Alcohol Dependence Syndrome Definition, Signs, Symptoms, Tests and Treatment
Alcohol Dependence Syndrome is becoming a big problem to the society.
As the years are progressing, the unhealthy and dangerous drinking habits are taking a complete new level.
Many people become addicted to alcohol consumption and a continuous habit develops in them.
This continuous habit is alcohol dependence, which is quite common and dangerous.
What is alcohol dependence?
Many people consume alcohol. The alcohol consumption may be in the form of beer, wine, whiskey or any other drink. The production and consumption has been done for thousands of years.
Having the origin from the ancient world, alcohol use has also been linked to religious beliefs, medicinal importance, antiseptic and analgesic benefits and facilitating relaxation.
But, alcohol dependence arises due to regular alcohol abuse.
To be clearly said, alcohol dependence is an internal force which cannot keep you off from drinking. It emerges inside the brain and is not under your control.
The urge to drink is so strong that you cannot overcome it by self control. This force controls your daily life and causes excessive damage to health, physically as well as mentally.
The terms such as “addiction” or “habituation” were replaced by the term “dependence”, as they did not relay the true information associated with the substance. This introduction was made by the World Health Organisation.
You must know some alcohol dependent people around you. Can you make out the difference in their life and a non-alcoholic’s life?
There is a clear difference between the capacity to work, quality of brain functions and their relationships.
The significance of alcohol is extreme in their lives and they keep it at the top in their priority list.
In many people, the body gets adapted to the alcohol consumption, and out of the need of their body, they are dependent upon alcohol.
Alcohol dependence definition
The basic definition of alcohol dependence was given by Griffith Edwards and Milton Gross in 1976. According to them, the alcohol dependence was defined by the given criteria:
- Continuous withdrawal symptoms
- Use in more amounts and for longer period of time than planned
- Unsuccessful resistance and persistent desire
- Time goes in recovering from effects of alcohol or consuming alcohol
- Despite knowing the harmful effects, the consumption is continued.
- Person becomes socially , occupationally and recreationally weak because of alcohol use
Any three of the above seven, if apply to a person, then he is alcohol dependent.
Alcohol dependence, as the Wikipedia defines it, is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon drinking alcohol.
On occasions, alcohol stays always by the side of people, but just like the drugs are addictive, alcohol is too. Drinking alcohol becomes the most prior job for alcohol dependent people.
People may be physically dependent as their body urges to drink alcohol by showing a range of withdrawal symptoms, for example, trembling, nausea and sweating.
Psychological dependence arises when you feel that something is missing in your happiness and enjoyment, and that “something” is a drink.
Alcohol dependence may be the consequence of any stress or depression, trauma, grief and some past dreadful experience. It may also arise due to some mental illness.
Many people become alcohol dependent due to their unsuccessful relationships or matters related to their loved ones.
Alcohol dependence syndrome
Alcohol dependence syndrome (ADS) is defined as a cluster of physiological, behavioural, and cognitive phenomena in which the use of alcohol takes on a much higher priority for an individual than other behaviours that once had greater value.
It is also known as alcoholism. This syndrome may develop as a result of genetic inheritance, environment
and peer influence.
Continuous research work and studies are trying to reveal the genetic reasons for alcohol dependence syndrome.
It is a serious health issue and despite being deeply studied, this disorder is difficult to spot. It is not a static disease, but a phenomenon which depends on biological and cultural factors.
According to Edwards, dependence would be an altered relationship between the person and his/her way of drinking. In this, feedback behavior also adds up.
There are seven elements of alcohol dependence syndrome:
- Narrowing of the repertoire
At the initial level, people drink alcohol according to their own flexible time. They have the drink they like in the quantity they want.
Gradually, the drinking habit becomes frequent. The consumption is on daily basis and the body adapts to the use.
At later stages, the consumption becomes necessary out of compulsion and can no more be controlled.
