Document Type : Review Article
Medical Toxicology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
Introduction: The most common substance of abuse/dependence in patients presenting for treatment in western countries is alcohol. Ethyl alcohol or ethanol which is also called medicinal alcohol is used as an official drug compendium. It is also administered as an antidote in methanol poisoning. However, regular consumption of high amounts of alcoholic drinks induces dependence and addiction leading to alcoholism.
Definition: Alcoholism is a broad term for advanced chronic ethanol abuse. It is, in fact, a compulsive and uncontrolled consumption of alcohol beverages usually to the detriment of the drinker's health, personal relationships, and social standing. World Health Organization expert committee discouraged the use of "alcoholism" in medicine and recommended a preferred term of "alcohol dependence syndrome". However, alcoholism is still used more frequently and the people suffering from alcoholism are called "alcoholics".
Clinical Manifestations and Complications: Women are more sensitive to ethanol than men. Long-term complications of alcohol dependence also develop more rapidly in women than in men with higher mortality. Genes play an important role in alcoholism and its complications. Brain, heart and liver are the main affected organs in alcoholism. Physical symptoms or diseases produced by alcohol addiction include cirrhosis of the liver, pancreatitis, epilepsy, polyneurpopathy, dementia, peptic ulcer, malabsorption, cardiovascular complications and even cancer. Death is mainly due to cardiovascular complications.
Management: All factors which encourage an alcoholic to continue drinking must be considered to successfully prevent a relapse. Detoxification alone does not actually treat alcoholism. It is thus necessary to follow-up detoxification with an appropriate treatment program to reduce the risk of relapse. Medications (benzodiazepines, acamprosate, calcium carbimide, disulfiram and naltrexone) have been used for treatment of alcoholism without great success. Even various forms of psychotherapy, social supports with medications have had limited success.
Conclusion: The most common and the worst substance of abuse is ethanol which leads to alcoholism with many social and health problems. Therefore, prevention of alcohol abuse is the most advisable.