ethanol, but impaired transport to the serosal compartment. The sodium-potassium-dependent ATPase of the basolateral membrane responsible for the active efflux of thiamin into the serosal fluid is inhibited by ethanol (Hoyumpa et al., 1977).

Addiction A Multicultural Problem In Need Of Multicultural Solutions

Just as addiction is a global, rather than a national or regional, phenomenon, so addiction problems in the United States are multicultural. The whole fabric of successful treatment needs to be woven around cultural realities. In this society, twelve-step fellowships, such as ALCOHOLICS The ' 'Big Book'' of Alcoholics Anonymous uses the terms ''spiritual experience'' and ''spiritual awakening,'' manifesting in many different forms, to describe what happens to bring about a personality change sufficient to induce recovery. While some of these may involve an ''immediate and overwhelming God consciousness,'' most are what William James called an ''educational variety'' of revelation, developing slowly over time. According to a ''Big Book'' appendix titled ''Spiritual Experience,'' the core of this process is the tapping of an ''unexpected inner resource'' by members who identify this resource with ''their own conception of a Power greater than themselves.'' Native Americans. The...

Importance In Drug Cases And Enforcement

EXPECTANCIES The beliefs a person has about the effects a drug will have are called expectancies. The study of expectancies began with the employment of the experimental balanced-placebo design in alcohol research in the early 1970s (see Marlatt & Rohsenow, 1980, for a review). Research on people ranging from light drinkers to inpatient alcoholics revealed that expectancies are predictive of some of the behaviors exhibited when people use a drug. These studies revealed that both the beliefs an individual has about whether a drink contains ALCOHOL and the specific outcomes that individual expects from consuming alcohol are in many cases more predictive of subsequent behavior than the pharmacological effects of the drug.

Examples Of Research Study

Behavioral observations following this manipulation reveal that the most powerful predictor of behavior after consuming the assigned drink is not whether the person actually receives alcohol, but whether that person believes he or she is drinking alcohol People who expect alcohol in this experi mental situation consume significantly more drink than those who are not expecting alcohol, regardless of whether or not they do receive alcohol in their drink. With the discovery of this phenomenon, even in people who are considered dependent on alcohol, this finding has been interpreted as providing contrasting evidence to the disease model's notion that ''loss of control'' is caused exclusively by the pharmacological effects of alcohol the findings introduced the idea that cognitive factors are influential in a person's drug-related behavior. The presence of expectancy effects have also been identified in research on drugs other than alcohol, including TOBACCO and MARIJUANA (Marlatt &...

Families And Drug Use One major

Debate in the area of families and drug use continues to be whether dysfunctional family life creates drug addiction or whether drug addiction produces dysfunctional families. In other words, are ALCOHOLISM and other drug addictions diseases of individuals or are they products of disorganized families and other social systems The former is an individual-focused view, often held by drug counselors who favor SELF-HELP groups such as AA, Al-Anon, NA, and the like. The latter is a systemic view held by professionals who prefer to treat drug addictions by working with families, in order to change family systems into more healthy environments.

Supplements Are They Necessary Are They Safe

To begin with, the RDAs take no account of individual circumstances. The fact is, nutritional needs vary enormously. Requirements for nutrients can vary according to genetic make-up, sex, age, levels of stress, activity levels, alcohol consumption, pollution, smoking, the use of prescription medications, pregnancy and menopause. The RDAs make no provision for the special requirements individuals may have for nutrients.

Treatment For Abusers

Shame, guilt, and denial are powerful emotions that impede both the recognition of problems and the admission of the need for help. It is popularly believed that perpetrators enter treatment only under coercion and with considerable reluctance. Given the strong association between substance abuse and marital violence in some individuals, questions arise as to whether treatment of alcohol or drug abuse alone will concomitantly diminish violent acts. Behavioral marital therapy teaches improved communication skills and has been used to improve the marital relationships of patients as their drinking abates (O'Farrell & Murphy, 1995). This treatment modality, however, does not directly address the problem of violence. A comparison was made between eighty-eight couples with a newly abstinent husband and a nonalcoholic control sample of eighty-eight couples undergoing marital therapy. The study covered the year before treatment and the year after it. Acts of domestic violence occurred...

Fetal Alcohol Syndrome Fetal

Following criteria growth deficiency a pattern of distinct and specific facial abnormalities and central nervous system (CNS) damage. In other cases, where there are no related physical findings, but a pattern of cognitive and behavioral deficits exist concurrent with confirmed prenatal alcohol exposure, a diagnosis of static encephalopathy may be given. Due to confusion, this term and fetal alcohol related conditions (FARC) are used in the place of fetal alcohol effects (FAE). The characteristics listed above and discussed later in this entry must occur in conjunction with confirmed maternal alcohol consumption. Racial, genetic, and familial influences must also be considered when such a diagnosis is made.

Psychosocial And Educational Issues

Diagnosis of alcohol-related birth defects is possible at birth but many physicians are either not trained to identify FAS or do not consider it a possibility. Perinatal behavioral manifestations of FAS include the following poor habituation, an exaggerated startle response, poor sleep wake cycle, poor sucking response, and hy-peractivity. Failure to thrive, alcohol withdrawal, and cardiac difficulties have become medical concerns frequently noted in this patient population.

