Alcohol dependence, known as “alcohol dependence” or “alcoholism”, often sets in insidiously. It can sometimes take several years for the person who drinks or those around him to really realize that it exists. It is often preceded by so-called “risky” habits (such as “binge drinking”, occasional and massive alcoholizations), then “harmful” where the person gradually loses control of his alcohol consumption.
In the more or less long term, alcohol takes over and the person becomes dependent. First, she gets used to alcohol and develops tolerance by drinking larger and larger amounts to feel the effects she seeks. Then there comes a time when she no longer drinks for what alcohol gives her but because it becomes a necessity. She seeks to avoid the lack, which manifests itself in particular by sweating, tremors, and dizziness.
Once the addiction is installed, it results in an irrepressible desire to drink (craving) and withdrawal, which, failing to take again alcohol, can induce a withdrawal syndrome: anxiety, tremors, sweating, restlessness, tachycardia, fever, and in the most severe cases epileptic seizure and delirium tremens which can be fatal.
The amount of alcohol can vary from one alcohol dependent individual to another. However, the World Health Organization (WHO) has established benchmarks that distinguish low-risk drinking from higher-risk drinking. The consumption limit thresholds are 2 standard drinks per day for women and 3 drinks per day for men (and 4 drinks for special events). In addition, the WHO advises to refrain from drinking alcohol at least one day a week.
Symptoms: Recognizing an Alcoholic
For the alcoholic, alcohol becomes one of the pillars of his life and it is difficult for him to consider living without. When she stops, she is weakened by the absence of this crutch and she has to face difficulties that alcohol allowed to obscure. Some signs allow you to recognize an addiction:
Alcohol consumption is more and more frequent.
The quantities of alcohol drunk are more and more important.
It appears negative consequences (conflicts, difficulties to ensure your days…) which become more and more numerous.
Stopping consumption is becoming more and more difficult.
The urge to drink is stronger and appears more often.
There are signs of withdrawal when stopped: tremors, sweating …
Alcohol consumption can also become problematic if it changes behavior and relationships with loved ones.
Causes of Alcoholism
Alcoholism is a neurobiological disease that affects the neurological reward circuit in the brain. The more alcohol is consumed in large quantities and / or frequently, the more the brain increases the tolerance threshold, i.e it demands more alcohol. Gradually, the addiction sets in and the person can no longer do without it, even to the point of feeling withdrawal symptoms when stopped.
Profiles at Risk
Not everyone is equal when it comes to alcohol: gender, age, genetic heritage, socio-economic and cultural background and certain mental disorders contribute to the risk of becoming dependent on alcohol. Women and adolescents are more vulnerable to alcohol. Studies of twins and families with frequent alcohol dependence have shown that certain genes may account for 50 to 60% of a person’s predisposition to become dependent on alcohol. People who grew up in poverty consume more alcoholic beverages than people from more advantaged social classes. In addition, people who suffer from psychosis (schizophrenia, for example), generalized anxiety, phobias, or obsessive-compulsive disorder, seem to have a greater vulnerability to alcohol.
Alcoholism causes different disorders depending on whether it is recent or old and depending on the amount of alcohol ingested. In the short term, it is likely to lead to pathologies such as ulcers, gastroesophageal reflux disease, hepatitis, nausea and vomiting. In the medium and long term, it leads to neurological pathologies, severe hepatic diseases, ethyl cirrhosis, pancreatitis, heart problems and libido disorders. In addition, alcohol considerably increases the risk of fatal road accidents and has significant psychological and social consequences (isolation, depression, anxiety, suicide attempts, violence, relationship disorders, etc.).
When to consult? Which specialist to consult?
It is possible to stop drinking alone, without outside help. However, the risks associated with withdrawal syndrome can be high, causing more serious problems than the usual symptoms of lack of alcohol.
This is why before any stop, it is advisable to meet an addictology professional, an addictologist, or his attending physician, in order to take stock of the addiction and to establish a suitable stop protocol. Weaning with or without hospitalization can be set up as well as a reflection on the place that alcohol has taken and the reasons leading to this consumption. Comprehensive care is essential, as alcohol consumption is never an isolated problem in a person’s life.
Diagnosis and Testing
The diagnosis of alcoholism can be easily made by questioning the patient who evokes the loss of control of his consumption, the symptoms of withdrawal and the urges to consume. The FACE or AUDIT (Alcohol Use Disorders Test) questionnaires are based on a series of questions relating to the analysis of consumption during the preceding twelve months. They can be very helpful in diagnosis. Biological examinations do not make it possible to make the diagnosis but to assess the consequences of consumption:
Macrocytosis, that is to say an increase in the volume of red blood cells in the blood;
The treatment of alcoholism requires awareness of the problem by the patient and his adherence to the management. It begins with the establishment of weaning, more or less gradual with objectives of reducing consumption and regular monitoring. The patient can be accompanied by an addictologist and / or a psychologist, a psychiatrist, the attending physician, a hepatologist, or a gastroenterologist for example. Certain support groups such as Alcoholics Anonymous (AA), for example, can help prevent relapse by providing psychotherapeutic support. Finally, there are drugs that reduce the desire to consume alcohol and limit long-term relapses. In some cases, hospitalization or treatment in a health center may be offered to limit the risks at the time of serfdom and to work towards the prevention of long-term relapses.