Description
Alcoholism is defined as the chronic, heavy consumption of alcohol. Over time, the body becomes physically dependent on alcohol. This coincides with the development of withdrawal symptoms upon the cessation of drinking. It is considered a chronic illness of unknown etiology. Intoxication often interferes with the ability to work and can lead to familial problems.
Alcohol is absorbed into the blood primarily from the small intestine. It accumulates in the bloodstream as it is more quickly absorbed than metabolized and excreted. Alcohol is considered a CNS depressant and people that become tolerant to alcohol also display tolerance to other CNS depressant drugs. The substance affects cell membranes, neurochemical systems, and the endocrine system. It primarily affects the brain and liver, and sexual functioning is also impaired. Very high doses of alcohol can be fatal due to respiratory depression.
The development of alcohol dependence occurs in four main stages which can take anywhere from five to twenty-five years to develop. The first stage includes the development of tolerance. This is the ability to drink a larger and larger quantity of alcohol before experiencing any of its effects. This stage is typical of heavy social drinkers. During the second stage, you are often not able to remember the events occurring while you were drinking. The third stage is marked by your loss of control over alcohol consumption. The fourth and final stage consists of long drinking binges and periods of intoxication with associated physiological or psychological sequelae.
Many people are able to stop their drinking behaviour during one of the first three stages. However, prevention is always best to avoid any complications. Keys to prevention include keeping to safe limits of alcohol intake, drinking slowly (do not "gulp" your drink down), and never drinking for relief of anxiety, tension, depression or on an empty stomach.
Symptoms and Signs: Symptoms of alcohol dependence are both behavioural and physical. Behavioural symptoms include hiding bottles (furtive behaviour) and aggressive or pompous behaviour. Personality changes and, often, frequent job changes soon occur. There may be changes in drinking pattern, which includes a change in type of alcohol consumed and when. The alcoholic often makes many promises to him/herself and to their loved ones to stop drinking. Food intake and personal appearance are neglected and longer periods of intoxication ensue.
The physical symptoms include nausea, vomiting, and morning shakes. You may experience abdominal pain and cramping, and numbness or tingling of the extremities. Weakness in legs and hands are often reported, as is an irregular pulse. Many capillaries in the face become enlarged and red. Other physical symptoms include unsteadiness, confusion, poor memory, and incontinence. People that are alcohol-dependent are more susceptible to other physical and mental diseases than those who are not.
Causes:
There is no specific cause of alcoholism. However, there are contributing factors that can cause people to be prone to alcohol dependence. Personality, environment, and the addictive nature of alcohol all interact in the etiology of the disease. Some believe that genetic factors also play a role. Availability, affordability, and social acceptance are important environmental factors. Stress is another important factor. It can cause moderate drinkers to begin to drink heavily in order to deal with grief. Some women turn to drinking when adolescent children move away from home.
What to Expect:
Toxicity
Alcohol is highly toxic to the liver. Chronic consumption of high amounts of alcohol often lead to liver damage or disease, which include fatty liver, hepatitis, and cirrhosis. This toxicity is compounded by inadequate nutrition secondary to high alcohol consumption. If the liver is permanently damaged, inadequate glycogen storage and hypoglycemia can result. Hypoglycemia is also accentuated by inadequate food intake.
People who are alcohol-dependent are particularly susceptible to thiamin deficiencies. The direct toxic effects of alcohol and the nutritional deficiencies are both responsible for nerve degeneration and brain damage that can result. This often presents itself as impaired cognition, memory, learning, and problem solving to name a few.
Alcohol is also toxic to the heart muscle. This, along with the thiamin deficiency, can lead to cardiomyopathies and arrythmias. Alcohol abuse affects the secretion of hormones, impairs sexual functioning (in both men and women), and increases your susceptibility to infectious diseases. Other alcohol-related disorders include cancer, liver damage or disease (particularly cirrhosis), nervous system disorders (such as peripheral neuropathies and brain damage), heart and circulatory disorders, psychiatric illness, gastritis, pancreatitis, peptic ulcers, and fetal alcohol syndrome (FAS).
