DOCSLIB.ORG

Two-Year Prognosis After Residential Treatment for Patients with Alcohol Dependence: Three Chief Guidelines for Sobriety in Japan

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Two-Year Prognosis After Residential Treatment for Patients with Alcohol Dependence: Three Chief Guidelines for Sobriety in Japan Journal name: Neuropsychiatric Disease and Treatment Article Designation: Original Research Year: 2016 Volume: 12 Neuropsychiatric Disease and Treatment Dovepress Running head verso: Cho et al Running head recto: Two-year prognosis of alcohol dependence in Japan open access to scientific and medical research DOI: http://dx.doi.org/10.2147/NDT.S111230 Open Access Full Text Article ORIGINAL RESEARCH Two-year prognosis after residential treatment for patients with alcohol dependence: three chief guidelines for sobriety in Japan Tetsuji Cho1,2 Background: In Japan, the three chief traditional guidelines for sobriety (3CGS) are regular Hideki Negoro3 medical checkups, participation in self-help groups, and pharmacotherapy with antidipsotropics. Yasuhiro Saka1 However, the official record of the origins of 3CGS is not clear. The aim of this current study Masayuki Morikawa1,2 was to assess 3CGS by an examination of the prognosis of patients with alcohol dependence Toshifumi Kishimoto2 2 years after their discharge from a residential treatment program. Subjects and methods: The association between subjects’ abstinence from alcohol and 1Mie Prefectural Mental Care Center, Tsu-Shi, Mie, 2Department of their regular medical checkups, participation in self-help groups, and treatment with antidipso- Psychiatry, Nara Medical University tropics were prospectively examined. Two years after discharge, the relationship between the School of Medicine, Kashihara, Nara, 3CGS compliance and abstinence rates was investigated as the primary outcome. In addition, 3Faculty of Education, Nara University For personal use only. of Education, Nara, Japan the following were examined as secondary outcomes: the time taken till the first drink after discharge, whether the participants were readmitted to residential treatment, the number of days to readmission, the number of heavy drinking days, and recovery. Results: A total of 98 patients participated. The perfect and partial abstinence rates for patients who followed all the principles of 3CGS were significantly higher than those for patients who followed no guidelines (P0.05 and P0.01, respectively). The perfect abstinence rates for patients who had continued attending checkup sessions (P0.001) and who were taking antidipsotropics (P0.05) were significantly higher than those for patients who did not follow these components of 3CGS. However, the perfect abstinence rates were not higher for patients who had continued to participate in self-help groups. In addition, the perfect abstinence rate was statistically associated with regular medical checkups (adjusted odds ratio =5.33, 95% confidence interval= 1.35–21.0) and participation in self-help groups (adjusted odds ratio =3.79, 95% confidence interval= 1.17–12.3). Neuropsychiatric Disease and Treatment downloaded from https://www.dovepress.com/ by 61.89.110.89 on 30-Nov-2016 Conclusion: This study, reports the effectiveness of 3CGS for the first time. The recovery rate of alcoholics 2 years after discharge from residential treatment was examined. However, due to the chronic nature of alcoholism, further studies are required to investigate the efficacy of 3CGS beyond 2 years. Keywords: alcohol dependence, three chief guidelines for sobriety (3CGS), disulfiram, self-help group, recovery Introduction Correspondence: Tetsuji Cho Alcohol dependence, which is characterized by “loss of control”, is a chronic relapsing Mie Prefectural Mental Care Center, disorder similar to diabetes or hypertension.1 It has a considerable component of genetic 1-12-1, Shiroyama, Tsu-Shi, Mie 514-0818, Japan susceptibility and is also influenced by environmental factors.2 Therefore, long-term Tel +81 59 235 2125 maintenance therapy is very important. We should recognize redrinking by alcoholics Fax +81 59 235 2135 Email [email protected] as a symptom such as relapse in cancer or re-injury of a joint sprain. In addition, submit your manuscript | www.dovepress.com Neuropsychiatric Disease and Treatment 2016:12 1983–1991 1983 Dovepress © 2016 Cho