Substance Abuse Neuroimaging and Crime

Relevant findings from the alcohol literature may be summarized as follows Prolonged excessive consumption of alcohol is associated with neuropsychological deficits in tests of executive functioning, cognitive efficiency, memory, and fine motor speed, particularly among alcoholics suffering from Korsakoff's syndrome.39 Alcohol abuse is also correlated with MRI and CT findings of cortical atrophy.40 The drug abuse literature yields fewer conclusive findings. In constrast to alcohol abuse, the neuropsychological sequellae of chronic drug use are not clearly defined, although various cognitive deficits have been identified in populations of substance abusers.41 Brain imaging may reveal neuropathological changes in cases of substance abuse, as when the vasoconstrictive effects of cocaine ingestion cause stroke, hemorrhage, or seizure, but the brain trauma must be significant for the residual cerebropathology to be visible in MRI or CT.42 Preliminary PET studies of violent offenders and...

The Addiction Model Of Pathological Gambling

The early psychoanalytic literature often referred to compulsive gamblers as ADDICTS, but it was not until the founding of Gamblers Anonymous (GA) in 1957 that the addictive-disease model became a basis for recovery. GA was initiated through the efforts of a recovering alcoholic who was both an Alcoholics Anonymous (AA) member and a compulsive gambler. GA adapted the TWELVE STEPS of AA, the fellowship's traditions, its spiritual base, and the general format of its meetings to aid in the recovery of gambling addicts. Gam-Anon, a twelve-step group for the friends and families of compulsive gamblers, modeled on Al-Anon Family Groups, was established shortly afterward. Local chapters of Gamblers Anonymous are increasingly available in U.S. communities as well as in treatment units, work settings, and prisons. The growth of the alcoholism- and drug-addiction-treatment system in the 1960s gave rise to a variety of professional program models that incorporated a cooperative working...

Identification And Treatment

Casinos) and posting notices of the availability of help, usually in the form of a toll-free helpline number. The government has made almost no effort to educate youth or the general public about risk factors for pathological gambling and its dangers, in spite of the high prevalence of gambling problems among adolescents. Although children of problem gamblers and alcoholics are known to be at higher risk than others, they have not been the target of organized prevention programs. Since the 1980s, makers of trading cards (e.g., baseball or basketball cards) have begun to insert valuable so-called chase cards at random into the packets of cards at pre-determined rates (e.g., one special card per 700 cards), to stimulate interest in purchasing the product. Because this is similar to a lottery, there has been concern about its immediate and future effects on the children who buy these packets in hopes of finding the valuable cards.

Bibliography Table of Contents

Alcohol and Alcoholism 269 with Alcoholism 277 Family History of Alcoholism 281 and Alcoholism 284 Benzodiazepines in Alcoholics 293 Alcohol and Alcoholism 306 with Alcoholism 311 Family History of Alcoholism 314 and Alcoholism 319 Alcohol and Alcoholism 335 with Alcoholism 343 Benzodiazepines and Alcoholism 349 Alcohol and Alcoholism 360 with Alcoholism 366 Family History of Alcoholism 373 Other Risk Factors for Alcoholism 374

Demographic Differences

There are large gender differences in the prevalence of occasions of heavy drinking among high school seniors (38 percent for male adolescents versus 24 percent for female adolescents in 1999) thus, as with heavy use of illicit drugs, heavy use of alcohol is more likely among male adolescents than it is among female adolescents. This gender difference is somewhat smaller than the one obtained in 1975, when the figures were 49 percent and 26 percent, respectively. The narrowing of the difference is primarily attributable to the greater decrease in heavy drinking among male adolescents than among female adolescents. The current differences are similar, though smaller, among the younger students. Among 1999 eighth graders, 16 percent of boys reported heaving drinking compared Both the South and the West tend to exhibit slightly lower rates of alcohol use than the Northeast and the North Central states. For example, in 1999 the prevalence of heavy-drinking occasions (that is, five or more...

Effect Of Ethanol On Prostacyclin

The effects of ethanol on PGI2, another endothelium-derived vasodilator and potent inhibitor of platelet aggregation, have also been investigated. Ethanol increased PGI2 production in cultured human umbilical vein endothelial cells and elevated plasma levels ofPGI2 in volunteers administered ethanol 29 , Guivernau et al. found that while ethanol did not affect vascular PGI2 release in control rats, in aortas from alcohol-fed animals ethanol stimulated PGI2 production 30 , These data imply that this response to ethanol may be altered by chronic alcohol consumption. In any case, ethanol's modulatory effect on endothelial PGI2 production could

Chronic Administration

M., Serafetinides, E. A., Lowenstam, I. and Pearson, D., EEG signs of brain impairment in alcoholism. Biol. Psychiatry 13 729-739, 1978. 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. Johannesson, G., Berglund, M. and Ingvar, D. H., EEG abnormalities in chronic alcoholism related to age. Acta Psychiatr. Scand. 65 148-157, 1982. Cohen, M. J., Schandler, S. L. and Naliboff, B. D., Psychophysiological measures from intoxicated and detoxified alcoholics. J. Stud. Alcohol 44 271-282, 1983. 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. Kaplan, R. F., Glueck, B. C., Hesselbrock, M. N. and Reed, H. B., Jr., Power and coherence analysis of the EEG in...

Chronic Effects Of Abused Drugs

Long-term drinking (chronic ethanol abuse) has toxic effects on the brain, and imaging techniques have added to the understanding of these effects. Brain glucose metabolism is decreased in recovering alcoholics (abstinent at least seven days), even if they do not show brain damage severe enough to be diagnosed as organic brain syndrome. The largest differences from controls were found in frontal lobe structures. Cerebral blood flow, measured using xenon-133, is also decreased in chronic alcoholics, with the largest differences in frontal and temporal lobe structures. To some extent, the changes are reversible with abstinence. Low cerebral blood flow is related to heavy drinking history, with the lowest flow rates in patients with brain damage (organic brain syndrome) due to alcohol.

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