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Alcoholism - Comprehensive Overview, Treatments, Complementary And Alternative Therapies

Posted Feb 05 2010 6:18am

Generals

As far as the body is concerned, alcohol is a poison. Some of the effects of chronic alcohol consumption include damage to the brain (women may be more vulnerable to chronic alcohol consumption), liver, pancreas, duodenum, and central nervous system. Alcoholism causes metabolic damage to every cell in the body and depresses the immune system. It may take years before the consequences of excessive drinking become evident, but if an alcoholic continues to drink, his or her life span may be shortened by ten to fifteen years or more.

Alcohol is broken down in the liver. The repeated consumption of alcohol inhibits the liver’s production of enzymes, impairing the body’s ability to absorb proteins, fats, and the fat-soluble vitamins (vitamins A, D, E, and K), as well as B-complex vitamins (especially thiamine and folic acid) and other water-soluble vitamins. Many essential nutrients are not retained for use by the body; they are rapidly eliminated through the urine. The toxic effect of alcohol on the liver is very serious. First, excessive amounts of fat accumulate in the liver, a result of alcohol’s effect on the body’s ability to digest fats properly. Next, the alcoholic may develop hepatitis, a condition in which liver cells become inflamed and may die. The final, usually fatal, stage of alcoholic liver damage is cirrhosis of the liver, a disease characterized by inflammation, hardening, and scarring of the liver This prevents the normal passage of blood through the liver, inhibiting the organ’s ability to filter out toxins and foreign substances.

The liver is one of the most robust organs of the body. It is the only organ that has the ability to regenerate itself after certain types of damage. Up to 25 percent of the liver can be removed, and within a short period of time, it will grow back to its original shape and size. It continually takes abuse, but if cared for properly, it will function more than adequately for decades. Alcohol is one of the toxins that the liver doesn’t handle as well as others. The liver cannot regenerate after being severely damaged by alcohol.


There are many other health consequences of alcoholism as well. Alcoholics often experience damage to their peripheral nervous systems. This damage may show up initially as a loss of sensation in the hands or feet, with an accompanying difficulty in walking. Chronic drinking also causes inflammation of the pancreas. This further hampers the body’s ability to digest fats and other nutrients, and can lead to diabetes.

Alcoholics face an in creased risk of mouth and throat cancer due to the direct toxicity of the alcohol. They may also experience high blood pressure, reduced testosterone production, visible dilation of blood vessels just beneath the skin’s surface, and pathological enlargement of the heart that can progress to congestive heart failure.

The social consequences of alcoholism can be very destructive as well. Alcohol abuse takes a tremendous toll on society through traffic and other accidents, poor job performance, and emotional damage to entire families.

Alcoholism and pregnancy

Drinking during pregnancy is particularly dangerous. The consumption of alcohol during pregnancy can cause birth defects and increases the chance of miscarriage. Alcohol passes through the mother’s placenta and into the fetal circulation. This toxic substance depresses the central nervous system of the fetus. Further, the fetal liver must try to metabolize the alcohol, but since the fetus’s liver is not fully developed, the alcohol remains in the fetal circulation. Women who drink during pregnancy generally give birth to babies with lower birth weights. Their growth may be retarded or stunted; their brains may be smaller than normal, and there may be mental retardation as well. Limbs, joints, fingers, and facial features may be deformed. Heart and kidney defects may occur. Some children exposed to alcohol in uterus become hyperactive at adolescence and exhibit learning disabilities. Every drink a pregnant woman consumes increases her child’s risk of being born with fetal alcohol syndrome, and also increases her chances of miscarriage. Even moderate amounts of alcohol may be harmful, especially in the first three to four months of pregnancy.

Signs and Symptoms

Alcoholism is often accompanied by the following signs and symptoms. Symptoms vary with the amount of alcohol taken and how long it has been abused.

