Alcoholism is a term with multiple and sometimes conflicting definitions. The short-term effects of alcohol on the human body can take several forms Regularly having more than two drinks a day increases the risk of developing Alcoholism, Alcoholic liver disease, and some forms of Cancer. The subject of alcohol and heart attacks is important because the major cause of death in many countries is Cardiovascular disease. Alcoholic liver disease is the major cause of Liver disease in Western countries (in Asian countries viral Hepatitis is the major cause Alcoholic hepatitis is Hepatitis (inflammation of the liver due to excessive intake of alcohol. "Considerable evidence suggests a connection between heavy alcohol consumption and increased risk for cancer with an estimated 2 to 4 percent of all cancer cases thought to be caused either Alcohol and weight is a subject relevant to millions of people who like to drink Alcoholic beverages and who also either want to maintain or to lose Body weight. History Historical references Anecdotal accounts of prohibitions against maternal alcohol use from biblical, ancient Greek, and ancient Roman A blackout is a phenomenon caused by the intake of alcohol in which long term memory creation is impaired Wernicke-Korsakoff syndrome (also called Wet brain, Korsakoff psychosis alcoholic encephalopathy Wernicke's disease and encephalopathy - alcoholic is a manifestation This article summarizes the recommended maximum intake (or 'safe limits' of alcohol as recommended by the health agencies of various governments In common and historic usage, alcoholism refers to any condition that results in the continued consumption of alcoholic beverages despite the health problems and negative social consequences it causes. Medical definitions describe alcoholism as a disease which results in a persistent use of alcohol despite negative consequences. A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly Alcoholism, also referred to as dipsomania^[1], may also refer to a preoccupation with or compulsion toward the consumption of alcohol and/or an impaired ability to recognize the negative effects of excessive alcohol consumption. Although not all of these definitions specify current and on-going use of alcohol as a qualifier, some do, as well as remarking on the long-term effects of consistent, heavy alcohol use, including dependence and symptoms of withdrawal. Physical dependence (or drug dependence) refers to a state resulting from habitual use of a drug where negative physical Withdrawal symptoms result from abrupt discontinuation Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes Physical dependence is

While the ingestion of alcohol is, by definition, necessary to develop alcoholism, the use of alcohol does not predict the development of alcoholism. The quantity, frequency and regularity of alcohol consumption required to develop alcoholism varies greatly from person to person. In addition, although the biological mechanisms underpinning alcoholism are uncertain, some risk factors, including social environment, emotional health and genetic predisposition, have been identified. The social environment (context, also known as the Milieu, is the identical or similar Social positions and Social roles as a whole that influence the individuals Mental health is a term used to describe either a level of cognitive or Emotional wellbeing or an absence of a Mental disorder. A genetic predisposition is a genetic effect which influences the Phenotype of an organism but which can be modified by the environmental conditions

"King Alcohol and his Prime Minister" circa 1820

Definitions and terminology

The definitions of alcoholism and related terminology vary significantly between the medical community, treatment programs, and the general public.

Medical definitions

The Journal of the American Medical Association defines alcoholism as "a primary, chronic disease characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking. JAMA The Journal of the American Medical Association is an international peer-reviewed general Medical journal, published 48 times per year by the American "^[2]

The DSM-IV (the standard for diagnosis in psychiatry and psychology) defines alcohol abuse as repeated use despite recurrent adverse consequences. The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association Alcohol abuse, as described in the DSM-IV, is a psychiatric diagnosis describing the use of Alcoholic beverages despite negative consequences ^[3] It further defines alcohol dependence as alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink. Alcohol dependence, as described in the DSM-IV, is a psychiatric diagnosis describing a Physical dependence on alcohol. Drug tolerance occurs when a subject's reaction to a Psychoactive drug (such as a painkiller or intoxicant decreases so that larger doses are required to achieve the same effect Withdrawal, also known as withdrawal/abstinence syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes Physical dependence is ^[3] (See DSM diagnosis below. )

