Alcohol abuse

For chronic alcohol abuse that results in significant health problems, see Alcoholism.
"Excessive drinking" redirects here. For excessive consumption of water and other liquids, see Polydipsia.
Alcohol abuse
"The Drunkard's Progress", 1846
SpecialtyPsychiatry
SymptomsRelationship difficulties, legal problems, problems at work or school, insomnia, irritability, chronic fatigue.
ComplicationsAlcoholic liver disease, Pancreatitis (acute or chronic), cancer
Diagnostic methodClinical history, DSM-5 criteria
TreatmentContingency management, motivational interviewing, Alcoholics Anonymous meeting attendance
The 2010 ISCD study "Drug Harms in the UK: a multi-criteria decision analysis" found that alcohol scored highest overall and in Economic cost, Injury, Family adversities, Environmental damage, and Community harm.

Alcohol abuse encompasses a spectrum of alcohol-related substance abuse, ranging from the consumption of more than 2 drinks per day on average for men, or more than 1 drink per day on average for women, to binge drinking or alcohol use disorder.[1]

Alcohol abuse was a psychiatric diagnosis in the DSM-IV, but it has been merged with alcohol dependence in the DSM-5 into alcohol use disorder.[2][3]

Globally, excessive alcohol consumption is the seventh leading risk factor for both death and the burden of disease and injury,[4] representing 5.1% of the total global burden of disease and injury, measured in disability-adjusted life years (DALYs).[5] After tobacco, alcohol accounts for a higher burden of disease than any other drug. Alcohol use is a major cause of preventable liver disease worldwide, and alcoholic liver disease is the main alcohol-related chronic medical illness.[6] Millions of people of all ages, from adolescents to the elderly, engage in unhealthy drinking.[7] In the United States, excessive alcohol use costs more than $249 billion annually.[8] There are many factors that play a role in causing someone to have an alcohol use disorder: genetic vulnerabilities, neurobiological precursors, psychiatric conditions, trauma, social influence, environmental factors, and even parental drinking habits.[9]

Definitions

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Main article: Binge drinking

Risky drinking (also called hazardous drinking) is defined by drinking above the recommended limits:

  • greater than 14 standard drinks units per week or greater than 4 standard drinks on a single occasion in men[10]
  • greater than 7 standard drinks units per week or greater than 3 standard drinks on a single occasion in women[10]
  • any drinking in pregnant women or persons < 21 years old[10]

Binge drinking is a pattern of alcohol consumption that brings blood alcohol concentration ≥ 0.08%, usually corresponding to:

  • ≥ 5 standard drinks on a single occasion in men[10]
  • ≥ 4 standard drinks on a single occasion in women[10]

In the DSM-IV, alcohol abuse and alcohol dependence were defined as distinct disorders from 1994 to 2013. The DSM-5 combined those two disorders into alcohol use disorder with mild, moderate, and severe sub-classifications of severity. The term "alcoholism" is no longer a diagnosis in medical care.[11]

Alcohol misuse is a term used by United States Preventive Services Task Force to describe a spectrum of drinking behaviors that encompass risky drinking, alcohol abuse, and alcohol dependence (similar meaning to alcohol use disorder but not a term used in DSM).[12]

Signs and symptoms

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Main articles: Alcohol and health and Long-term effects of alcohol consumption

Individuals with an alcohol use disorder will often complain of difficulty with interpersonal relationships, problems at work or school, and legal problems. Additionally, people may complain of irritability and insomnia.[13] Alcohol use disorder is also an important cause of chronic fatigue.[14] Signs of alcohol abuse are related to alcohol's effects on organ systems. However, while these findings are often present, they are not necessary to make a diagnosis of alcohol abuse. Alcohol use disorder causes acute central nervous system depression which leads to inebriation, euphoria, impulsivity, sedation and poor judgment. Chronic alcohol use may lead to dependence, reckless behavior, anxiety, irritability, and insomnia.

Alcohol is hepatotoxic and chronic use leads to elevated liver enzyme levels in the bloodstream (classically the aspartate aminotransferase level is at least twice as high as the alanine transaminase level), cirrhosis, and liver failure. Cirrhosis leads to an inability to process hormones and toxins and increased estrogen levels. The skin of a patient with alcoholic cirrhosis can feature spider angiomas, palmar erythema, and — in acute liver failure — jaundice and ascites. The derangements of the endocrine system may lead to the enlargement of the male breasts. The inability to process toxic metabolites such as ammonia in alcoholic cirrhosis may lead to hepatic encephalopathy.

Alcohol is also an established carcinogen and its excessive use causes an increased risk of various cancers, such as breast cancer and head and neck cancer.[15][16] Using alcohol, especially together with tobacco, is a major risk factor for head and neck cancer. 72% of head and neck cancer cases are caused by using both alcohol and tobacco.[17] This rises to 89% when looking specifically at laryngeal cancer.[18]

Chronic alcohol use is also associated with malnutrition, Wernicke-Korsakoff syndrome, alcoholic cardiomyopathy, hypertension, stroke, arrhythmias, pancreatitis, depression, and dementia. Alcohol is also an established carcinogen with chronic use associated with increased risk of cancer.[15][16]

Alcohol use disorder can result in brain damage which causes impairments in executive functioning such as impairments to working memory and visuospatial function. Alcohol abuse is also associated with incidence of personality disorders, affective disorders, and emotional dysregulation.[19][20] Binge drinking is associated with individuals reporting fair to poor health compared to non-binge drinking individuals and which may progressively worsen over time. Alcohol also causes impairment in critical thinking, ability to handle stress, and attention.[21] Alcoholism can cause significant impairment in social skills, due to the neurotoxic effects of alcohol on the brain, especially the prefrontal cortex area of the brain. The prefrontal cortex is responsible for cognitive functions such as working memory, impulse control, and decision making. This region of the brain is vulnerable to chronic alcohol-induced oxidative DNA damage.[22] The social skills that can be impaired by alcohol abuse include impairments in perceiving facial emotions, difficulty with perceiving vocal emotions, theory of mind deficits, and ability to understand humor.[23] Adolescent binge drinkers are most sensitive to damaging neurocognitive functions especially executive functions and memory.[24] People who abuse alcohol are less likely to survive critical illness with a higher risk for having sepsis and increased risk of death during hospitalization.[25] Cessation of alcohol use after dependence is formed may lead to alcohol withdrawal disorder and associated sequela including seizures, insomnia, anxiety, cravings, and delirium tremens.[8]

A smaller volume of consumed alcohol has a greater impact on the older adult than it does on a younger individual. As a result, the American Geriatrics Society recommends for an older adult with no known risk factors less than one drink a day or fewer than two drinks per occasion regardless of gender.[26][27][28][29][30][21][31][32][33][excessive citations]

Violence

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Alcohol use disorder has a significant association with suicide and violence. Though many people with Alcohol use disorder may take alcohol to ease their mental suffering, an increased intake of alcohol may serve to further exacerbate psychological issues. This could lead to an increase in suicidal behavior.[34] Alcohol has been implicated in up to 80 percent of suicides and 60 percent of violent acts in Native American communities.[35][failed verification]

Pregnancy

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A label on alcoholic drinks promoting zero alcohol during pregnancy

Alcohol consumption during pregnancy can pose significant risk facts, as it can harm the developing fetus. The umbilical cord is a direct pathway for the mother's blood alcohol to reach the infant, which can result in miscarriage, and a number of lasting physical and cognitive impairments that can persist throughout the child's life.

