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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, and the use of alcoholism terminology is discouraged due to its heavily stigmatized connotations. Predominant diagnostic classifications are alcohol use disorder (DSM-5) or alcohol dependence (ICD-11); these are defined in their respective sources.
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, erectile dysfunction, 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. There is also an increased risk for accidental injuries, for example, those sustained in traffic accidents and falls. Studies show that individuals with heavy substance use have a much higher risk of having other disorders. A cross-sectional observational study found evidence that people who used substances had the highest risk for five of the disorders studied. However, even light and moderate alcohol consumption increase the risk for developing certain types of cancer. Among women, light drinkers have a four percent increase risk of breast cancer, while moderate drinkers have a 23 percent increase in risk of the disease.
Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol.
Naltrexone, sold under the brand names Revia and Vivitrol among others, is a medication primarily used to manage alcohol use or opioid use disorder by reducing cravings and feelings of euphoria associated with substance use disorder. It has also been found effective in the treatment of other addictions and may be used for them off-label. An opioid-dependent person should not receive naltrexone before detoxification. It is taken by mouth or by injection into a muscle. Effects begin within 30 minutes, though a decreased desire for opioids may take a few weeks to occur. Side effects may include trouble sleeping, anxiety, nausea, and headaches. In those still on opioids, opioid withdrawal may occur. Use is not recommended in people with liver failure. It is unclear if use is safe during pregnancy. Naltrexone is an opioid antagonist and works by blocking the effects of opioids, including both opioid drugs as well as opioids naturally produced in the brain.
Neuropharmacology is the study of how drugs affect function in the nervous system, and the neural mechanisms through which they influence behavior. There are two main branches of neuropharmacology: behavioral and molecular. Behavioral neuropharmacology focuses on the study of how drugs affect human behavior (neuropsychopharmacology), including the study of how drug dependence and addiction affect the human brain. Molecular neuropharmacology involves the study of neurons and their neurochemical interactions, with the overall goal of developing drugs that have beneficial effects on neurological function. Both of these fields are closely connected, since both are concerned with the interactions of neurotransmitters, neuropeptides, neurohormones, neuromodulators, enzymes, second messengers, co-transporters, ion channels, and receptor proteins in the central and peripheral nervous systems. Studying these interactions, researchers are developing drugs to treat many different neurological disorders, including pain, neurodegenerative diseases such as Parkinson's disease and Alzheimer's disease, psychological disorders, addiction, and many others.
Apomorphine, sold under the brand name Apokyn among others, is a type of aporphine having activity as a non-selective dopamine agonist which activates both D2-like and, to a much lesser extent, D1-like receptors. It also acts as an antagonist of 5-HT2 and α-adrenergic receptors with high affinity. The compound is historically a morphine decomposition product made by boiling morphine with concentrated acid, hence the -morphine suffix. Contrary to its name, apomorphine does not actually contain morphine or its skeleton, nor does it bind to opioid receptors. The apo- prefix relates to it being a morphine derivative ("[comes] from morphine").
Alcohol tolerance refers to the bodily responses to the functional effects of ethanol in alcoholic beverages. This includes direct tolerance, speed of recovery from insobriety and resistance to the development of alcohol use disorder.
Acamprosate, sold under the brand name Campral, is a medication used along with counseling to treat alcohol use disorder.
The modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function.
George F. Koob is a Professor and former Chair of the Committee on the Neurobiology of Addictive Disorders at the Scripps Research Institute and Adjunct Professor of Psychology, Psychiatry, and Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of California, San Diego. In 2014 he became the director of the National Institute on Alcohol Abuse and Alcoholism.
Gamma-aminobutyric acid receptor subunit alpha-2 is a protein in humans that is encoded by the GABRA2 gene.
