Alcoholism FAQ

Alcoholism

Do Alcoholics Die Early?

Alcoholics can die earlier than individuals who never had an addiction to alcohol.

According to recent research in Manchester, alcohol-addicted individuals die 7.6 years earlier on average than patients without an experience of the disease [1].

Meanwhile, a study done in Denmark, Finland, and Sweden found out that patients with alcohol addiction live 24–28 years shorter than the rest of the population [2].

Women who have been hospitalized for alcohol use disorder are expected to live up to the age of 50–58 years  [2].

Men who have been hospitalized for alcohol use disorder are expected to live up to the age of 47–53 years [2].

 

There is a general consensus among researchers that world-wide that women tend to live longer than men [3].

Experts cite various biological, behavioural, and environmental factors not specifically connected to alcoholism as a condition.

 

Alcohol addiction is a preventable disease.

Alcohol Use Disorder (AUD) is the formal term for alcohol addiction.

 

AUD is a characterised by the inability to stop or control alcohol use despite negative social, occupational (work), or health consequences [4].

The cure for alcohol addiction is life-long abstinence from alcohol.

However, to make it easier for AUD sufferers, addiction experts approach the problem step-by-step.

 

Individuals who have AUD are given the suggestion not to suddenly stop using alcohol without professional support, as sudden withdrawal could be life-threatening. [5]

 

According to the National Institute on Alcohol Abuse and Alcoholism or NIAAA (US), the most common diseases that AUD sufferers die from are: [4]

  • >> liver cirrhosis (last stage of liver disease)
  • >> cancer of the mouth
  • >> cancer of the oesophagus
  • >> cancer of the pharynx
  • >> cancer of the larynx
  • >> cancer of the liver
  • >> cancer of the breast

 

Other life-threatening diseases include alcohol-related pancreatitis and complications of heart disease.

Additionally, deadly vehicular accidents can be caused by drunk driving.

Liver disease, the most-occurring medical condition that an alcoholic suffers from has four distinct stages [5].

 

Stage One: Alcoholic fatty liver disease

In this stage, there are usually no obvious symptoms apart from pain in the upper right side of the abdomen. Liver cells could be damaged and the liver could be inflamed [5].

 

Stage Two: Alcoholic Hepatitis

  • >> The most obvious symptom is yellowing of the skin (jaundice) [5].
  • >> Alcoholic hepatitis can be classified as mild or severe. In the most severe cases, kidney and liver failure can occur.
  • >> Serious symptoms can show up without warning
  • >> Can be triggered in alcoholics by consuming a heavy amount of alcohol

 

 

Stage Three: Fibrosis

  • Experts have identified two specific brain areas that alcohol affects [6].
  • >> When the liver is continuously and repeatedly damaged by alcoholic hepatitis, it forms scar tissues.
    • >> Scar tissue formation is the main feature of fibrosis.
    • >> Scar tissues block blood flow to and in the liver.
    • >> Blood pressure in the portal vein, which carried blood to the intestine to the liver, also increases with fibrosis patients

 

Stage Four: Cirrhosis [6]

  • >> At this stage, liver damage is permanent.
  • >> Scarring that began with fibrosis is wide-spread in liver cirrhosis.
  • >> However, a person can still survive this disease if it is professionally intervened.
  • >> Symptoms come from liver failure and portal hypertension
  • >> The patient is also at risk of liver cancer
  • >> Liver failure can manifest in difficulty digesting and absorbing food, bleeding, and problems thinking clearly.
  • >> While a sign of portal hypertension is passing blood through the rectum.

 

Is Alcoholism A Disease Or Addiction?

Alcoholism is considered a disease. Formally it is called Addiction Use Disorder. AUD is an addictive disorder characterised by the need to use alcohol even if faced with negative consequences [7].

Individuals who suffer from AUD are successfully treated with professional help from addiction experts in a rehab clinic.

Because it is a lifestyle disease like hypertension and diabetes, a person with AUD needs to make lifestyle changes.

 

Lifestyle changes are implemented best if psychotherapy and psycho-social interventions are utilised.

Currently, Cognitive Behavioural Therapy and 12 Step Facilitation are the most popular forms of psychosocial intervention. [4]

 

As an addiction, AUD manifests itself in physical and behavioural symptoms.