-  Craving for alcohol

-  Inability to control drinking habits

-  Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking

-  Tolerance (the need for increasing amounts of alcohol in order to feel its effects)

-  Psychological, social, occupational dysfunction

-  Malnutrition, anorexia

-  Cardiovascular symptoms (leading cause of death)

-  Increased levels of cancer (second leading cause of death)

-  Repeated infections—for example, tuberculosis, urinary tract infections

-  Lung conditions—complicated by smoking; for example, respiratory failure, pneumonia

-  Central nervous system disorders—unsteady gait or stance; cognitive impairment; psychiatric manifestations (for example, mood, anxiety, psychotic disorders); blackouts; coma; sleep disruptions

-  Diarrhea, vomiting

-  Gastrointestinal bleeding

-  Men—increased sexual drive with decreased ability to maintain an erection

-  Women—miscarriage, stopping of menstrual periods

-  Inflammation of the pancreas

-  Hepatitis (a disease of the liver)

-  Poor wound healing

-  Buildup of fluid in the body

-  Swollen, painful muscles, paralysis, lack of reflexes

-  Increased bone fractures

-  Hypoglycemia (low blood sugar)

-  Hypothermia (reduction of body temperature)

Moderate drinking

Alcoholism is caused by chronic over-consumption of alcohol.

Moderate drinking is probably best defined as the level of drinking that poses a low risk of alcohol-related problems, both for the drinker and for others. It is difficult to give a quantitative definition of moderate drinking because alcohol can have different effects on different individuals.

The Centre for Addiction and Mental Health of Ontario and the Canadian Centre on Substance Abuse defines moderation, or 'low risk drinking guidelines' as follows: 'Healthy adults who choose to drink should limit alcohol consumption to 2 or fewer standard drinks per day, with consumption not exceeding 14 standard drinks a week for men and 9 standard drinks per week for women.

Who's Most At Risk?

People with the following conditions or characteristics are at a higher-than-average risk for developing alcoholism.

-  Genetically predisposed

-  Preexisting psychiatric disorder

-  Began consuming alcohol at an early age

-  Stress

What to Expect at Your Health Provider's Office

If you or someone you care for is experiencing symptoms associated with alcoholism, you should see your health care provider. He or she can help make a diagnosis and guide you in determining which treatment or combination of therapies including alternative therapies will work best.

Your provider will take a history and do a physical exam to look for specific organ damage or trauma and to evaluate if your muscles are tender or weak. Laboratory tests will reveal any indicators of alcoholism, such as high blood alcohol. Imaging techniques may be used to diagnose alcohol-related disorders.

 

Treatment Options

- prevention

The nature of treatment depends on the severity of your alcoholism and available resources, and must address both medical issues and rehabilitation. Treatments may be provided in a hospital, a residential treatment setting, or on an outpatient basis.

- treatment plan

To understand treatment and make the right treatment choices, it helps to have an overview. Treatment is often seen as having four general phases:

- Getting started (assessment and evaluation of disease symptoms and accompanying life problems, making treatment choices and developing a plan)

- Detoxification (stopping use)

- Active treatment (residential treatment or therapeutic communities, intensive and regular outpatient treatment, medications to help with alcohol craving and discourage alcohol use, medications to treat concurrent psychiatric illnesses, 12-step programs, other self-help and mutual-help groups)

- Maintaining sobriety and relapse prevention (outpatient treatment as needed, 12-step programs, other self-help and mutual-help groups)

Promising types of counseling and complementary alternative medicine teach people to identify situations and feelings that trigger their urge to drink and to find new ways to cope without using include alcohol use. In addition, because the involvement of family members is important to the recovery, many programs also offer marital counseling and family therapy as part of the treatment process. Some programs also link up individuals with community resources, such as legal assistance, job training, child-care, and parenting classes.

Here are 12 questions to consider when selecting an alcohol or substance abuse treatment or rehabilitation program, according to the Center for Substance Abuse Treatment (USA):
1. Does the program accept your insurance? If not, will they work with you on a payment plan or find other means of support for you?

2. Is the program run by accredited, licensed and/or trained professionals?

3. Is the facility clean, organized and well-run?

4. Does the program encompass the full range of needs of the individual (medical: including infectious diseases; psychological: including co-occurring mental illness; social; vocational; legal; etc.)?

5. Does the treatment program also address sexual orientation and physical disabilities as well as provide age, gender and culturally appropriate treatment services?

