Drinking alcohol is a long-established habit and social custom in China, and now it has become an important public health issue in the country.
Some data show that usually among the general adult population, less than 5% of people do not drink alcohol in their lifetime, those who drink only on specific occasions such as festivals and parties account for most 80%, problem drinkers account for 10%, and those who are truly alcohol dependent account for about 5%.
The sociodemographic characteristics of alcohol-dependent patients can be summarized as follows.
Male dominated, high in heavy manual laborers, and more patients from ethnic minorities, however, there is now a trend towards lower age of drinking with a rise in the drinking rate of women.
Alcohol causes physical damage to the body mostly seen in.
1, neurological damage such as peripheral nerve damage, epilepsy, cerebellar lesions, and rare ones such as optic nerve atrophy, central gray matter hemorrhage in the basal ganglia, ataxia, and even dementia.
2. Alcohol also leads to nutritional disorders, which can be seen as abnormal liver function, cirrhosis, gastritis, gastric ulcer, cardiomyopathy, cholecystitis, etc.
3.Long-term alcohol consumption can also lead to acute and chronic infections, anemia, thrombocytopenia, etc.
4.Alcohol causes psychological changes in people
5.Alcohol dependence can also lead to personality changes, such as increased self-centeredness, reduced sense of obligation and responsibility, lack of care for family and work, little regard for relatives and family, laziness and irresponsibility for work, and neglect of duties. Many see a lower standard of character, excessive alcoholics are also not uncommon anxiety or depression state.
6, social damage caused by alcohol.
7, drunk driving, violent crime, suicide, bring more and more social problems, but also bring more and more economic losses.
The above are also the reasons why we actively advocate abstinence from alcohol.
Clinical manifestations
1.Alcohol dependence syndrome.
This is a special psychological state caused by repeated alcohol consumption. Patients have a thirst for alcohol and a compulsive feeling of constantly needing to drink, which can occur continuously or intermittently, and psychological and life withdrawal symptoms will occur if they stop drinking alcohol.
(1) An uncontrollable craving for alcohol.
(2) A fixed drinking pattern in which the patient must drink at a fixed time regardless of the occasion in order to avoid or alleviate withdrawal symptoms.
(3) Drinking has become central to all activities to the extent that it significantly interferes with work, family life, and social activities.
(4) Tolerance gradually increases, and the patient needs to keep increasing the amount of alcohol consumed in order to achieve the effect achieved at the beginning of drinking or to prevent the occurrence of physiological withdrawal symptoms.
(5) Recurrence of withdrawal syndromes; patients with more severe conditions may experience severe convulsions, clouding of consciousness, or delirium tremens if they are in relative or absolute withdrawal.
(6) Patients with alcohol dependence who return to drinking after a period of withdrawal will more rapidly reproduce all the symptoms of the dependence syndrome.
2. Delirium tremens.
Patients who suddenly reduce the amount of alcohol or stop drinking after a long period of drinking can quickly produce transient disorders of consciousness. During the attack, the patient is unconscious, with time and place orientation disorder, vivid and distinct hallucinations and delusions of victimization; thus, the patient shows extreme fear and anxiety or impulsive behavior. The patient may also experience gross tremor and ataxia of the extremities, often accompanied by fever, profuse sweating, tachycardia, elevated blood pressure, and dilated pupils. In severe cases, it can be life-threatening. The duration of delirium tremens varies, usually from 3 to 5 days. After recovery, the patient is partially or completely oblivious to the course of the illness.
3. Alcoholic hallucinosis.
A hallucinatory state caused by long-term alcohol consumption. Patients suddenly reduce or stop drinking alcohol for various reasons within 1-2 days after the appearance of a large number of rich and distinct hallucinations, mainly hallucinatory vision. Primitive hallucinations as well as commentary and command hallucinations are common. On the basis of hallucinations, fragmentary delusions and corresponding nervousness and fear or depression may also occur.
4. Alcohol toxicity delusions.
Delusions of jealousy and delusions of victimization occur in patients with clear consciousness, the former being the most common clinically. Patients unjustifiably suspect that their spouses are unfaithful and often react with rage, which may also lead to attacks on the suspect or spouse.
5. Alcoholic toxic encephalopathy.
This is the most serious psychotic state of chronic alcoholism, which is the result of organic brain damage caused by long-term heavy drinking. Clinical delirium, memory loss, dementia and personality changes are the main features, and the vast majority of patients cannot fully recover.
6. Korsakoff’s psychosis.
Clinically characterized by prominent near memory deficits, difficulties in learning new knowledge, often fiction and misconstruction, and patients unintentionally fabricating experiences and episodes or distant events to fill gaps in memory. In addition to near-memory impairment, many patients have euphoric expressions, disorientation, and sensorimotor disorders.
The diagnosis of alcohol-induced psychosis is based primarily on a history of established alcohol use and a well-founded conclusion that the patient’s psychotic symptoms are directly caused by alcohol use or withdrawal.
Treatment
1.Withdrawal from alcohol
Abstinence from spilling is a key step in the success of treatment. Patients with chronic alcoholism should be allowed to receive treatment under inpatient conditions, withdrawal reactions, and withdrawal syndrome. In order to wean the body from the continuous damage of alcohol.
2.Symptomatic treatment
For patients with symptoms of anxiety and nervousness and insomnia, they can be treated with benzodiazepines, and the treatment process herbal medicine attention, due to drug delirium caused by improper drug use. The presence of psychiatric symptoms using psychotropic drug treatment.
3.Supportive treatment
Because most patients have neurological damage and poor somatic nutritional status, should be given to promote neurotrophic drug therapy, while supplementing a large number of vitamins, especially B vitamins.
4.Psychotherapy
Psychological treatment methods such as supportive psychotherapy and cognitive therapy are also beneficial to help patients quit drinking and prevent relapse.