The physical symptoms of AUD are largely brought about when the person tries to quit drinking.

 

Meanwhile, psychological symptoms include craving alcohol, being preoccupied with alcohol, and having difficulty performing expected responsibilities because of alcohol use.

Addiction experts determine the diagnosis of AUD by taking a person’s history and conducting specific assessments.

AUD is rated as mild, moderate, or severe depending on the individuals’ symptoms, physical as well as psychological.

 

The NIAAA defines AUD as a “chronic relapsing brain disease”, meaning:

  • >> Scientific studies have shown alcoholism is a problem at the level of the brain
  • >> Alcoholism is not a matter of will, self-discipline or morals
  • >> If left without treatment, it will progress, causing the individual more harm
  • >> Relapse will likely occur if the person is not adequately supported in treatment

 

As signs of problem drinking become obvious, it is wise to immediately seek treatment.

Many individuals can be functioning alcoholics or grey area drinkers.

Functional alcoholics or high functioning alcoholics are likely to  [9]:

  • >> Keep their jobs
  • >> Perform parental duties
  • >> Keep problematic drinking behaviour a secret
  • >> Experience emotional problems such as anxiety or depression
  • >> Can have emotional problems at a level that is not yet a mental health condition
  • >> Fall into the category of Mild AUD

 

Meanwhile, grey area drinkers also exhibit problematic behaviours associated with AUD, but their number of symptoms do not qualify them to the full diagnosis of AUD.

Grey area drinkers may not have the correct number of symptoms to have AUD, but their drinking is already causing them problems in day-to-day life.

 

Most grey area drinkers shy away from alcohol rehab or therapy because they do not outright believe they are sick.

Some grey area drinkers are also not ready for treatment because they have not “hit rock bottom”.[10]

Sadly, this way of thinking can be detrimental to a person’s physical, psychological, and emotional health.

 

Individuals who are in AUD treatment are given the procedure to gradually reduce alcohol intake.

Professionally managed detox also involves use of medication to ease the withdrawal symptoms.

Individuals who suffer from AUD are encouraged to approach this disease as a health issue to take away the stigma of seeking cure.

 

Is It Safe To Stop Drinking Cold Turkey?

It is not safe to stop drinking alcohol cold turkey [11]

According to addiction experts, persons who quit cold turkey, meaning, suddenly stopping alcoholic consumption, without help or professional intervention, are at risk of:

  • >> Delirium Tremens (DT) – a severe reaction after stopping alcohol, occurring 2-3 days after their last drink.
    • >> DT could be fatal.
    • >> DT is caused by changes in the brain due to heavy drinking
    • >> Symptoms of DT are:
    • >> Trembling of the hands and feet
    • >> Feeling agitated or very irritated
    • >> The person is confused about where s/he is or what s/he is doing
    • >> Seeing and hearing things that are not there (hallucinating)
    • >> Convulsions (in the form of grand mal or tonic-clonic seizures)

 

  • >> Kindling – Worsening of alcohol withdrawal symptoms every time an attempt to quit is performed. Symptoms include [12]:
    • >> Depression
    • >> Anxiety
    • >> Irritability
    • >> Panic attacks
    • >> Difficulty sleeping, staying asleep, and early morning awakenings (EMA)
    • >> Emotionally unable to cope with the daily demands of life

 

  • >> High rate of relapse – Due to the desire to stop the withdrawal symptoms of alcohol, AUD sufferers tend to use alcohol to self-medicate. Scientific data has shown: [13]
    • >> 79% of untreated individuals do not achieve abstinence from alcohol
    • >> 20 to 50% of individuals who did not seek treatment relapse (percentage depends on the severity of alcohol addiction)
    • >> 40% of treated individuals were able to be problem-free from alcohol up to one year after treatment
    • >> 43% of treated individuals stayed sober three years after joining a treatment program

 

How Can I Stop Drinking So Much?

The safest way to stop drinking so much is to do alcohol detox with professional intervention.

Quitting alcohol with proper help tends to:

  • >> Be safer
  • >> Guarantee a better success rate
  • >> Prevent the chance or a relapse

 

Professional intervention can be in the form of inpatient or outpatient alcohol rehab.

