Alcohol Withdrawal Syndrome
Alcohol Withdrawal Syndrome Introduction:-
- Substance use disorder is due to substance use refers to Alcohol abuse, Psychoactive drugs, and other Chemicals.
- Substance use disorder is an addiction disorder in which patients physiologic and psychological dependence on alcohol or other drugs, that are affect the central Nervous System.
- Substance abuse is referred to a repeated taking of a substance.
Classification of alcoholism –
A/c to ICD-10
- F10-F19 Mental and behavior disorder due to psychoactive substance use.
- F10 – Mental and behavior disorder due to use of alcohol
- F11 – Mental and behavioral disorder due to the use of opioids
- F12 – Mental and behavioral disorder due to the use of Cannabinoids
- F13 – Mental and behavioral disorder due to use of Sedative
- F14 – Mental and behavioral disorder due to use of cocaine
- F16 – Mental and behavioral disorder due to use of Hallucinogens.
Psychoactive Substance Drugs
Alcohol Dependence Syndrome
- Alcoholism is a disorder in which a patient feels physical and psychological dependence on alcohol and express the withdrawal symptoms after discontinue the alcohol.
- Alcoholism is indicated the excessive use of alcohol to the point of causing and affect the individual, society and both.
- Alcoholic patient commonest physically depend on alcohol
Cause of Alcohol Dependence
Psychological cause –
- Stress, anxiety, depression
- Failure in Exam
- Low self-esteem
- Poor impulsive control
- Frustration and depression
Social Cause –
- Religious factors
- Social status and pear pressure
- Easily available of alcohol
- Family and occupational tension
Biological factor –
- Alcoholic family
- Family support
- Social unsuccessful
- Less satisfaction in social relationships.
- Environmental factors
Signs and symptoms of alcoholism
- Nutritional deficiency
- Poor personal hygiene and untreated injuries
- Increase tolerance capacity
- Increase self-confidence
- Violence behavior and the use of abusive words
- Abnormal movement during walking
- Slurred speech
- Erectile dysfunction
- Psychiatric disorder due to Alcohol Dependence
- Impaired attention or memory
- Inappropriate sexual or aggressive behavior
- Impaired judgment capacity
- Delirium Tremors
- Impaired psycho-Sexual function
- Alcoholic hallucinations.
Diagnosis of Alcohol Withdrawal Syndrome:-
Screening test –
- Use the CAGE questionnaires, which were given by John Ewing.
- C – Cut down the quantity of alcohol
- A – Annoyed
- G – Guilt
- E – Eye opener (do you need alcohol at awakening time)
GGT Test (Gamma-glutamyl transpeptidase test)
- Normal GGT Value – 9-48 I.U.
- Increase the level in liver in chronic alcoholic patient.
- Blood alcohol level assess
- Liver function test
- ECG, 2-D ECHO
Best Treatment for Alcohol Withdrawal Syndrome
- Self-control is the best management.
- Alcoholic anonymous (Self-help group meeting is arranged by the group of alcoholic patients)
- The drug of choice of alcohol withdrawal symptoms is a benzodiazepine
- Group psychotherapy
- Disulfiram drug is used for aversion therapy
- Disulfiram is contraindicated in cardiac and pulmonary disease patient.
- Psychological treatment –
- Group therapy
- Motivational interviews
- Cognitive behavior therapy
- Relaxation training
- Aversion conditioning therapy
Complication of alcoholism
The physical complication of Alcoholism–
- Liver cancer and Liver Cirrhosis
- Fracture and injury
Social complications of Alcoholism –
- Social withdrawal
- Financial crisis
- Divorce and family broken
- Loss the self-status in society
- Economic crisis and loss of job.
- 6th cranial nerve palsy
- 3rd Cranial nerve palsy
Wernicke Korsakoff Syndrome –
These syndromes occur due to deficiency of Vitamin B1 (Thiamine) and chronic alcoholic patients.
- a). Wernicke Encephalopathy Symptoms are Alexia, Motor activity Disturb, Slurred Speech, Numbness
- b). Korsakoff syndrome symptoms are Confabulation, Amnesia, Recent and immediate memory loss.
- 5. Marchia fava Bignami Disease- Neurological Disorder
- 6. Alcoholic Hallucination – Visual, tactile and auditory hallucination are present.
- Auditory hallucination is most commonly present in withdrawal of Alcohol.
- 7. Alcoholic Fits – Occurs due to intake of excessive alcohol.
- 8. Delirium Tremor – Most common psychological complication. The symptoms seen are Confusion, Disorientation, Tachycardia, Hypertension, Visual Hallucination, and Tremor.
how to prevent alcoholism
Primary Prevention of Alcoholism
- Identify the substance abusers.
- Motivational and encourage the all abuser to stop alcohol use
- Health Educational Provide
- Improve family condition and socio- economic status
Secondary prevention of Alcoholism
- Early Detection and Counselling.
- Motivation interviewing
- Full assessment done – Medical, psychological and Social problems.
- Detoxification with Benzodiazepines
- Psychological therapy provides.
- Treat the complication of treatment.
Tertiary Prevention of Alcholism
- Disulfiram or Antabuse provide.
- Alcoholics anonymous
- Identify High risk situation and deal with them.
- Family counselling to reduce interpersonal conflicts
- Stress management
- Develop the work habit and capacity
- Finical management
How to Prevent a Hangover:-
- Tack A water Bottel:- Sip water or fruit juice to prevent Dehydration and reduce the Quantity of Alcohol.
- Have a light Snakes:- eat some food like snakes, lemon juice, etc.
- tack Bed Rest
Key points of Alcoholism:-
- Physiological and psychological dependence on alcohol is known – Alcohol abuse
- After alcohol use, feel happy and better is known as – Euphoria
- Excessive Drinking of Alcohol is known – Dypsomnia
- Drug of choice of alcohol withdrawal symptom – Benzodiazepines
- Drug use for aversion therapy in alcohol abuse – Disulfiram
- Most common psychological complication of alcohol abuse – Delirium Tremor
- Wernicke Korsakoff syndrome occur due to – Thiamine deficiency and chronic alcohol use.