According to the APA Dictionary of Psychology, alcoholism is a new and popular term for alcohol dependence. ^[3] The condition has been traditionally referred to by the medical community as dipsomania^[4]. Note that there is debate whether dependence in this use is physical (characterised by withdrawal), psychological (based on reinforcement), or both. In Operant conditioning, reinforcement is an immediate increase in the strength of a response following a change in environment

Terminology

Many terms are applied to a drinker's relationship with alcohol. Use, misuse, heavy use, abuse, addiction, and dependence are all common labels used to describe drinking habits, but the actual meaning of these words can vary greatly depending upon the context in which they are used. Habits are habituated routines of behavior that are repeated regularly tend to occur Subconsciously and tend to occur without directly thinking consciously Even within the medical field, the definition can vary between areas of specialization. The introduction of politics and religion further muddles the issue.

Use refers to simple use of a substance. An individual who drinks any alcoholic beverage is using alcohol. Misuse, problem use, and heavy use do not have standard definitions, but suggest consumption of alcohol to the point where it causes physical, social, or moral harm to the drinker. The definitions of social and moral harm are highly subjective and therefore differ from individual to individual.

Within politics, abuse is often used to refer to the illegal use of any substance. Within the broad field of medicine, abuse sometimes refers to use of prescription medications in excess of the prescribed dosage, sometimes refers to use of a prescription drug without a prescription, and sometimes refers to use that results in long-term health problems. Within religion, abuse can refer to any use of a poorly regarded substance. The term is often avoided because it can cause confusion with audiences that do not necessarily share a single definition.

Remission is often used to refer to a state where an alcoholic is no longer showing symptoms of alcoholism. The American Psychiatric Association considers remission to be a condition where the physical and mental symptoms of alcoholism are no longer evident, regardless of whether or not the person is still drinking. The American Psychiatric Association (APA is the main Professional organization of Psychiatrists and trainee psychiatrists in the United States, and the They further subdivide those in remission into early or sustained, and partial or full. Some groups, most notably Alcoholics Anonymous, do not recognize remission. Alcoholics Anonymous ( AA) is an informal meeting society for recovering and recovered alcoholics, with the stated purpose to help its members "to stay sober and Instead, these groups use the term recovery to describe those who have completely stopped consumption of alcohol and are addressing underlying emotional and social factors.

Etymology

The term "alcoholism" was first used in 1849 by the physician Magnus Huss to describe the systematic adverse effects of alcohol. ^[5]

In the United States, use of the word "alcoholism" was largely popularized by the inception and growth of Alcoholics Anonymous in 1939. The United States of America —commonly referred to as the Alcoholics Anonymous ( AA) is an informal meeting society for recovering and recovered alcoholics, with the stated purpose to help its members "to stay sober and Although lacking a specific definition for alcoholism, AA's "Big Book" compares alcoholism to an allergy and an illness. ^[6]

A 1960 study by E. Morton Jellinek is considered the foundation of the modern disease theory of alcoholism. Elvin Morton Jellinek (1890-1963 E Morton Jellinek, or most often E Alcoholism is a disease characterized by the compulsive drinking of Alcoholic beverages. ^[7] Jellinek's definition restricted the use of the word "alcoholism" to those showing a particular natural history. Natural history of Disease refers to a description of the uninterrupted progression of the disease in an individual from the moment of exposure to the causal agents until recovery or death The modern medical definition of alcoholism has been revised numerous times since then. The American Medical Association currently uses the word alcoholism to refer to a particular chronic primary disease. The American Medical Association (AMA founded in 1847 and incorporated 1897 is the largest association of Physicians and Medical students in the United States ^[8] A small minority within the field, notably Herbert Fingarette and Stanton Peele, argue against the existence of this disease. However, critics of the disease model acknowledge that the word "alcoholism" refers to a disease, and use the term "heavy drinking" when discussing the negative effects of alcohol consumption.

