By Dr. Arif Maghribi
Alcohol is becoming a major substance of abuse across the world, including Kashmir. Alcohol abuse is responsible for suicides and road accidents worldwide. Mixed abuse of alcohol and other drugs is also very common in Jammu region of Jammu and Kashmir state.
There are two groups of alcoholics:
Type 1: Adult onset, steady, gradually escalating consumption, form 75 percent of alcoholics.
Type 2: Alcohol seeking from adolescence, strong family history, anti-social characteristics, form 25 percent of alcoholics.
Why is alcohol enjoyable at start? Alcohol stimulates the release of dopamine and produces euphoria. Over time dopaminergic neurons atrophy and natural level of dopamine fails producing malaise, unless the level is stimulated by alcohol and hence it leads to painful urge to take alcohol again.
Symptoms: In the beginning, alcoholics function fairly well most of the time and go unrecognized by physicians until their social and occupational lives, and their physical lives and physical health are harmed, and it results in a dysfunctional life at home and job.
Screening tests CAGE can be used to diagnose alcohol addiction:
Ask these questions to an alcoholic:
Question 1: Have u ever felt you should ‘cut’ down on your drinking?
Question 2: Have people ‘annoyed’ you by criticizing your drinking?
Question 3: Have you ever had a ‘guilty’ feeling?
Question 4: Do you need to drink as first important thing of day? Eye opener?
Chronic drinking elevates serum gamma-glutamyl transferase [GGT] and RBC MCV (together they identify 90 percent of alcoholics).
Important tip: Don’t ask anybody to stop alcohol suddenly without consulting a doctor as that may lead to life threatening conditions including tremulousness, weakness, unstoppable vomiting, blurred vision, and pounding heart palpitations.
Alcohol withdrawal delirium is a life threatening delirium and its symptoms are being disorientation, agitated, hypertension, and seeing or hearing people or voices which do not exist (hallucinations).
Complications of alcoholism:
1: Gastric ulcer, anaemia, cirrhosis, impotence.
2: Severe nerve weakness [Vitamin B deficiencies].
3: Heart diseases like myopathy and cardiac myopathy.
4: Wernicke encephalopathy (triad of confusion, ataxia, and eye movement dysfunction).
5: Loss of memory.
1: Don’t abuse the patient or use derogatory words for him.
2: Treat all medical complications of drinking.
3: Enlist family members in treatment. Evaluate family’s contribution to problem or help in resolving problems.
4: Group therapy appears to be most effective.
(Author is a mental health consultant and has received MH GAP training from Royal College of Psychiatry. He has delivered free lectures on subjects related to mental health. He can be mailed at firstname.lastname@example.org)