Conclusion

Alcoholism is a disease that manifests itself through social, medical, legal, and family consequences. Alcohol dependence and alcohol abuse are amenable to reliable diagnostic criteria. Subjectively, the alcoholic struggles with prolonged cravings for the substance, fear of functioning without alcohol, and doubts about his or her ability to abstain, and hence to recover. Concomitant with the ambivalent struggle to change, the alcoholic endures remorse, regret, guilt, and shame.

The physician, if not cognizant of the protean manifestations of this disease, or if blinded to the suffering of the patient by the alcoholic's often outrageous behavior, may miss or decline to take the opportunity for a life-changing clinical encounter. On the other hand, the physician prepared for the diagnosis and treatment of addictive disorders will find clinical experiences that contradict the pessimism often instilled during training years.

The psychiatrist's role in the treatment of alcoholism is especially pertinent given the significant issue of comorbidity and the biopsychosocial orientation of modern psychiatry. With an understanding of the overlapping relationships between substance use disorders and other psychiatric disorders, and an ability to establish treatment priorities, the psychiatrist is in a unique position to provide medical leadership to treat effectively this complex biopsychosocial disorder.

REFERENCES

Adler, R. A. (1992). Clinically important effect of alcohol on endocrine function. J Clin Endocrinol Metab, 74, 957-960.

Allen, J. O., & Anthenelli, R. M. (2003). Problem drinking: The case for routine screening. Curr Psychiatry, 2(6), 27-44.

Altura, B. A., & Altura B. T. (1989). Cardiovascular functions in alcoholism and after acute administration of alcohol: Heart and blood vessels. In H. W. Goedde & D. P. Agarwal (Eds.), Alcoholism: Biochemical and genetic aspects (pp. 167-215). New York: Pergamon Press.

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

Anton, R. F., Lieber, C., Tabakoff, B., and CDTect Study Group. (2002). Carbohydrate-deficient transferrin and gamma-glutamyltransferase for the detection and monitoring of alcohol use: Results from a multi-site study. Alcohol Clin Exp Res, 26(8), 1215-1222.

Bagnardi, V., Blangiardo, M., La Vecchia, C., & Corras, G. (2001). Alcohol consumption and the risks of cancer: A meta-analysis. Alcohol Res Health, 25, 263-270.

Bassetti, C., & Aldrich, M. S. (1996). Alcohol consumption and sleep apnea in patients with transient ischemic attack and ischemic stroke: A prospective study of 59 patients. Neurology, 47, 1167-1173.

Bean, P., & Daniel, P. (1996). CDT current facts and future projections for the insurance industry. On the Risk, 12, 43-48.

Becker, U., Gronbaek, M., Johansen, D., & Sorensen, T. I. (2002). Lower risk for alcohol-induced cirrhosis in wine drinkers. Hepatology, 35, 868-875.

Blomgren, K. B., Sundstrom, A., Steineck, G., Genell, S., Sjostedt, S., & Wikohm, B. E. (2002). A Swedish case-control network for studies of drug-induced morbidity-acute pancreatitis. Eur J Clin Pharmacol, 58, 275-283.

Bor, S., Caymaz-Bor, C., Tobey, N. A., Abdulmour-Nakhoul, S., Marten, E., & Orlando, R. C. (1998). The effect of ethanol on the structure and function of rabbit esophageal epithelium. Am J Physiol, 274, G819-G826.

Bunout, D. (1999). Nutritional and metabolic effects of alcoholism: Their relationship with alcoholic liver disease. Nutrition, 15, 583-589.

Caetano, R., & Clark, C. L. (1998a). Trends in alcohol consumption patterns among Whites, Blacks and Hispanics: 1984-1995. J Stud Alcohol, 59, 659-668

Caetano, R., & Clark, C. L. (1998b). Trends in alcohol-related problems among Whites, Blacks, and Hispanics: 1984-1995. Alcohol Clin Exp Res, 22, 534-538.