6. Is long-term aftercare support and/or guidance encouraged, provided and maintained?

7. Is there ongoing assessment of an individual's treatment plan to ensure it meets changing needs?

8. Does the program employ strategies to engage and keep individuals in longer-term treatment, increasing the likelihood of success?

9. Does the program offer counseling (individual or group) and other behavioral therapies to enhance the individual's ability to function in the family/community?

10. Does the program offer medication as part of the treatment regimen, if appropriate?

11. Is there ongoing monitoring of possible relapse to help guide patients back to abstinence?

12. Are services or referrals offered to family members to ensure they understand addiction and the recovery process to help them support the recovering individual?

- prognosis

Recovery from alcoholism is a life-long process. In fact, people who have suffered from alcoholism are encouraged to refer to themselves ever after as "a recovering alcoholic," never a recovered alcoholic. This is because most researchers in the field believe that, since the potential for alcoholism is still part of the individual's biological and psychological makeup, one can never fully recover from alcoholism. The potential for relapse (returning to illness) is always there, and must be acknowledged and respected. Statistics suggest that, among middle-class alcoholics in stable financial and family situations who have undergone treatment, 60% or more can be successful at an attempt to stop drinking for at least a year, and many for a lifetime.

- drug therapies

Your provider may prescribe the following medications.

- Tranquilizers called benzodiazepines which are used during the first few days of treatment to help patients safely withdraw from alcohol

- Antipsychotic medications for people who do not respond to benzodiazepines

- Naltrexone, a recently approved medication to help people remain sober. When used in combination with counseling, this medication may lessen the craving for alcohol and help prevent a return to heavy drinking.

- Disulfiram, an older medication, which discourages drinking by causing nausea, vomiting, and other unpleasant physical reactions when alcohol is used

Medications for specific organ damage or for symptoms associated with alcohol withdrawal.

- complementary and alternative therapies

A comprehensive treatment plan for alcoholism may include a range of complementary and alternative therapies.

 

  - nutrition (Western Medicine)

A well-balanced, nutritionally adequate diet helps to stabilize alcohol-induced blood-sugar fluctuations and decrease cravings. Following these tips can help reduce symptoms.

- Eliminate simple sugars.

- Increase complex carbohydrates (whenever possible, replace highly processed grains, cereals, and sugars with minimally processed whole-grain products).

- Consume adequate protein. (If you eat meat, steer yourself toward the leanest cuts. If you like dairy products, skim or low-fat versions are healthier choices. Beans, soy, nuts, and whole grains offer protein without much saturated fat and with plenty of healthful fiber and micronutrients).

- Increase essential fatty acids (essential fatty acids - two polyunsaturated fatty acids [PUFAs] that cannot be made in the body are linoleic acid [omega 6 family – e.g. oils from Safflower, Sunflower, Corn, Soya, Evening primrose, Pumpkin, Wheatgerm] and alpha-linolenic acid [omega 3 family – e.g. Linseed (flaxseeds), Rapeseed (canola), Soya beans]. They must be provided by diet and are known as essential fatty acids. Within the body both can be converted to other PUFAs such as arachidonic acid, or eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). In the body PUFAs are important for maintaining the membranes of all cells; for making prostaglandins which regulate many body processes which include inflammation and blood clotting. Another requirement for fat in the diet is to enable the fat-soluble vitamins A, D, E and K to be absorbed from food; and for regulating body cholesterol metabolism.)

- Decrease saturated fats and fried foods (saturated fats - usually derived from animal sources e.g. lard, suet and butter. Saturated and monounsaturated fats are not necessary in the diet as they can be made in the human body).

- Avoid caffeine.

Potentially beneficial nutrient supplements include the following.