Among pregnant women, alcohol use disorder can result in a condition called fetal alcohol syndrome. Fetal alcohol syndrome is a pattern of physical abnormalities and impairments of mental development seen among children of alcoholic mothers.[36] Fetal alcohol syndrome is the most common preventable cause of intellectual disability in the United States. Symptoms include a thin upper lip, short palpebral fissures, smooth philtrum, microcephaly, and other facial dysmorphic features. Surviving infants may also have structural heart defects, heart-lung fistulas, skeletal abnormalities, impaired renal development, short stature, and various cognitive disabilities. Prenatal alcohol exposure is associated with lasting deleterious effects on the endocrine, reproductive, and immune systems. Prenatal alcohol exposure is also associated with increased incidence of disease, cancer, and behavioral issues during adulthood[37][38] There is no safe quantity or time period for alcohol use during pregnancy and complete abstinence is recommended.[39][40] Therefore, the biological implications of alcohol abuse are also further reaching than just the physical issues experienced by the consumer.[41]

Adolescence

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Adolescence and the onset of puberty invoke significant physical, social, emotional, and cognitive changes. Increases in risk-taking, impulsivity, reward sensitivity, and social behavior lead to the emergence of alcohol use.[42][43] New research is shedding light on pre-existing neurobiological markers that are predictive for the initiation of drug and alcohol abuse in adolescents.[44] Alcohol use in adolescence is consistently associated with loss of grey matter volume, aberrant white matter development, and poor white matter integrity. A dose-dependent relationship among adolescent alcohol users is also consistently found for declines in various areas of cognition including executive function, visuospatial learning, impulsivity, working memory, attention, and language abilities. In the US, about 38% of adolescents aged 15–19 drink with 19% being classified as binge drinkers.[42] Adolescents who drink are more likely to display symptoms of conduct disorder including disruptive behavior in school, violating social norms or the rights of others, aggression, learning disabilities, and other social impairments.[45]

Alcohol abuse during adolescence greatly increases the risk of developing an alcohol use disorder in adulthood due to changes to neurocircuitry in the vulnerable adolescent brain.[46] Younger ages of initial consumption among males in recent studies has shown to be associated with increased rates of alcohol abuse within the general population.[47]

Risk factors

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The causes of alcohol abuse are complex and multi-faceted. Alcohol abuse is related to economic and biological origins and is associated with adverse health consequences.[45] Peer pressure influences individuals to abuse alcohol; however, most of the influence of peers is due to inaccurate perceptions of the risks of alcohol abuse.[48] Easy accessibility, social influence, and positive and negative reinforcement contribute to continued use. Another influencing factor among adolescents and college students are the perceptions of social norms for drinking; people will often drink more to keep up with their peers, as they believe their peers drink more than they actually do. They might also expect to drink more given the context (e.g. sporting event, house party, etc.).[49][50] This perception of norms results in higher alcohol consumption than is normal. Alcohol abuse is also associated with acculturation, because social and cultural factors such as an ethnic group's norms and attitudes can influence alcohol abuse.[51]

Mental illness

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Alcohol consumption is often used as a temporary reprieve from states of severe anxiety, stress, or depression. Among individuals with mood disorders and anxiety disorders, the prevalence of a comorbid alcohol use disorder was significant. One study suggests that the median lifetime prevalence of alcohol use disorder in individuals with major depressive disorder was 30% across 35 US epidemiological studies. Despite this evidence, debate exists among how the relationship exists between alcohol use disorder and mood and anxiety disorders. That is, the role of alcohol use disorder as casual in depression and anxiety and alcohol use disorder as resultant have been established within the literature.[52]

The numbing effects afforded by alcohol and other substances can serve as a coping strategy for traumatized people otherwise are unable to dissociate themselves from trauma. However, the altered or intoxicated state of the abused person prevents the full consciousness necessary for healing.[53] Often both the alcohol misuse and psychological problems need to be treated at the same time.[citation needed]

Puberty

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Gender differences may affect drinking patterns and the risk for developing alcohol use disorders.[54] Sensation-seeking behaviors have been previously shown to be associated with advanced pubertal maturation, as well as the company of deviant peers.[43] Early pubertal maturation, as indicated by advanced morphological and hormonal development, has been linked to increased alcohol usage in both male and female individuals.[55] Additionally, when controlling for age, this association between advanced development and alcohol use still held true.[56]

Until recently, the underlying mechanisms mediating the link between pubertal maturation and increased alcohol use in adolescence was poorly understood. Now research has suggested that sex steroid hormone levels may play a role in this interaction. When controlling for age, it was demonstrated that elevated estradiol and testosterone levels in male teenagers undergoing pubertal development was linked to increased alcohol consumption.[57] It has been suggested that sex hormones promote alcohol consumption behaviors in teens by stimulating areas in the male adolescent brain associated with reward processing. The same associations with hormone levels were not demonstrated in females undergoing pubertal development. It is hypothesized that sex steroid hormones, such as testosterone and estradiol, are stimulating areas in the male brain that function to promote sensation-seeking and status-seeking behaviors and result in increased alcohol usage.[57]

Additionally, the enzyme TTTAn aromatase, which functions in the male brain to convert testosterone to estradiols, has been linked to addictive and reward-seeking behaviors. Therefore, the increased activity of the enzyme may be influencing male adolescent alcohol-usage behaviors during pubertal development.[58] The underlying mechanisms for female alcohol consumption and abuse is still under examination, but is believed to be largely influenced by morphological, rather than hormonal, changes during puberty as well as the presence of deviant peer groups.[55]

Genetic Influences

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Several research studies suggest significant genetic contributions to alcohol use disorder. According to some adoption research, biological influences were strongly related to outcomes of adoptees. Among adoptees, a stronger correlation was found between alcohol use disorder and their biological parents than their adoptive parents. Other research adds that while multiple genes may be potentially implicated, alcohol dehydrogenase 1B (ADH1B) and aldehyde dehydrogenase 2 (ALDH2; mitochondrial aldehyde dehydrogenase), have been chiefly associated with excess alcohol consumption.

Nevertheless, it is important to note that alcohol use disorder entails a biopsychosocial component and genetics alone may not necessarily be causal in alcohol use disorder. There are numerous contributing risk factors which add to the complexity of alcohol including age, environment, psychiatric comorbidities and other substance use.[59]

Mechanisms

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Effects of alcohol use on volume of various brain regions

Excessive alcohol use causes neuroinflammation and leads to myelin disruptions and white matter loss. The developing adolescent brain is at increased risk of brain damage and other long-lasting alterations to the brain.[60] Adolescents with an alcohol use disorder damage the hippocampal, prefrontal cortex, and temporal lobes.[46] Chronic alcohol exposure can result in increased DNA damage in the brain, as well as reduced DNA repair and increased neuronal cell death.[61] Alcohol metabolism generates genotoxic acetaldehyde and reactive oxygen species.[62]

The brain goes through dynamic changes during adolescence as a result of advancing pubertal maturation, and alcohol can damage long- and short-term growth processes in teenagers.[63] The rewarding effects of alcohol are attributed to dopamine, serotonin, GABA, endocannabinoids, serotonin and opioid peptides.[8]