et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you http://dx.doi.org/10.2147/NDT.S111230 hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Powered by TCPDF (www.tcpdf.org) 1 / 1 Cho et al Dovepress we have to take into account not only the abstinence from controlled trials in Japan. In a questionnaire study12 in Japan, alcohol but also the recovery of quality of life. The prognosis 86% of specialists responded that antidipsotropics should be of alcoholism is more influenced by social–psychological taken for 1 year. However, research on the ideal duration factors of the patient than by therapeutic interventions.3 The of antidipsotropic usage is lacking. According to Japanese first study4 about the prognosis of alcoholism in Japan found guidelines for the treatment of alcoholism and related that a good prognosis was related more strongly to social disorders,13 “psychotherapy is more important than the effects factors than physical factors. In particular, the continuation of of antidipsotropics, and there are many differences in the effi- therapy was strongly related to a good prognosis. However, cacy of antidipsotropics between facilities and researchers”. there are only a few studies in Japan on the factors associated However, no mention is made of a recommended period of with a good prognosis. antidipsotropic usage. In addition, naltrexone, nalmefene, The three chief traditional guidelines for sobriety (3CGS) and acamprosate were not registered in Japan during the in Japan are regular medical checkups, participation in self- research period. Many reports support the effectiveness of help groups, and therapy with antidipsotropics.5 3CGS have disulfiram14–20 and cyanamide,21 but compliance to the admin- been extensively used in the treatment of alcohol dependence istration regimen is also important.22 Diehl et al16 reported that in Japan. disulfiram is more effective than acamprosate, particularly However, the official record of the origins of 3CGS is in patients with a long duration of alcohol dependence, and not clear. Prospective evidence to support these guidelines Berglund14 reported evidence from a meta-analysis of a pos- has been obtained abroad, but they have not been extensively sible additive effect for naltrexone as well as for aversive studied in Japan. treatment (disulfiram) in alcohol dependence. With regard to the first guideline, alcoholics tend to The aim of the current study was to assess 3CGS by discontinue attending medical checkups. Baekeland and an examination of the prognosis of patients with alcohol Lundwall6 reported that 57%–75% of outpatients dropped out dependence 2 years after their discharge from a residential before the fourth consultation. In addition, Scivoletto et al7 treatment program. For personal use only. reported that a half or more number of patients stopped attending consultations within several months, and only 16% Subjects and methods continued attending checkup sessions for 1 year after the first Participants consultation. On the other hand, continuing to attend medical Subjects recruited for this prospective study were patients checkups is strongly related to a good prognosis.8 with alcohol dependence, who were diagnosed according to Similarly, in Japan, more than half of the patients with the criteria of the International Statistical Classification of alcoholism stopped attending medical checkups within Diseases, tenth revision,23 and the Diagnostic and Statistical 6 months, and only 21.1% of patients were seen 1 year after Manual of Mental Disorders, fourth edition,24 and who were their first consultation.9 Japanese patients with alcoholism hospitalized in the Mental Care Center, Prefecture of Mie, who continued therapy had a significantly higher rate of Japan. Subjects were admitted between November 2007 and abstinence after 1 year, indicating that continued attendance August 2008. Participants were recruited within 2 weeks 4 Neuropsychiatric Disease and Treatment downloaded from https://www.dovepress.com/ by 61.89.110.89 on 30-Nov-2016 of checkup sessions is strongly related to abstinence. of admission after a period of withdrawal symptoms. The Many studies support the usefulness of the second guide- exclusion criteria for this study were any of the following line, participation in self-help groups. For example, the rate of at the time of recruitment: severe episode of a depressive or abstinence of those who participate in alcoholics anonymous manic mood, diagnosis of dementia, psychomotor excite- (AA) is approximately twice that of those who do not partici- ment, compulsory admission, pregnancy, or severe liver, pate in any self-help group.10 In Japan, research has supported kidney, or cardiac dysfunction. Of the 117 patients who we the usefulness of Dansyukai (a traditional Japanese self-help attempted to recruit for this study, 15 fell under the exclusion group). Suzuki3 reported that membership in Dansyukai criteria, two refused our request, and two dropped out