Clarren, S. K., Randels, S. P., Sanderson, M., & Fineman, R. M. (2001). Screening for fetal alcohol syndrome in primary schools: A feasibility study. Teratology, 63, 3-10.

Cloninger, C. R. (1987). Neurogenetic adaptive mechanisms in alcoholism. Science, 236, 410-416.

Cravo, M. L., & Camilo, M. E. (2000). Hyperhomocysteinemia in chronic alcoholism: Relations to folic acid and vitamin B (6) and B (12) status. Nutrition, 16, 296-302.

Criqui, M. H. (1990). The reduction of coronary heart disease with light to moderate alcohol consumption: Effect or artifact. Br J Addict, 85, 854-857.

Dackis, C. A., & O'Brien, C. P. (2002). The neurobiology of alcoholism. In S. Gershon & R. Soires (Eds.), Handbook of psychiatric disorders (pp. 563-580). New York: Marcel Dekker.

Dansky, D. S., Brewerton, T. D., & Kilpatrick, D. G. (2000). Comorbidity of bulimia nervosa and alcohol use disorders: Results from the National Women's Study. Int J Eat Disord, 27, 180-190.

Davidson, D. M. (1989). Cardiovascular effects of alcohol. West J Med, 151(4), 430-439.

Drake, R. E., & Vaillant, G. E. (1985). A validity study of Axis II of DSM-III. Am J Psychiatry, 142, 553-558.

Dufour, M. C. (2001). If you drink alcoholic beverages do so in moderation: What does this mean? J Nutr, 131, 552-561.

Ellis, R. J., & Oscar-Berman, M. (1989). Alcoholism, aging, and functional cerebral asymmetries. Psychol Bull, 106(1), 128-147.

Evert, D. L., & Oscar-Berman, M. (1995). Alcohol-related cognitive impairments: An overview of how alcohol may effect the workings of the brain. Alcohol Health Res World, 19(2), 189-196.

Ewing, J. A. (1984). Detecting alcoholism: The CAGE questionnaire. JAMA, 252(14), 1905-1907.

Garcia-Andrade, C., Wall, T. L., & Ehlers, C. L. (1997). The firewater myth and response to alcohol in Mission Indians. Am J Psychiatry, 154, 983-988.

Gish, R. (1996, November 30). Rational evaluation of liver dysfunction of the chemically dependent patient and diagnosis and treatment of hepatitis C. Audiotape presentation at the 7th annual meeting and symposium of the American Academy of Addiction Psychiatry, San Francisco.

Goforth, H. W., Primeau, M., & Fernandez, F. (2003). Alcohol and HIV/AIDS. In B. Johnson, P. Ruiz, & M. Galanter (Eds.), Handbook of clinical alcoholism treatment (pp. 249-257). Baltimore: Lippincott/Williams & Wilkins.

Greenfield, L. A., & Henneberg, M. A. (2001). Victim and offender self-reports of alcohol involvement in crime. Alcohol Res Health, 25, 20-31.

Greenfield, S. F., Weiss, R. D., & Mirin, S. M. (1997). Psychiatric substance use disorder. In A. J. Gelenberg & E. L. Bassuk (Eds.), The practitioner's guide to psychoactive substances (pp. 243-316). New York: Plenum Press.

Greenfield, T. K. (2000). Ways of measuring drinking patterns and the difference they make: Experience with graduated frequencies. J Subst Abuse, 12, 33-49.

Group for the Advancement of Psychiatry. (1996). Alcoholism in the United States: Racial and ethnic considerations (Report No. 141, VII-X). Washington DC: American Psychiatric Press.

Gupta, M. A., Schork, N. J., Gupta, A. K., & Ellis, C. N. (1993). Alcohol intake and treatment responsiveness of psoriasis: A prospective study. J Am Acad Dermatol, 5(1), 730-732.

