Alcohol and Alcohol Use Disorder _ _____________________________________________________________
RELAPSE Because alcohol use disorder is a chronic disease, another symptom that is increasingly being recognized and treated is relapse. Although alcohol use disorder is a treatable, chronic disease, as yet, no cure has been found. This means that even if individuals with alcohol use disorder have been sober for a long time and have regained their health and reclaimed other important aspects of their lives, they may experience a relapse that will require further treatment in order to return to remission. PHYSICAL CLUES THAT MAY SUGGEST ALCOHOL USE DISORDER While a strong attachment to alcohol is the hallmark of early dependency, if the patient refuses to acknowledge a problem and no one from home or work helps to confirm the diagnosis, healthcare professionals are often left with nothing more than clinical intuition, resulting in a missed diagnosis. However, late in the course of alcohol use disorder, physical clues typically become increasingly apparent and suggestive of alcohol abuse and/or dependence. Alcohol abuse and dependence are often referred to as the “Great Masquerader” because many of the signs and symptoms are also commonly found in other conditions [95]. Elevated Laboratory Findings • Serum glutamic oxaloacetic transaminase (SGOT) • Lactic acid dehydrogenase (LDH) • Cholesterol • Gamma-glutamyltransferase (GGT) • Mean corpuscular volume (MCV) • Alkaline phosphatase • Triglycerides • Blood alcohol concentration (BAC) • Urinary ethyl glucuronide (EtG) and ethyl sulfate (EtS) • Whole blood phosphatidylethanol (PEth) • Serum transferrin • Uric acid Gastrointestinal Signs/Symptoms • Nausea • Vomiting • Reflux
• Arrhythmias • Recurrent respiratory infections Central Nervous System (CNS) Signs/Symptoms • Anxiety • Insomnia • Memory impairment
• Depression • Irritability • Panic
• Suicide attempt(s) • Suicidal thinking Behavioral Clues • Loss of interest in previously favorite activities and people • Marital and financial problems • Positive family history • Cigarette smoking • Problems at home and work • Anger when someone asks about drinking • Legal difficulties • Higher than normal scores on screening questionnaires, such as the Michigan Alcohol Screening Test (MAST) and CAGE Miscellaneous Signs/Symptoms • Gout
• Impotence • Bloated face
• Parotid swelling • Trauma injuries • Aches and pains • Unusual accidents • Broken bones • Driving accidents, multiple citations, and other problems
COMPLICATIONS
Alcohol use disorders are often associated with physical disorders and related problems. LIVER DISEASE The liver is a particularly vulnerable organ to alcohol consumption, in large part because it is where alcohol is metabolized prior to elimination from the body. As few as six drinks a day for men have been found to be associated with liver damage. The most common manifestation among persons with alcohol use disorder is called “fatty liver.” Among heavy
• Diarrhea • Gastritis • Ulcers • Esophagitis Cardiopulmonary Signs/Symptoms • Hypertension • Palpitations
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MDMI1826
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