Alcohol is the most recreationally used drug internationally,[64] throughout history it has played a variety of roles, from medicine to a mood enhancer. Alcoholism and alcohol abuse however have undergone rigorous examination as a disease which has pervasive physiological and biosocial implications. The genesis and maintenance of the disease involves the mind, body, society and culture. A common anthropological approach to understanding alcoholism is one which relates to a social factor, and this is cross-cultural studies. The description and analysis of the degree of possibilities in drinking and its results among various populations indeed constitutes one of anthropology's major contributions to the field of alcohol studies. Understanding interactions between factors and evaluating ideas regarding how alcohol usage correlates to other cultural elements requires a number of cross-cultural comparisons. Anthropologists have analyzed a large global sample of cultures examining the association between particular traits for each which relate to the cultural components of alcoholism, these include significant measures which emphasize the social system, reliance and anxiety and strength as physical and social measures. These are the primary drivers of consuming alcohol affecting individuals on a psychosocial level.[65]

Cultural influences

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Individualistic cultures such as the United States or Australia are amongst some of the highest consumers of alcohol in the whole world,[4] however this rate of consumption does not necessarily coincide with the rate of abuse as countries like Russia which are highly collectivist see the highest rates of alcohol use disorder. Research suggests that people who score highly on individualism, a trait commonly fostered by the culture, report a lower rate of alcohol abuse and alcohol related disorders so much so that the association was negative, however a higher average consumption of alcohol per week. It is implied that individuals will drink more in a given setting, or on average because they are less receptive towards negative social attitudes surrounding excessive consumption. This however acts on another component, by where individualism protects from maladaptive consumption by lowering the need to drink socially. The final axis by which individualism protects from abusive consumption is that it promotes higher degrees of individualization and achievement values which promote personally suited rewards, this allow the individual to be more cognizant of potential alcohol abuse, and therefore protect from damaging mentalities in those who already identify as drinkers.[66]

Alcohol use disorder also has a variety of biosocial implications, such as the physiologically effects of a detox, how the detox period interacts with ones social life and how these interactions can make overcoming addiction a complex, difficult process. Alcohol use disorder can lead to a number of physical issues and may even create a mental health condition, leading to a double classification for the alcoholic. The stress, the social perceptions of these issues may reinforce abusive drinking habits.

Diagnosis

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DSM-IV

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Alcohol abuse was defined in the DSM-IV as a maladaptive pattern of drinking. For its diagnosis, at least one of the following criteria had to be fulfilled in the last 12 months:

  • Recurrent use of alcohol resulting in a failure to fulfill major role obligations at work, school, or home
  • Recurrent alcohol use in situations in which it is physically hazardous
  • Recurrent alcohol-related legal problems
  • Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol [67][68]

DSM-5

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The alcohol abuse diagnosis is no longer used in the DSM-5 (released in 2013), it is now part of the alcohol use disorder diagnosis. Of the four alcohol abuse criteria, all except the one referring to alcohol-related legal problems are included in the alcohol use disorder criteria.[69]

See also: Alcohol dependence § Diagnosis, and Alcohol use disorder § Diagnosis

Screening

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See also: Alcohol dependence § Screening

The Alcohol Use Disorders Identification Test (AUDIT) is considered the most accurate alcohol screening tool for identifying potential alcohol misuse, including dependence.[70] It was developed by the World Health Organisation, designed initially for use in primary healthcare settings with supporting guidance.[71]

Prevention

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The United States Navy provides informative, in-depth training on alcohol and drug abuse prevention to sailors and supervisors.
Further information: Alcohol education

Preventing or reducing the harm has been called for via increased taxation of alcohol, stricter regulation of alcohol advertising, and the provision of brief Interventions. Brief Interventions for alcohol abuse reduce the incidence of unsafe sex, sexual violence, unplanned pregnancy, and, likely, STD transmission.[72] Information and education on social norms and the harms associated with alcohol abuse delivered via the internet or face-to-face has not been found to result in any meaningful benefit in changing harmful drinking behaviours in young people.[48]

According to European law, individuals who are suffering from alcohol abuse or other related problems cannot be given a driver's license, or if in possession of a license cannot get it renewed. This is a way to prevent individuals driving under the influence of alcohol, but does not prevent alcohol abuse per se.[73]

An individual's need for alcohol can depend on their family's alcohol use history. For instance, if it is discovered that their family history with alcohol has a strong pattern, there might be a need for education to be set in place to reduce the likelihood of reoccurrence (Powers, 2007).[74] However, studies have established that those with alcohol abuse tend to have family members who try to provide help. On many of these occasions, the family members would try to help the individual to change or to help improve the individual's lifestyle.[citation needed]

Social stigma

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Several research studies suggest that stigmatization of substance use disorder is partially rooted in the belief that addiction is not a chronic illness but rather a conscious decision indicative of poor self-control or lacking restraint. Necessarily, public and internalized stigma surrounding alcoholism can have widespread effects. In an epidemiological survey of individuals with reported alcohol use disorder, the desire to both initiate and complete treatment were severely impacted by the stigma of substance use disorder. Participants conveyed fears pertaining to social rejection and discrimination, job loss, and potential legal consequences.

Men's issues with alcohol are shockingly common, yet societal norms often downplay the severity of this problem. Prevailing cultural images of men as stoic figures who can handle their alcohol perpetuate the dangerous myth that excessive drinking is a sign of strength. However, the reality is far from this stereotype, as men face unique challenges contributing to their struggles with alcohol, such as societal expectations, workplace pressures, and traditional notions of masculinity that discourage vulnerability.[75]

A major barrier to seeking treatment for those struggling with alcohol abuse is the stigma associated with alcohol abuse itself. Those who struggle with alcohol abuse are less likely to utilize substance (or alcohol) abuse treatment services when they perceived higher stigma with alcohol abuse.[76] Additionally, study participants described the physical act of initiating treatment as substantiation of problematic drinking. Others attempted to avoid treatment and subsequent stigmatization by adjusting drinking behaviors to what they believed to be less maladaptive. Modifications included limiting excessive drinking to non-school or workdays, avoiding alcohol consumption before 5PM, or limiting use to weekends.[76][77] stigmatization of individuals who abuse alcohol has been linked to increased levels of depression, increased levels of anxiety, decreased levels of self-esteem, and poor sleeping habits.[78] While negative thoughts and views around the subject of alcohol abuse can keep those struggling with this issue from seeking the treatment they need, there have been several things that have been found to reduce this stigma. Social support can be an effective tool for counteracting the harmful effects of stigma and shame on those struggling with alcohol abuse.[78] Social support can help push those struggling with alcohol abuse to overcome the negative connotation associated with their struggle and finally seek the treatment that they need.

Treatment

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Rehabilitation

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  • Outpatient: Patients may live at home while in treatment and schedule therapy as needed. This allows patients the ability to work, attend school, and attend to activities of daily living as they normally would.
  • Intensive Outpatient: Allows patients who do not require regular supervision to attend weekly therapy and is less intensive than PHPs.
  • Partial Hospitalization Program: Allows patients who require regular supervision and need further detoxification to attend frequent therapy. While services are outpatient, sessions may occur up to 5 days per week and up to 8hrs per day.
  • Residential: Available as short-term or long-term. Residential treatment offers 24-hour rehabilitation and care. Patients receive supervised and structured therapy focusing on how to manage their alcohol use disorder in a day to day living situation, learning how to interact with the world without the use of substances.