Hardin, R. I. (2001). Disorders of the platelet and vessel wall. In E. Braunwald, A. Fuuci, D. Kasper, S. Hauser, D. Longo, & J. Jameson (Eds.), Harrison's principles of internal medicine (15th ed., pp. 745-750). New York: McGraw-Hill.

Harwood, H. (2000). Updating estimates of the economic costs of alcohol abuse in the United States: Estimates, update methods, and data [Report prepared by the Lewin Group for the National Institute on Alcohol Abuse and Alcoholism]. Washington, DC: U.S. Department of Health & Human Services.

Hauge, T., Nilsson, A., Persson, J., & Hultberg, B. (1998). Gamma-glutamyl trans-ferase, intestinal alkaline phosphatase and beta-hexoaminidase activity in duodenal biopsies of chronic alcoholics. Hepatogastroenterology, 45, 985-989.

Hays, J. T., Schroeder, D. R., Offord, K. P., Croghan, T. T., Patten, C. A., Hurt, R. D., et al. (1999). Response to nicotine dependence treatment in smokers with current and past alcohol problems. Ann Behav Med, 21, 244-250.

Helzer, J. E., & Pryzbeck, T. R. (1988). The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment. J Stud

Hermann, D., Heinz, A., & Mann, K. (2002). Dysregulation of the hypothalamice-pituitary-thyroid axis in alcoholism. Addiction, 97(11), 1369-1381.

Higgins, E. M., & du Vivier, A. W. P. (1992). Alcohol and the skin. Alcohol, 27, 595602.

Howard, M. O., Kivlahan, D., & Walker, R. D. (1997). Cloninger's tri-dimensional theory of personality and psychopathology: Applications to substance use disorders. J Stud Alcohol, 58, 48-66.

Kessler, R. C., Crum, R. M., Warner, L. A., Nelson, C. B., Schulenberg J., & Anthony J. C. (1997). Lifetime co occurrence of DSM-III-R alcohol abuse and dependence with other psychiatric disorders in the National Comorbidity Survey. Arch Gen Psychiatry, 54, 313-321.

Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12 month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry, 51, 8-19.

Klatsky, A. L., Friedman, G. D., & Armstrong, M. A. (1986). Relationships between alcoholic beverage use and other traits to blood pressure: A new Kaiser Permanente study. Circulation, 73(4),628-636.

Koenigsberg, H. W., Kaplan, R. D., Gilmore, M. M., & Cooper, A. M. (1985). The relationship between syndrome and personality disorder in DSM-III: Experience with 2,462 patients. Am J Psychiatry, 142(2), 207-212.

Laitinen, K., Karkkainen, M., Lalla, M., Lamberg-Allardt, C., Tunninen, R., Tahtela, R., & Volamaki, M. (1993). Is alcohol an osteoporosis-inducing agent for young and middle-aged women? Metabolism, 42, 875-881.

Latif, O., Peterson, J. D., & Waltenbaugh, C. (2002). Alcohol-mediated polarization of type I and type II immune responses. Front Biosci, 7, 135-147.

Lee, G. R. (1999). Folate deficiency: Causes and management. In G. R. Lee, J. Foerster, J. Lukens, F. Paraskeras, J. Greer, & G. Rodgers (Eds.), Wintrole's clinical hematology (10th ed., pp. 965-972). Baltimore: Williams & Wilkins.

Lee, W. K., & Regan, T. J. (2002). Alcoholic cardiomyopathy: Is it dose dependent? Congest Heart Fail, 8(6), 303-306, 312.

Lieber, C. S. (1998). Hepatic and other medical disorders of alcoholism: From pathogenesis to treatment. J Stud Alcohol, 59(1), 9-25.

Luczak, S. E., Wall, T. L., Shea, S. H., Byun, S. M., & Carr, L. G. (2001). Binge drinking in Chinese, Korea, and White college students: Genetic and ethnic group differences. Psychol Addict Behav, 15, 306-309.

