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Alcohol Abuse
Risk Factors and Causes
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Genetic,
biological, environmental, psychological, and sociocultural factors play a part
in alcoholism.
Genetic
Scientists suggest that genetics may play a role in the following:
- Increased risk for alcoholism
- Increased tolerance
- Ongoing craving for alcohol
Genes that may be involved in alcoholism
have not been identified. A number of studies of twins and adoptions support
the idea that genetics may be involved in alcoholism. In one study, identical
male twins, raised in separate environments, shared patterns of alcohol use,
including dependence. Another study showed a continued likelihood of alcoholism
in male siblings born into alcoholic familieshttp://mindzone.in/ but adopted into nonalcoholic families.
Biology
Research notes that Chinese, Japanese, and Koreans with a deficiency or absence
of alcohol dehydrogenase (a liver enzyme) tend to drink less and are at lower
risk for alcoholism. Because their livers do not break down alcohol, these
people experience vomiting, flushing, and increased heart rate and don't drink
as often. Researchers hope to provide a biological account for the low
incidence of alcoholism in Jews who consume a large amount of alcohol. Other
groups are at an increased risk for alcoholism. Native Americans (a population
with a high incidence of alcoholism) generally don't become intoxicated as
quickly as other races and so may tend to drink more.
At least two studies have shown a possible
correlation between certain brain wave patterns and an increased risk
for alcoholism.
Environment, Psychology, and Culture
Gender, family history, and parenting influence drinking behavior. A
substantially higher number of men than women abuse alcohol; some estimate the
ratio to be as high as 5:1. However, the number of women who drink, abuse, and
become dependent on alcohol is rising. Studies indicate that up to 25% of sons
of alcoholic fathers will develop alcohol abuse or dependence.
Most children of alcoholics do not develop
dependence. Children in families with multiple risk factors are at greater risk
for alcohol abuse and/or dependence. Some of these risk factors include growing
up with parents who:
- are dependent on alcohol
- have coexisting psychological disorder(s)
- use alcohol to cope with stress
Family violence and having several close
blood relatives who are alcohol dependent are also risk factors.
The expectations and beliefs about alcohol
may influence alcohol use. Younger family members tend to mimic the alcohol use
patterns of their parents, siblings, and other family members. Peers also
influence drinking behavior.
Some studies show that regardless of a
family history of alcoholism, a lack of parental monitoring, severe and
recurrent family conflict, and poor parent-child relationships can contribute
to alcohol abuse in adolescents. Children with conduct disorders, poor
socialization, and ineffective coping skills as well as those with little
connection to parents, other family members, or school may be at an increased
risk for alcohol abuse and/or dependence.
Recently, the NIH reported that lower
educational levels and unemployment do not cause higher rates of alcoholism.
Results from a 1996 study show that the rates of alcoholism in adult welfare
recipients were comparable to those of the general population. The study did
show higher rates of death from alcoholism in welfare recipients.
Signs and Symptoms
Alcohol is absorbed by the small intestine into the bloodstream. The blood then
enters the liver, where most of the alcohol is metabolized. The body excretes a
small amount of unprocessed alcohol. The body absorbs alcohol more quickly than
it metabolizes, so the blood alcohol concentration increases quickly and
effects occur rapidly.
Alcohol is a central nervous system
depressant. In general, the first noticeable effects of alcohol—reduced
anxiety, sedation—occur when blood alcohol concentration is at 0.04 gr per 100
mL of blood. As blood alcohol levels rise, the person may show the following
signs:
- Confusion
- Coordination difficulties
- Expansive mood
- Impaired memory
- Poor judgment
- Sense of well-being
- Short attention span
- Slurred speech
- Talkativeness
On average, between three and six standard
drinks cause legal intoxication, which, depending on state laws, is defined as
blood alcohol concentration of 0.08 gr or 0.10 gr per 100 mL of blood.
When blood alcohol levels fall, the person
experiences symptoms such as being withdrawn, sedate, and/or depressed.
Eventually, the body metabolizes and excretes the alcohol and the person sobers
up.
Very high levels of blood alcohol cause
the person to fall asleep or pass out. More rarely, severe intoxication caused
by alcohol poisoning is life threatening:
- At .40 BAC, alcohol suppresses the cardiorespiratory
system. Coma or death may result.
- At .45 BAC, alcohol suppresses major organ systems.
Death results.
Several factors, such as the amount of
alcohol consumed, body weight, and food intake, affects the rate at which a
person becomes intoxicated. Water content also affects the rate at which
alcohol is metabolized: the higher the water content, the more alcohol
absorbed. Women, whose bodies typically have a higher percentage of water
content, show signs of intoxication more quickly.
Tolerance occurs when a person's body is less responsive to alcohol because of
repeated exposure. Alcohol causes neurons (nerve cells) in the central nervous
system to adapt to its presence. Those who are tolerant require more alcohol to
produce an effect, such as reducing anxiety.
In addition, liver enzymes that detoxify
alcohol increase with frequent drinking; thus, the liver of an alcoholic breaks
down alcohol more quickly than it did when first exposed to alcohol,
contributing to the development of tolerance. Tolerance levels can increase to
the point that a long-term alcoholic can consume a quantity of alcohol that
would be extremely dangerous to a nondrinker.
Abuse is characterized by frequent drinking that causes the person to neglect
responsibilities such as working, caring for children, or attending school.
Difficulties with family, friends, and coworkers because of drinking are also
signs of abuse. The person may drink when it is dangerous, for example while
driving. It is common for those who abuse alcohol to have legal problems
related to drinking, such as being arrested for disorderly conduct. Abuse may
lead to dependence.
In clinical withdrawal, two or more of the following symptoms occur several
hours or up to a few days after someone stops drinking:
- Anxiety
- Autonomic hyperactivity (i.e., sweating, pulse rate
greater than 100)
- Delirium tremens (i.e., anxiety, increased heart rate,
sweating, trembling, confusion)
- Difficulty performing tasks involving coordination
- Grand mal seizures (i.e.,
convulsions resulting in loss of consciousness and muscle contractions)
- Hallucinations (sights, sounds, or physical sensations
on the skin, elevated or decreased temperature)
- Hand tremor
- Insomnia
- Nausea, vomiting
Symptoms vary in incidence and severity,
and usually subside within hours or a few days. The risk for symptoms depends
on drinking patterns, coexisting illnesses, genetic factors, and the make-up of
the person's central nervous system. In general, larger amounts of alcohol
correlate with more severe symptoms. Medical attention may be necessary to
prevent serious complications. Chronic alcoholism causes vitamin deficiencies,
particularly vitamin B, which contributes to withdrawal symptoms.
People who are alcohol dependent are unable to reduce the amount they drink or
to stop drinking, though they often try. Most telling, alcohol use takes over
more and more of the person's life, and he or she may deny the complications it
causes. Those who are dependent often experience physical and psychological
dependence. Psychological dependence is characterized by the belief that
alcohol is necessary in order to perform everyday activities. Dependence is
confirmed when alcohol use is accompanied by signs of tolerance, withdrawal, abuse, and the compulsion to drink even when
there are clear signs that it interferes with daily life.
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