Alcohol is the most commonly abused substance around the world. Alcoholism involves pattern of alcohol use that involves problems controlling drinking, being preoccupied with alcohol, continuing to use alcohol even it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when rapidly stopping drinking. Alcohol abuse plays role in many social and domestic problems.

Symptoms

• Cannot quit or control drinking
• Need to drink more for same effect
• Withdrawal symptoms when one stop drinking
• Spending lot of time drinking
• Drinking in the morning
• Feeling guilty for driking
• Physical symptoms of drinking eg. Gastritis , gynecomastia etc 

Symptoms of alcohol withdrawal:

• Nausea
• Vomiting
• Excessive sweating
• Agitation
• Headache
• Tremor
• Seizure

Diagnosis

Screening: CAGE questionnaire

• Felt need to Cut down?
• People Annoyed you by criticizing your drinking?
• Felt bad or Guilty about your drinking?
• Need as an Eye opener
• Investigation:
• GGT (γ-glutyl-transferase)
• MCV (mean corpuscular volume)
• Alkaline phosphatase
• AST, ALT, uric acid, blood triglyceride

Blood Alcohol Concentration 

Complications

• Social and Psychological problems

• End stage liver damage
• Peripheral neuropathy

• Wernicke encephalopathy: ataxia, eye paralysis,confusion
• Korsakoff syndrome: amnesia
• Hepatic encephalopathy
• Chronic gastritis, peptic ulcer
• Malabsorption syndrome, Malnutrition
• Pancreatitis
• Damage to fetus in pregnant woman
•  Impotence in man

Treatment

• Detoxification:

This is the treatment of alcohol withdrawal symptoms. The best way to stop alcohol is to stop suddenly unless there is high risk. Drugs are given to assist withdrawal symptoms. Benzodiazepam (diazepam, chlordiazepoxide), vitamins are used. Hospitalization may be necessary.

• Treatment of alcohol dependence: After detoxification, one of the several methods is chosen.

• Behavior therapy
• Psychotherapy
• Group therapy: Alcoholic Anonymous group is particularly important.
• Detergent Drugs: eg. Disulfiram