Epidemiology

Substance use disorders are a major public health problem facing many countries. Public health is "the science and art of preventing disease prolonging life and promoting health through the organised efforts and informed choices of society organisations "The most common substance of abuse/dependence in patients presenting for treatment is alcohol. "^[9] In the United Kingdom, the number of 'dependent drinkers' was calculated as over 2. 8 million in 2001. ^[10] The World Health Organization estimates that about 140 million people throughout the world suffer from alcohol dependence. ^[11][12]

Within the medical and scientific communities, there is broad consensus regarding alcoholism as a disease state. For example, the American Medical Association considers alcohol a drug and states that "drug addiction is a chronic, relapsing brain disease characterized by compulsive drug seeking and use despite often devastating consequences. It results from a complex interplay of biological vulnerability, environmental exposure, and developmental factors (e. g. , stage of brain maturity). " ^[13]

Current evidence indicates that in both men and women, alcoholism is 50-60% genetically determined, leaving 40-50% for environmental influences. ^[14]

A 2002 study by the National Institute on Alcohol Abuse and Alcoholism surveyed a group of 4,422 adult alcoholics and found that after one year some were no longer alcoholics, even though only 25. The National Institute on Alcohol Abuse and Alcoholism (NIAAA as part of the U 5% of the group received any treatment,^[15] with the breakdown as follows:

• 25% still dependent
• 27. 3% in partial remission (some symptoms persist)
• 11. 8% asymptomatic drinkers (consumption increases chances of relapse)
• 35. 9% fully recovered — made up of 17. 7% low-risk drinkers plus 18. 2% abstainers.

Identification and diagnosis

Multiple tools are available to those wishing to conduct screening for alcoholism. Identification of alcoholism may be difficult because there is no detectable physiologic difference between a person who drinks frequently and a person with the condition. Identification involves an objective assessment regarding the damage that imbibing alcohol does to the drinker's life compared to the subjective benefits the drinker perceives from consuming alcohol. While there are many cases where an alcoholic's life has been significantly and obviously damaged, there are always borderline cases that can be difficult to classify.

Addiction Medicine specialists have extensive training with respect to diagnosing and treating patients with alcoholism.

Screening

Several tools may be used to detect a loss of control of alcohol use. These tools are mostly self reports in questionnaire form. A self report study is a research method employed by Sociologists and Criminologists to determine the extent of crime and deviance Another common theme is a score or tally that sums up the general severity of alcohol use.

• The CAGE questionnaire, named for its four questions, is one such example that may be used to screen patients quickly in a doctor's office. The CAGE questionnaire, the name of which is an Acronym of its four questions is a widely used method of screening for Alcoholism.

Two "yes" responses indicate that the respondent should be investigated further. The questionnaire asks the following questions:

1. Have you ever felt you needed to Cut down on your drinking?
2. Have people Annoyed you by criticizing your drinking?
3. Have you ever felt Guilty about drinking?
4. Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?^[16][17]

The CAGE questionnaire, among others, has been extensively validated for use in identifying alcoholism. It is not valid for diagnosis of other substance use disorders, although somewhat modified versions of the CAGE are frequently implemented for such a purpose.

• The Alcohol Dependence Data Questionnaire is a more sensitive diagnostic test than the CAGE test. ^[18] It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use.

• The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses,^[19] driving under the influence being the most common. Driving under the influence of alcohol ( driving while intoxicated, drunk driving, drinking and driving, drink-driving) or other drugs

• The Alcohol Use Disorders Identification Test (AUDIT) is a screening questionnaire developed by the World Health Organization. The Alcohol Use Disorders Identification Test ( AUDIT) is a simple ten-question test developed by the World Health Organization to determine if a person's alcohol consumption This test is unique in that it has been validated in six countries and is used internationally. ^[20] Like the CAGE questionnaire, it uses a simple set of questions - a high score earning a deeper investigation.