Pharmacotherapy

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  • Naltrexone: Naltrexone is a prescribed opioid receptor antagonist which reduces both the cravings and the rewarding effects associated with alcohol consumption. Because patients may experience an overall reduction of alcohol consumption (reduced drinks per day, extended time between drinking days), it may allow some patients to moderate their alcohol use. As Naltrexone will precipitate withdrawal in patients with opioid dependence, patients should be detoxified from opioids.[79]
  • Acamprosate: Though the mechanism of action is unclear, it is thought that Acamprosate modulates glutamate transmission. By modifying transmission along GABA and glutamine pathways, patients may experience decreased rewarding effects associated with alcohol intake and decreased withdrawal cravings.[80]
  • Disulfiram: Disulfiram is a prescribed medication which acts as an Aldehyde Dehydrogenase inhibitor, resulting in the accumulation of acetaldehyde. When Alcohol is consumed following Disulfiram, acetaldehyde builds up leading to unpleasant physiological effects (tachycardia, flushing, headache, nausea, and vomiting). Further, the severity of the reaction is dependent on the amount of alcohol consumed. Because of this physical discomfort, Disulfiram functions as a psychological deterrent and can be effective for highly motivated, abstinent patients under supervised settings. Notably, due its distressing effects with continued alcohol consumption, medication adherence can be difficult.[81]
  • Topiramate: Topiramate is an anticonvulsant approved for the management of epileptic seizures and used off label in the treatment of alcohol use disorder. It modulates GABA neurotransmission, and inhibits glutamate receptors, reducing cravings for alcohol and alcohol use.[82]
  • Gabapentin: Gabapentin is an anticonvulsant approved for the management of epileptic seizures and neuropathic pain and used off label in the treatment of alcohol use disorder. It modulates GABA synthesis, reducing cravings for alcohol and alcohol use.[83]

Therapy Based Treatment

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  • Cognitive Behavioral Therapy (CBT): Patient and therapist set an agenda, review homework, and challenge cognitive distortions. The patients learn how their feelings and behavior are influenced by their thoughts. It can help patients manage the urge to drink using a problem-solving based approach.
  • Motivational Interviewing (MI): Focuses on strengthening personal motivations for change. Patients discuss the need to alter their behavior and the reasons underlying their desire to do so.
  • Motivational Enhancement Therapy (MET): MET is a version of MI that focuses specifically on patients struggling with alcohol and/or substance use. It is organized based on interventions designed changing patterns of alcohol consumption summarized as FRAMES: Feedback, Responsibility, Advice, Menu, Empathy, Self-Efficacy
  • Mindfulness: Mindfulness-based intervention programs (that encourage people to be aware of their own experiences in the present moment and of emotions that arise from thoughts) can reduce the consumption of alcohol.[84][85]

Peer Support Groups

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Prognosis

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Alcohol abuse during adolescence, especially early adolescence (i.e. before age 15), may lead to long-term changes in the brain which leaves them at increased risk of alcoholism in later years; genetic factors also influence age of onset of alcohol abuse and risk of alcoholism.[86] For example, about 40 percent of those who begin drinking alcohol before age 15 develop alcohol dependence in later life, whereas only 10 percent of those who did not begin drinking until 20 years or older developed an alcohol problem in later life.[87] It is not entirely clear whether this association is causal, and some researchers have been known to disagree with this view.[88]

Alcohol use disorders often cause a wide range of cognitive impairments that result in significant impairment of the affected individual. If alcohol-induced neurotoxicity has occurred a period of abstinence for on average a year is required for the cognitive deficits of alcohol abuse to reverse.[89]

College/university students who are heavy binge drinkers (three or more times in the past two weeks) are 19 times more likely to be diagnosed with alcohol dependence, and 13 times more likely to be diagnosed with alcohol abuse compared to non-heavy episodic drinkers, though the direction of causality remains unclear. Occasional binge drinkers (one or two times in the past two weeks), were found to be four times more likely to be diagnosed with alcohol abuse or dependence compared to non-heavy episodic drinkers.[21]

Epidemiology

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Alcohol abuse is said to be most common in people aged between 15 and 24 years, according to Moreira 2009.[48] However, this particular study of 7275 college students in England collected no comparative data from other age groups or countries.

Causes of alcohol abuse are complex and are likely the combination of many factors, from coping with stress to childhood development. The US Department of Health & Human Services identifies several factors influencing adolescent alcohol use, such as risk-taking, expectancies, sensitivity and tolerance, personality and psychiatric comorbidity, hereditary factors, and environmental aspects.[90]

Studies show that child maltreatment such as neglect, physical, and/or sexual abuse,[91] as well as having parents with alcohol abuse problems,[92] increases the likelihood of that child developing alcohol use disorders later in life. According to Shin, Edwards, Heeren, & Amodeo (2009), underage drinking is more prevalent among teens that experienced multiple types of childhood maltreatment regardless of parental alcohol abuse, putting them at a greater risk for alcohol use disorders.[93] Genetic and environmental factors play a role in the development of alcohol use disorders, depending on age. The influence of genetic risk factors in developing alcohol use disorders increase with age[94] ranging from 28% in adolescence and 58% in adults.[95]

Societal and economic costs

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"After Whisky Driving Risky." Safety roadsign in Ladakh, India
See also: Alcohol-related crime

Alcohol abuse is associated with many accidents, fights, and offences, including criminal. Alcohol is responsible in the world for 2.6 million deaths and results in disability in approximately 115.9 million people. Approximately 40 percent of the 115.9 million people disabled through alcohol abuse are disabled due to alcohol-related neuropsychiatric disorders.[96] Alcohol abuse is highly associated with adolescent suicide. Adolescents who abuse alcohol are 17 times more likely to commit suicide than adolescents who don't drink.[97] Additionally, alcohol abuse increases the risk of individuals either experiencing or perpetrating sexual violence.[72] Alcohol availability and consumption rates and alcohol rates are positively associated with violent crimes, through specifics differ between particular countries and cultures.[98]

By country

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According to studies of present and former alcoholic drinkers in Canada, 20% of them are aware that their drinking has negatively impacted their lives in various vital areas including finances, work and relationships.[99]

Problems caused by alcohol abuse in Ireland cost about 3.7 billion euro in 2007.[100] The last cost analysis of the financial burden of alcohol-related harm was carried out in 2014 and amounted to around €2.35 billion.[1] The OECD estimates that the annual damage is now between 9.6 and 12 billion euros.[2]

In South Africa, where HIV infection is epidemic, alcohol abusers expose themselves to an increased risk of this infection due to displaying more sexually risky behaviour after drinking. This kind of behaviour includes not using protection, taking part in transactional sex, and/or having multiple sexual partners.[101][102]

The introduction of alcopops, sweet and pleasantly flavoured alcoholic drinks, was responsible for half of the increase in alcohol abuse in 15- and 16-year-olds, according to one survey in Sweden. In the case of girls, the alcopops, which disguise the taste of alcohol, were responsible for two thirds of the increase. The introduction of alcopops to Sweden was a result of Sweden joining the European Union and adopting the entire European Union law.[103]

Alcohol misuse costs the United Kingdom's National Health Service £3 billion per year. The cost to employers is 6.4 billion pounds sterling per year. These figures do not include the crime and social problems associated with alcohol misuse. The number of women regularly drinking alcohol has almost caught up with men.[104] According to the Institute of Alcohol Studies in 2024, the annual cost of alcohol harm to society in England is £27.44 billion.[3]