Load more

Recommended publications
  • The 12-Month Prevalence and Trends in DSM–IV Alcohol Abuse and Dependence
    The 12-Month Prevalence and Trends in DSM–IV Alcohol Abuse and Dependence United States, 1991–1992 and 2001–2002 Bridget F. Grant, Ph.D., Ph.D.,a Deborah A. Dawson, Ph.D.,a Frederick S. Stinson, Ph.D.,a S. Patricia Chou, Ph.D.,a Mary C. Dufour, M.D., M.P.H.,b Roger P. Pickering, M.S.a Background: Alcohol abuse and dependence can be disabling disorders, but accurate information is lacking on the prevalence of current Diagnostic and Statistical Manual, Fourth Edition (DSM–IV) alcohol abuse and dependence and how this has changed over the past decade. The purpose of this study was to present nationally representative data on the prevalence of 12-month DSM–IV alcohol abuse and dependence in 2001–2002 and, for the first time, to examine trends in alcohol abuse and dependence between 1991–1992 and 2001–2002. Methods: Prevalences and trends of alcohol abuse and dependence in the United States were derived from face-to-face interviews in the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC: n = 43,093) and NIAAA’s 1991–1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES: n = 42,862). Results: Prevalences of DSM–IV alcohol abuse and dependence in 2001–2002 were 4.65 and 3.81 percent. Abuse and dependence were more common among males and among younger respondents. The prevalence of abuse was greater among Whites than among Blacks, Asians, and Hispanics. The prevalence of dependence was higher in Whites, Native Americans, and Hispanics than Asians.
    [Show full text]
  • Naltrexone and Disulfiram in Patients with Alcohol Dependence and Comorbid Post-Traumatic Stress Disorder Ismene L
    Naltrexone and Disulfiram in Patients with Alcohol Dependence and Comorbid Post-Traumatic Stress Disorder Ismene L. Petrakis, James Poling, Carolyn Levinson, Charla Nich, Kathleen Carroll, Elizabeth Ralevski, and Bruce Rounsaville Background: Although disulfiram and naltrexone have been approved by the Food and Drug Administrationfor the treatment of alcoholism, the effect of these medications on alcohol use outcomes and on psychiatric symptoms is still unknown in patients with co-occurring disorderspost-traumatic stress disorder(PTSD). Methods: Patients (n = 254) with a major Axis I psychiatric disorderand comorbid alcohol dependence were treatedfor 12 weeks in a medication study at three Veterans Administration outpatient clinics. Randomization included (1) open randomization to disulfiram or no disulfiram; and (2) double-blind randomization to naltrexone or placebo. This resulted in four groups: (1) naltrexone alone; (2) placebo alone; (3) disulfiram and naltrexone; or (4) disulfiram and placebo. Outcomes were measures of alcohol use, PTSD symptoms, alcohol craving, GGT levels and adverse events. Results: 93 individuals (36.6%) met DSM-IV criteriafor PTSD. Subjects with PTSD had better alcohol outcomes with active medication (naltrexone, disulfiram or the combination) than they did on placebo; overallpsychiatric symptoms of PTSD improved. Individuals with PTSD were more likely to report some side effects when treated with the combination. Conclusions: The results of this study suggest that disulfiram and naltrexone are effective and safe for individuals with PTSD and comorbid alcohol dependence. Key Words: Alcohol, disulfiram, dual diagnosis, naltrexone, Post PTSD symptoms in non-alcohol dependent individuals because of its mechanism of action on the opioid receptor. Two early Traumatic Stress Disorder (PTSD) reports showed improvements in PTSD symptoms with naltrex one (Bills and Kreisler 1993) and the opioid antagonist nalmefene Naltrexone and disulfiram are two of only three medica (Glover 1993) in patients diagnosed with PTSD.