• The Paddington Alcohol Test (PAT) was designed to screen for alcohol related problems amongst those attending Accident and Emergency departments. The Paddington Alcohol Test (PAT was first published in the Journal of Accident and Emergency Medicine in 1996. It concords well with the AUDIT questionnaire but is administered in a fifth of the time. ^[21]

Genetic predisposition testing

Psychiatric geneticists John I. Nurnberger, Jr. , and Laura Jean Bierut suggest that alcoholism does not have a single cause—including genetic—but that genes do play an important role "by affecting processes in the body and brain that interact with one another and with an individual's life experiences to produce protection or susceptibility. Gene-environment interaction, also called genotype-environment interaction or GxE, is a term used to describe any phenotypic effects that are due to interactions " They also report that less than a dozen alcoholism-related genes have been identified, but that more likely await discovery. ^[22]

At least one genetic test exists for an allele that is correlated to alcoholism and opiate addiction. ^[23] Human dopamine receptor genes have a detectable variation referred to as the DRD2 TaqI polymorphism. Those who possess the A1 allele (variation) of this polymorphism have a small but significant tendency towards addiction to opiates and endorphin releasing drugs like alcohol. An allele (ˈæliːl (UK /əˈliːl/ (US (from the Greek αλληλος allelos, meaning each other) is one member of a pair or series of different forms ^[24] Although this allele is slightly more common in alcoholics and opiate addicts, it is not by itself an adequate predictor of alcoholism, and some researchers argue that evidence for DRD2 is contradictory. ^[22]

DSM diagnosis

The DSM-IV diagnosis of alcohol dependence represents one approach to the definition of alcoholism. The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association In part this is to assist in the development of research protocols in which findings can be compared with one another. According to the DSM-IV, an alcohol dependence diagnosis is:

. . . maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae. A sequela, (sɨˈkwiːlə plural sequelæ) is a Pathological condition resulting from a Disease, Injury, or other trauma.

Urine and blood tests

There are reliable tests for the actual use of alcohol, one common test being that of blood alcohol content (BAC). Blood alcohol content or blood alcohol concentration (abbreviated BAC) is the concentration of alcohol in a person's Blood. These tests do not differentiate alcoholics from non-alcoholics; however, long-term heavy drinking does have a few recognizable effects on the body, including:

• Macrocytosis (enlarged MCV)¹
• Elevated GGT²
• Moderate elevation of AST and ALT and an AST:ALT ratio of 2:1. Macrocytosis is the enlargement of Red blood cells with near-constant Haemoglobin concentration and is defined by a Mean corpuscular volume (MCV of greater The mean corpuscular volume, or MCV, is a measure of the average Red blood cell volume (i Gamma-glutamyl transferase ( GGT or GGTP, or Gamma-GT) ( is primarily a Liver Enzyme. Aspartate Transaminase ( AST) also called serum glutamic oxaloacetic transaminase ( SGOT) or aspartate aminotransferase ( ASAT/AAT Alanine transaminase or ALT is a Transaminase Enzyme ( It is also called serum glutamic pyruvic transaminase (SGPT or alanine aminotransferase
• High carbohydrate deficient transferrin (CDT)

However, none of these blood tests for biological markers are as sensitive as screening questionaires. Carbohydrate-deficient transferrin ( CDT) is a laboratory test used to help detect heavy Ethanol consumption

Effects

Main article: Alcohol consumption and health#Heavy consumption

The primary effect of alcoholism is to encourage the sufferer to drink at times and in amounts that are damaging. Regularly having more than two drinks a day increases the risk of developing Alcoholism, Alcoholic liver disease, and some forms of Cancer. The secondary damage caused by an inability to control one's drinking manifests in many ways.

It is common for a person suffering from alcoholism to drink well after physical health effects start to manifest. The physical health effects associated with alcohol consumption may include cirrhosis of the liver, pancreatitis, epilepsy, polyneuropathy, alcoholic dementia, heart disease, increased chance of cancer, nutritional deficiencies, sexual dysfunction, and death from many sources. Cirrhosis is a consequence of chronic Liver Disease characterized by replacement of liver tissue by fibrous Scar tissue as well as regenerative Pancreatitis is the Inflammation of the Pancreas. See also Acute pancreatitis and Chronic pancreatitis for more details Epilepsy is a common chronic Neurological disorder that is characterized by recurrent unprovoked seizures. Polyneuropathy is a Neurological disorder that occurs when many Peripheral nerves throughout the body malfunction simultaneously Wernicke-Korsakoff syndrome (also called Wet brain, Korsakoff psychosis alcoholic encephalopathy Wernicke's disease and encephalopathy - alcoholic is a manifestation Sexual dysfunction or sexual malfunction (see also Sexual function) is difficulty during any stage of the Sexual act (which includes desire,

