Alcohol and Alcohol Use Disorder _ _____________________________________________________________
• Poor reasoning and judgment skills • Sleep and sucking problems as an infant • Vision or hearing problems • Problems with the heart, kidneys, or bones
Alcohol is especially neurotoxic to the developing fetus. Vulnerability is highest at six months’ gestation to several years after birth. During this period, alcohol exposure can kill millions of neurons in the developing brain. This helps to explain reduced brain size and behavior disturbances associated with FAS. The most disabling effects are hyperactivity and learning disabilities, depression, and psychosis. Depending on the time of exposure to alcohol, different neurons are depleted, which shows evidence of alcohol being an agent that can contribute to many mental disabilities. The Centers for Disease Control and Prevention (CDC) reported in 2022 that nearly 14% (or 1 in 7) pregnant women 18 to 44 years of age used alcohol and 5.0% (1 in 20) were binge drinkers [192]. According to the CDC, the cost to the United States for FAS alone is more than $4 billion annually [192]. Additionally, an estimated 6 to 9 out of 1,000 U.S. school children may have FASDs [180]. Binge drinking among pregnant women increased from 4.7% in 2021 to 5.3% in 2022[12]. FASD is 100% preventable when pregnant women abstain from drinking alcohol [180; 193]. EFFECTS ON FAMILIES Living with a non-recovering family member with alcohol use disorder can contribute to stress for all members of the family. Children raised in these families have different life experiences than children raised in nonalcoholic families. For example, children living with a non-recovering alcoholic score lower on measures of family cohesion, intellectual cultural orientation, active recreational orientation, and independence. They also experience higher levels of conflict within the family. Many children of alcoholics experience other family members as distant and noncommunicative and may be hampered by their inability to grow in developmentally healthy ways. The level of dysfunction or resiliency of the nonalcoholic spouse is a key factor in the effects of problems impacting the children. Support groups, such as Children of Alcoholics, are available to help people deal with these issues. Alcohol use disorder usually has strong negative effects on marital relationships. Separated and divorced men and women were three times as likely as married men and women to say they had been married to a person with alcohol use disorder or problem drinker. Almost two-thirds of separated and divorced women and almost one-half of separated or divorced men younger than 45 years of age have been exposed to alcohol use disorder in the family at some time. As of 2022, approximately 29.7 million Americans met the diagnostic criteria for alcohol use disorder; this number represents an increase from 18.1 million Americans in 2002 [12]. Child Abuse The majority of studies suggest an increased prevalence of alcohol use disorder among parents who abuse children. Existing research suggests that alcoholism is more strongly related to child abuse than are other disorders, such as parental depression, but the most important factor is whether the
There are a variety of conditions that are considered FASDs. Alcohol-related neurodevelopmental disorder (ARND) is associated with intellectual difficulties and problems with behavior and learning. Patients with ARND may do poorly in school, with particular issues with math, memory, attention, judgment, and impulse control [180]. Offspring of mothers who consumed alcohol, during pregnancy may also develop alcohol-related birth defects, including congenital malformations of the heart, kidneys, and/or bones or hearing problems. The most commonly studied FASD is FAS. FAS is defined by the existence of certain physical characteristics of children whose mothers drank during pregnancy. These characteristics include [180]:
• Intellectual disability • Growth deficiencies • Central nervous system dysfunction • Decreased brain size • Low birth weight • Distorted facial features
• Behavioral maladjustments • Abnormal joints and limbs Other less visible symptoms of FAS include [181; 182; 183; 184; 185; 186; 187; 188; 189; 190]: • Verbal learning and memory problems • Visual-spatial learning problems • Attention deficits and hyperactivity • Increased reaction time/slow information processing • Executive function problems • Structural and functional changes in the brain Alcohol apoptotic neurodegeneration has been shown to appear in the forebrain when rats are injected with alcohol. Seven-day-old rats were divided into a group receiving saline solution and another group receiving alcohol solution. The brains were examined after 24 hours of ingesting alcohol or saline. The alcohol group showed a very dense, widely distributed area of deterioration (cell death). When alcohol is administered, various neurons in the forebrain show sensitivity. Also, the brain weight of the alcohol-treated rats was much lower than the saline group. Exposure of the developing rat brain to alcohol for a certain period of time during a specific developmental stage induces destruction of brain cells that deletes large numbers of neurons from several areas of the brain. This period of time in humans is the last three months of gestation [191].
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MDMI1826
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