    [Show full text]
  • Alcohol-Medication Interactions: the Acetaldehyde Syndrome
    arm Ph ac f ov l o i a g n il r a n u c o e J Journal of Pharmacovigilance Borja-Oliveira, J Pharmacovigilance 2014, 2:5 ISSN: 2329-6887 DOI: 10.4172/2329-6887.1000145 Review Article Open Access Alcohol-Medication Interactions: The Acetaldehyde Syndrome Caroline R Borja-Oliveira* University of São Paulo, School of Arts, Sciences and Humanities, São Paulo 03828-000, Brazil *Corresponding author: Caroline R Borja-Oliveira, University of São Paulo, School of Arts, Sciences and Humanities, Av. Arlindo Bettio, 1000, Ermelino Matarazzo, São Paulo 03828-000, Brazil, Tel: +55-11-30911027; E-mail: [email protected] Received date: August 21, 2014, Accepted date: September 11, 2014, Published date: September 20, 2014 Copyright: © 2014 Borja-Oliveira CR. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Medications that inhibit aldehyde dehydrogenase when coadministered with alcohol produce accumulation of acetaldehyde. Acetaldehyde toxic effects are characterized by facial flushing, nausea, vomiting, tachycardia and hypotension, symptoms known as acetaldehyde syndrome, disulfiram-like reactions or antabuse effects. Severe and even fatal outcomes are reported. Besides the aversive drugs used in alcohol dependence disulfiram and cyanamide (carbimide), several other pharmaceutical agents are known to produce alcohol intolerance, such as certain anti-infectives, as cephalosporins, nitroimidazoles and furazolidone, dermatological preparations, as tacrolimus and pimecrolimus, as well as chlorpropamide and nilutamide. The reactions are also observed in some individuals after the simultaneous use of products containing alcohol and disulfiram-like reactions inducers.
    [Show full text]
  • AN OPEN RANDOMIZED STUDY COMPARING DISULFIRAM and ACAMPROSATE in the TREATMENT of ALCOHOL DEPENDENCE AVINASH DE SOUSA* and ALAN DE SOUSA
    Alcohol & Alcoholism Vol. 40, No. 6, pp. 545–548, 2005 doi:10.1093/alcalc/agh187 Advance Access publication 25 July 2005 AN OPEN RANDOMIZED STUDY COMPARING DISULFIRAM AND ACAMPROSATE IN THE TREATMENT OF ALCOHOL DEPENDENCE AVINASH DE SOUSA* and ALAN DE SOUSA Get Well Clinic And Nursing Home, 33rd Road, Off Linking Road, Bandra, Mumbai 400050, Maharashtra State, India (Received 11 March 2005; first review notified 6 June 2005; in final revised form 21 June 2005; accepted 2 July 2005; advance access publication 25 July 2005) Abstract — Aims: To compare the efficacy of acamprosate (ACP) and disulfiram (DSF) for preventing alcoholic relapse in routine clinical practice. Methods: One hundred alcoholic men with family members who would encourage medication compliance and accom- pany them for follow-up were randomly allocated to 8 months of treatment with DSF or ACP. Weekly group psychotherapy was also available. The psychiatrist, patient, and family member were aware of the treatment prescribed. Alcohol consumption, craving, and adverse events were recorded weekly for 3 months and then fortnightly. Serum gamma glutamyl transferase was measured at the start Downloaded from https://academic.oup.com/alcalc/article/40/6/545/125907 by guest on 27 September 2021 and the end of the study. Results: At the end of the trial, 93 patients were still in contact. Relapse (the consumption of >5 drinks/40 g of alcohol) occurred at a mean of 123 days with DSF compared to 71 days with ACP (P = 0.0001). Eighty-eight per cent of patients on DSF remained abstinent compared to 46% with ACP (P = 0.0002).