- Vitamin B1 (50 to 100 mg a day - Alcoholics are deficient in B vitamins, especially B1 )

- Vitamin B2 (50 mg a day), B3 (25 mg a day), B5 (100 mg a day - Aids the body in alcohol detoxification. Needed to counteract stress), B6 (50 to 100 mg a day), B12 (100 to 1,000 mg a day)

- Vitamin C with bioflavonoids (3,000 to 10,500 mg a day in divided doses - )

- Vitamin E (400 IU a day) to protect the heart

- Calcium (2,000mg daily at bedtime) a vital mineral that has a sedative effect

- Magnesium (250 – 1000 mg ) to decrease withdrawal symptoms

- Selenium (200 mcg a day) to protect the liver

- Zinc (15 mg a day) to aid metabolism

- Amino acids: carnitine (500 mg two times a day) to protect the liver, glutamine (1 g a day) to decrease cravings, glutathione (300 mg a day) to protect liver and heart

- Multienzyme complex (as directed on label. Take with meals - To aid digestion) plus proteolytic enzymes - As directed on label. Take between meals - Essential for assimilation of protein. Caution: Do not give these supplements to a child.)

- Chromium (250 to 500 mcg twice a day) helps reduce sugar cravings and reduces low blood sugar related to alcohol cravings.

- herbs

Herbs are generally available as dried extracts (pills, capsules, or tablets), teas or decoctions, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 tsp/cup water steeped for 10 minutes (roots need 20 minutes). Herbal extracts made with alcohol should be avoided in alcoholics. For TCM herbs the dosage is prescribed by the TCM Practitioner or Herbalist.

- Western Herbs

The use of certain Western herbal remedies may offer relief from symptoms.

- Milk thistle ( Silybum marianum ): 80 to 200 mg three times a day, to support the liver

- Primrose oil ( Oenothera biennis ): 1,000mg 3 times daily, with meals. Used successfully in Europe, this supplement is a good source of essential fatty acids.

- Dandelion ( Taraxacum officinale ): 2 to 8 g of root three times a day in tea, or 5 ml three times a day of leaf tincture helps detoxify the liver. Works well with milk thistle.

- Skullcap ( Scutellaria lateriflora ): historic use for hysteria, tension, and nervous disorders, especially anxiety; a cup of tea before bed can help insomnia.

- Valerian root ( Valeriana officinalis ) has a calming effect. It is best taken at bedtime.

- Desiccated liver capsules (500 mg three times a day) help heal liver tissue.

- Traditional Medicine Herbs & Diet

Dietary plan for the Garden of Eden: In the book of Genesis, Chapter one, verse 29, God tells man what he should eat: “See, I have given you every herb that yields seed which is on the face of the face of the earth, and every tree whose fruit yields seeds; to you shall be for food.”

Certain cooling, detoxifying foods are commonly prescribed by TCM in the treatment of alcoholism: tofu, mung bean sprouts, mung beans, fresh wheat germ, romaine lettuce, banana, either sugar cane or dried unrefined cane juice, pears, and spinach. Honey eaten by the spoonful until satiation during a hangover reduces the desire for more alcohol. Soups are helpful and provide a good medium for tofu, mung beans, romaine lettuce, and spinach in the diet.

Kudzu or Ge Gen (otherwise known as Pueraria lobata) is one of the earliest medicinal plants used in TCM. Researchers at the Center for Biochemical and Biophysical Sciences and Medicine, Harvard Medical School, Boston, USA have many profound pharmacological actions including antidipsotropic (anti-alcohol abuse) activity. Although both the roots and flowers of Kudzu (Ge Gen), Radix and Flos Puerariae, respectively, have been used to treat alcohol abuse safely and effectively in China for more than a millennium (reduce cravings).

The herb American ginseng, Xi Yang Shen in Mandarin, (Panax quinquefolium) is prized in East Asia for the treatment of alcoholism, and may be used in conjunction with the golden seal or chaparral formulas. In the event of extreme weakness, American ginseng is indicated as part of the regeneration diet herbal formula containing it in equal parts (in fact this formula is a hybrid between Chinese and Native American traditional medicine):

Suma root ( Pfaffia paniculata )
Dried Ling Zhi (Reishi - Ganoderma lucidum ), Maitake, or Shiitake mushroom
Job’s tear’s seeds (Coix lacryma-jobi)
American/Canadian Ginseng root ( Panax quinquefolium )
Astragalus root ( Astragalus membranaceus )
Because of its warming nature, do not use Chinese or Korean Panax ginseng. Avoid warming spices such as ginger, cinnamon, and black pepper.