- Importance of the behaviour of searching alcohol
The alcohol gains importance in the lives of people. Even in the unacceptable situations, they take drink as their first priority
3. Increase in the tolerance to alcohol
The need for high alcohol doses increases. The body becomes resistant to lower doses, and slowly gains resistivity to high doses as well.
Repeated symptoms of abstinence
When there is reduced alcohol consumption, the symptoms intensify. They may be physical, affective or sensoriperception.
- Physical: nausea, vomiting, cramps, dizziness, headache
- Affective: anxiety, weakness, depression, restlessness, irritability
- Sensoriperception: hallucinations, nightmares, illusions
Relief or avoidance of abstinence symptoms by increasing the ingestion of alcohol
Once the alcohol is consumed, the abstinence symptoms evade.
Subjective perception of the need of drinking
Reinstallation after abstinence
Once a person keeps off from alcohol for a longer period of time, and then the barrier of abstinence breaks, then the alcohol dependence reinstalls itself.
Signs of alcohol dependence
You may be alcohol dependent without even realising. There are some signs which will make you realise and check whether you or someone else is alcohol dependent or not.
- If you often have a strong desire or the inner force to drink, then you are likely to be alcohol dependent.This strong desire comes from within. If you want to consume alcohol for the very first time as there is some “urge” inside you to drink, then obviously you are not alcohol dependent.It is merely a thrill inside you or excitement which wishes to explore what an alcoholic drink tastes like.
- Drinking habit is usually not appreciated by family members, especially parents. Even if they allow you to do so to some extent, crossing the limits will put you in odds.And, if you are possessive about your drinking habits, then you may find yourself as a part of a heated argument. This certainly is a sign of alcohol dependence.
- Do you feel anxious in social occasions without a drink? Does a drink relax your anxiety?
- If you had drinks twice or thrice and you want even more. You cannot stop drinking. It is no more under your control.
- People will often criticise your drinking habits. Do you get offended soon? This explains your love for drinking.
- Sometimes, you cannot control your behaviour and may be outrageous. This loss of control is the consequence of alcohol dependence.
- You know that you have some health problem caused by your drinking habit. Still you wish to continue drinking despiteknowing the fact that it is harming you?
- You cannot manage your emotional front and thus make poor judgements.
- Poor decision making may put you as well as others in danger.
- You like to drink alone and have some “secret” time with yourself. You and your drink, and some solitude.
- To get a specific feeling or to attain satisfaction, you need the help of a drink. Without it you cannot have the same effect.
- Physical health problems.
Alcohol dependence symptoms
Alcohol dependence is characterised by the following symptoms:
- Strong need or compulsion to drink.
- No control over the quantity of drinking.
- Withdrawal symptoms if alcohol is not consumed for a longer period of time. These are listed below:
- Trembling and shivering
- Depression and stress
There are some life-threatening symptoms as well such as convulsions.
- The body develops tolerance power to the doses of alcohol. The low quantity no more gives you any satisfaction.
Alcohol intoxication is increased alcohol content in the blood.
It causes behavioral problems such as mood swings, impaired judgement, and speech orientation changes and there is poor coordination.
Memory gets affected and “blackouts” often occur. Very high alcohol levels in blood also may lead to coma and death.
Alcohol dependence test
A wide variety of tests are devised for figuring out the alcohol dependence. Some are available online and some may be taken offline.
Some are based on self assessment and some are taken by the psychotherapists.
- The CAGE questionnaire is a test which uses four questions to screen the drinking problem. Out of the four questions, any two “yes” responses indicate that alcoholic dependence exists.
The four questions for self about alcoholism are as follows:
- Have you ever felt that you need to cut down on your drinking?
- Are you criticized for your drinking?
- Have you ever felt guilty about drinking?
- Do you constantly feel that you need a drink first in the morning as an Eye-opener?
- AUDIT (Alcohol Use Disorder Identification Test)
This has more number of questions than the CAGE test. Developed by WHO, this screening tool picks up the early signs of alcohol dependence.