In the United States, many people are arrested for drinking and driving. Also, people under the influence of alcohol commit a large portion of various violent crimes, including child abuse and homicide. They also commit a large portion of acts of suicide. In addition, people of minority groups are affected by alcohol-related problems disproportionately, with the exception of Asian Americans.[105] According to criminologist Hung-En Sung "alcohol is the most widely abused psychoactive substance in the United States".[98]

See also

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References

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  1. ^ "Alcohol & Substance Misuse | Workplace Health Strategies by Condition | Workplace Health Promotion". cdc.gov. 2021-05-12. Retrieved 2023-11-02.
  2. ^ Diagnostic and statistical manual of mental disorders: DSM-5 (Fifth ed.). American Psychiatric Association. 2013. p. 490. ISBN 978-0-89042-557-2.
  3. ^ "Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5". November 2013. Archived from the original on 18 May 2015. Retrieved 9 May 2015.
  4. ^ a b Griswold MG, Fullman N, Hawley C, Arian N, Zimsen SR, Tymeson HD, et al. (GBD 2016 Alcohol Collaborators) (September 2018). "Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016". Lancet. 392 (10152): 1015–1035. doi:10.1016/S0140-6736(18)31310-2. PMC 6148333. PMID 30146330.
  5. ^ "Alcohol". who.int. Retrieved 2023-01-27.
  6. ^ Fuster D, Samet JH (September 2018). "Alcohol Use in Patients with Chronic Liver Disease". The New England Journal of Medicine. 379 (13): 1251–1261. doi:10.1056/nejmra1715733. PMID 30257164. S2CID 52842989.
  7. ^ "Alcohol Facts and Statistics | National Institute on Alcohol Abuse and Alcoholism (NIAAA)". niaaa.nih.gov. Retrieved 2023-01-27.
  8. ^ a b c Witkiewitz K, Litten RZ, Leggio L (September 2019). "Advances in the science and treatment of alcohol use disorder". Science Advances. 5 (9): eaax4043. Bibcode:2019SciA....5.4043W. doi:10.1126/sciadv.aax4043. PMC 6760932. PMID 31579824.
  9. ^ "Understanding Alcohol Use Disorder | National Institute on Alcohol Abuse and Alcoholism (NIAAA)". niaaa.nih.gov. Retrieved 2021-05-01.
  10. ^ a b c d e "Drinking Levels Defined | National Institute on Alcohol Abuse and Alcoholism (NIAAA)". niaaa.nih.gov. Retrieved 2023-01-27.
  11. ^ "Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5". niaaa.nih.gov. Retrieved 2023-11-02.
  12. ^ "Recommendation: Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions | United States Preventive Services Taskforce". uspreventiveservicestaskforce.org. Retrieved 2023-11-02.
  13. ^ "Alcohol Alert". NIAA. Retrieved 10 January 2019.
  14. ^ Aichmüller C, Soyka M (April 2015). "[Fatigue in substance abuse disorders]". Revue Médicale Suisse (in French). 11 (471): 927–930. doi:10.53738/REVMED.2015.11.471.0927. PMID 26072600.
  15. ^ a b Birková A, Hubková B, Čižmárová B, Bolerázska B (September 2021). "Current View on the Mechanisms of Alcohol-Mediated Toxicity". International Journal of Molecular Sciences. 22 (18): 9686. doi:10.3390/ijms22189686. PMC 8472195. PMID 34575850.
  16. ^ a b Hendriks HF (March 2020). "Alcohol and Human Health: What Is the Evidence?". Annual Review of Food Science and Technology. 11: 1–21. doi:10.1146/annurev-food-032519-051827. PMID 32209032. S2CID 214645440.
  17. ^ Gormley, Mark; Creaney, Grant; Schache, Andrew; Ingarfield, Kate; Conway, David I. (2022-11-11). "Reviewing the epidemiology of head and neck cancer: definitions, trends and risk factors". British Dental Journal. 233 (9): 780–786. doi:10.1038/s41415-022-5166-x. ISSN 0007-0610. PMC 9652141. PMID 36369568.
  18. ^ Hashibe, Mia; Brennan, Paul; Chuang, Shu-chun; Boccia, Stefania; Castellsague, Xavier; Chen, Chu; Curado, Maria Paula; Dal Maso, Luigino; Daudt, Alexander W.; Fabianova, Eleonora; Fernandez, Leticia; Wünsch-Filho, Victor; Franceschi, Silvia; Hayes, Richard B.; Herrero, Rolando (2009-02-01). "Interaction between Tobacco and Alcohol Use and the Risk of Head and Neck Cancer: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium". Cancer Epidemiology, Biomarkers & Prevention. 18 (2): 541–550. doi:10.1158/1055-9965.EPI-08-0347. ISSN 1055-9965. PMC 3051410. PMID 19190158.
  19. ^ Fitzpatrick LE, Jackson M, Crowe SF (2008). "The relationship between alcoholic cerebellar degeneration and cognitive and emotional functioning". Neuroscience and Biobehavioral Reviews. 32 (3): 466–485. doi:10.1016/j.neubiorev.2007.08.004. PMID 17919727. S2CID 19875939.
  20. ^ van Holst RJ, Schilt T (March 2011). "Drug-related decrease in neuropsychological functions of abstinent drug users". Current Drug Abuse Reviews. 4 (1): 42–56. doi:10.2174/1874473711104010042. PMID 21466500.
  21. ^ a b c Courtney KE, Polich J (January 2009). "Binge drinking in young adults: Data, definitions, and determinants". Psychological Bulletin. 135 (1): 142–156. doi:10.1037/a0014414. PMC 2748736. PMID 19210057.
  22. ^ Fowler AK, Thompson J, Chen L, Dagda M, Dertien J, Dossou KS, et al. (2014). "Differential sensitivity of prefrontal cortex and hippocampus to alcohol-induced toxicity". PLOS ONE. 9 (9): e106945. Bibcode:2014PLoSO...9j6945F. doi:10.1371/journal.pone.0106945. PMC 4154772. PMID 25188266.
  23. ^ Uekermann J, Daum I (May 2008). "Social cognition in alcoholism: a link to prefrontal cortex dysfunction?". Addiction. 103 (5): 726–735. doi:10.1111/j.1360-0443.2008.02157.x. PMID 18412750.
  24. ^ Amrani L, De Backer L, Dom G (2013). "[Adolescent binge drinking: neurocognitive consequences and gender differences]" [Adolescent binge drinking: neurocognitive consequences and gender differences] (PDF). Tijdschrift voor Psychiatrie (in Dutch). 55 (9): 677–689. PMID 24046246. Archived (PDF) from the original on 2016-03-06.
  25. ^ "Alcohol Abuse". Juvenile Justice Digest. 35 (2): 7. 2007-01-31. ISSN 0094-2413.
  26. ^ Michaud PA (February 2007). "[Alcohol misuse in adolescents - a challenge for general practitioners]" [Alcohol misuse in adolescents – a challenge for general practitioners]. Therapeutische Umschau. Revue Therapeutique (in German). 64 (2): 121–126. doi:10.1024/0040-5930.64.2.121. PMID 17245680.