After a cleansing program that purges heat and other signs of excess, high protein sources can be added for one to two years to rebuild the liver. It is very important to tonify the body after or even simultaneously because during cleansing a lot of qi (energy) is lost. TCM purging (cleansing) herb formula are balanced from this stand point.

Especially beneficial is spirulina or other green micro-algae; in cases of weakness, small amounts (1—3 ounces) of animal products may be necessary three or four times per week: sardine, mackerel, tuna, pork liver, and pork or beef kidney.

 

- Homeopathy

An experienced homeopath can prescribe a regimen for treating alcoholism that is designed especially for you. Some of the most common acute remedies are listed below.

- Arsenicum album for anxiety and compulsiveness, with nausea, vomiting, and diarrhea

- Nux vomica for irritability and compulsiveness with constipation, nausea, and vomiting

- Lachesis for cravings for alcohol, headaches, and difficulty swallowing

- Lycopodium for low self-esteem, heartburn, impotence

Acute dose is three to five pellets of 12X to 30C every one to four hours until symptoms are relieved.

- Acupuncture

Alcoholics who stop drinking often experience withdrawal symptoms, especially during the first week or so that they abstain from alcohol. Insomnia, visual and auditory hallucinations, convulsions, acute anxiety, a rapid pulse, profuse perspiration, and fever can occur. With time, however, and with appropriate supervision if necessary, these symptoms pass and the alcoholic is set free to begin the lifelong work of recovery.

Acupuncture can help committed people to stop drinking by reducing or eliminating the withdrawal symptoms of alcohol abstinence and reducing cravings. Ear and/or body acupuncture can be used by TCM practitioners to treat people with alcoholism based on an individualized and thorough assessment of the excesses and deficiencies of qi (life force) located in various meridians. In the case of alcoholism, a qi deficiency is usually detected in the liver meridian, while the gallbladder meridian tends to contain excess qi. From a TCM perspective the related syndromes of addiction to alcohol or other substances can be defined as follows:

- liver qi stagnation (swellings, lumps, distended abdomen and chest, tension, thyroid problems, repressed emotions, frustration, anger, impatience), which over time leads to liver heat (red face, eyes, and tongue, insomnia, splitting headaches, constipation, aggression, violence), liver wind (moving or fluctuating pain, pulsating headache, spasms, cramps, dizziness, manic/depression) and/or deficient liver yin (dry eyes, weak vision, night blindness, dry brittle nails, and other general deficient yin signs).

- kidney-adrenal stress, resulting in deficient kidney yin (ringing in the ears, dry throat, dizziness, low backache, weak legs, red tongue, insecurity, agitation), deficient kidney yang (cold extremities, aversion to cold, weak knees and low back, frequent urination, edema, enlarged, pale tongue, lack of will power), and deficient jing (poor physical and/or mental development, inadequate brain function, early senility, impotence, dizziness, loose teeth, loss of head hair). Many drug “highs” consume massive amounts of jing essence.

- heart-mind spirit lack of balance (lack of mental focus, forgetfulness, poor sleep patterns, mental illness, speech problems, and agitation during de toxification).

- general qi deficiency (frailty, weakness, faint voice and shallow breath, little or no tongue coating, lack of motivation) and blood deficiency (pale lips, nail beds, tongue, and complexion; thinness; thin, dry hair; spots in the field of vision; irregular menstruation).

One of the primary aims in addiction work is a smooth, obstruction-releasing qi flow throughout the body-mind so that intoxicants are no longer craved. This entails clearing the liver, which directs smooth qi flow in general. Imbedded in the liver are chemical residues representing the life history of unresolved problems, denials, resentments, and repressions that have been masked by alcohol?

In addition to performing needling treatment, acupuncturists may employ other methods such as moxibustion, herbal remedies, diet and therapeutic massage.