The questions need to be answered on the basis of past one year experience. Some of the questions are listed below:
- How often do you have an alcoholic drink?
- How many units do you drink on a typical day?
- How often you had about 6 to 8 drinks on an occasion?
- How often were you not able to stop yourself from drinking?
- How often your actions have turned out to be something else than the normal actions?
- How often have you been unable to remember what happened last night?
- Is anyone concerned about your drinking habit?
And there are many other questions. A score card is developed on the basis of the answers and indicates whether the alcohol consumption is at the hazardous level or not.
- CRAFFT Screening Test
This test is another clinical test which determines the substance related risks and health problems.
The 6 letters in the name stand for the six objects- Car, Relax, Alone, Forget, Friends and Trouble. The format of this test is “yes” or “no”.
The questionnaire consists of two parts: part A and part B. Part A inquires about the alcohol use over the past year, and part B relates to the situations in which the person used alcohol and the possible consequences.
- Severity of Alcohol Dependence Questionnaire
SADQ or SAD-Q is a clinical screening test which makes use of 20 items to measure the level of alcohol dependence. Each item has 4 points and the score above 30 is considered under alcohol dependence.
Alcohol dependence treatment
Do you find yourself alcohol dependent? Do you accept your unhealthy drinking habits and want to change? The strong will power along with the proper treatment shall solve your problem.
The ultimate aim of the treatment is abstinence. People who receive good moral support and motivation are likely to recover soon than those with poor social support and approval.
Success of the treatment is measured by the longer period of abstinence, less consumption of alcohol, improved physical and mental health along with the proper functioning in regular life.
There are four dominant and efficient treatments. The healthcare provider may suggest you to follow any one or more of these:
This is the process of breakdown of physical addiction of alcohol to the body.
This is usually carried out in healthcare center or hospital, as due to sudden discontinuity in alcohol consumption, the patient might suffer from withdrawal symptoms.
These symptoms may sometimes lead to coma and death, as a result of which, utmost care needs to be taken.
You may also be required to take some medicines in order to prevent the symptoms.
- Modifying behavioural aspect
As long as you are in the healthcare centre, you may battle the urge of drinking alcohol to a great extent.
But, once you get back to the old surroundings, the environment might compel you to continue your drinking habit.
In order to combat such situation, you need to learn some skills and coping techniques. For this, you can join some treatment programs suggested by your doctor.
There are many people who face similar challenges. Hence, you need to know that you no longer are alone in this journey. Counselling helps a lot.
Individual as well as group counselling have great impact upon the treatment process. It increases your will power to fight the urge of drinking.
Also, you get to understand your level of abstinence, and how much more you need to persevere.
Alcohol addiction can be treated with the help of medicines. Some of the conventional medicines are given below:
- Disulfiram: it is a drug which interferes with the alcohol metabolism. This lowers the intensity of the driving force to drink alcohol by making you feel sick whenever you consume alcohol.
- Naltrexone: this drug reduces the craving for alcohol. Alcoholic drinks have a “pleasure” effect which gives a good feeling on consumption.Many people have addiction to drinking as an outcome of this good feeling. Naltrexone diminishes this good feeling and makes alcohol no more soothing.
- Acamprosate: FDA approved, this drug restores some chemical compounds in brain which in turn combat the alcohol cravings.
Recovery is a long term process and apart from the direct treatment, some indirect sources also contribute towards the therapy.
The love and support from family and friends can do wonders. Proper nutrition and diet needs to be maintained and a positive approach should be instilled in mind.
Difference between alcohol dependence and alcohol abuse
The two terms “Alcohol abuse” and “Alcohol dependence” have the common origin as alcohol related problems, but they are distinct.
Alcohol abuse is “a pattern of drinking that result in harm to one’s health, interpersonal relationships, or ability to work”.