Social effects

The social problems arising from alcoholism can be significant. Being drunk or hung over during work hours can result in loss of employment, which can lead to financial problems including the loss of living quarters. Termination of employment is the end of an Employee 's duration with an Employer. Drinking at inappropriate times, and behavior caused by reduced judgment, can lead to legal consequences, such as criminal charges for drunk driving or public disorder, or civil penalties for tortious behavior. Driving under the influence of alcohol ( driving while intoxicated, drunk driving, drinking and driving, drink-driving) or other drugs Tort law is the name given to a body of law that creates and provides remedies for civil wrongs that do not arise out of Contractual duties An alcoholic's behavior and mental impairment while drunk can profoundly impact surrounding family and friends, possibly leading to marital conflict and divorce, or contributing to domestic violence. NOTICE TO WOULD-BE ROMEOS ************** Divorce or dissolution of marriage is the termination of a Marriage. Domestic violence (also known as domestic abuse or spousal abuse) occurs when a family member partner or ex-partner attempts to physically or psychologically dominate This can contribute to lasting damage to the emotional development of the alcoholic's children, even after they reach adulthood. The alcoholic could suffer from loss of respect from others who may see the problem as self-inflicted and easily avoided.

Alcohol withdrawal

Alcohol withdrawal differs significantly from most other drugs because it can be directly fatal. While it is possible for heroin addicts, for instance, to die from other health problems made worse by the strain of withdrawal, an otherwise healthy alcoholic can die from the direct effects of withdrawal if it is not properly managed. Heroin ( INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid synthesized from Morphine, a derivative Heavy consumption of alcohol reduces the production of GABA, which is a neuroinhibitor. Gamma-aminobutyric acid (GABA is the chief inhibitory Neurotransmitter in the Mammalian Central nervous system. An abrupt stop of alcohol consumption can induce a condition where neither alcohol nor GABA exists in the system in adequate quantities, causing uncontrolled firing of the synapses. This manifests as hallucinations, shakes, convulsions, seizures, and possible heart failure, all of which are collectively referred to as delirium tremens. Delirium tremens (colloquially the DTs, " the horrors " " the fear "" the shakes "" jazz hands "" All of these withdrawal issues can be safely controlled with a medically supervised detoxification program.

Treatments

Treatments for alcoholism are quite varied because there are multiple perspectives for the condition itself. Those who approach alcoholism as a medical condition or disease recommend differing treatments than, for instance, those who approach the condition as one of social choice.

Most treatments focus on helping people discontinue their alcohol intake, followed up with life training and/or social support in order to help them resist a return to alcohol use. Since alcoholism involves multiple factors which encourage a person to continue drinking, they must all be addressed in order to successfully prevent a relapse. An example of this kind of treatment is detoxification followed by a combination of supportive therapy, attendance at self-help groups, and ongoing development of coping mechanisms. The treatment community for alcoholism typically supports an abstinence-based zero tolerance approach; however, there are some who promote a harm-reduction approach as well. Zero tolerance is the concept of compelling persons in positions of authority who might otherwise exercise their discretion in making subjective judgments regarding the severity of a given ^[9]

Effectiveness

The effectiveness of alcoholism treatments varies widely. When considering the effectiveness of treatment options, one must consider the success rate based on those who enter a program, not just those who complete it. Since completion of a program is the qualification for success, success among those who complete a program is generally near 100%. It is also important to consider not just the rate of those reaching treatment goals but the rate of those relapsing. Results should also be compared to the roughly 5% rate at which people will quit on their own. ^[25] A year after completing a rehab program, about a third of alcoholics are sober, an additional 40 percent are substantially improved but still drink heavily on occasion, and a quarter have completely relapsed. ^[26]

Detoxification

Main article: Alcohol detoxification

Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol drinking coupled with the substitution of drugs that have similar effects to prevent alcohol withdrawal. Alcohol detoxification, or detox, for individuals with Alcohol dependence, is the abrupt cessation of alcohol intake coupled with the substitution of alcohol with Alcohol detoxification, or detox, for individuals with Alcohol dependence, is the abrupt cessation of alcohol intake coupled with the substitution of alcohol with Alcoholism is a term with multiple and sometimes conflicting definitions

Detoxification treats the physical effects of prolonged use of alcohol, but does not actually treat alcoholism. After detox is complete, relapse is likely without further treatment. These rehabilitations (or 'rehabs') may take place in an inpatient or outpatient setting. A patient is any person who receives medical attention care or treatment.