Acupuncture has shown potential as an effective treatment for addictions, according to the studies performed in last two decades in China, Europe and North America. They found that acupuncture may reduce the desire to drink alcohol and the lower the number of admissions to alcohol detoxification centers, other studies have failed to duplicate these findings. Interestingly however, many addiction programs that currently offer acupuncture report that people appear to "like acupuncture" and, in many cases, want to continue with their detox program for longer periods of time when acupuncture is provided as a treatment option. This is very important since attendance is essential for the success of treatment.

Following Up

After initial care, medical and/or health care follow-up should continue for 6 to 12 months.

Recommendations

- Avoid all alcohol. Total abstinence is a mandatory requirement for taking back the control over your life and your health.   You cannot begin drinking again and expect to maintain control over it even after years of sobriety. As little as a sip of any drink containing alcohol can renew the drinking pattern. You must choose not to drink.

- Seek help from a person or persons knowledgeable about this disorder. Alcoholics Anonymous has been doing wonderful work for many years in helping alcoholics achieve and maintain sobriety. Al-Anon is a similar group that pro vides support for the friends and families of alcoholics. The assistance and counseling services of these groups are avail able in nearly every city and town nationwide. Look in your local telephone directory for the group nearest you, or call your local mental health association for information.

- If possible, consult a nutritionally oriented physician or a TCM practitioner to determine your specific nutritional needs.

- Go on a ten-day live juice and cleansing fast to remove toxins from the body quickly.

- Eat a nutrient-dense diet of fresh whole foods, organically grown if possible, and follow the nutritional supplement program outlined above. Your primary foods should be raw fruits and vegetables, whole grains, and legumes.

- Avoid saturated fats and fried foods, which put stress on the liver. For essential fatty acids, use primrose oil supplements plus small amounts of cold-pressed organic vegetable oils.

- Do not consume refined sugar or anything that contains it. Alcoholics often have disorders of sugar metabolism.

- Get plenty of rest, especially in the early weeks of recovery, to allow your body to cleanse and repair itself.

- Avoid people, things, and places that are associated with drinking. Make new friendships with people who do not drink. Taking up a hobby, becoming involved in sports, and exercising (including Yoga, Tai-chi, Qi-Gong) or promote self-esteem and provide a productive outlet for energy.

- As much as possible, avoid stress. Cultivate patience, meditate, pray; this will be needed for the long, slow road to recovery.

- Do not take any drugs except for those prescribed by your physician.

- If you suspect that someone you know may be abusing alcohol, encourage the person to seek professional care.

 

ANNEX 1 - 'Alcohol worse for female brains'

 Pictures of the brains of more than 150 volunteers revealed how women come to more harm and quicker than men when they drink heavily.

Scientists have suspected for some time that men might be more resilient to booze than women. The German research gives visible evidence of this. The University of Heidelberg team published their findings in Alcoholism.

In the study, around half of the volunteers were alcoholics. All of the volunteers had brain scans at the start and end of the six week study. Those who were alcoholic were helped to "dry out" during the six weeks.

When the researchers analyzed the brain scan results they found obvious evidence of brain damage among the heavy drinkers.

The drinkers had smaller brains, due to loss or atrophy, than the controls.

Brain loss

Women who were heavy drinkers lost the same amount of brain volume as the drinking men, but over a much shorter period of alcohol dependence.

Lead author Professor Karl Mann said although men generally drink more alcohol, women probably develop alcohol dependence and adverse consequences more readily.

Other alcohol-related disorders, such as heart problems, depression and liver disease, also occurred earlier in women than men, he said:

"Women typically start drinking later in life, consume less...and one could reason that women are less affected by alcohol. But there is evidence for a faster progress of the events leading to dependence among female alcoholics and an earlier onset of adverse consequences of alcoholism. This suggests that women may be more vulnerable to chronic alcohol consumption."

For these reasons, he said it was even more important to spot and treat alcohol abuse early in women.

A spokesman from the Institute of Alcohol Studies said: "This study supports previous findings that women experience much alcohol-related harm before men at the same level of drinking. These results are particularly concerning given the rising alcohol consumption in UK women, and the increased risk of alcohol dependence that goes with it. This worryingly suggests that alcohol-related damage experienced by women in the UK is set to increase rapidly in the coming years."

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