A chronic disease characterized by uncontrolled drinking and clinically significant psychosocial and behavioural problems associated with alcohol use
Alcoholism is the inability to control drinking due to both physical and emotional dependence on alcohol. Alcohol dependence syndrome is a cluster of physiological, behavioural, and cognitive phenomena in which the use of a substance or a class of substance takes on a much higher priority for a given individual than other behaviours that once had greater value
AUD is a chronic condition in which an uncontrolled pattern of alcohol use leads to significant physical, psychological, and social impairment or distress. Symptoms of withdrawal emerge when drinking is discontinued
It accounts for > 3 million deaths per year worldwide and the Peak incidence of onset is in the late 2nd or early 3rd decade
Whole-body: blackout, dizziness, shakiness, craving, or sweating
Behavioural: aggression, agitation, compulsive behaviour, self-destructive behaviour, or lack of restraint
Mood: anxiety, euphoria, general discontent, guilt, or loneliness
Gastrointestinal: nausea or vomiting
Psychological: delirium or fear
Also common: physical substance dependence, problems with coordination, slurred speech, or tremor
Delirium tremens(DT) – Most severe alcohol withdrawal syndrome. It occurs within 2-4 days of complete or significant abstinence from heavy alcohol drinking. It happens in about 5% of patients and requires emergency care
Alcoholic seizures: Generalized tonic-clonic seizures occur in about 10% of alcohol dependence patients, usually 12-48 hours after a heavy bout of drinking. Sometimes status epilepticus may be precipitated
Clinical diagnosis is done based on DSM 5 or ICD 11 criteria.
Laboratory investigations: GGT( gamma-glutamyl transferase), MCV, LFT are the markers used to detect dependence.
MAST (Michigan Alcoholism Screening Test), AUDIT-C and CAGE questionnaire are used to screen and rate the severity of the condition.
Acute alcohol intoxication: High BAC( Blood alcohol concentration )
Chronic alcohol intoxication
↑ GGT (a most sensitive marker of alcohol abuse)
↑ ALT, ↑ AST
(AST levels are at least 2 times higher than those of ALT in case of alcoholic hepatitis).
Carbohydrate-deficient transferrin (CDT) is the most specific marker for AUD. For CDT levels to become elevated, approximately 50–80 g of alcohol must be consumed daily for 1–2 weeks.