Friday, May 3, 2013


Substance abuse is a globally recognized major mental health problem. Alcohol addiction known as alcohol dependence is a problem with humanity since the discovery of euphoric nature of alcohol. Almost all addicts get into the problem for experimental reasons. Initially for kick but later to escape from physical problems associated with state without alcohol.

What is alcohol or about alcohol?

Chemically it is ethyl alcohol and a substance of abuse.

What is dependence (addiction)?

Many people take alcohol but are not dependent on alcohol. However they are too are abusing alcohol and can slip into dependence any time. However dependence or addiction is a crippling state which grossly lowers the quality of life of a patient.
Medically dependence is defined as fulfilling of three or more criteria in a year’s period-
1.      Tolerance- it is the need for more amount of alcohol to get same intoxication as used to get in smaller amounts earlier.
2.      Craving-urge to drink alcohol.
3.      Withdrawal-presence of symptoms like tremors, anxiety, loss of appetite and sleep, nausea vomiting.
4.      Use despite harm
5.      Neglect of alternate pleasurable activities
6.      Loss of control
A simpler criteria is CAGE CRITERIA
C- Cut down, felling that one should cut amount of alcohol
A-annoyance on being called alcoholic
E- Eye opener, need of alcohol on waking from sleep.

Treatment of alcohol addiction

On being diagnosed with alcohol addiction by a psychiatrist following stages are underwent for treatment.
1.      Detoxification
2.      Maintenance phase
Detoxification of alcohol is done by benzodiazepines, with thiamine supplements. This lasts for approximately 15-20 days
Maintenance phase-after detoxification maintenance is on anti-craving agents like
During maintenance phase a patient can also be prescribed disulfiram(ant abuse) but great care should be taken as any contact with alcohol can lead to fatal disulfiram alcohol reaction.
This lasts for 6-8 months.
Psychological support is also helpful in getting out of this ailment.
Psychotherapies include-
A.      Cue extinction
B.      Relapse prevention
C.      Motivation enhancement therapies
Self-help groups like
Alcohol-anonymousare of great help in maintaining abstinence
For family of dependent patients there are groups like
Al Anon, AlAteen
Alcohol addiction is not a moral problem but a disease and should be handled as such.
Wishing you a long and healthy life
Dr Hitesh Sharma 
MBBS MD (Psychiatry)

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