  27. ^ Dufour MC, Archer L, Gordis E (February 1992). "Alcohol and the elderly". Clinics in Geriatric Medicine. 8 (1): 127–141. doi:10.1016/S0749-0690(18)30502-0. PMID 1576571.
  28. ^ Moos RH, Schutte KK, Brennan PL, Moos BS (August 2009). "Older adults' alcohol consumption and late-life drinking problems: a 20-year perspective". Addiction. 104 (8): 1293–1302. doi:10.1111/j.1360-0443.2009.02604.x. PMC 2714873. PMID 19438836.
  29. ^ Wilson SR, Fink A, Verghese S, Beck JC, Nguyen K, Lavori P (March 2007). "Adding an alcohol-related risk score to an existing categorical risk classification for older adults: sensitivity to group differences". Journal of the American Geriatrics Society. 55 (3): 445–450. doi:10.1111/j.1532-5415.2007.01072.x. PMID 17341250. S2CID 22634737.
  30. ^ Wallace C (2010). "Integrated assessment of older adults who misuse alcohol". Nursing Standard. 24 (33): 51–7, quiz 58. doi:10.7748/ns2010.04.24.33.51.c7718. PMID 20461924.
  31. ^ Barker P (7 October 2003). Psychiatric and mental health nursing: the craft of caring. London: Arnold. ISBN 978-0-340-81026-2. Archived from the original on 27 May 2013. Retrieved 17 December 2010.
  32. ^ "Alcoholism and alcohol abuse". PubMed Health. A.D.A.M., Inc. Archived from the original on 3 December 2012. Retrieved 3 December 2012.
  33. ^ Babor TF, Aguirre-Molina M, Marlatt GA, Clayton R (1999). "Managing alcohol problems and risky drinking". American Journal of Health Promotion. 14 (2): 98–103. doi:10.4278/0890-1171-14.2.98. PMID 10724728. S2CID 3267149.
  34. ^ Pompili, Maurizio; Serafini, Gianluca; Innamorati, Marco; Dominici, Giovanni; Ferracuti, Stefano; Kotzalidis, Giorgio D.; Serra, Giulia; Girardi, Paolo; Janiri, Luigi; Tatarelli, Roberto; Sher, Leo; Lester, David (March 29, 2010). "Suicidal Behavior and Alcohol Abuse". International Journal of Environmental Research and Public Health. 7 (4): 1392–1431. doi:10.3390/ijerph7041392. PMC 2872355. PMID 20617037.
  35. ^ Jiwa A, Kelly L, Pierre-Hansen N (July 2008). "Healing the community to heal the individual: literature review of aboriginal community-based alcohol and substance abuse programs". Canadian Family Physician. 54 (7): 1000–1000.e7. PMC 2464791. PMID 18625824.
  36. ^ Landesman-Dwyer S (1982). "Maternal drinking and pregnancy outcome". Applied Research in Mental Retardation. 3 (3): 241–263. doi:10.1016/0270-3092(82)90018-2. PMID 7149705.
  37. ^ Chung DD, Pinson MR, Bhenderu LS, Lai MS, Patel RA, Miranda RC (August 2021). "Toxic and Teratogenic Effects of Prenatal Alcohol Exposure on Fetal Development, Adolescence, and Adulthood". International Journal of Molecular Sciences. 22 (16): 8785. doi:10.3390/ijms22168785. PMC 8395909. PMID 34445488.
  38. ^ Vorvick L (August 15, 2011). "Fetal alcohol syndrome". PubMed Health. Archived from the original on 20 September 2012. Retrieved 9 April 2012.
  39. ^ CDC (2023-10-03). "Alcohol Use During Pregnancy". Centers for Disease Control and Prevention. Retrieved 2023-11-02.
  40. ^ "Drinking alcohol while pregnant". nhs.uk. 2020-12-02. Retrieved 2023-11-02.
  41. ^ Douglas M (2013-10-16). Constructive Drinking. Routledge. ISBN 978-1-134-55778-3.
  42. ^ a b Lees B, Meredith LR, Kirkland AE, Bryant BE, Squeglia LM (May 2020). "Effect of alcohol use on the adolescent brain and behavior". Pharmacology, Biochemistry, and Behavior. 192: 172906. doi:10.1016/j.pbb.2020.172906. PMC 7183385. PMID 32179028.
  43. ^ a b Martin CA, Kelly TH, Rayens MK, Brogli BR, Brenzel A, Smith WJ, Omar HA (December 2002). "Sensation seeking, puberty, and nicotine, alcohol, and marijuana use in adolescence". Journal of the American Academy of Child and Adolescent Psychiatry. 41 (12): 1495–1502. doi:10.1097/00004583-200212000-00022. PMID 12447037.
  44. ^ Squeglia LM, Cservenka A (February 2017). "Adolescence and Drug Use Vulnerability: Findings from Neuroimaging". Current Opinion in Behavioral Sciences. 13: 164–170. doi:10.1016/j.cobeha.2016.12.005. PMC 5241101. PMID 28111629.
  45. ^ a b McArdle P (June 2008). "Alcohol abuse in adolescents". Archives of Disease in Childhood. 93 (6): 524–527. doi:10.1136/adc.2007.115840. PMID 18305075. S2CID 25568964.
  46. ^ a b Nixon K, McClain JA (May 2010). "Adolescence as a critical window for developing an alcohol use disorder: current findings in neuroscience". Current Opinion in Psychiatry. 23 (3): 227–232. doi:10.1097/YCO.0b013e32833864fe. PMC 3149806. PMID 20224404.
  47. ^ Stewart SH (July 1996). "Alcohol abuse in individuals exposed to trauma: a critical review". Psychological Bulletin. 120 (1): 83–112. CiteSeerX 10.1.1.529.4342. doi:10.1037/0033-2909.120.1.83. PMID 8711018.
  48. ^ a b c Foxcroft DR, Moreira MT, Almeida Santimano NM, Smith LA (December 2015). "Social norms information for alcohol misuse in university and college students". The Cochrane Database of Systematic Reviews. 2015 (12): CD006748. doi:10.1002/14651858.CD006748.pub4. hdl:10284/8115. PMC 8750744. PMID 26711838.
  49. ^ Lewis MA, Litt DM, Blayney JA, Lostutter TW, Granato H, Kilmer JR, Lee CM (September 2011). "They drink how much and where? Normative perceptions by drinking contexts and their association to college students' alcohol consumption". Journal of Studies on Alcohol and Drugs. 72 (5): 844–853. doi:10.15288/jsad.2011.72.844. PMC 3174028. PMID 21906511.
  50. ^ Nepomuceno TC, de Moura JA, e Silva LC, Costa AP (December 2017). "Alcohol and violent behavior among football spectators: An empirical assessment of Brazilian's criminalization". International Journal of Law, Crime and Justice. 51: 34–44. doi:10.1016/j.ijlcj.2017.05.001. ISSN 1756-0616.
  51. ^ Vélez-McEvoy M (April 2005). "Alcohol abuse and ethnicity". AAOHN Journal. 53 (4): 152–155. doi:10.1177/216507990505300402. PMID 15853289.
  52. ^ Castillo-Carniglia A, Keyes KM, Hasin DS, Cerdá M (December 2019). "Psychiatric comorbidities in alcohol use disorder". The Lancet. Psychiatry. 6 (12): 1068–1080. doi:10.1016/S2215-0366(19)30222-6. PMC 7006178. PMID 31630984.
