special subjects
Alcohol Use
Symptoms of Alcohol Use Disorder
Alcohol causes three basic types of problems: Those that occur immediately when people drink too much at a particular time (intoxication and overdose) Those that occur over a long period of time when people regularly consume excessive amounts Those that occur when heavy, long-term use is stopped suddenly ( Withdrawal symptoms ) Alcohol has almost immediate effects because it is absorbed faster than it is processed (metabolized) and eliminated from the body. As a result, alcohol levels in the blood rise rapidly. Effects can occur within a few minutes of drinking. Effects vary greatly from person to person. For example, people who drink regularly (2 or more drinks per day) are less affected by a given amount of alcohol than those who normally do not drink or drink only socially, a phenomenon termed tolerance. People who have developed tolerance to alcohol may also be tolerant to other drugs that slow brain function, such as barbiturates and benzodiazepines. Effects vary depending on the level of alcohol in the bloodstream, which is usually expressed in the United States in terms of milligrams per deciliter (1/10 liter of blood), abbreviated mg/dL and in other parts of the world as millimoles per liter abbreviated mmol/L. Actual blood levels required to produce given symptoms vary greatly with tolerance, but in typical users who have not developed tolerance, the following symptoms are typical: 20 to 50 mg/dL (4.3 to 10.9 mmol/L): Tranquility, mild drowsiness, some decrease in fine motor coordination, and some impairment of driving ability 50 to 100 mg/dL (10.9 to 21.7 mmol/L): Impaired judgment and a further decrease in coordination 100 to 150 mg/dL (21.7 to 32.6 mmol/L): Unsteady gait, slurred speech, loss of behavioral inhibitions, and memory impairment 150 to 300 mg/dL (32.6 to 65.1 mmol/L): Delirium and lethargy (likely) 300 to 400 mg/dL (65.1 to 86.8 mmol/L): Often unconsciousness ≥400 mg/dL (≥86.8 mmol/L): Possibly fatal is common with moderate to severe alcohol intoxication. Because people may be very drowsy, vomited material may enter the lungs (be aspirated), sometimes leading to Aspiration Pneumonia and Chemical Pneumonitis and death. In the United States, all states define driving with a blood alcohol content (BAC) at or above 80 mg/dL (17.4 mmol/L; 0.08%) as a crime, but specific state laws and penalties vary. 86.8 mmol/L) can be fatal. Death can occur due to impaired breathing or abnormal heart rhythms ( Overview of Abnormal Heart Rhythms ), especially when large quantities are drunk rapidly. The effects of a particular blood level differ in chronic drinkers. Many seem unaffected and appear to function normally with relatively high levels, such as 300 to 400 mg/dL (65.1 to 86.8 mmol/L). Alcohol, even in moderate doses, interferes with short-term memory formation which may cause blackouts. The intoxicated individual may seem gregarious and loquacious but will have limited memory of the blackout period. Prolonged use of excessive amounts of alcohol damages many organs of the body, particularly the liver ( ). Because people may not eat an adequate diet, they may also develop severe vitamin and other nutritional deficiencies. Alcohol-Related Liver Disease None Usually, people with liver failure also have liver flap ( Hepatic Encephalopathy ). When the arms and hands are outstretched, the hands suddenly drop, then resume their original position. Liver flap resembles but is not a tremor. Cirrhosis of the Liver None Inflammation of the pancreas ( Acute Pancreatitis ) also can be caused by excessive alcohol use. When the nerves to the arms and legs ( Overview of the Peripheral Nervous System ) are affected, people may have loss of sensation or feel pins and needles in their hands and feet. People may develop a chronic A severe Thiamin Deficiency None Existing Depression None , including low birth weight, short body length, small head size, heart damage, muscle damage, and low intelligence or intellectual disability, can be caused by alcohol use in pregnant women. These effects are called the Alcohol . Avoidance of alcohol is therefore recommended during pregnancy. If people who drink continually for a period of time suddenly stop drinking, withdrawal symptoms are likely. For example, withdrawal can occur during hospitalization (for example, for elective surgery) because drinkers are unable to obtain alcohol. Withdrawal symptoms vary from mild to severe. Severe untreated alcohol withdrawal can be fatal. usually begins within 6 hours after drinking stops. Mild symptoms include tremor, headache, weakness, sweating, and nausea. Some people have Seizure Disorders (called alcohol-related epilepsy or rum fits). Alcohol-related hallucinosismay occur in heavy drinkers who stop drinking. They hear voices that seem accusatory and threatening, causing apprehension and terror. Alcohol-related hallucinosis may last for days and can be controlled with antipsychotic medications, such aschlorpromazineorthioridazine. Delirium tremens (DTs)is the most serious group of withdrawal symptoms. Usually, delirium tremens does not begin immediately. Rather, it appears about 48 to 72 hours after the drinking stops. People are initially anxious. Later, they become increasingly confused, do not sleep well, have frightening nightmares, sweat excessively, and become very depressed. The pulse rate speeds up and the blood pressure rises. Fever typically develops. The episode may escalate to include fleeting hallucinations, illusions that arouse fear and restlessness, and disorientation with visual hallucinations that may be terrifying. Objects seen in dim light may be particularly terrifying, and the people become extremely confused. Their balance is impaired, sometimes making them think the floor is moving, the walls are falling, or the room is rotating. As the delirium progresses, a persistent tremor develops in the hands and sometimes extends to the head and body. Most people become severely uncoordinated. Delirium tremens can be fatal, particularly when untreated. 