    [Show full text]
  • Alcohol Use Disorder
    Section: A B C D E Resources References Alcohol Use Disorder (AUD) Tool This tool is designed to support primary care providers (family physicians and primary care nurse practitioners) in screening, diagnosing and implementing pharmacotherapy treatments for adult patients (>18 years) with Alcohol Use Disorder (AUD). Primary care providers should routinely offer medication for moderate and severe AUD. Pharmacotherapy alone to treat AUD is better than no therapy at all.1 Pharmacotherapy is most effective when combined with non-pharmacotherapy, including behavioural therapy, community reinforcement, motivational enhancement, counselling and/or support groups. 2,3 TABLE OF CONTENTS pg. 1 Section A: Screening for AUD pg. 7 Section D: Non-Pharmacotherapy Options pg. 4 Section B: Diagnosing AUD pg. 8 Section E: Alcohol Withdrawal pg. 5 Section C: Pharmacotherapy Options pg. 9 Resources SECTION A: Screening for AUD All patients should be screened routinely (e.g. annually or when indicators are observed) with a recommended tool like the AUDIT. 2,3 It is important to screen all patients and not just patients eliciting an index of suspicion for AUD, since most persons with AUD are not recognized. 4 Consider screening for AUD when any of the following indicators are observed: • After a recent motor vehicle accident • High blood pressure • Liver disease • Frequent work avoidance (off work slips) • Cardiac arrhythmia • Chronic pain • Rosacea • Insomnia • Social problems • Rhinophyma • Exacerbation of sleep apnea • Legal problems Special Patient Populations A few studies have reviewed AUD in specific patient populations, including youth, older adults and pregnant or breastfeeding patients. The AUDIT screening tool considered these populations in determining the sensitivity of the tool.
    [Show full text]
  • Alcohol Dependence, Withdrawal, and Relapse
    Alcohol Dependence, Withdrawal, and Relapse Howard C. Becker, Ph.D. Continued excessive alcohol consumption can lead to the development of dependence that is associated with a withdrawal syndrome when alcohol consumption is ceased or substantially reduced. This syndrome comprises physical signs as well as psychological symptoms that contribute to distress and psychological discomfort. For some people the fear of withdrawal symptoms may help perpetuate alcohol abuse; moreover, the presence of withdrawal symptoms may contribute to relapse after periods of abstinence. Withdrawal and relapse have been studied in both humans and animal models of alcoholism. Clinical studies demonstrated that alcohol­dependent people are more sensitive to relapse­ provoking cues and stimuli than nondependent people, and similar observations have been made in animal models of alcohol dependence, withdrawal, and relapse. One factor contributing to relapse is withdrawal­related anxiety, which likely reflects adaptive changes in the brain in response to continued alcohol exposure. These changes affect, for example, the body’s stress response system. The relationship between withdrawal, stress, and relapse also has implications for the treatment of alcoholic patients. Interestingly, animals with a history of alcohol dependence are more sensitive to certain medications that impact relapse­like behavior than animals without such a history, suggesting that it may be possible to develop medications that specifically target excessive, uncontrollable alcohol consumption. KEY WORDS: Alcoholism; alcohol dependence; alcohol and other drug (AOD) effects and consequences; neuroadaptation; AOD withdrawal syndrome; AOD dependence relapse; pharmacotherapy; human studies; animal studies he development of alcohol expectations about the consequences of drinking (Koob and Le Moal 2008). dependence is a complex and alcohol use.
    [Show full text]
  • Redalyc.Neurobiological Alterations in Alcohol Addiction: a Review
    Adicciones ISSN: 0214-4840 [email protected] Sociedad Científica Española de Estudios sobre el Alcohol, el Alcoholismo y las otras Toxicomanías España Erdozain, Amaia M.; Callado, Luis F. Neurobiological alterations in alcohol addiction: a review Adicciones, vol. 26, núm. 4, octubre-diciembre, 2014, pp. 360-370 Sociedad Científica Española de Estudios sobre el Alcohol, el Alcoholismo y las otras Toxicomanías Palma de Mallorca, España Available in: http://www.redalyc.org/articulo.oa?id=289132934009 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative revisión adicciones vol. 26, nº 3 · 2014 Neurobiological alterations in alcohol addiction: a review Alteraciones neurobiológicas en el alcoholismo: revisión Amaia M. Erdozain*,*** and Luis F. Callado*,** *Department of Pharmacology, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain. **Biocruces Health Research Institute, Bizkaia, Spain. ***Neuroscience Paris Seine, Université Pierre et Marie Curie, Paris, France Resumen Abstract Todavía se desconoce el mecanismo exacto mediante el cual el etanol The exact mechanism by which ethanol exerts its effects on the brain produce sus efectos en el cerebro. Sin embargo, hoy en día se sabe is still unknown. However, nowadays it is well known that ethanol que el etanol interactúa con proteínas específicas de la membrana interacts with specific neuronal membrane proteins involved in neuronal, implicadas en la transmisión de señales, produciendo así signal transmission, resulting in changes in neural activity.