Group therapy and psychotherapy

A regional service center for Alcoholics Anonymous. Alcoholics Anonymous ( AA) is an informal meeting society for recovering and recovered alcoholics, with the stated purpose to help its members "to stay sober and

After detoxification, various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues that are related to alcohol addiction, as well as provide relapse prevention skills. Group psychotherapy is a form of Psychotherapy in which one or more therapists treat a small group of clients together as a group Psychotherapy is an Interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living

The mutual-help group-counseling approach is one of the most common ways of helping alcoholics maintain sobriety. Many organizations have been formed to provide this service. Alcoholics Anonymous was the first group, and has more members than all other programs combined. Alcoholics Anonymous ( AA) is an informal meeting society for recovering and recovered alcoholics, with the stated purpose to help its members "to stay sober and Some of the others include LifeRing Secular Recovery, Rational Recovery, SMART Recovery, and Women For Sobriety. LifeRing Secular Recovery ( LifeRing or LSR) is a Secular, Non-profit organization providing peer-run addiction recovery groups for Rational Recovery ( RR) is a source of counseling guidance and direct instruction on self-recovery from Addiction, Alcohol and other drugs through SMART Recovery ( Self Management and Recovery Training) is an international Non-profit organization which provides assistance to individuals seeking abstinence from

Rationing and moderation

Rationing and moderation programs such as Moderation Management and DrinkWise do not mandate complete abstinence. Moderation Management ( MM) is a Secular Non-profit organization providing peer-run non-coercive Support groups for anyone who would like to reduce While most alcoholics are unable to limit their drinking in this way, some return to moderate drinking. A 2002 U. S. study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17. The National Institute on Alcohol Abuse and Alcoholism (NIAAA as part of the U 7% of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. However, this group showed fewer initial symptoms of dependency. ^[27] A follow-up study, using the same NESARC subjects that were judged to be in remission in 2001-2002, examined the rates of return to problem drinking in 2004-2005. The major conclusion made by the authors of this NIAAA study was "Abstinence represents the most stable form of remission for most recovering alcoholics". ^[28]

Medications

A variety of medications may be prescribed as part of treatment for alcoholism.

• Antabuse (disulfiram) prevents the elimination of acetaldehyde, a chemical the body produces when breaking down ethanol. Disulfiram is a drug used Disulfiram is a drug used Acetaldehyde, sometimes known as ethanal, is an organic chemical compound with the formula C[[Hydrogen H]]3CH O or MeCHO Acetaldehyde itself is the cause of many hangover symptoms from alcohol use. A hangover ( veisalgia) describes the sum of unpleasant physiological effects following heavy consumption of drugs particularly Alcoholic beverages The most commonly The overall effect is severe discomfort when alcohol is ingested: an extremely fast-acting and long-lasting uncomfortable hangover. This discourages an alcoholic from drinking in significant amounts while they take the medicine. A recent 9-year study found that incorporation of supervised disulfiram and a related compound carbamide into a comprehensive treatment program resulted in an abstinence rate of over 50%. Urea is an Organic compound with the Chemical formula ( N[[hydrogen H]]22 C[[oxygen O]] ^[29]