Surinabant (SR147778) is a cannabinoid receptor type 1 antagonist developed by Sanofi-Aventis. It is being investigated as a potential treatment for nicotine addiction, to assist smoking cessation. It may also be developed as an anorectic drug to assist with weight loss, however there are already several CB1 antagonists or inverse agonists on the market or under development for this application, so surinabant is at present mainly being developed as an anti-smoking drug, with possible application in the treatment of other addictive disorders such as alcoholism. Other potential applications such as treatment of ADHD have also been proposed.
Alcohol withdrawal syndrome (AWS) is a set of symptoms that can occur following a reduction in alcohol use after a period of excessive use. Symptoms typically include anxiety, shakiness, sweating, vomiting, fast heart rate, and a mild fever. More severe symptoms may include seizures, and delirium tremens (DTs) which can be fatal in untreated patients. Symptoms start at around 6 hours after last drink. Peak incidence of seizures occurs at 24-36 hours and peak incidence of delirium tremens is at 48-72 hours.
The short-term effects of alcohol consumption range from a decrease in anxiety and motor skills and euphoria at lower doses to intoxication (drunkenness), to stupor, unconsciousness, anterograde amnesia, and central nervous system depression at higher doses. Cell membranes are highly permeable to alcohol, so once it is in the bloodstream, it can diffuse into nearly every cell in the body.
Addiction is generally a neuropsychological disorder defining pervasive and intense urge to engage in maladaptive behaviors providing immediate sensory rewards, despite their harmful consequences. Dependence is generally an addiction that can involve withdrawal issues. Addictive disorder is a category of mental disorders defining important intensities of addictions or dependences, which induce functional disabilities. There are no agreed definitions on these terms – see section on 'definitions'.
SoRI-9409 is a mixed mu opioid receptor partial agonist and delta opioid receptor antagonist, used in biomedical research. It produces moderate analgesic effects without development of tolerance and with reduced withdrawal symptoms compared to standard opioid analgesics, as well as showing anti-addictive effects that may be useful in the treatment of alcoholism.
Alcohol, sometimes referred to by the chemical name ethanol, is a depressant drug that is the active ingredient in drinks such as beer, wine, and distilled spirits. It is one of the oldest and most commonly consumed recreational drugs, causing the characteristic effects of alcohol intoxication ("drunkenness"). Among other effects, alcohol produces happiness and euphoria, decreased anxiety, increased sociability, sedation, impairment of cognitive, memory, motor, and sensory function, and generalized depression of central nervous system (CNS) function.
Alcoholism is a chronic disease characterized by trouble controlling the consumption of alcohol, dependence, and withdrawal upon rapid cessation of drinking. According to ARDI reports approximately 88,000 people had alcohol-related deaths in the United States between the years of 2006 and 2010. Furthermore, chronic alcohol use is consistently the third leading cause of death in the United States. In consequence, research has sought to determine the factors responsible for the development and persistence of alcoholism. From this research, several molecular and epigenetic mechanisms have been discovered.
Marisa Roberto is an Italian-American neuroscientist and professor in the Department of Molecular Medicine and Neuroscience at The Scripps Research Institute in La Jolla, California. Roberto is recognized for her contributions to the understanding of alcohol addiction, specifically for her research on the effects of alcohol and neuromodulators on synaptic transmission in the central amygdala, a critical addiction-related brain region.
Jessica Barson is an American neuroscientist and associate professor at Drexel University College of Medicine. Barson investigates neuropeptide signalling in the paraventricular nucleus of the thalamus as well as the nucleus accumbens to understand the neurobiological basis of addiction and elucidate targets for therapy.
References
- ↑ "Addiction Biology - Editorial Board". Wiley. doi:10.1111/(ISSN)1369-1600 . Retrieved 19 January 2014.
{{cite journal}}: Cite journal requires|journal=(help) - ↑ "Professor Hilary J Little". KCL. 17 December 2013. Retrieved 19 January 2014.
- ↑ "MIFCOG". KCL. Retrieved 19 January 2014.
- ↑ "APA PsycNet".
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