Antabuse® (disulfiram)

The patient educational material on this website does not provide all available information about this condition and is not intended as a substitute for seeking professional medical care and advice. If you have any further questions or concerns, please discuss them with your doctor.

Alcohol Dependence

What is Alcohol Dependence?
Alcohol is the one of the biggest drug problem after tobacco, and is worse in regard to social impact. Alcohol related illness and social problems have far reaching consequences on the individual, friends, family and the community.

Alcohol dependence develops after prolonged consumption of excessive amounts of alcohol. Alcohol dependence causes physical dependence (where a person feels like they need to consume alcohol to avoid the withdrawal symptoms) or psychological dependence (where the person’s life revolves around alcohol, and alcohol is used to obtain relief from tension and emotional discomfort).

Alcohol dependence is an addictive cycle, which leads to loss of control (the inability to stop drinking once he/she starts) and relapse (return to heavy drinking after a period of being sobriety).

What causes Alcohol Dependence?
The underlying cause of this condition is unknown. Certain personality groups have shown to be more prone to the development of alcohol dependence. These include depressed, lonely, dependent, hostile and self-destructive impulsive individuals. In some individuals the development of alcohol dependence may be due to a genetic predisposition.

What are the risk factors?
While the cause of alcohol dependence is unknown, a number of risk factors have been identified. They include the following:

• Availability of alcohol
• Family history – a family predisposition
• Sex – Alcohol dependence is more common in males than females.
• Age – Usually develops for males in their 20s-30s, whilst it often develops later in life for females.
• Geographic factor – There is a higher number of reported cases in the suburbs than in the rural areas.
• Occupation
• Income
• Nationality
• Religion

What are the signs and symptoms of Alcohol Dependence?
Heavy drinkers are those patients, for whom drinking has become a central activity in their life. They develop psychological problems and other dilemmas, as listed here below.

• Preoccupation with alcohol – where the person thinks about alcohol from morning till night
• Self-deception – person does not admit to themselves that they have an alcohol problem
• Guilt – feeling guilty about drinking
• Amnesia – loss of memory
• Anxiety and depression
• Neglect of hygiene, appearance
• Poor appetite, nutritional deficits
• Sleep disruption
• Impaired balance
• Recurrent gastritis and oesophagitis, abnormal liver function test results (blood test)
• Difficulty in controlling/treating their existing medical condition(s) e.g. blood pressure or blood sugar levels
• May experience alcohol-withdrawal syndrome

The Alcohol-withdrawal syndrome will vary between each individual patient, depending on the amount of alcohol consumed, length of time etc., and range from mild to life threatening symptoms which can last 3 to 7 days. This syndrome develops usually within 12 to 72 hours after stopping alcohol intake, particularly in severely alcohol dependent patients. Patient may develop withdrawal symptoms such as increased anxiety, restlessness, sweating, high body temperature, tremor, nausea, vomiting, diarrhoea, fits, nightmares and hallucinations.

Are there other diseases associated with Alcohol Dependence?
Often several other disorders are associated with alcohol dependence, such as liver and malnutrition disorders (for more, see Prognosis). The most common is depression.

How is Alcohol Dependence diagnosed?
The initial step in seeking medical advice for alcohol dependence is usually brought to the attention of the physician through family and friends, or the individual themselves.

The diagnosis of alcohol dependence is often made through obtaining a full medical history of the patient. However, questionnaires are also helpful tools, in determining a person’s drinking habits and patterns. For example, the amount of alcohol consumed on an occasion, how often they drink i.e. frequency, and their background such as jobs and relationship.

There is really no clear-cut guideline on how much alcohol needs to be consumed before a person is diagnosed to be an alcohol dependent person. Everybody has different alcohol tolerance.

Physical examination may be also useful, it can reveal signs of a poor nutritional status; whilst laboratory blood tests may show changes in the blood cells and liver enzymes.

What is the prognosis?
Alcohol dependence has serious consequences if not treated. If affects the individual’s health and personal life, as well as the society at large. Alcohol dependence causes a wide range of health problems such as memory disorders, poor nutrition, liver diseases, high blood pressure and blood content changes, as well as disruption to the function of the heart and reproductive system. It could be said that the effects of long-term use of alcohol causes damage to most, if not all of the major organs and cells of the body (e.g. liver, stomach, brain and nerves).

Alcohol influences and causes a variety of severe social problems: homelessness, violent crime, suicide, injury and most commonly, motor vehicle accidents or deaths.

On a personal level, alcohol can be responsible for marital and relationship difficulties and break-ups, depression, unemployment, child abuse, and general family dysfunction.

What treatment/management options are there?
Treatment of alcohol dependence is based on a long-term goal in mind, and involves 1) detoxification and 2) rehabilitation. Detoxification involves the elimination and reduction of the amount of alcohol in the person’s body, and frees the person from their alcohol habit. Whilst rehabilitation involves providing help to the person to assist them to stop drinking, or, to restore his/her drinking levels back to normal (i.e. within the safe alcohol consumption range).

In many cases, alcoholism detoxification and rehabilitation treatment may involve some of the following:

1. Psychotherapy
2. Support groups e.g. group discussion and social programs
3. Behaviour therapy
4. Cognitive therapy (aimed to change a person’s drinking behaviour via helping them to practice the power of positive thinking)
5. Pharmacotherapy (treatment with medicines)

The involvement of the patient’s physician, family members (i.e. family support) and peer support play a critical role in the success of the long-term positive treatment outcome.

For further information about your health, your condition or your medication, please consult your doctor.

Where can I find more information about this condition or support organisations?
Additional information is available from the following website(s):

www.adca.org.au
www.adf.org.au

The information is intended for use only by customers, patients and health care professionals within Australia. Countries outside Australia may have regulatory and legal requirements, and available medical treatments, which are different than those in Australia.