Alcohol abuse is a previous psychiatric diagnosis in which there is recurring

harmful use of ethanol despite its negative consequences. In 2013 it was

reclassified as alcohol use disorder along with alcohol dependence. There are two
types of alcohol abuse, those who have anti-social and pleasure-seeking tendencies,
and those who are anxiety-ridden people who are able to go without drinking for
long periods of time but are unable to control themselves once they start. Binge
drinking is another form of alcohol abuse. According to surveys, the heaviest
drinkers are the United Kingdom's adolescents. In 2013, 139,000 deaths globally
were directly due to alcohol abuse
Definitions
Alcohol abuse is a pattern of drinking that results in harm to ones health,
interpersonal relationships, or ability to work. According to Gelder, Mayou &
Geddes alcohol abuse is linked with suicide. They state the risk of suicide is
high in older men who have a history of drinking, as well as those suffering from
depression. Certain manifestations of alcohol abuse include failure to fulfill
responsibilities at work, school, or home; drinking in dangerous situations,
including the operation of a motor vehicle; legal concerns associated with alcohol
use; and continued drinking despite problems that are caused or worsened by
drinking. Alcohol abuse can lead to alcohol dependence. In the diagnosis manual
DSM-5 alcohol abuse is combined with alcohol dependence to create one unified
disorder, alcohol use disorder, that includes a graded clinical severity from
moderate to severe with at least 2 criteria to make diagnoses. For adolescents, the
DSM-5 proposes that diagnoses meeting 2 or 3 criteria would be similar to alcohol
abuse while meeting over 4 criteria would be equivalent to alcohol dependence when
compared to the DSM-IV.
Alcohol abuse has both short-term and long-term risks. If a person drives while
drunk or regularly consuming binge drink, they are considered to have been involved
in alcohol abuse. Short-term abuses of alcohol include, but are not limited to,
violence, injuries, unprotected sexual activities and, additionally, social and
financial problems.
The older adult population is frequently overlooked when discussing alcohol abuse.
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, this is less than
current recommendations of maximum alcohol consumption per week, for adults noted
to be nine drinks for a male and seven for a female.
Binge drinking
In the USA, binge drinking is defined as consuming more than five units in men and
four units in women. It increases chances for vandalism, fights, violent
behaviours, injuries, drunk driving, trouble with police, negative health, social,
economic, or legal consequences to occur. Binge drinking is also associated with
neurocognitive deficits of frontal lobe processing and impaired working memory as
well as delayed auditory and verbal memory deficits. The chances of becoming
dependent are increased greatly in men who have 15 or more drinks each week or
women who have 12 or more drinks each week. This is known as alcohol dependency.
It is believed that one way to prevent binge drinking is to raise the legal
drinking age.
Signs and symptoms
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. Alcohol abuse is
also an important cause of chronic fatigue.
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. Signs of alcohol abuse show its drastic effects on the central
nervous system, including inebriation and poor judgment; chronic anxiety,
irritability, and insomnia. Alcohol's effects on the liver include elevated liver
function tests . Prolonged use leads to cirrhosis and liver failure. With
cirrhosis, patients develop an inability to process hormones and toxins. The skin
of a patient with alcoholic cirrhosis can feature cherry angiomas, palmar erythema
and in acute liver failure jaundice and ascites. The derangements of the
endocrine system lead to the enlargement of the male breasts. The inability to
process toxins leads to liver disease, such as hepatic encephalopathy.
Alcohol abuse can result in brain damage which causes impairments in executive
functioning such as impairments to working memory, visuospatial skills, and can
cause an abnormal personality as well as affective disorders to develop. 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 a person's critical thinking. A person's ability
to reason in stressful situations is compromised, and they seem very inattentive to
what is going on around them. Adolescent binge drinkers are most sensitive to
damaging neurocognitive functions especially executive functions and memory. People
who abuse alcohol are less likely to survive critical illness with a higher risk
for having sepsis and were more likely to die during hospitalization.
Violence
Alcohol abuse is significantly associated with suicide and violence. Alcohol is the
most significant health concern in Native American communities because of very high
rates of alcohol dependence and abuse; up to 80 percent of suicides and 60 percent
of violent acts are a result of alcohol abuse in Native American communities.
Pregnancy
Alcohol abuse among pregnant women causes their fetus to develop fetal alcohol
syndrome. Fetal alcohol syndrome is the pattern of physical abnormalities and the
impairment of mental development which is seen with increasing frequency among
children with alcoholic mothers. Alcohol exposure in a developing fetus can result
in slowed development of the fetal brain, resulting in severe retardation or death.
Surviving infants may suffer severe abnormalities such as abnormal eyes, fissures,
lips and incomplete cerebella. Some infants may develop lung disease. It is even
possible that the baby throughout pregnancy will develop heart defects such as
ventricular septal defect or atrial septal defect. Experts suggest that pregnant
women take no more than one unit of alcohol per day. However, other organizations
advise complete abstinence from alcohol while pregnant.
Adolescence
Adolescence and the onset of puberty have both a physiological and social impact on
a developing person. About half of grade 12 students have been drunk, and a third
binge drink. About 3% drink every day. One of these social impacts is the increase
in risk-taking behaviors, such as the emergence of alcohol use. Children aged 16
