The incidences of alcohol abuse and alcohol dependence seem to be higher than anticipated. In alcohol dependence the problems seem to be more severe than alcohol abuse. Family history does seem to play an important role in the initiation and progression of alcohol use, along with external factors. In Western Countries, the incidences of alcohol consumption are higher due to the cultural implications.
In these cultures, alcohol use in fact begins during the teenage period. The incidences of alcohol related problems have reduced over the past few decades in the US, due to increased awareness levels. The incidences of alcohol abuse and alcohol dependences are higher in males than females, although females develop it more easily than males. Alcohol consumption was higher in the Europeans than the American and other communities.
During the management of alcohol-related disorders, alcohol abuse and alcohol dependence has to be differentiated properly using the DSM-IV-TR criteria. Treatment should be initiated after determining the needs of the individual. It would be logical to provide counseling sessions and motivating the patient to become alcohol-free. Counseling and short-term administration of medications, play a very important role during treatment.
Hospitalization may be required for a few days to help the individual refrain from the habit. The individual may develop certain symptoms while abstaining from alcohol initially which slowly reduce with time. The risk of relapses following treatment is very high. Hence, it would be advisable to keep a constant check on the individual.
20 % of the individuals admitted in mental hospitals have suffered either alcohol abuse or alcohol dependence. It affects individuals from all socio-economic backgrounds.
The prevalence of alcohol dependence in the US Colleges was 6%, and alcohol abuse was 20%. At least 15000 students die a year due to alcohol disorders. Alcohol dependence and alcohol abuse puts the individual at a very high risk to develop depressive disorders, panic disorders, anxiety disorders, mood disorders, mania, schizophrenia, etc (Schuckit, M. A., 2005).
Alcohol dependence is a condition in which the repeated presence of three out of 7 impairments, alcohol can have over life and normal functioning, during a 12-month period. The impairments of defects in functioning include tolerance, withdrawal symptoms, interference with normal functioning at school, workplace, home or in social setting, physical and psychological symptoms, etc (According to the DSM-IV-TR).
There is a difference in withdrawal developing separately and that developing in association with dependence. Withdrawal symptoms that develop separately can follow a severe course. When withdrawal is present in relation to depression, a milder course is followed. Individuals without alcohol dependence may not be considered as alcohol abusers (Schuckit, M. A., 2005).
In alcohol abuse, the individual may not be dependent on alcohol but develops a constant problem related to alcohol use during a 12-month period (such as legal, social, work-based and family problems, and using alcohol in dangerous environments). At least one or two of the 4 areas are present in abuse (Schuckit, M. A., 2005).
The DSM-IV-TR code for alcohol abuse is 305.00, and that of alcohol dependence is 303.90.
The background characteristics of alcohol abuse and alcohol dependence remain the same that is a family history of alcohol misuse or dependence. It may be as high as 80 %. The ICD has offered an alternate classification of alcohol dependence. It suggests 3 out of 6 areas, in difference to the DSM-IV-TR classification of 3 out of 7 areas (Schuckit, M. A., 2005).
The prevalence of drinking is relatively high in America, and about 90% of the population drink. They usually start during early or mid-teens. About 80% of the people drink when they complete high school. About 60% go to the extent of intoxicating themselves with alcohol. On an average, two out of three men drink in the US (Schuckit, M. A., 2005).
Individuals who are educated and have a higher socio-economic background drink more frequently. Amongst religious groups, Jewish minorities consume the most, but do not develop alcohol dependence often.
Conservative groups drink less compared to liberal groups. American-Indians drink more quantities of alcohol compared to other groups. Adults on an average consume about 2.2 gallons of absolute alcohol per annum. At the time of American Revolution, this figure was as high as 5 gallons. During the 1970’s, the figures significantly increased as trends were high and awareness was low.
A study conducted to determine the long-term effects in about 500 middle-aged males demonstrated that one-fourth to one-third had alcohol-related problems. One-third drove under the influence of alcohol, and about one-fifth did not attend to school due to frequent hangovers or disciplinary problems. However, studies have shown that people tend to learn something out of the less severe alcohol-related problems.
Thus, the alcohol-related problems have reduced in the 30’s, 40’s and 50’s age groups. The life time risk for alcohol dependence is 10 to 15% in males and about 3 to 5 % in females. Alcohol dependence usually develops in the age group of 20 to 40 years.
Thy somehow tend to hold on to their jobs, family relations and social functioning. If alcohol dependence in teenagers is reported, the incidence of associated antisocial personality disorders is high. Sometimes alcohol dependence can begin late in life, and in such circumstances is associated with reduced social problems (Schuckit, M. A., 2005).
Europeans consume the most amount of alcohol a year, especially the northern European countries. About 90% of the teenagers consume alcohol during their school days. This rate was much higher compared to the US. Most Europeans drink by the age of 12 or 13 years. In Denmark, the incidences of alcohol consumption were particularly high in female teenagers.
The incidences of Binge drinking (drinking large amount of alcohol within a short period of time to the extent of intoxication) were high in the UK, Denmark and Ireland. The main reason for this was merry-making. The Irish tend to spend the most on drinking, with Denmark a distant second. Relatively, lower amounts of money were spent on alcohol by people belonging to Norway, Sweden, Finland and Iceland (Finfacts Ireland, 2007).
Throughout history, alcohol has played a role in the economic, social, medicinal, cultural, religious and spiritual sectors of life. The nomadic Rechabites did not drink wine because they felt that it was associated with bad agricultural habits. Prophet Mohammed did not allow his devotees to consume alcohol.
Ancient Egypt considered alcohol a source of energy and nutrients. In fact, their alcohol contained several nutritional supplements that helped to treat nutritional deficiency disorders. Alcohol has been utilized by a medicine by several cultures. Several studies have demonstrated it effect in lowering the incidences of coronary heart disorders, cancer and bone-degenerative disorders such as osteoporosis.
It had also been during the early days of medicine to control pain during surgeries. Even today, several alternative forms of medicine use alcohol as a solvent in their medicinal preparations, and also as a painkiller. Alcohol is often utilized as a social lubricant, and can improve the taste and appetite for food. Many communities consider that alcohol should not be a problem because it has been misused only by a small number of people. It was beneficial to greater numbers of the society (Hanson, D. J., 2005).
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