onslaught of hepatotoxic drugs and alcohol may
overwhelm its renewal mechanisms. Alcohol is a
potent hepatotoxin; it is a poison that destroys
liver cells. Many medications are also hepatotoxic
and in combination with alcohol consumption can
result in significant liver damage and LIVER FAILURE.
Some of the most dangerous drugs in combination
with alcohol are those in such common use that
many people fail to recognize their potential risks
or the frequency with which they take them: acet-
aminophen and the NONSTEROIDAL ANTI-INFLAMMA-
TORY DRUGS (NSAIDS). These drugs are common
ingredients in numerous products to relieve symp-
toms of COLDS, sinus congestion, menstrual
cramps, arthritis pain, and general pain (such as in
prescription analgesic medications). It is important
to minimize or avoid drinking alcohol when tak-
ing products that contain these drugs. Various pre-
scription medications are also hepatotoxic
themselves or in combination with alcohol.
See also COGNITIVE FUNCTION AND DYSFUNCTION;
DRUG INTERACTION; HEPATOTOXINS; ILLICIT DRUG ABUSE;
LIVER DISEASE OF ALCOHOLISM; MEDICINAL HERBS AND
BOTANICALS; MILK THISTLE; OVERDOSE; SUBSTANCE ABUSE
PREVENTION; SUBSTANCE ABUSE TREATMENT.
alcoholic hallucinosis A state of temporary PSY-
CHOSISthat may occur after sudden withdrawal of
ALCOHOLin a person who has heavily consumed
alcohol for an extended time. Typical symptoms
include auditory and sometimes visual HALLUCINA-
TIONS, PARANOIA, and vivid nightmares. However,
thought processes remain clear, and the person
remains fully alert and aware of his or her sur-
roundings. Symptoms do not usually require
treatment beyond reassurance that they will soon
end, though some people benefit from short-term
treatment with a BENZODIAZEPINES such as chlor-
diazepoxide. Most people recover in 10 to 14 days
though some symptoms may linger up to 3 weeks.
See also ALCOHOLISM; ANTIANXIETY MEDICATIONS;
DELIRIUM TREMENS; SCHIZOPHRENIA; WITHDRAWAL SYN-
DROME.
alcoholism A health condition resulting from
ADDICTION to ALCOHOL. As with other addictions,
alcoholism is a combination of physiologic, psy-
chologic, behavioral, and social factors. About 20
million Americans abuse alcohol, at least half of
whom have alcohol addiction (alcoholism). Alco-
holism has extensive health and social conse-
quences.Symptoms and Diagnostic Path
A significant factor with alcoholism is hiding the
amount of drinking the person is doing. Indica-
tions of excessive drinking are often behaviors
that might appear normal in isolation but that in
aggregate are problematic. These indications may
include- establishing rituals around drinking
- changing plans or missing appointments to drink
- denying drinking or that drinking is a problem
- drinking alone or seeking ways to drink in
secret - hiding bottles of alcohol in odd places
- needing double shots or multiple drinks to feel
the effects of the alcohol
Indications of problem drinking that others
notice may include- frequent absences from work or school
- forgetting people, conversations, or events
- unexplained changes in personality or interests
- disappearing at times throughout the day
- out-of-control drinking episodes that the per-
son denies - frequent illness or health complaints, especially
gastrointestinal conditions
The diagnostic path includes physical and psy-
chologic examinations with an initial screening
questionnaire about alcohol use. Health-care
providers who treat alcoholism use a variety of
such screening and assessment tools. Further test-
ing may include diagnostic procedures to diagnose
physical health problems associated with alcohol
abuse such as LIVERdisease, CARDIOVASCULAR DISEASE
(CVD), and gastrointestinal disorders. The doctor
may also want to test for DIABETES, as chronic alco-
hol consumption interferes with the
GLUCOSE–INSULIN balance. However, there are no
BLOODtests or other procedures to conclusively
diagnose alcoholism. The doctor makes the finalalcoholism 319