    [Show full text]
  • Global Status Report on Alcohol and Health WHO Library Cataloguing-In-Publication Data
    Global status report on alcohol and health WHO Library Cataloguing-in-Publication Data Global status report on alcohol and health. 1.Alcoholism - epidemiology. 2.Alcohol drinking - adverse effects. 3.Social control, Formal - methods. 4.Cost of illness. 5.Public policy. I.World Health Organization. ISBN 978 92 4 156415 1 (NLM classification: WM 274) © World Health Organization 2011 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication.
    [Show full text]
  • The Impact of Alcohol on Health
    The impact of alcohol on health Peter Anderson Introduction Apart from being a drug of dependence, alcohol has been known for many years as a cause of some 60 different types of disease and condition, including injuries, mental and behavioural disorders, gastrointestinal conditions, cancers, cardiovascular diseases, immunological disorders, lung diseases, skeletal and muscular diseases, reproductive disorders and pre-natal harm, including an increased risk of prematurity and low birth weight (Anderson & Baumberg, 2006). In recent years, overwhelming evidence has confirmed that both the volume of lifetime alcohol use and the combination of frequency of drinking and amount drunk per incident increase the risk of alcohol-related harm, largely in a dose-dependent manner (WHO Regional Office for Europe, 2009; Rehm et al., 2010) with the higher the alcohol consumption, the greater the risk. For some conditions, such as cardiomyopathy, acute respiratory distress syndrome and muscle damage, harm appears only to result from a sustained level of high alcohol consumption, but even at high levels, alcohol increases the risk and severity of these conditions in a dose- dependent manner. The frequency and volume of episodic heavy drinking are of particular importance for increasing the risk of injuries and certain cardiovascular diseases (coronary heart disease and stroke). Although there is a protective effect of light to moderate drinking on ischaemic diseases, overwhelmingly alcohol is toxic to the cardiovascular system. Alcohol is an intoxicant affecting a wide range of structures and processes in the central nervous system which, interacting with personality characteristics, associated behaviour and sociocultural expectations, are causal factors for intentional and unintentional injuries and harm to both the drinker and others.
    [Show full text]
  • The Alcohol Withdrawal Syndrome
    Downloaded from jnnp.bmj.com on 4 September 2008 The alcohol withdrawal syndrome A McKeon, M A Frye and Norman Delanty J. Neurol. Neurosurg. Psychiatry 2008;79;854-862; originally published online 6 Nov 2007; doi:10.1136/jnnp.2007.128322 Updated information and services can be found at: http://jnnp.bmj.com/cgi/content/full/79/8/854 These include: References This article cites 115 articles, 38 of which can be accessed free at: http://jnnp.bmj.com/cgi/content/full/79/8/854#BIBL Rapid responses You can respond to this article at: http://jnnp.bmj.com/cgi/eletter-submit/79/8/854 Email alerting Receive free email alerts when new articles cite this article - sign up in the box at service the top right corner of the article Notes To order reprints of this article go to: http://journals.bmj.com/cgi/reprintform To subscribe to Journal of Neurology, Neurosurgery, and Psychiatry go to: http://journals.bmj.com/subscriptions/ Downloaded from jnnp.bmj.com on 4 September 2008 Review The alcohol withdrawal syndrome A McKeon,1 M A Frye,2 Norman Delanty1 1 Department of Neurology and ABSTRACT every 26 hospital bed days being attributable to Clinical Neurosciences, The alcohol withdrawal syndrome (AWS) is a common some degree of alcohol misuse.5 Despite this Beaumont Hospital, Dublin, and management problem in hospital practice for neurologists, Royal College of Surgeons in substantial problem, a survey of NHS general Ireland, Dublin, Ireland; psychiatrists and general physicians alike. Although some hospitals conducted in 2000 and 2003 indicated 2 Department of Psychiatry, patients have mild symptoms and may even be managed that only 12.8% had a dedicated alcohol worker.6 In Mayo Clinic, Rochester, MN, in the outpatient setting, others have more severe addition, few guidelines exist promoting the USA symptoms or a history of adverse outcomes that requires initiation of clear and uniform AWS treatment 7–9 Correspondence to: close inpatient supervision and benzodiazepine therapy.