• Naltrexone is a competitive antagonist for opioid receptors, effectively blocking our ability to use endorphins and opiates. Naltrexone is an Opioid receptor antagonist used primarily in the management of Alcohol dependence and Opioid dependence. A competitive antagonist is a Receptor antagonist that binds to a receptor but does not activate the receptor Naltrexone is used in two very different forms of treatment. The first treatment uses naltrexone to decrease cravings for alcohol and encourage abstinence. The other treatment, called pharmacological extinction, combines naltrexone with normal drinking habits in order to reverse the endorphin conditioning that causes alcohol addiction. The Sinclair Method is a treatment for Alcoholism that involves the use of Opiate antagonists such as Naltrexone or Nalmefene in order
  Naltrexone comes in two forms. Oral naltrexone, originally but no longer available as the brand ReVia, is a pill form and must be taken daily to be effective. Vivitrol is a time-release formulation that is injected in the buttocks once a month. Naltrexone is an Opioid receptor antagonist used primarily in the management of Alcohol dependence and Opioid dependence.

• Acamprosate (also known as Campral) is thought to stabilize the chemical balance of the brain that would otherwise be disrupted by alcoholism. Acamprosate, also known by the brand name Campral, is a drug used for treating Alcohol dependence. Acamprosate, also known by the brand name Campral, is a drug used for treating Alcohol dependence. The Food and Drug Administration (FDA) approved this drug in 2004, saying "While its mechanism of action is not fully understood, Campral is thought to act on the brain pathways related to alcohol abuse. . . Campral proved superior to placebo in maintaining abstinence for a short period of time. . . "^[30] The COMBINE study was unable to demonstrate efficacy for Acamprosate. ^[31]

• Topiramate (brand name Topamax), a derivative of the naturally occurring sugar monosaccharide D-fructose, has been found effective in helping alcoholics quit or cut back on the amount they drink. Topiramate (brand name Topamax) is an Anticonvulsant drug produced by Ortho-McNeil Neurologics and Noramco Inc In one study heavy drinkers were six times more likely to remain abstinent for a month if they took the medication, even in small doses. ^[32] In another study, those who received topiramate had fewer heavy drinking days, fewer drinks per day and more days of continuous abstinence than those who received the placebo. ^[33] Topiramate works by reducing dopamine so that drinkers no longer get any pleasure from consuming alcohol and is the only medication shown to be effective for persons who are still drinking.

Societal impact

The various health problems associated with long-term alcohol consumption are generally perceived as detrimental to society, for example, money due to lost labor-hours, medical costs, and secondary treatment costs. Alcohol use is a major contributing factor for head injuries, motor vehicle accidents, violence, and assaults. Traumatic brain injury. THIS PAGE IS FOR INFORMATION ON HEAD INJURY (NOT SPECIFICALLY THE BRAIN--> Head injury is Beyond money, there is also the pain and suffering of the all individuals besides the alcoholic affected. Pain and suffering is the legal term for the physical and emotional stress caused from an injury (see also Pain and Suffering) For instance, alcohol consumption by a pregnant woman can lead to Fetal alcohol syndrome,^[34] an incurable and damaging condition. History Historical references Anecdotal accounts of prohibitions against maternal alcohol use from biblical, ancient Greek, and ancient Roman ^[35]

Estimates of the economic costs of alcohol abuse, collected by the World Health Organization, vary from one to six per cent of a country's GDP. ^[36] One Australian estimate pegged alcohol's social costs at 24 per cent of all drug abuse costs; a similar Canadian study concluded alcohol's share was 41 per cent. ^[37]

A study quantified the cost to the UK of all forms of alcohol misuse as £18. 5–20 billion annually (2001 figures). ^[38][10]

Stereotypes

Depiction of a wino or town drunk

Stereotypes of alcoholics are often found in fiction and popular culture. A stereotype (from Greek: stereo + týpos = "solid impression" is a generalized perception of first impressions behaviors presumed by a group Fiction is the telling of stories which are not real More specifically fiction is an imaginative form of Narrative, one of the four basic Rhetorical modes. Popular culture (or pop culture) is the Culture — patterns of human activity and the symbolic structures that give such activities significance and importance — The 'town drunk' is a stock character in Western popular culture. The town drunk (also called a tavern fool) is a Stock character, almost always Male, who is Drunk more often than sober. A stock character is one which relies heavily on cultural types or names for his or her personality manner of speech and other characteristics

Stereotypes of drunkenness may be based on racism, as in the depiction of the Irish as heavy drinkers. List of racism-related topics|Racism by country Racism, by its simplest definition is the belief that race is the primary determinant of human traits and capacities and that The Irish people ( Irish: Muintir na hÉireann, na hÉireannaigh, na Gaeil) are a Western European Ethnic group who originate ^[39][40] In Australia and Canada, Aboriginal people have similarly been stereotyped as alcoholics.

