Alcoholism is, broadly, any drinking of alcohol that results in significant mental or physical health problems. Because there is disagreement on the definition of the word alcoholism, it is not a recognized diagnostic entity. Predominant diagnostic classifications are alcohol use disorder (DSM-5) or alcohol dependence (ICD-11); these are defined in their respective sources.
Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases, criminal or anti-social behaviour occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur. In addition to possible physical, social, and psychological harm, the use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.
Alcohol abuse encompasses a spectrum of unhealthy alcohol drinking behaviors, ranging from binge drinking to alcohol dependence, in extreme cases resulting in health problems for individuals and large scale social problems such as alcohol-related crimes.
The long-term heavy consumption of alcohol can cause severe detrimental effects. Health effects associated with alcohol intake in large amounts include an increased risk of developing an alcohol use disorder, malnutrition, chronic pancreatitis, heart failure, atrial fibrillation, gastritis, stomach ulcers, alcoholic liver disease, certain types of dementia, and several types of cancer. In addition, damage to the central nervous system and peripheral nervous system can occur from chronic heavy alcohol consumption. Besides, an increased risk for accidents exist like car accidents and related injuries. Even light and moderate alcohol consumption increase the risk for developing certain types of cancer. In fact, a 2018 study confirms that no level of alcohol consumption is safe, even a little.
Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol.
The gateway drug effect is a comprehensive catchphrase for the often observed effect that the use of a psychoactive substance is coupled to an increased probability of the use of further substances. Possible causes are biological alterations in the brain due to the earlier substance exposure and similar attitudes of people who use different substances across different substances. In 2020, the National Institute on Drug Abuse released a study backing allegations that marijuana is a "gateway" to more dangerous substance use, though not for the majority of people who use substances.
Brief intervention can often be referred to as screening and brief intervention (SBI) or, in England, identification and brief advice (IBA). Brief interventions are a technique used to initiate change for an unhealthy or risky behaviour such as smoking, lack of exercise or alcohol misuse. This page primarily describes brief interventions as applied to alcohol. As an alcohol intervention it is typically targeted to non-dependent drinkers, or drinkers who might be experiencing problems but are not seeking treatment. It is an approach which aims to prevent the acceleration or impact of alcohol problems, and/or to reduce alcohol consumption. It can be carried out in a range of settings such as in primary care, emergency or other hospital departments, criminal justice settings, workplaces, online, university/college settings, and other settings.
Alcohol has a number of effects on health. Short-term effects of alcohol consumption include intoxication and dehydration. Long-term effects of alcohol include changes in the metabolism of the liver and brain, several types of cancer and alcohol use disorder. Alcohol intoxication affects the brain, causing slurred speech, clumsiness, and delayed reflexes. Alcohol stimulates insulin production, which speeds up glucose metabolism and can result in low blood sugar, causing irritability and possibly death for diabetics. There is an increased risk of developing an alcohol use disorder for teenagers while their brain is still developing. Adolescents who drink have a higher probability of injury including death.
The Paddington alcohol test (PAT) was first published in the Journal of Accident and Emergency Medicine in 1996. It was designed to identify alcohol-related problems amongst those attending accident and emergency departments. It concords well with the Alcohol Use Disorders Identification Test (AUDIT) questionnaire but is administered in a fifth of the time.
The CAGE questionnaire, the name of which is an acronym of its four questions, is a widely used screening test for problem drinking and potential alcohol problems. The questionnaire takes less than one minute to administer, and is often used in primary care or other general settings as a quick screening tool rather than as an in-depth interview for those who have alcoholism. The CAGE questionnaire does not have a specific intended population, and is meant to find those who drink excessively and need treatment. The CAGE questionnaire is reliable and valid; however, it is not valid for diagnosis of other substance use disorders, although somewhat modified versions of the CAGE questionnaire have been frequently implemented for such a purpose.
Polysubstance dependence refers to a type of substance use disorder in which an individual uses at least three different classes of substances indiscriminately and does not have a favorite substance that qualifies for dependence on its own. Although any combination of three substances can be used, studies have shown that alcohol is commonly used with another substance. This is supported by one study on polysubstance use that separated participants who used multiple substances into groups based on their preferred substance. The results of a longitudinal study on substance use led the researchers to observe that excessively using or relying on one substance increased the probability of excessively using or relying on another substance.
The Severity of Alcohol Dependence Questionnaire is a 20 item clinical screening tool designed to measure the presence and level of alcohol dependence.
Ethyl glucuronide (EtG) is a metabolite of ethanol which is formed in the body by glucuronidation following exposure to ethanol, usually from drinking alcoholic beverages. It is used as a biomarker to test for ethanol use and to monitor alcohol abstinence in situations where drinking is prohibited, such as by the military, in alcohol treatment programs, in professional monitoring programs, in schools, liver transplant clinics, or in recovering alcoholic patients. In addition to its use to monitor abstinence and detect drinking, EtG also has potential for monitoring the amount of alcohol use over time because it can be detected in hair and nails, though the effectiveness of this has not yet been proven.
The CRAFFT is a short clinical assessment tool designed to screen for substance-related risks and problems in adolescents. CRAFFT stands for the key words of the 6 items in the second section of the assessment - Car, Relax, Alone, Forget, Friends, Trouble. As of 2020, updated versions of the CRAFFT known as the “CRAFFT 2.1” and "CRAFFT 2.1+N" have been released.
Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; driving while intoxicated; and physiological withdrawal symptoms. Drug classes that are involved in SUD include: alcohol; cannabis; phencyclidine and other hallucinogens, such as arylcyclohexylamines; inhalants; opioids; sedatives, hypnotics, or anxiolytics; stimulants; tobacco; and other or unknown substances.
Cannabis use disorder (CUD), also known as cannabis addiction or marijuana addiction, is defined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and ICD-10 as the continued use of cannabis despite clinically significant impairment.
The Clinical Institute Withdrawal Assessment for Alcohol, commonly abbreviated as CIWA or CIWA-Ar, is a 10-item scale used in the assessment and management of alcohol withdrawal. Each item on the scale is scored independently, and the summation of the scores yields an aggregate value that correlates to the severity of alcohol withdrawal, with ranges of scores designed to prompt specific management decisions such as the administration of benzodiazepines. The maximum score is 67; Mild alcohol withdrawal is defined with a score less than or equal to 10, moderate with scores 11 to 15, and severe with any score equal to or greater than 16.
Goldberg test may refer to any of various psychiatric tests used to assess mental health in general or as screening tools for specific mental disorders e.g. depression or bipolar disorder. Goldberg, after whom some psychiatric tests are named, might be one of two psychiatrists who share the same last name: Ivan Goldberg, an American psychiatrist, and Sir David Goldberg, a British psychiatrist. Psychiatric screening tests generally don't substitute getting help from professionals.
Alcoholism in Ireland is a significant public health problem. In Ireland, 1.35 million Irish people aged between the ages of 18 and 75 are considered to be harmful drinkers. In the same age group, there are over one hundred and fifty thousand Irish people who are classified as 'dependent drinkers'.
Screening, Brief Intervention and Referral to Treatment (SBIRT) is a model that encourages mental health and substance use screenings as a routine preventive service in healthcare.