Withdrawal Syndrome
Withdrawal from alcohol is unpleasant, to say the very least. It begins 12 to 48 hours after you stop drinking. With a mild withdrawal syndrome you can experience tremors, weakness, sweating, hyper-reflexia and gastrointestinal symptoms. Some people have seizures called alcoholic epilepsy or rum fits. More severe cases of withdrawal can be fatal. Some people will experience alcoholic hallucinations. This often follows abrupt abstinence from alcohol after prolonged excessive use. It resembles schizophrenia. Symptoms include auditory illusions and hallucinations that are often accusatory or threatening in nature. It is transient, however, and recovery occurs within one to three weeks. Recurrence is likely if you begin drinking excessively again.
People undergoing withdrawal customarily experience alcoholic hallucinations. These hallucinations are auditory in nature and are often accusatory and threatening. It may be mistaken for schizophrenia, but it is transient. Recovery occurs within one to three weeks.
Delirium tremens is also generally experienced during withdrawal. It begins 48 to 72 hours after alcohol withdrawal. Symptoms include perspiration, increased pulse rate, anxiety attacks, confusion, increasing temperature, poor sleep, frightening dreams, and depression. The person is often disoriented, and may perform a previously habitual task during the delirium; that is they might imagine they are at work and begin to perform the task they would do if at work. They are sensitive to many sensory stimuli. The person experiences what are called vestibular disturbances; they feel like the floor is moving or that the walls are falling. As the delirium progresses, they may experience a resting tremor of the head and/or trunk and ataxia. This stage of withdrawal usually comes to a close within 12 to 24 hours, ending with a long sleep, but it can be fatal. Generally, a high temperature indicates an adverse outcome.
Korsakoff's Syndrome
This is one of several complications of alcoholism. Memory of recent events is severely affected, such that confabulation ensues. Memory of distant events is not so severely affected. As a result, there is often a disorientation to time. There are also emotional changes that may leave you apathetic or emotionally unresponsive to events. There may be some improvement of the condition 1 to 2 years after onset. However, if there is irreversible brain damage due to a thiamine deficiency, improvement is unlikely.
Wernicke's Disease
This complication is related to thiamine deficiency more so than Korsakoff's syndrome. It is characterized by confusion, staggering gait, drowsiness, loss of memory, the inability to focus the eyes, tremors, agitation, and hypothermia.
Cerebellar Degeneration
This complication involves atrophy of certain parts of the brain, and its symptoms are ataxia of stance and gait.
Marchiafava-Bignami Disease
This is a rare disease whereby the brain is severely affected. People become agitated and confused. Progressive dementia is common. Some people recover over several months while others can experience seizures, coma, and likely death.
Pathologic Intoxication
This is a rare syndrome whereby the sufferer experiences extreme excitement, automatic movements, and irrational and aggressive behaviour after ingesting a small amount of alcohol. This could last minutes or hours. It is often followed by sleep. Once the person awakes, they do not remember the incident.
Remedies
Amino Acids
Carnitine has been shown to inhibit alcohol-induced fatty liver disease. It helps promote the breakdown of fats and improves liver function. Take 300mg three times daily.
Cysteine and glutathione have been shown to protect the liver from damage due to alcohol consumption. Take 500mg of cysteine, twice daily, and 300mg of glutathione.
Glutamine helps regulate brain function and is used as a source of fuel for the brain. It is excellent for the treatment of alcoholism and to prevent alcohol poisoning. Studies also show it can lower your cravings for alcohol. Take 1,000mg twice daily.
Taurine may help reduce symptoms of alcohol withdrawal. Take 500 to 1,000mg daily in divided doses.