On the other hand, studies by social psychologists Stivers and Greeley^[41] attempt to document the perceived prevalence of high alcohol consumption amongst the Irish in America.

In Film and Literature

In modern times, the recovery movement has led to more realistic depictions of problems that stem from heavy alcohol use. Authors such as Charles R. Jackson and Charles Bukowski describe their own alcohol addiction in their writings. Charles R Jackson, Charles Reginald Jackson (1902-1968 was an American author best known for his 1944 novel The Lost Weekend. Henry Charles Bukowski ( August 16 1920 – March 9 1994) was a German American Poet, Novelist, and

Films like Days of Wine and Roses, My Name is Bill W., Arthur, Leaving Las Vegas, and The Lost Weekend, chronicle similar stories of alcoholism. Days of Wine and Roses ( 1962) is a film directed by Blake Edwards with a screenplay by JP Miller adapted from his own critically acclaimed My Name Is Bill W is a 1989 CBS Television movie directed by Daniel Petrie, starring James Woods and James Garner Arthur is a 1981 film set in New York City which tells the story of drunken playboy millionaire Arthur Bach ( Dudley Moore) who is on the brink of Leaving Las Vegas is a 1995 Romantic drama film about a relationship between a suicidal alcoholic and a Prostitute from Las Vegas The Lost Weekend is a 1945 motion picture directed by Billy Wilder for Paramount Pictures, starring Ray Milland,

Politics and public health

For more details on this topic, see Addiction recovery groups. Addiction recovery groups are voluntary associations of people who share a common desire to overcome drug addiction

Because alcohol use disorders are perceived as impacting society as a whole, governments and parliaments have formed alcohol policies in order to reduce the harm of alcoholism. The World Health Organization, the European Union and other regional bodies are working on alcohol action plans and programs. The European Union ( EU) is a political and economic union of twenty-seven member states, located primarily in

See also

• Adult Children of Alcoholics
• Alcohol consumption and health
• Alcohol-related traffic crashes
• Alcohol tolerance
• Drunkenness
• Ethanol Metabolism biochemical discussion of alcohol metabolism
• List of deaths through alcohol
• Substance abuse
• Wernicke-Korsakoff syndrome
• Medical diagnostics to test for alcohol use
  • Blood alcohol content
  • Full blood count
  • Liver function tests

References

Further reading

• Berry, Ralph E. ; Boland James P. The Economic Cost of Alcohol Abuse The Free Press, New York, 1977 ISBN 0-02-903080-3
• Royce, James E. and Scratchley, David Alcoholism and Other Drug Problems Free Press, March 1996 ISBN-10: 0-684-82314-4 ISBN-13: 978-0-684-82314-0
• Valliant, George E. , The Natural History of Alcoholism Revisited, Harvard University Press, May 1995 ISBN-10: 0-674-60378-8 ISBN-13: 978-0-674-60378-3
• Pence, Gregory, "Kant on Whether Alcoholism is a Disease," Ch. The Natural History of Alcoholism Revisited (1995 is a book by Psychiatrist George E 2, The Elements of Bioethics, McGraw-Hill Books, 2007 ISBN-10: 0-073-13277-2.
• Milam, Dr. James R. and Ketcham, Katherine Under The Influence: A Guide to the Myths and Realities of Alcoholism. Bantam, 1983, ISBN 0-553-27487-2
• Warren Thompson, MD, FACP. “Alcoholism. ” Emedicine. com, June 6, 2007. Retrieved 2007-09-02.
• Etiology and Natural History of Alcoholism. National Institute on Alcohol Abuse and Alcoholism.

External links

Alcoholism at the Open Directory Project