  53. ^ Herman J (1997). Trauma and Recovery: The Aftermath of Violence – from domestic abuse to political terror. Basic Books. pp. 44–45. ISBN 978-0-465-08730-3.
  54. ^ Witt ED (October 2007). "Puberty, hormones, and sex differences in alcohol abuse and dependence". Neurotoxicology and Teratology. 29 (1): 81–95. Bibcode:2007NTxT...29...81W. doi:10.1016/j.ntt.2006.10.013. PMID 17174531.
  55. ^ a b Costello EJ, Sung M, Worthman C, Angold A (April 2007). "Pubertal maturation and the development of alcohol use and abuse". Drug and Alcohol Dependence. 88 (Suppl 1): S50–S59. doi:10.1016/j.drugalcdep.2006.12.009. PMID 17275214.
  56. ^ Westling E, Andrews JA, Hampson SE, Peterson M (June 2008). "Pubertal timing and substance use: the effects of gender, parental monitoring and deviant peers". The Journal of Adolescent Health. 42 (6): 555–563. doi:10.1016/j.jadohealth.2007.11.002. PMC 2435092. PMID 18486864.
  57. ^ a b de Water E, Braams BR, Crone EA, Peper JS (February 2013). "Pubertal maturation and sex steroids are related to alcohol use in adolescents". Hormones and Behavior. 63 (2): 392–397. doi:10.1016/j.yhbeh.2012.11.018. PMID 23229027. S2CID 5031450.
  58. ^ Lenz B, Heberlein A, Bayerlein K, Frieling H, Kornhuber J, Bleich S, Hillemacher T (September 2011). "The TTTAn aromatase (CYP19A1) polymorphism is associated with compulsive craving of male patients during alcohol withdrawal". Psychoneuroendocrinology. 36 (8): 1261–1264. doi:10.1016/j.psyneuen.2011.02.010. PMID 21414724. S2CID 29572849.
  59. ^ Edenberg HJ, Foroud T (August 2013). "Genetics and alcoholism". Nature Reviews. Gastroenterology & Hepatology. 10 (8): 487–494. doi:10.1038/nrgastro.2013.86. PMC 4056340. PMID 23712313.
  60. ^ Alfonso-Loeches S, Guerri C (2011). "Molecular and behavioral aspects of the actions of alcohol on the adult and developing brain". Critical Reviews in Clinical Laboratory Sciences. 48 (1): 19–47. doi:10.3109/10408363.2011.580567. PMID 21657944. S2CID 26880669.
  61. ^ Fowler AK, Hewetson A, Agrawal RG, Dagda M, Dagda R, Moaddel R, et al. (December 2012). "Alcohol-induced one-carbon metabolism impairment promotes dysfunction of DNA base excision repair in adult brain". The Journal of Biological Chemistry. 287 (52): 43533–43542. doi:10.1074/jbc.M112.401497. PMC 3527940. PMID 23118224.
  62. ^ Kruman II, Henderson GI, Bergeson SE (July 2012). "DNA damage and neurotoxicity of chronic alcohol abuse". Experimental Biology and Medicine. 237 (7): 740–747. doi:10.1258/ebm.2012.011421. PMC 3685494. PMID 22829701.
  63. ^ "Find Out More, Do More". Office of Substance Abuse, Maine Department of Health and Human Services. Archived from the original on March 10, 2013. Retrieved December 27, 2012.
  64. ^ "Global status report on alcohol and health 2018". who.int. Retrieved 2022-09-12.
  65. ^ Sudhinaraset M, Wigglesworth C, Takeuchi DT (2016). "Social and Cultural Contexts of Alcohol Use: Influences in a Social-Ecological Framework". Alcohol Research. 38 (1): 35–45. PMC 4872611. PMID 27159810.
  66. ^ Foster DW, Yeung N, Quist MC (December 2014). "The influence of individualism and drinking identity on alcohol problems". International Journal of Mental Health and Addiction. 12 (6): 747–758. doi:10.1007/s11469-014-9505-2. PMC 4267053. PMID 25525420.
  67. ^ Administration (US), Substance Abuse and Mental Health Services; Alcoholism (US), National Institute on Alcohol Abuse and; General (US), Office of the Surgeon (2007). Appendix B: DSM-IV-TR Diagnostic Criteria for Alcohol Abuse and Dependence. Office of the Surgeon General (US).
  68. ^ Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Vol. 1. 2000. doi:10.1176/appi.books.9780890423349. ISBN 978-0-89042-334-9.
  69. ^ Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington: American psychiatric association. 2013. ISBN 9780890425558.
  70. ^ "AUDIT – Alcohol Use Disorders Identification Test". Alcohol Learning Centre. 28 June 2010. Archived from the original on 17 March 2012. Retrieved 3 June 2012.
  71. ^ "Supporting guidance" (PDF). Archived from the original (PDF) on 2006-05-02.
  72. ^ a b Chersich MF, Rees HV (January 2010). "Causal links between binge drinking patterns, unsafe sex and HIV in South Africa: its time to intervene". International Journal of STD & AIDS. 21 (1): 2–7. doi:10.1258/ijsa.2000.009432. PMID 20029060. S2CID 3100905.
  73. ^ Appenzeller BM, Schneider S, Yegles M, Maul A, Wennig R (December 2005). "Drugs and chronic alcohol abuse in drivers". Forensic Science International. 155 (2–3): 83–90. doi:10.1016/j.forsciint.2004.07.023. PMID 16226145.
  74. ^ Powers RA (2007). "Alcohol and Drug Abuse Prevention". Psychiatric Annals. 37 (5): 349–358. Archived from the original on 2013-11-05. Retrieved 2013-11-05.
  75. ^ Grant BF, Chou SP, Saha TD, Pickering RP, Kerridge BT, Ruan WJ, et al. (September 2017). "Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: Results From the National Epidemiologic Survey on Alcohol and Related Conditions". JAMA Psychiatry. 74 (9): 911–923. doi:10.1001/jamapsychiatry.2017.2161. PMC 5710229. PMID 28793133.
  76. ^ a b Keyes KM, Hatzenbuehler ML, McLaughlin KA, Link B, Olfson M, Grant BF, Hasin D (December 2010). "Stigma and treatment for alcohol disorders in the United States". American Journal of Epidemiology. 172 (12): 1364–1372. doi:10.1093/aje/kwq304. PMC 2998202. PMID 21044992.
  77. ^ Rogers SM, Pinedo M, Villatoro AP, Zemore SE (2019). ""I Don't Feel Like I Have a Problem Because I Can Still Go To Work and Function": Problem Recognition Among Persons With Substance Use Disorders". Substance Use & Misuse. 54 (13): 2108–2116. doi:10.1080/10826084.2019.1630441. PMC 7032932. PMID 31232135.
  78. ^ a b Birtel MD, Wood L, Kempa NJ (June 2017). "Stigma and social support in substance abuse: Implications for mental health and well-being" (PDF). Psychiatry Research. 252: 1–8. doi:10.1016/j.psychres.2017.01.097. PMID 28237758. S2CID 207453622.
  79. ^ Center for Substance Abuse Treatment (2009). "Chapter 4—Oral Naltrexone". Incorporating Alcohol Pharmacotherapies Into Medical Practice. Substance Abuse and Mental Health Services Administration (US). Retrieved 2023-11-15.