and under who consume alcohol heavily display symptoms of conduct disorder. Its
symptoms include troublesome behaviour in school, constantly lying, learning
disabilities and social impairments. 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.
Societal inequalities have influenced an adolescents decision to consume alcohol.
One study suggests that girls were scrutinized for "drinking like men," whereas
magazines that target the male population sent underlying messages to boys and or
men that drinking alcohol was "masculine."
Causes
The cause of alcohol abuse is complex. Alcohol abuse is related to economic and
biological origins and is associated with adverse health consequences. 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 groups norms and attitudes can influence alcohol abuse.
Mental illness
A person misusing alcohol may be doing so because they find alcohol's effects
provide relief from a psychological problem, such as anxiety or depression. Often
both the alcohol misuse and psychological problems need to be treated at the same
time.
The numbing effects of alcohol and narcotics can become a coping strategy for
traumatized people who are unable to dissociate themselves from the trauma.
However, the altered or intoxicated state of the abuser prevents the full
consciousness necessary for healing.
Puberty
Gender differences may affect drinking patterns and the risk for developing alcohol
use disorders. Sensation-seeking behaviors have been previously shown to be
associated with advanced pubertal maturation, as well as the company of deviant
peers. Additionally, when controlling for age, this association between advanced
development and alcohol use still held true.
Mechanisms
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. Adolescents with an alcohol
use disorder damage the hippocampal, prefrontal cortex, and temporal lobes. 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. 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. The rapid effect of drugs releases the neurotransmitter
dopamine which acts as reinforcement for the behavior. If two or more of the
questions are positive, alcohol abuse is considered.
Prevention
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.
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.
According to European law, individuals who are suffering from alcohol abuse or
other related problems cannot be given a 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.
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 . However, studies have established that those with
alcohol abuse tend to have family members who try to provide help. In many of these
occasions the family members would try to help the individual to change or to help
improve the individual's lifestyle.
Treatment
Youth treatment and intervention should focus on eliminating or reducing the
effects of adverse childhood experiences, like childhood maltreatment, since these
are common risk factors contributing to the early development of alcohol abuse.
Approaches like contingency management and motivational interviewing have shown to
be effective means of treating substance abuse in impulsive adolescents by focusing
on positive rewards and redirecting them towards healthier goals. Educating youth
about what is considered heavy drinking along with helping them focus on their own
drinking behaviors has been shown to effectively change their perceptions of
drinking and could potentially help them to avoid alcohol abuse.
Completely stopping the use of alcohol, or "abstinence," is the ideal goal of
treatment. A strong social network and family support maybe important in achieving
this goal.
Some people who abuse alcohol may be able to reduce the amount they drink, also
called "drinking in moderation." If this method does not work, the person may need
to try abstinence. Abstinence has been regularly achieved by many alcoholics in
Alcoholics Anonymous.
Mindfulness-based intervention programs can reduce the consumption of alcohol.
Epidemiology
Alcohol abuse is said to be most common in people aged between 15 and 24 years,
according to Moreira 2009. Studies show that child maltreatment such as neglect,
physical, and/or sexual abuse, increases the likelihood of that child developing
alcohol use disorders later in life. According to Shin, Edwards, Heeren, &
Amodeo, 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. 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
ranging from 28% in adolescence and 58% in adults.
Prognosis
Alcohol abuse during adolescence, especially early adolescence, 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. 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. It is not entirely clear whether this association is causal,
and some researchers have been known to disagree with this view.
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.
College/university students who are heavy binge drinkers 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, were found to be four times
more likely to be diagnosed with alcohol abuse or dependence compared to non-heavy
episodic drinkers. 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.
Societal and economic costs
Alcohol abuse is associated with many accidents, fights, driving offenses and
unprotected sex. Alcohol is responsible in the world for 1.8 million deaths and
results in disability in approximately 58.3 million people. Approximately 40
percent of the 58.3 million people disabled through alcohol abuse are disabled due
to alcohol-related neuropsychiatric disorders. In South Africa, where HIV infection
is epidemic, alcohol abusers exposed themselves to double the risk of this
infection. Moreover, problems caused by alcohol abuse in Ireland cost about 3.7
billion euro in 2007. Additionally, alcohol abuse increases the risk of individuals
either experiencing or perpetrating sexual violence.
Also, 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.
Alcohol misuse costs the United Kingdom's National Health Service L3 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.
See also
0-0-1-3 - a United States Air Force program for alcohol abuse prevention
Alcoholism
American Indian Committee on Alcohol and Substance Abuse
References
External links
, National Institute on Alcohol Abuse and Alcoholism
Bureau of Justice Statistics

Bibliography:
Wikipedia
@baygross