May, P., & Gossage, J. (2001). The epidemiology of alcohol consumption among American Indians living on four reservations and in nearby border towns. Drug Alcohol Depend, 63(Suppl 1), S100.

McEvoy, J. P. (1982). The chronic neuropsychiatric disorders associated with alcohol. In E. M. Pattison & E. Kauknan (Eds.), Encyclopedic handbook of alcoholism (pp.167-179). New York: Gardner Press.

Midanik, L. T., Tam, T. W., Greenfield, T. K., & Caetano, R. (1996). Risk functions for alcohol-related problems in a 1988 US national sample. Addiction, 91, 14271437.

Nace, E. P. (1995). Achievement and addiction: A guide to the treatment of professionals. New York: Brunner/Mazel.

Nace, E. P., Davis, C., & Gaspari, J. D. (1991). Personality disorders in substance abusers. Am J Psychiatry, 148, 118-120.

Narrow, W. E., Rae, D. S., Robins, L. N., & Regier, D. A. (2002). Revised prevalence estimates of mental disorders in the United States: Using a clinical significance criteria to reconcile two surveys estimates. Arch Gen Psychiatry, 59, 115-123.

National Highway Traffic Safety Administration. (1999). An analysis of alcohol-related motor vehicle fatalities by ethnicity. Annals Emerg Med, 34, 550-553.

National Institute on Alcohol Abuse and Alcoholism. (1998). Alcohol and tobacco (Alcohol Alert No. 39). Rockville, MD: Author.

Ohmoris, S., Kiyohara, Y., Kato, I., Kubo, M., Tanzaki, Y., Iwamoto, H., et al. (2002). Alcohol intake and future incidents of hypertension in a general Japanese population: The Hisayoma study. Alcohol Clin Exp Res, 26, 1010-1016.

Olson, H. C., Feldman, J. J., Streissguth, A. P., Sampson, P. D., & Bookstein, F. L. (1998). Neuropsychological deficits in adolescents with fetal alcohol syndrome: Clinical findings. Alcohol Clin Exp Res, 22, 1998-2012.

Osher, F. C., & Kofoed, L. L. (1989). Treatment of patients with psychiatric and psychoactive substance abuse disorders. Hosp Community Psychiatry, 40, 1025-1030.

Petrakis, I. L., Gonzales, G., Rosenheck, R., & Krystal, J. H. (2002). Comorbidity of alcoholism and psychiatric disorders: An overview. Alcohol Res Health, 26, 81-89.

Pettinati, H. N. (2001). The use of selective serotonin reuptake inhibitors in treating alcoholic subtypes. J Clin Psychiatry, 62(Suppl 20), 26-31.

Randall, C. L., Thomas, S., & Thevos, A. K. (2001). Concurrent alcoholism and social anxiety disorder: A first step towards developing effective treatments. Alcohol Clin Exp Res, 25, 210-220.

Regan, R. J. (1990). Alcohol and the cardiovascular system. JAMA, 264, 377-381.

Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., & Goodwin, K. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. JAMA, 264, 2511-2518.

Regier, D. A., Narrow, W. E., Rae, D. S., Manderscheid, R. W., Lock, B. Z., & Goodwin, F. K. (1993). The defacto US mental and addictive disorder service system: Epidemiologic Catchment Area perspective one-year prevalence rates of disorders and services. Arch Gen Psychiatry, 50, 85-94.

Reynolds, K., Lewis, L. B., Nolen, J. D. L., Kinney, G. L., Sathya, B., & He, J. (2003). Alcohol consumption and risk of stroke: A meta-analysis. JAMA, 289, 579-588.

Russell, M., Martier, S. S., Sokol, R. J., Jacobson, S., Jacobson, J., & Bottoms, S. (1994). Screening for pregnancy risk-drinking: TWEAKING the tests. Alcohol Clin Exp Res, 18(5), 1156-1161.

Schiave, R. C., Stimmel, B. B., Mandeli, J., & White, D. (1995). Chronic alcoholism and male sexual function. Am J Psychiatry, 152, 1045-1051.

