Alcohol use disorder is real. Learn when drinking starts becoming harmful and what steps to take next.
What is alcohol use disorder?
In the U.S., more than half of a population aged 12 years and more are current drinkers. A small amount of alcohol could be harmless, but how do you distinguish when your drinking is a problem? Drinking alcohol is a problem when it negatively affects your daily activities and social and professional life.
Alcohol use disorder is a medical term that healthcare professionals use to describe alcohol addiction. You or someone around you may have alcohol use disorder if two or more of the following are present: A person
If you think you have an alcohol use disorder, the first step is to meet your GP.
During alcohol use, people have symptoms of alcohol intoxication. The latter is caused by excessive amounts of alcohol in the bloodstream. Symptoms of alcohol intoxication are
When a person with alcohol use disorder stops drinking, “withdrawal symptoms” occur. Here is the list of common “ withdrawal symptoms”:
Some people are not alcohol dependent but are in a high-risk group for developing alcohol use disorder or alcohol-related problems. They occasionally feel consequences of heavy alcohol drinking, e.g., accidental injuries.
When we talk about problem drinkers, first, we should outline what is called one standard drink.
In the U.S. a standard drink contains about 0.6 fluid ounces or 14 grams of “pure” alcohol and is the equivalent of
🗸 12 oz beer (5%)
🗸 8–9 oz malt liquor (7%)
🗸 5 oz wine (12%)
🗸 1.5 oz hard liquor (40%)
Moderate drinkers have a low risk of alcohol-related problems. Moderate drinkers drink no more than one drink per day (for women and people over 65) and no more than two drinks per day (for men).
Heavy drinkers are in a high-risk group for having alcohol-related problems.
Binge drinkers are another group of people that have drinking problems. They only drink on occasions: within about two hours, women drink more than 4 drinks and men more than 5 drinks.
Some factors increase the risk of getting alcohol use disorder.
Alcohol affects and depresses the nervous system. It impairs judgment, thinking, and memory and puts a drinker in immediate physical danger. The complications are also related to the devastating effects of alcohol on different organs of our body.
Dangerous situations and behaviors related to alcohol use are:
Health-related problems are diverse and include almost every organ system. Health problems that are caused by heavy drinking are :
A healthcare specialist will ask you some questions about your habits, past medical history, and family history. The questions include the amount and frequency of alcohol consumption, the impact of drinking on your life and the presence or absence of withdrawal symptoms. Based on these questions your disorder will be specified as mild, moderate or severe. During a thorough physical exam, a healthcare professional also will look for signs of alcohol consequences on your physical health.
There are no lab tests or imaging tests for the diagnosis of alcohol use disorder. But some of them are essential for the diagnosis of complications and for the evaluation of different organs (e.g., liver, heart, etc.). Sometimes, you may be referred to another specialist, including a mental health professional, for a comprehensive psychological evaluation.
Usually, before the start of treatment, the care team establishes a goal. Ideally, the goal of treatment is to fully exclude alcohol from your life, but sometimes, lowering the amount of consumption also could be acceptable. The complete stop of alcohol consumption is called abstinence.
Identification and treatment of alcohol withdrawal is another key aspect of treating alcohol use disorder. If left untreated, alcohol withdrawal symptoms can cause fear and avoidance from treatment.
Treatment plans for alcohol use disorder vary depending on the disorder’s severity. Some people may need to stay in a specialised centre (inpatient treatment) for rehabilitation (rehab). The presence of complications also should be taken into account before the initiation of treatment.
Treatment options for mild disorders are behavioural treatments and support groups. But treatment of severe alcohol use disorder should include medications. Medications help to stop or lower the consumption of alcohol or prevent resuming drinking. Several agents are effective for treatment: naltrexone, acamprosate, disulfiram and topiramate. All these medications are available in oral dosage forms, and only naltrexone is available as a solution for intramuscular injection (brand name Vivitrol).
Vivitrol is prescription injectable medicine. It is an opioid antagonist, which means that it blocks opioid receptors. These receptors are responsible for the feeling of euphoria and “high” that is caused by alcohol and opioids.
Vivitrol reduces alcohol cravings and the amount of alcohol that you use. Vivitrol is not an opioid, which means that it can’t cause addiction or withdrawal symptoms. When starting Vivitrol, you should not be physically dependent on alcohol or other substances. Vivitrol is usually used after the detox process.
In comparison to oral naltrexone, which is taken daily, Vivitrol is injected once monthly by a specialist. It is injected into the muscle of your buttocks by a healthcare provider. You can’t inject yourself, because serious reactions might happen.
Before starting treatment with Vivitrol, you should tell your healthcare provider if you:
Call your healthcare specialist if any of these side effects bother you and do not go away.
Prognosis
For most people, treatment of alcohol use disorder is effective. Fighting alcohol dependence is an ongoing process. You may relapse (return to alcohol consumption), especially to cope with stress. Though, you should keep trying to quit and return to treatment right away.
Sources:
Cleveland Clinic
Medline Plus
UpToDate
Vivitrol.com
Substance Abuse and Mental Health Administration
