impotence. Alcohol also acts as a
diuretic, increasing urine output.
In the long term, regular excessive
alcohol consumption can cause gastritis
(inflammation and ulceration of the
stomach lining), and lead to alcohol-
related disorders. Heavy drinking in
the long term may also lead to alcohol
dependence. However, people who drink
regular, small amounts of alcohol (an
average of 1–2 units a day) seem to
have lower rates of coronary heart dis-
easeand strokethan total abstainers.
alcohol dependenceAn illness char-
acterized by habitual, compulsive, long-
term, heavy consumption of alcohol and
the development of withdrawal symp-
toms when drinking is suddenly stopped.
Three causative factors interact in the
development of the illness: personality,
environment, and the addictive nature
of alcohol. Inadequate, insecure, or
immature personalities are more at risk.
Environmental factors are important,
especially the ready availability, afford-
ability, and social acceptance of alcohol.
Genetic factors may play a part in caus-
ing dependence in some cases, but it is
now widely believed that anyone, irre-
spective of personality, environment, or
genetic background, can become an
alcoholic. Stress is often a majorfactor
in precipitating heavy drinking.
Alcohol dependence usually develops
in 4 main stages that occur over a num-
ber of years. In the 1st phase, tolerance
to alcohol develops in the heavy social
drinker. In the 2nd phase, the drinker
experiences memory lapses relating to
events during the drinking episodes. In
the 3rd phase, there is loss of control
over alcohol consumption. The final
phase is characterized by prolonged
binges of intoxication and mental or
physical complications.
Behavioural symptoms are varied and
can include furtive, aggressive, or grand-
iose behaviour; personality changes
(such as irritability, jealousy, or uncon-
trolled anger); neglect of food intake
and personal appearance; and lengthy
periods of intoxication.
Physical symptoms may include nau-
sea, vomiting, or shaking in the morning;
abdominal pain; cramps; numbness or
tingling; weakness in the legs and
hands; irregular pulse; enlarged blood
vessels in the face; unsteadiness; confu-
sion; memory lapses;and incontinence.
After sudden withdrawal from alcohol,
delirium tremensmay occur.
Alcohol-dependent persons are more
susceptible than others to a variety of
physical and mental disorders (see
alcohol-related disorders).
Many alcoholics require detoxification
followed by long-term treatment. Dif-
ferent methods of treatment may be
combined. Psychological treatments in-
volve psychotherapyand are commonly
carried out as group therapy. Social
treatments may offer practical help and
tend to include family members in the
process. Physical treatment generally
includes the use of disulfiram, a drug
that sensitizes the drinker to alcohol so
that he or she experiences unpleasant
side effects when drinking. Alcoholics
Anonymousand other self-help organiz-
ations can provide support and advice.
Alcoholics AnonymousA worldwide,
independent, self-help organization that
is operated locally by people working
on a voluntary basis to overcome alco-
hol dependence. Regular group meetings
are held in which members are encour-
aged to help one another stay sober by
sharing their experiences openly and
offering support and advice.
alcohol intoxicationThe condition that
results from consuming an excessive
amount of alcohol, often over a relativ-
ely short period. The effects of a large
alcohol intake depend on many factors,
including physical and mental state,
body size, social situation, and acquired
tolerance. The important factor, how-
ever, is the blood alcohol level. Mild
intoxication promotes relaxation and
increases social confidence. Alcohol
causes acute poisoning if taken in suf-
ficiently large amounts, however. It
depresses the activity of the central ner-
vous system, leading to loss of normal
mental and physical control. In extreme
cases, intoxication may lead to loss of
consciousness and even death.
In most cases, recovery from alcohol
intoxication takes place naturally as
the alcohol is gradually broken down inALCOHOL DEPENDENCE ALCOHOL INTOXICATION
A