    [Show full text]
  • ALCOHOLISM Getting the Facts
    ALCOHOLISM Getting the Facts For many people, the facts about alcoholism are not clear. What is alcoholism, exactly? How does it differ from alcohol abuse? When should a person seek help for a problem related to his or her drinking? The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has prepared this booklet to help individuals and families answer these and other common questions about alcohol problems. The following information explains both alcoholism and alcohol abuse, the symptoms of each, when and where to seek help, treatment choices, and additional helpful resources. A Widespread Problem For most people who drink, alcohol is a pleasant accompaniment to social activities. Moderate alcohol use—up to two drinks per day for men and one drink per day for women and older people—is not harmful for most adults. (A standard drink is one 12-ounce bottle or can of either beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.) Nonetheless, a large number of people get into serious trouble because of their drinking. Currently, nearly 14 million Americans—1 in every 13 adults—abuse alcohol or are alcoholic. Several million more adults engage in risky drinking that could lead to alcohol problems. These patterns include binge drinking and heavy drinking on a regular basis. In addition, 53 percent of men and women in the United States report that one or more of their close relatives have a drinking problem. The consequences of alcohol misuse are serious—in many cases, life threatening. Heavy drinking can increase the risk for certain cancers, especially those of the liver, esophagus, throat, and larynx (voice box).
    [Show full text]
  • COVID-19 and Alcoholism: a Dangerous Synergy?
    Journal of Contemporary Studies in Epidemiology and Public Health 2020, 1(1), ep20002 ISSN 2634-8543 (Online) https://www.jconseph.com/ Review Article OPEN ACCESS COVID-19 and Alcoholism: A Dangerous Synergy? Ademola Samuel Ojo 1* , Ayotemide Akin-Onitolo 2 , Paul Okediji 3 , Simon Balogun 4 1 St George’s University School of Medicine, GRENADA 2 Solina Center for International Development and Research, Abuja, NIGERIA 3 Synberg Research & Analytics, Abuja, NIGERIA 4 Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, NIGERIA *Corresponding Author: [email protected] Citation: Ojo AS, Akin-Onitolo A, Okediji P, Balogun S. COVID-19 and Alcoholism: A Dangerous Synergy?. Journal of Contemporary Studies in Epidemiology and Public Health. 2020;1(1):ep20002. https://doi.org/10.30935/jconseph/8441 ABSTRACT The 2019 novel coronavirus disease (COVID-19) has triggered the world’s worst public health challenge in the last 100 years. In response, many countries have implemented disease control measures such as enforced quarantine and travel restrictions. These measures have inadvertent adverse effects on the mental health and psyche of populations. Long-term social isolation is associated with alcohol use and misuse, creating a potential public health crisis. Alcohol and its intermediate products of metabolism have a multisystemic effect with an impact on the liver, heart, lungs as well as other organs in the body. Similarly, COVID-19 mediate a damaging effect on organ systems through cytopathic effects and cytokine storm. Alcoholism potentially increases the risk of cardiac injury, acute respiratory distress syndrome, pulmonary fibrosis, and liver damage in synergy with COVID-19; thereby worsening disease prognosis and outcome.
    [Show full text]