  80. ^ Hunter K, Ochoa R (2006-08-15). "Acamprosate (Campral) for Treatment of Alcoholism". American Family Physician. 74 (4): 645–646.
  81. ^ Skinner MD, Lahmek P, Pham H, Aubin HJ (2014-02-10). "Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis". PLOS ONE. 9 (2): e87366. Bibcode:2014PLoSO...987366S. doi:10.1371/journal.pone.0087366. PMC 3919718. PMID 24520330.
  82. ^ Winslow BT, Onysko M, Hebert M (March 2016). "Medications for Alcohol Use Disorder". American Family Physician. 93 (6): 457–465. PMID 26977830.
  83. ^ Gregory C, Chorny Y, McLeod SL, Mohindra R (August 2022). "First-line Medications for the Outpatient Treatment of Alcohol Use Disorder: A Systematic Review of Perceived Barriers". Journal of Addiction Medicine. 16 (4): e210–e218. doi:10.1097/ADM.0000000000000918. PMID 34561352. S2CID 237628274.
  84. ^ Chiesa A, Serretti A (April 2014). "Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence". Substance Use & Misuse. 49 (5): 492–512. doi:10.3109/10826084.2013.770027. PMID 23461667. S2CID 34990668.
  85. ^ Garland EL, Froeliger B, Howard MO (January 2014). "Mindfulness training targets neurocognitive mechanisms of addiction at the attention-appraisal-emotion interface". Frontiers in Psychiatry. 4 (173): 173. doi:10.3389/fpsyt.2013.00173. PMC 3887509. PMID 24454293.
  86. ^ "Early Age At First Drink May Modify Tween/Teen Risk For Alcohol Dependence". Medical News Today. 21 September 2009. Archived from the original on 13 February 2010.
  87. ^ Grant BF, Dawson DA (1997). "Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic Survey". Journal of Substance Abuse. 9: 103–110. CiteSeerX 10.1.1.473.9819. doi:10.1016/S0899-3289(97)90009-2. PMID 9494942.
  88. ^ Schwandt ML, Lindell SG, Chen S, Higley JD, Suomi SJ, Heilig M, Barr CS (February 2010). "Alcohol response and consumption in adolescent rhesus macaques: life history and genetic influences". Alcohol. 44 (1): 67–80. doi:10.1016/j.alcohol.2009.09.034. PMC 2818103. PMID 20113875.
  89. ^ Stavro K, Pelletier J, Potvin S (March 2013). "Widespread and sustained cognitive deficits in alcoholism: a meta-analysis". Addiction Biology. 18 (2): 203–213. doi:10.1111/j.1369-1600.2011.00418.x. PMID 22264351. S2CID 205401192.
  90. ^ "Diagnostic Criteria for Alcohol Abuse and Dependence". Alcohol Alert (30 PH 359). October 1995. Archived from the original on 2011-08-17. Retrieved 1 Nov 2013.
  91. ^ Dube SR, Anda RF, Felitti VJ, Edwards VJ, Croft JB (2002). "Adverse childhood experiences and personal alcohol abuse as an adult". Addictive Behaviors. 27 (5): 713–725. doi:10.1016/S0306-4603(01)00204-0. PMID 12201379.
  92. ^ Lieb R, Merikangas KR, Höfler M, Pfister H, Isensee B, Wittchen HU (January 2002). "Parental alcohol use disorders and alcohol use and disorders in offspring: a community study". Psychological Medicine. 32 (1): 63–78. doi:10.1017/S0033291701004883. PMID 11883731. S2CID 2251288. Archived from the original on 2022-03-14. Retrieved 2019-07-01.
  93. ^ Shin SH, Edwards E, Heeren T, Amodeo M (2009). "Relationship between Multiple Forms of Maltreatment by a Parent or Guardian and Adolescent Alcohol Use". The American Journal on Addictions. 18 (3): 226–234. doi:10.1080/10550490902786959. PMID 19340641.
  94. ^ Brown SA, McGue M, Maggs J, Schulenberg J, Hingson R, Swartzwelder S, et al. (April 2008). "A developmental perspective on alcohol and youths 16 to 20 years of age". Pediatrics. 121 (Suppl 4): S290–S310. doi:10.1542/peds.2007-2243D. PMC 2765460. PMID 18381495.
  95. ^ van Beek JH, Kendler KS, de Moor MH, Geels LM, Bartels M, Vink JM, et al. (January 2012). "Stable genetic effects on symptoms of alcohol abuse and dependence from adolescence into early adulthood". Behavior Genetics. 42 (1): 40–56. doi:10.1007/s10519-011-9488-8. PMC 3253297. PMID 21818662.
  96. ^ "Global status report on alcohol and health and treatment of substance use disorders" (PDF). World Health Organization. June 25, 2024. Archived from the original on August 16, 2024. Retrieved August 16, 2024.
  97. ^ Groves SA, Stanley BH, Sher L (2007). "Ethnicity and the relationship between adolescent alcohol use and suicidal behavior". International Journal of Adolescent Medicine and Health. 19 (1): 19–25. doi:10.1515/IJAMH.2007.19.1.19. PMID 17458320. S2CID 23339243.
  98. ^ a b Sung HE (2016). "Alcohol and Crime". The Blackwell Encyclopedia of Sociology. American Cancer Society. pp. 1–2. doi:10.1002/9781405165518.wbeosa039.pub2. ISBN 9781405165518.
  99. ^ "Send Us a Message". Alcoholism in Canada. 3 April 2012. Archived from the original on 29 March 2012.
  100. ^ "Alcohol and costs". AlcoholAction. 30 May 2011. Archived from the original on 7 December 2014. Retrieved 1 December 2014.
  101. ^ Maddock, Jay (2012-05-16). Public Health: Social and Behavioral Health. BoD – Books on Demand. ISBN 978-953-51-0620-3.
  102. ^ Rosenberg, Molly; Pettifor, Audrey; Van Rie, Annelies; Thirumurthy, Harsha; Emch, Michael; Miller, William C.; Gómez-Olivé, F. Xavier; Twine, Rhian; Hughes, James P.; Laeyendecker, Oliver; Selin, Amanda; Kahn, Kathleen (2015-05-08). "The Relationship between Alcohol Outlets, HIV Risk Behavior, and HSV-2 Infection among South African Young Women: A Cross-Sectional Study". PLOS ONE. 10 (5): e0125510. Bibcode:2015PLoSO..1025510R. doi:10.1371/journal.pone.0125510. ISSN 1932-6203. PMC 4425652. PMID 25954812.
  103. ^ Romanus G (December 2000). "Alcopops in Sweden--a supply side initiative". Addiction. 95 (12s4): S609–S619. doi:10.1046/j.1360-0443.95.12s4.12.x. PMID 11218355.
  104. ^ Dooldeniya MD, Khafagy R, Mashaly H, Browning AJ, Sundaram SK, Biyani CS (November 2007). "Lower abdominal pain in women after binge drinking". The BMJ. 335 (7627): 992–993. doi:10.1136/bmj.39247.454005.BE. PMC 2072017. PMID 17991983. Archived from the original on 2009-07-26.
  105. ^ Alcoholism. (2013). Columbia Electronic Encyclopedia, 6th Edition, 1-2.

Further reading

[edit]
  • Christopher M. Finan (2017). Drunks: An American History. Beacon Press. ISBN 978-0807001790.
[edit]
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