Alcohol Use Disorder: Patterns of use
- Phase I. Pre-alcoholic phase: Characterized by use of alcohol to relieve everyday stress and tensions of life
- Phase II. Early alcoholic phase: Begins with blackouts—brief periods of amnesia that occur during or immediately following a period of drinking; alcohol is now required by the person.
- Phase III. The crucial phase: Person has lost control; physiological dependence is clearly evident.
- Phase IV. The chronic phase: Characterized by emotional and physical disintegration. The person is usually intoxicated more often than sober.
Effects of Alcohol on the Body
- Peripheral neuropathy, characterized by:
- Peripheral nerve damage
- Pain
- Burning
- Tingling
- Prickly sensations of the extremities
- Alcoholic myopathy: Thought to result from same B vitamin deficiency that contributes to peripheral neuropathy
- Acute: Sudden onset of muscle pain, swelling, and weakness; reddish tinge to the urine; rapid rise in muscle enzymes in the blood
- Chronic: Gradual wasting and weakness in skeletal muscles
- Wernicke’s encephalopathy: Most serious form of thiamine deficiency in alcoholic patients
- Korsakoff’s psychosis: Syndrome of confusion, loss of recent memory, and confabulation in alcoholic patients
- Alcoholic cardiomyopathy: Effect of alcohol on the heart is an accumulation of lipids in the myocardial cells, resulting in enlargement and a weakened condition.
- Esophagitis: Inflammation and pain in the esophagus
- Gastritis: Effects of alcohol on the stomach include inflammation of the stomach lining characterized by epigastric distress, nausea, vomiting, and distention
- Pancreatitis
- Acute: Usually occurs 1 or 2 days after a binge of excessive alcohol consumption. Symptoms include constant, severe epigastric pain; nausea and vomiting; and abdominal distention.
- Chronic: Leads to pancreatic insufficiency resulting in steatorrhea, malnutrition, weight loss, and diabetes mellitus
- Alcoholic hepatitis
- Caused by long-term heavy alcohol use
- Symptoms: Enlarged, tender liver; nausea and vomiting; lethargy; anorexia; elevated white blood cell count; fever; and jaundice. Also ascites and weight loss in severe cases.
- Cirrhosis of the liver
- Cirrhosis is the end-stage of alcoholic liver disease and is believed to be caused by chronic heavy alcohol use. There is widespread destruction of liver cells, which are replaced by fibrous (scar) tissue.
- Complications of cirrhosis of the liver can include:
- Portal hypertension
- Ascites
- Esophageal varices
- Hepatic encephalopathy
- Leukopenia: Impaired production, function, and movement of white blood cells
- Thrombocytopenia: Platelet production and survival are impaired as a result of the toxic effects of alcohol.
- Sexual dysfunction
- In the short term, enhanced libido and failure of erection are common.
- Long-term effects include gynecomastia, sterility, impotence, and decreased libido.