Schmidt, L. G., Schmidt, K., Dufeu, P., Ohse, A., Rommelspacher, H., & Muller, C. (2000). Superiority of carbohydrate-deficient transferrin to gamma-glutamyltransferase in detecting relapse in alcoholism. Am J Psychiatry, 154(1), 75-80.

Schuchardt, V. (2000). Alcohol and the peripheral nervous system. Ther Umsch, 57(4), 196-199.

Skinner, H. (1981). Early identification of alcohol abuse. Can Med Assoc J, 124, 12791295.

Smith, K. E., & Fenske, N. A. (2000). Cutaneous manifestations of alcohol abuse. J Am Acad Dermatol, 43(1), 1-25.

Sohn, T. A., Campbell, K. A., Pitt, H. A., Sauter, P. K., Coleman, J. A., Lillemo, K. D., Yeo, C. J., & Cameron, J. L. (2000). Quality of life and long-term survival after surgery for chronic pancreatitis. J Gastrointest Surg, 4(4), 355-364.

Spencer, R. L., & Hutchinson, K. E. (1999). Alcohol, aging and the stress response. Alcohol Res Health, 23, 272-283.

Stinson, F. S., Grant, B. F., & Dufour, M. C. (2001). The critical dimension of ethnicity in liver cirrhosis mortality statistics. Alcohol Clin Exp Res, 25, 1181-1187.

Stratton, K., Howe, C., & Battaglia, F. (Eds.). (1996). Fetal alcohol syndrome: Diagnosis, epidemiology, prevention and treatment. Washington, DC: National Academy Press.

Sutton, R., & Shields, R. (1995). Alcohol and esophageal varices. Alcohol, 30(5), 581589.

Tabakoff, B., Hoffman, P. L., Lee, J. M., Saio, T., Willard, B., & Deleon-Jones, R. (1988). Differences in platelet enzyme activity. N Engl J Med, 313, 134-139.

Turner, R. T. (2000). Skeletal response to alcohol. Alcohol Clin Exp Res, 24, 1693-1701.

Vachon, C. M., Cerhan, J. R., Vierkant, R. A., & Sellers, T. A. (2001). Investigation of an interaction of alcohol intake and family history on breast cancer risk in the Minnesota Cancer Family Study. Cancer, 92, 240-248.

Victor, M. (1989). Alcohol and alcoholism. In R. D. Adams (Ed.), Principles of neurology (pp. 870-888). New York: McGraw-Hill.

Villalta, F., Ballesca, J. L., Nicholas, J. M., Martinez di Osaba, M. J., Antunez, E., & Pimentel, C. J. (1977). Testicles function in asymptomatic chronic alcoholics: Relation to ethanol intake. Alcohol Clin Exp Res, 21(1), 128-133.

Vitiello, M. V. (1997). Sleep, alcohol and alcohol abuse. Addict Biol, 2, 151-158.

Wedel, M., Pieters, J. E., Pikaar, N. A., & Ockhuizen, T. (1991). The application of a three-compartment model to a study of the effects of sex, alcohol dose and concentration, exercise, and food consumption on the pharmacokinetics of ethanol in healthy volunteers. Alcohol, 26(3), 329-336.

Westermeyer, J. (1986). A clinical guide to alcohol and drug problems. New York: Praeger.

Yanauchi, M., Takeda, K., Sakamoto, K., Searaski, Y., Vetake, S., Kenichi, H., & Toda, G. (2001). Association of polymorphism in the alcohol dehydrogenase 2 gene with alcohol-induced testicular atrophy. Alcohol Clin Exp Res, 25 (Suppl 6), 165-185.

Zakari, S. (1997). Alcohol and the cardiovascular system: Molecular mechanisms for beneficial and harmful actions. Alcohol Health Res World, 21 , 21-29.

Beat The Battle With The Bottle

Beat The Battle With The Bottle

Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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