What Is Alcohol Dependence?
Alcohol dependence is also referred to as alcoholism or alcohol use disorder(AUD). Your body becomes dependent on alcohol when you consume too much alcohol over a period of time. Your body becomes addicted to alcohol, and you end up having severe withdrawal symptoms without it. Alcohol becomes an important thing in your life. This results in alcohol use disorder.
This pattern of alcohol use results in problems with controlling the amount you drink, being preoccupied with alcohol, and continuing to drink even after it causes problems and affects body functioning. More amount of alcohol would be needed to produce the same effect in your body compared to before.
Alcohol abuse is a health and safety risk. Severe alcohol abuse that causes repeated distress and problems with body functioning daily is likely to be AUD. Alcohol abuse refers to the milder version of AUD. A person with AUD will not be able to control or stop drinking even though it’s causing severe problems in their life. They lose control of your drinking.
The exact cause of AUD is not known. When you continuously drink a lot over time, chemical changes in the brain increase the pleasurable feelings you get when you drink alcohol. You start to drink often because of these feelings. After a point in time, the pleasurable feelings may decrease, but you may find it very hard to stop drinking. This is to prevent withdrawal symptoms that may be dangerous. There is a genetic component also involved.
Symptoms of Alcohol Dependence
AUD may be mild or severe symptoms based on the amount you drink and the number of symptoms you experience. Behavioral changes and physical outcomes are commonly observed in alcohol dependence. These include
- Having a high tolerance to alcohol, drinking more to feel the effects
- Drinking alone
- Strong urge to drink alcohol
- Spending too much time drinking or recovering after
- Ignoring work or other commitments because of drinking
- Wanting to cut down the amount you drink but not be able to do so
- Lesser social interaction
- Poor diet
- Drinking even when it’s not safe, for example, while driving
Withdrawal symptoms include
- Severe nausea
- Vomiting
- Tremors
- Memory lapses
- Cirrhosis
- Restlessness
- Trouble sleeping
Genetics and Alcohol Dependence
ADH1B Gene
The ADH1B gene carries instructions for producing a protein called Alcohol dehydrogenase 1 B. This enzyme is involved in metabolizing various compounds, including ethanol, retinol, and others. This protein, along with two other similar proteins, is important for the breakdown of ethanol. Changes in this gene can affect the efficiency of ethanol breakdown.
rs1229984
rs1229984 is a single nucleotide polymorphism or SNP in the ADH1B gene. Carriers of the T allele are found to have a decreased ability to metabolize alcohol and risk for increased alcohol consumption. Carries of the CC genotype are found to have a reduced risk of alcohol dependence.
rs1789891
rs1789891 is an SNP found in the ADH gene cluster. This cluster contains genes that encode various subunits of the alcohol dehydrogenase enzymes, including ADH1A, ADH1B, and ADH1C. This SNP is located between the ADH1B and ADH1C genes. The A allele is the risk allele, and people with this allele are at a higher risk of developing alcohol dependence. People with the CC genotype are at a reduced risk of alcohol dependence.
Non-Genetic Factors That Influence Alcohol Dependence
Apart from genetics, certain factors can increase your risk of developing this disease. These include
Number of drinks
More than 15 drinks per week for males and 12 drinks per week for females increase the risk of alcohol dependence. Binge drinking can also lead to AUD. More than 5 drinks a day, at least once a week, is termed binge drinking.
Age
People who begin drinking continuously at an early age are at an increased risk.
Mental Health
People with mental health problems such as high levels of stress, depression, anxiety, schizophrenia, or bipolar disorder are more prone to having problems with alcohol use. People with a history of trauma are also at an increased risk.
Bariatric Surgery
Studies show that bariatric surgery, commonly called gastric bypass surgery, can increase the risk of developing alcohol dependence or relapsing after recovery.
Social and cultural factors
Peer pressure and family members who have AUD or drink regularly can affect the amount you drink and increase your risk of developing alcohol dependence.
Effects of Alcohol Dependence on Health
AUD doesn’t happen overnight. This disorder develops gradually over time. AUD can cause severe and long-lasting damage to the liver. Due to increased alcohol intake, the liver finds it harder to filter all the alcohol and other toxins from the blood. This can lead to liver disease like cirrhosis and other complications, including heart, digestive, and eye, and decreased immunity. It can lead to internal bleeding in the gastrointestinal tract, increase the severity of mental health problems, and high blood pressure. It can also affect the central nervous system and create problems with speech, muscle coordination, and vital centers of the brain.
Recommendations
Diagnosing signs and symptoms early makes managing and curing the disorder easier.
Self-test
If you think you might be at risk of developing this disorder, the National Council on Alcoholism and Drug Dependence and AlcoholScreening.org have comprehensive self-tests. These can help you assess if you’re addicted.
It is advisable to consult a doctor also if you think your drinking is out of control. Your doctor can give you a professional diagnosis and help you manage the symptoms.
Treatment
- Treatment usually starts with detox and withdrawal. Your doctor may prescribe medication to help manage withdrawal symptoms. A proper treatment plan will be established.
- Rehabilitation is usually recommended to learn new skills and cope with behavioral changes.
- Several support groups help people who are recovering from alcohol dependence.
- Psychological counseling and therapy can be done to help you understand why you’re addicted to alcohol and what steps to take to overcome this addiction.
- Your doctor may prescribe medication at different stages of recovery to help manage symptoms.
Things you can do on your own
- Start doing some physical activity regularly.
- Get good sleep and have a healthy diet.
- Yoga or meditation can help relax you and decrease stress.
- Talk openly about your problem and get help when needed.
Summary
- Alcohol dependence, also referred to as alcoholism or alcohol use disorder(AUD), occurs when your body becomes dependent or addicted to alcohol on prolonged consumption. You may have severe withdrawal symptoms without it.
- This pattern of alcohol use results in problems with controlling the amount you drink, being preoccupied with alcohol and continue to drink even after it causes problems and affects body functioning. Severe alcohol abuse that causes repeated distress and problems with body functioning daily is likely to be AUD.
- AUD can cause severe and long-lasting damage to the liver. This can lead to liver disease like cirrhosis and other complications like decreased immunity. It can also affect the central nervous system and create problems with speech, muscle coordination, and vital centers of the brain.
- People with the T allele of SNP rs1229984 in the ADH1B gene are at an increased risk of developing alcohol dependence due to reduced enzyme activity. People with the CC genotype of SNP rs1789891 in the ADH gene cluster are found to have a reduced risk of developing alcohol dependence.
- The number of drinks, age, mental health, social and cultural factors, and bariatric surgery are certain factors that influence the risk of alcohol dependence.
- Early diagnosis can help manage symptoms better and prevent the problem from becoming severe. Certain treatment measures, including detox, withdrawal, and rehabilitation, are needed to
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860472/
https://www.healthline.com/health/alcoholism/basics
https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243
https://www.webmd.com/mental-health/addiction/what-is-alcohol-abuse#1
https://pubmed.ncbi.nlm.nih.gov/21968928/
https://pubmed.ncbi.nlm.nih.gov/24166409/
https://pubmed.ncbi.nlm.nih.gov/29058369/