Herbs
Dandelion root will help detoxify the liver. Gently boil 2 to 3 teaspoons powdered root per cup of water for 15 minutes. Let cool. Drink up to 3 cups daily
Milk Thistle can aid liver detoxification and can also repair liver damage. You should use a supplement containing at least 70 to 80 percent silymarin (the active ingredient). Take 70 to 210mg three times daily. You can take a higher dose if liver damage is severe.
Homeopathy
Certain remedies can be used in acute situations if your symptoms fit the symptom picture of the remedy. For dosages, see the dedicated section on Homeopathy. Consult your homeopath or naturopath to determine your constitutional remedy: the remedy that best fits you as a whole person. Your homeopath or naturopath will take a complete case history considering all of your mental and physical ailments and match these symptoms with the symptom picture of the remedy.
Crotalus-Horridus: For people who have a lot of varicosities on the nose and the lips and liver spots on the skin. Drowsy but cannot sleep. Numbness with a lot of trembling.
Lachesis: For chronic alcoholics. Becomes very sentimental when drinks. Cannot tolerate any tightness around the neck. Trembles.
Nux Vomica: Good for all stages of alcoholism. There is always need for stimulation. Gets drunk easily and sometimes becomes violent. Desires for beer, whisky, and brandy. The more one drinks, the more thirsty one becomes for alcohol. Can become sexually immoral. Ineffectual urge for stool, hearing impaired when drunk, trembling, hallucinations, highly sensitive.
Opium: For later stages of alcoholism. Person is obese, has a dark red face, and is always hot. Desires for brandy, beer, and liquor. Small amount of alcohol will cause trembling.
Sulphur: Drinking occurs only when depressed. Drinks on the sly and wants to drink alone.
Sulphuric-Acid: For later stages of alcoholism or chronic alcoholics. The person is very physically weak. Constant internal trembling, sensation of coldness in the stomach, cravings for acidic fruits, bruises and bleeds easily.
Food Supplements
The intestinal flora of alcoholics is severely compromised. Acidophilus and Bifidus supplementation will restore beneficial bacteria counts and help keep harmful bacteria at bay. It is essential that these bacteria be restored to the body, particularly after the use of antibiotics. Look for a dairy-free formulation with at least 2.5 billion viable cultures per capsule and keep refrigerated. Take 2 or 3 capsules daily on an empty stomach, preferably in the morning or right before bed. Supplements with Fructooligosaccharides (FOS) provide a beneficial "bed" and initial food source for the bacteria. If dairy allergies have been ruled out, you can also eat yogurt that has had either bacterial culture added.
Supplementing with an omega 6 fatty acids, such as evening primrose oil may decrease the severity of withdrawal symptoms and may prevent liver damage. Take 500 to 1,000mg daily.
Pantethine may help prevent liver disease, cardiomyopathy, and atherosclerosis due to alcohol abuse. Take 300mg two to three times daily.
Lifestyle
A well balanced diet is imperative for the prevention of alcohol-related diseases. It can also curb cravings and reduce symptoms of withdrawal. Alcohol inhibits the absorption of many vitamins and other nutrients. It also impairs the absorption of water and salt.
In one experiment, 32 people with hypertension were given a diet whereby 62 percent of the calories they consumed were from raw foods. These patients ate this diet for an average of 6.7 months. Eighty percent of the patients that smoked or drank alcohol spontaneously stopped doing so.
Social treatment includes getting help with problems at work, and especially, inclusion of family members in the treatment process. It is strongly advised by many leading authorities to join a self-help organization such as Alcoholics Anonymous (AA). This type of group therapy has been touted as the most effective approach to remaining sober. Find one in your area in which you feel comfortable with, that has members with similar interests. A contact for AA is listed below.
Minerals
Chromium will help to stabilize blood sugar levels (which helps to prevent cravings). Take 200mcg daily.
Magnesium is often deficient in alcoholics and also prevents withdrawal symptoms. Take 250 to 500mg daily.
