Alcoholism
How to detect and address problems with alcohol? Learn about the causes, symptoms, diagnostic tests, and treatment options for alcoholism.
Symptoms and Causes
Alcoholism, or alcohol use disorder, is a dependence on this psychoactive substance that is harmful to the body. In Spanish society, the consumption of alcoholic beverages is highly normalized, but it becomes a problem when abuse leads to physical and psychological illnesses or significantly and negatively impacts daily life.
According to data from the WHO, alcohol use disorder causes around three million deaths each year worldwide, accounting for 5.3% of all deaths. The percentage increases among people aged 20 to 39, with alcoholism playing a key role in 13.5% of deaths in this age group.
Depending on the level of dependence and the addict's behavior, alcoholism is classified into several types:
- Alpha alcoholism: causes psychological dependence, so there is no withdrawal syndrome. The individual controls their consumption but does not quit the habit because it helps them feel better.
- Beta alcoholism: social factors lead to regular excessive drinking, although no physical dependence is present. Even though abstinence does not cause discomfort, physical ailments (such as gastritis or cirrhosis) may still occur.
- Gamma alcoholism: involves both physiological and psychological dependence, resulting in periods of daily intoxication alternating with abstinence. Usually, the consumption phase ends when alcoholism causes serious health or social problems.
- Delta alcoholism: individuals are known as chronic drinkers and share similar characteristics with the previous type but are unable to abstain.
- Epsilon alcoholism: also known as dipsomania, involves long periods of abstinence suddenly interrupted by compulsive alcohol consumption.
In general, alcoholics tend to resist acknowledging their addiction, so they typically seek medical attention either under pressure or when the disorder is already advanced, by which time comorbidities such as cirrhosis, hepatitis, or personality disorders have developed. When an alcoholic refuses help, it is advisable to encourage positive thinking, show empathy, and—without coercion—instill the idea of seeking help.
Symptoms
Alcoholism causes severe damage to the body and manifests with the following symptoms:
- Delirium tremens: acute confusion caused by alcohol withdrawal, which leads to visual hallucinations (alcoholic hallucinosis), delusions, and intense emotional changes.
- Drunkenness
- Irritability
- Behavioral disorders
- Premature aging
- Inability to limit alcohol intake
Causes
There is no single cause of alcoholism; instead, multiple factors are involved, such as the normalization of alcohol use or the need to relieve physical or emotional pain.
Risk Factors
Some risk factors for developing alcohol dependence include:
- Family history
- Starting to drink at an early age
- Depression
- Low self-esteem
Complications
Alcoholism can lead to other conditions, including:
- Psychological disorders: depression, anxiety, psychosis
- Physical diseases: cirrhosis, hepatitis, pancreatitis, arrhythmias, neuronal damage, osteoporosis
- Increased risk of accidents
- Social and personal problems
- Death
Prevention
The best way to prevent alcoholism among adolescents is to avoid alcohol consumption before the age of 18 and to set a good example by not drinking frequently in front of them.
What specialist treats alcoholism?
Alcohol dependence is treated in psychology or psychiatry clinics. Diagnosis can also be made in a general medicine consultation.
Diagnosis
To diagnose alcoholism, the following tests are performed:
- Medical history and drinking habits
- General physical exam
- Blood tests, conducted to:
- Determine the mean corpuscular volume (MCV), i.e., the size of red blood cells, which is usually above normal in cases of excessive alcohol consumption.
- Measure gamma-glutamyl transferase (GGT), a liver enzyme that serves as a reliable marker for alcoholism. Elevated GGT levels indicate liver disease.
- Check transaminase levels, which increase due to excessive alcohol use and lead to liver cell damage.
- Perform a lipid profile, as high alcohol levels disrupt lipid metabolism, the process by which fats are broken down in the liver.
- Psychological evaluation: assesses mental health to determine how alcohol use affects the patient’s mental state and to identify any underlying disorders that may have triggered the addiction.
- Alcoholism screening tests: such as the MALT test, the Brief Alcoholism Screening Questionnaire (CBA), or the Alcohol Use Disorders Identification Test (AUDIT) to determine the severity of the disorder.
Treatment
For alcoholism treatment to be effective, the first step is getting the individual to acknowledge their addiction. Once accepted, treatment proceeds through several phases:
- Detoxification: complete cessation of alcohol intake. In severe cases, patients may experience withdrawal syndrome requiring hospitalization, continuous monitoring, and medication.
- Withdrawal support: medication and psychosocial therapies help patients give up the habit.
- Psychotherapy or group therapy to understand the disease and gain support in facing challenges.
- Pharmacological treatment: several medications are available to help individuals stop drinking.
- Rehabilitation and social reintegration: usually requires weekly follow-ups for approximately two years.
