Alcohol dependence

Fetal Alcohol Syndrome

Alcohol diagram

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Al-Anon Essen

The Drunkard's Progress 1846

Alcohol dependence, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems. The disorder was previously divided into two types: alcohol abuse and alcohol dependence. In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use. Risky situations include drinking and driving or having unsafe sex, among others. Alcohol use can affect all parts of the body but particularly affects the brain, heart, liver, pancreas, and immune system. This can result in mental illness, Wernicke–Korsakoff syndrome, an irregular heartbeat, liver cirrhosis, and an increased risk of cancer, among other diseases.

Causes

The causes of alcohol dependence are complex and multifactorial. Genetic, psychological, social, and environmental factors can influence the development and progression of the disorder. It is characterized by a pattern of compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.

Diagnosis

Diagnosis of alcohol dependence involves a comprehensive medical and psychological assessment. Criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD) are commonly used to diagnose AUD. These criteria include a strong desire to drink alcohol, difficulties in controlling its use, persisting in drinking despite harmful consequences, a higher priority given to alcohol use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.

Treatment

Treatment for alcohol dependence may involve a combination of psychosocial and pharmacological interventions. Psychosocial treatments include counseling, cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), and support groups like Alcoholics Anonymous (AA). Pharmacological treatments may include medications such as naltrexone, acamprosate, or disulfiram, which work to reduce the desire to drink or the effects of alcohol.

Prognosis

The prognosis for alcohol dependence varies depending on the severity of the dependence, the individual's personal health and life circumstances, and their willingness to engage with treatment and support. Recovery from alcohol dependence is a long-term process and often requires ongoing support to maintain sobriety.

Epidemiology

Alcohol dependence is a significant public health issue worldwide. It is a leading cause of morbidity and mortality and has a profound impact on individuals, families, and society. The prevalence of AUD varies by country and is influenced by cultural, social, and economic factors.

See also

• Alcohol abuse
• Substance use disorder
• Wernicke–Korsakoff syndrome
• Liver cirrhosis
• Cognitive behavioral therapy
• Alcoholics Anonymous

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