Zaid Hjab college of health and medical technology - baghdad/Physiotherapy and Rehabilitation Department Alcohol is the most commonly abused substance in most parts of the world and is associated with significant morbidity and mortality. While common in the general population, alcohol use disorders are even more frequent in hospital patients, including 25%–50% of medical-surgical patients and up to 50%–60% of psychiatric inpatients in some settings. People who misuse alcohol are commonly referred to as “alcoholic” by the lay public. There are two to three men for each woman with an alcohol use disorder, and the usual age at onset is between ages 16 and 30. Onset is earlier in men than women, although the medical complications progress more rapidly in women. People in certain occupations are prone to alcohol use disorder, including bartenders, construction workers, and writers. Other groups prone to alcoholism include individuals who use tobacco; those with mood and anxiety disorders; those with antisocial personality disorder; and those with a gambling disorder.

1. Alcohol addiction
Report about
College of
Health and medical technology
Baghdad
Department of
Physiotherapy & Rehabilitation
Done by
Zaid Hjab Tawfeeq
4th
stage student
Supervised by
Dr. Mohamed Al-Quraishi
Ph.D. Assistant prof. Abdullah Eiada Mecheser

2. 1
Introduction:
Alcohol is the most commonly abused substance in most parts of the world
and is associated with significant morbidity and mortality. While common in the
general population, alcohol use disorders are even more frequent in hospital
patients, including 25%–50% of medical-surgical patients and up to 50%–60% of
psychiatric inpatients in some settings. People who misuse alcohol are commonly
referred to as “alcoholic” by the lay public.
There are two to three men for each woman with an alcohol use disorder,
and the usual age at onset is between ages 16 and 30. Onset is earlier in men than
women, although the medical complications progress more rapidly in women.
People in certain occupations are prone to alcohol use disorder, including
bartenders, construction workers, and writers. Other groups prone to alcoholism
include individuals who use tobacco; those with mood and anxiety disorders; those
with antisocial personality disorder; and those with a gambling disorder.

3. 2
Diagnosis and Assessment:
Alcohol use disorder is a problematic pattern of alcohol use leading to
clinically significant impairment or distress. Two or more of 11 problematic
behaviors must occur within a 12-month period for the diagnosis to be made.
Depending on the number of symptoms present, the disorder is specified as mild,
moderate, or severe. Separate categories are used for alcohol intoxication and
alcohol withdrawal. The clinician should record all diagnoses that are present (e.g.,
alcohol intoxication, moderate alcohol use disorder).
Symptoms of alcohol addiction are:
 increased quantity or frequency of use
 high tolerance for alcohol, or lack of “hangover” symptoms
 drinking at inappropriate times, such as first thing in the morning, or in places
like church or work
 wanting to be where alcohol is present and avoiding situations where there
is none
 changes in friendships; someone with an alcohol addiction may choose
friends who also drink heavily
 avoiding contact with loved ones
 hiding alcohol, or hiding while drinking
 dependence on alcohol to function in everyday life
 increased lethargy, depression, or other emotional issues
 legal or professional problems such as an arrest or loss of a job

4. 3
Complications are associated with alcohol addiction:
Alcohol addiction can result in heart disease and liver disease. Both can be fatal.
Alcoholism can also cause:
 ulcers
 diabetes complications
 sexual problems
 birth defects
 bone loss
 vision problems
 increased risk of cancer
 suppressed immune function

5. 4
Options for Treatment:
Alcohol-related disorders often require medical intervention. Intoxication is
the most common disorder and rarely requires more than simple supportive
measures, such as decreasing external stimuli and removing the source of alcohol.
When respiration is compromised by excessive alcohol intake, intensive care may
be required.
When asked how alcohol problems are treated, people commonly think of 12-
step programs or 28-day inpatient rehab, but may have difficulty naming other
options. In fact, there are a variety of treatment methods currently available,
thanks to significant advances in the field over the past 60 years.
Types of Treatment:
Behavioral Treatments Behavioral treatments are aimed at changing drinking
behavior through counseling. They are led by health professionals and supported
by studies showing they can be beneficial.
• Developing the skills needed to stop or reduce drinking
• Helping to build a strong social support system
• Working to set reachable goals
• Coping with or avoiding the triggers that might cause relapse
Medications:
Three medications are currently approved in the United States to help people
stop or reduce their drinking and prevent relapse. They are prescribed by a
primary care physician or other health professional and may be used alone or in
combination with counseling.
Mutual-Support Groups:
Alcoholics Anonymous (AA) and other 12-step programs provide peer support for
people quitting or cutting back on their drinking. Combined with treatment led by
health professionals, mutual-support groups can offer a valuable added layer of
support.

6. 5
Rehabilitation:
Rehabilitation follows the alcohol detoxification process. There are two goals: 1)
that the patient remain sober, and 2) that coexisting disorders be identified and
treated. Perhaps two-thirds of these patients have additional mental disorders
(including mood or anxiety disorders) and will benefit from their treatment.
Because an alcohol use disorder itself can cause depression and most alcohol-
induced depressions lift with sobriety, antidepressants are probably needed only
for patients who remain depressed after 2–4 weeks of sobriety.
As a first step, the patient should be told that his or her disorder is significant
and potentially life-threatening. Receiving a diagnosis may be the single most
important step in leading to change.
Patients should be encouraged to attend Alcoholics Anonymous (AA), a
worldwide self-help group for recovering alcoholic persons founded in 1935. AA
uses a program of 12 steps; new members are asked to admit their problems, to
give up a sense of personal control over the disease, to make personal amends, and
to help others to achieve sobriety. The meetings provide a blend of acceptance,
belonging, forgiveness, and understanding.
A team approach is used for hospitalized patients. Group therapy enables
patients to see their own problems mirrored in others and to learn better coping
skills. With individual therapy, the person can learn to identify triggers that prompt
drinking and learn more effective coping strategies. Family therapy is often
important because the family system that has been altered to accommodate the
person’s drinking may end up reinforcing it. These issues can be addressed in family
therapy. Inpatient programs also provide education about the harmful effects of
alcohol.
Motivational interviewing is being increasingly used to help persuade patients to
make their own case for change (i.e., to abandon alcohol). Avoiding confrontation,
the therapist seeks to achieve clarity about the patient’s motivation for change,
impediments that stand in the way of making needed change, and possible actions
that might bring about change.

7. 6
References:
1- Donald w. Black, Nancy c. Andresen. Introductory textbook of psychiatry. Sixth edition.
American psychiatric publishing.2014.pp 391-395
2- Treatment for alcohol problems: finding and getting help. National institute on alcohol
abuse and alcoholism. NIH publication. No. 14–7974.