Alcohol and Alcohol Use Disorder _ _____________________________________________________________
USE OF ALCOHOL DESPITE ADVERSE CONSEQUENCES
• 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
Continued drinking despite adverse consequences is characterized by the inability of individuals with alcohol use disorder to stop drinking even when they recognize that their family, interpersonal, spiritual, occupational, legal, and financial problems are the result of their drinking. Furthermore, alcohol may be causing serious health and psychological problems (e.g., anemia, gastritis, liver disease, neurologic disorders, depression) and still the dependent individual cannot stop. DENIAL AS A DEFENSE MECHANISM Denial is a common characteristic distortion in thinking that becomes profound in people with alcohol use disorder. For decades, those who have treated individuals with alcohol use disorder, and recovering alcoholics themselves, have puzzled over why these persons continue to drink when the link between alcohol and the losses they suffer is so clear. Denial is an integral part of the disease of alcohol use disorder and a major obstacle to recovery. Although the term denial is not specifically used in the wording of the diagnostic criteria, it underlies the primary criteria described as, “drinking despite adverse consequences.” 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)
• Diarrhea • Gastritis • Ulcers • Esophagitis Cardiopulmonary Signs/Symptoms • Hypertension
• Palpitations • 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
54
MDMI1826
Powered by FlippingBook