Selenium is a powerful antioxidant. Take 200mcg daily or eat brazil nuts. This mineral should be taken along with vitamins C and E to enhance its effects.
Zinc deficiency has been noted in alcoholics and supplementation can help prevent alcohol toxicity. Take 25 to 50mg daily.
Therapies, Healing Aids and More
Exercise is a great way to help decrease stress levels. Take up a new sport or join a health club. Many health clubs provide fitness instructors or trainers that can help design a fitness program that is right for you and that you can enjoy. It is also fun to go with a friend.
Vitamins
Folic acid also helps prevent complications due to alcoholism. Low folate levels have also been associated with depression. Take 1mg daily.
Vitamin A deficiency is quite common among those who are alcohol dependent. The deficiency can lead to several common disorders associated with alcoholism (night blindness, skin disorders, etc.). One animal study showed that supplementation with vitamin A inhibited alcohol consumption by male rats. However, the same was not true of female rats. The suggested dose for vitamin A supplementation is 25,000 IU daily. This should be supplemented ONLY if you are currently abstaining from alcohol AND if there is no evidence of liver damage.
Vitamin B Complex is often deficient in alcoholic and this in turn may increase cravings for alcohol. Take 50mg twice daily.
Vitamin B1 is a key vitamin that is often deficient in those dealing with this condition. Thimine deficiency may be responsible for Wernicke's Syndrome. Supplementation will help restore B1 levels and help reduce alcohol cravings. It may also be beneficial for those suffering from alcohol psychosis. Take 50 to 100mg daily. It is likely you will require higher doses, administered by injection. Consult with your naturopath or other health practitioner.
Vitamin B3, or niacin, supplementation can reduce toxicity and alcohol craving. Take 250mg twice daily. Do not be alarmed if you experience a "Niacin Flush". This natural dilation of blood vessels around your limbs at upper chest area will subside after approximately 15 minutes.
B12 helps prevent complications due to alcoholism. Take 1,000mcg daily in sublingual form.
Studies with vitamin C show that it helps to reduce the effects of alcohol toxicity. Vitamin C may help to prevent fatty infiltration of the liver. It has also been shown that higher levels of vitamin C in white blood cells is associated with a faster rate of detoxification and removal of alcohol from the bloodstream. Take 1,000mg three times daily. This vitamin should be taken with vitamin E and selenium to enhance its effects.
Vitamin E is a well known antioxidant. It protects the liver from damage. It also can prevent fatty infiltration of the liver. Take 400 to 800 IU daily. This vitamin should be taken with vitamin C and selenium to enhance its effects.
Actions and Remedy Listings
For More Information ...
Alcoholics Anonymous (A)
234 Eglinton Avenue East, Suite 202
Toronto, ON, Canada
M4P 1K5
Tel: 416.487.5591
Fax: 416.487.5855
Canadian Centre on Substance Abuse
75 Albert Street, Suite 300
Ottawa, ON, Canada
K1P 5E7
Tel: 613.235.4048
Fax: 613.235.8101
Centre for Addiction and Mental Health
33 Russell Street
Toronto, ON, Canada
M5S 2S1
Tel: 416.595.6000
Fax: 416.595.5017
Website: www.camh.net
Metro Addiction Assessment Referral Service (MAARS)
175 College Street
Toronto, ON, Canada
M5T 1P7
Tel: (416) 599-1448
Fax: (416) 599-1324
Breakaway Youth and Family Services
2 Dunbloor Road, Suite 302
Etobicoke, ON, Canada
M9A 2E4
Tel: 416.234.1942
Fax: 416.234.5702
Toll Free: 1-800-863-6209
E-mail: breakwy@inforamp.net
Web Site: www.breakawayyouth.org
Rainbow Centre (alternative therapy available)
18 Eastern Avenue
Toronto, ON, Canada
M5A 1H5
Tel: 416.361.1669
Fax: 416.363.6875
See also
Substance Abuse.
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