People know that what they are consuming is harmful to their health and they shall be acquiring illness, but still they continue to drink.
Their relationships might get spoiled, they may get into some legal issue or they may put others in danger. The risk factor increases with the poor judgement of the alcoholic.
Alcohol dependence is inability to quit drinking alcohol. If people keep on drinking alcohol for a continuous period of time and in considerable quantity, then they are likely to develop alcohol dependence.
The body becomes physically addicted as well as mentally attached, as the behavioural changes and the inner force to drink is observed often. The withdrawal symptoms occur during abstinence.
Once the limits are crossed, the urge is so strong that there is no self control over the drinking habit. This calls for treatment.
Alcohol dependence is only one potential complication of drinking alcohol, whereas the alcohol abuse is accompanied with a range of potential complications.
If your drinking habit is causing disruption in your life, then keep in mind, that your drinking habit is the problem. Clear it out.
Frequently asked questions about Alcohol Dependence Syndrome
What is Alcohol Dependence?
Answer: A case of previous psychiatric diagnosis where an individual is physically or mentally dependent on consuming alcohol is known as “Alcohol Dependence”.
In other words, it is also known as alcoholism or alcohol abuse.
What is addiction to alcohol?
Answer: When a person continues to drink even after knowing that it is causing a problem for him/her.
If you continue alcohol abuse or over consumption of alcohol for longer duration of time then it may lead to alcohol dependence or alcoholism.
A strong craving or urgent need to drink in an alcoholic person is normally termed as alcohol addiction.
What is considered to be an alcoholic?
Answer: The criteria for being an alcoholic or alcohol dependence is different for men and women which can be seen as under:
For Men: 15 or more drinks per week
For Women: 8 or 8+ drinks per week
Here, One Drink is defined as: 12 Ounce of Beer, 5 Ounce wine, 1.5 Ounce spirit.
What makes you an alcoholic?
Answer: If you are dependent on alcohol for your functioning or you mentally feel compelled to drink then you fall under the category of alcoholic.
If you are a regular drinker and drinks more than a daily limit then slowly you become addicted to alcohol and the symptoms of alcohol abuse starts appearing in you.
This simply can make you alcoholic as your daily requirement or need or consumption goes beyond the limits.
What is functioning alcoholic?
Answer: If someone is engaged too much in drinking then we often call him/her an alcoholic but there are few drinkers who seems to be fine when they drink too much or in other words they abuse alcohol and such kind of people are known as “high functional alcoholics” or simply “functioning alcoholics”.
How many stages are there in alcoholism?
Answer: As per experts and the classification of the progress of alcoholism there exists three stages of the disease which are as follows:
- Early stage
- Late or end-stage
Few wise men consider that there are 4 stages of alcoholism which are:
- Adaptive stage
- Alcohol Dependence
How many drinks per week is healthy?
Answer: For a healthy person, drinking more than his/her daily limit or crossing weekly limit is considered to be ‘at risk’ or heavy drinking. These limits may be defined as:
For a man, more than 4 drinks a single day or taking 14 drinks per week and for women 3+ drinks per day or 7 drinks in a single week.
What is chronic alcoholic?
Answer: Alcohol dependence or Alcoholism has been primarily defined as a chronic disease where it’s development and manifestation are influenced by psychosocial, genetic and environmental factors.
Is drinking alcohol is good for health?
Answer: Moderate use of alcohol may have some health benefits but it doesn’t make alcohol ‘risk-free’.
If you take it in a very limited amount just like some medicine than it may offer some benefits to your heart but your health is always “at risk” while you consume alcohol.
My dear friends, Let me clear one thing to you that consumption of alcohol is seriously not good for health in long term as you become addicted to it knowingly or unknowingly.
So, if you want a healthy and happy life, you should keep yourself away from alcohol and if you are already a victim of alcohol dependence syndrome then you must consult an expert who can guide you away from alcoholism.
We wish you a healthy and happy life!
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