Alcohol-related disorders

After heart disease and cancer, alcohol-related disorders are considered the third most important health problem in the United States, estimated to account for at least one fourth of all hospitalizations in this country. Almost 50% of those who suffer from alcohol dependence also abuse other legal and illicit drugs (see Appendix D). Alcohol is involved in 25% to 35% of all suicides and 50% to 70% of all homicides it also figures prominently in accidental deaths and domestic violence (388, 389). Furthermore, causes of death resulting from excessive alcohol use include the following ... 

Schuckit MA. Alcohol-related disorders. In Kaplan HI, Sadock BJ, eds. Comprehensive textbook of psychiatry, 6th ed, Vol. 1. Baltimore Williams Wilkins, 1995 775-791. 

Schuckit, M. A. (1995). Alcohol-related disorders. In H. I. Kaplan B. J. Sadock (Eds.), Comprehensive textbook of psychiatry/VI (6th ed.). Baltimore Williams c Wilkins. 

Medications can play an important role in the treatment of alcohol-related disorders. Figure 12-C lists medications that can be used in the treatment of alcohol-related disorders. Most of those medications are covered in part three of this book. The exception is disulfiram (Antabuse), a medication used to assist in the maintenance of abstinence. Disulfiram causes an accumulation of acetaldehyde if a person drirrks alcohol while taking it, which leads to an unpleasant and potentially dangerous reaction involving flushing, throbbing headache, nausea, and vomiting. Only certain people are appropriate for disulfiram treatment. Some are able to remain abstinent without it some will drirrk in spite of it. In between are those who will... 

Alcohol-Related Disorders and Medications for Treating Them ... 

H. G. Gika and I. D. Wilson, Global Metabolic Profiling for the Study of Alcohol-Related Disorders, Bioanalysis, 2014, 6, 59. 

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

The 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES), based on interviews with a national probability household sample of nearly 43,000 adults age 18 years and older, showed the 1-year prevalence of DSM-IV alcohol use disorder to be 7.4% (i.e., 3.0% with alcohol abuse and 4.4% with alcohol dependence) (Grant et al. 1994). Findings from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a community-based survey of nearly 43,000 individuals conducted in 2001—2002 (Grant... 

A number of randomized chnical trials have demonstrated the efficacy of CBT for treating substance use disorders, compared with no-treatment control conditions (see Carroll 1996 for review). However, the superiority of CBT over other psychosocial treatments is not as clear. Although some studies have found CBT to be more effective than other treatments, others have found this method to be comparable to other treatment approaches (Carroll 1996). In Project MATCH, for instance, CBT, MET, and 12-step facihtation produced similar outcomes, with each therapy leading to substantial improvement in alcohol-related symptoms during the 12-week treatment period (Project MATCH Research Group 1997). 

See Chap. 68, Substance-Related Disorders Overview and Depressants, Stimulants, and Hallucinogens, authored by Paul L. Doering and Lisa Boothby, and Chap. 69, Substance-Related Disorders Alcohol, Nicotine, and Caffeine, authored by Paul L. Doering, W. Klugh Kennedy, and Lisa A. Boothby, for a more detailed discussion of the topic. 

Comorbid dysthymia and substance disorder. A total of 642 patients were assessed. Thirty-nine had substance-related disorder and dysthymia (SRD-dysthymia) and 308 had SRD only. Data on past use were collected by a research associate using a questionnaire. The patients with SRD-dysthymia and SRD did not differ with regard to use of alcohol, tobacco, and benzodiazepines. The patients with SRD-dysthymia started caffeine use at an earlier age, had shorter use careers of cocaine, amphetamines, and opiates, and had fewer days of cocaine and cannabis use in the last year. They also had a lower rate of cannabis... 

Because several major diseases are commonly associated with alcoholism, treatment of alcohol-related psychiatric disorders may have to be modified if one of these... 

Because lithium shows some utility in certain patients whose dual diagnosis includes bipolar disorder, and because the anticonvulsants attenuate several types of withdrawal syndromes, these agents may be useful and safe for selected alcoholic patients with bipolar and related disorders. 

Alcohol indirectly affects hematopoiesis through metabolic and nutritional effects and may also directly inhibit the proliferation of all cellular elements in bone marrow. The most common hematologic disorder seen in chronic drinkers is mild anemia resulting from alcohol-related folic acid deficiency. Iron deficiency anemia may result from gastrointestinal bleeding. Alcohol has also been implicated as a cause of several hemolytic syndromes, some of which are associated with hyperlipidemia and severe liver disease. 

Over 50% of Americans who currently drink report having a close relative who abuses alcohol 25% are children of an alcoholic parent. Alcohol abuse can devastate families by causing separation, divorce, and domestic violence, as well child abuse and neglect. Six million children live with an alcohol-abusing parent, and this can result in problems at school such as low attendance, academic difficulties, attention deficit disorders, and behavioral problems. Each year in America, more than 100,000 people die from alcohol-related accidents (cars, falls, fires, drownings, burns), cancer, liver disease, and stroke. 

The use of alcohol (ethanol) prepared from the fermentation of sugars, starches and other carbohydrates dates back to the beginning of recorded history. Alcohol is the most important drug of dependence in all industrialized countries, and the clinical and social problems that arise from its widespread abuse are legion. In the US, the total annual economic cost of alcoholism and its related disorders has been estimated to be approximately 80 billion, and this does not take into account the human cost, which is impossible to quantify. It has been calculated that the lifetime... 

Substance abuse and related disorders represent a major problem area facing the clinician. Despite the "war on drugs" they continue to be a widespread problem. At least 5 percent of Americans are alcoholic, and stimulant abuse is a serious problem among teenagers and young adults. Any solution to these problems will undoubtedly involve social and political factors in addition to clinical programs. This chapter focuses on the differing types of clinical syndromes related to each commonly abused substance and medications that may be useful as an adjunct to treatment. 

Very many chemicals are recognized teratogens in animals a significantly smaller subset of these is known or suspected to be developmental neurotoxicants in humans. Some of the more significant of the latter group include ethanol, which causes a constellation of effects ranging from fetal alcohol syndrome to alcohol-related neurodevelopmental disorder maternal smoking of tobacco (fetal tobacco syndrome) excess vitamins A and D heavy metals, particularly... 

The European Journal of Nutrition links aging and age-related disorders to acid-alkaline imbalances.1 In my book The Brain Wash, I discuss the dangers of exposure to heavy metals and pesticides, as well as the damage caused by alcohol consumption. These substances contribute to excess acidity in the body as our systems try to metabolize, neutralize, or eliminate them. Once they are in our bodies, it can be difficult to get rid of them. They promote inflammation and increase the formation of free radicals (charged molecules that attack healthy tissues). Both inflammation and free radicals are associated with brain diseases such as Alzheimer s. 

Bromocriptine Alcohol Bromocriptine is an ergot alkaloid and a dopamine receptor D2 agonist that inhibits prolactin release from the pituitary gland [228]. Bromocriptine is typically used to treat Parkinsonian syndrome as well as hyperprolactinaemia, growth hormone- and prolactin-related disorders such as menstrual disorders, infertility, and hypogonadism. 

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