Alcohol Use Disorder: Patterns of use

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.

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