Home detox for mild cases of Alcohol Use Disorder can also be arranged.

To keep motivated in drinking too much, a person needs to go dive deep into the motivations that keep him or her drinking.

Careful examination of these motives is best done with counseling or psychosocial interventions.

12 Step Facilitation, Cognitive Behavioural Therapy, Dialectical Based Therapy, and Holistic Therapy are found to be successful in combating alcoholism [14].

In the US, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines Drinking at Low Risk for Developing Alcohol Addiction as

  • >> Women: No more than 3 drinks on any single day and no more than 7 drinks per week.
  • >> Men: No more than 4 drinks on any single day and no more than 14 drinks per week.

 

One drink = 14 grams of pure alcohol (US measures)

 

In the UK, The Chief Medical Officers’ guidelines for both men and women [15] is:

  • >> Do not drink regularly more than 14 units per week
  • >> If a person does drink as much as 14 units per week, it is recommended to spread this amount evenly over 3 days or more.
  • >> Heavy drinking sessions are not recommended

 

According to the NHS [16], 14 units Alcohol in the UK means:

  • >> 14 single measures of spirits (ABV 37.5%)
  • >> 7 pints of average-strength (4%) lager
  • >> About 9 and one-third 125ml glasses of average-strength (12%) wine
  • >> 7 glasses of 175ml average-strength (12%) wine
  • >> About 4 four 250ml glasses of average-strength (12%) wine

 

References

  1.   Universitat Bonn. 2016. Alcohol study yields surprising results. [Press Release]. Available at: https://www.uni-bonn.de/Press-releases/alcohol-study-yields-surprising-results
  2.   Westman, et. al. (2015). Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland and Sweden. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402015/
  3.   Ortiz-Ospina, E. & Beltekian D. (2018). Why do women live longer than men? Our World in Data. Available at: https://ourworldindata.org/why-do-women-live-longer-than-men
  4.   National Institute on Alcohol Abuse and Alcoholism. (2019). Alcohol Facts and Statistics. Available at: niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics
  5.   Felman, A. (2018). What’s to know about alcoholic liver disease? Medical News Today. Available at: https://www.medicalnewstoday.com/articles/215638.php
  6.   Orfanidis, N. (2015). Overview of Vascular Disorders of the Liver. In Merck Manuals. Available at: https://www.msdmanuals.com/professional/hepatic-and-biliary-disorders/vascular-disorders-of-the-liver/overview-of-vascular-disorders-of-the-liver?query=liver%20cirrhosis#
  7.   Thompson, W. (2011). Alcoholism Clinical Presentation. In Medscape. Available at: https://emedicine.medscape.com/article/285913-clinical
  8.   Science Daily. (2019, April 2). Study reveals genes associated with heavy drinking and alcoholism. Science Daily. Available at: https://www.sciencedaily.com/releases/2019/04/190402124314.htm
  9.   National Institutes of Health. (2015). Researchers Identify Alcoholism Subtypes. Available at: https://www.nih.gov/news-events/news-releases/researchers-identify-alcoholism-subtypes
  10.   Gonzales, G. At 30, My Gray Area Drinking Problem Spiraled Into Alcoholism—and I Lost My Dream Job. Prevention. Available at: https://www.prevention.com/health/mental-health/a27224609/signs-of-alcoholism/
  11.   Tidy, C. (2018). Alcohol Withdrawal and Alcohol Detoxification. Patient Info. Available at: https://patient.info/healthy-living/alcohol-and-liver-disease/alcohol-withdrawal-and-detox-alcohol-detoxification
  12.   Modesto-Lowe, V., Huard, J. & Conrad, C. (2005). Alcohol Withdrawal Kindling: Is There a Role for Anticonvulsants? Psychiatry, 2(5), 25–31. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000183/
  13.   Moos, R. & Moos, B. (2006). Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction, 101(2), 212-222. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1976118/
  14.   Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. (2018). Available at: https://www.ncbi.nlm.nih.gov/books/NBK424859/#ch4.s24
  15.   UK Department of Health. (2016). Chief Medical Officers’ Alcohol Guidelines Review. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/489795/summary.pdf
  16.   NHS. (2018). Alcohol units. Available at: https://www.nhs.uk/live-well/alcohol-support/calculating-alcohol-units/