According to the DSMIV (Diagnostic and statistical manual) Alcohol abuse refer to maladaptive patterns of alcohol use, that impair health in a broader sense. So the signs of alcohol abuse can be categorized as physical, mental and social.
What are the physical signs a person may show?
Excessive alcohol use damages the body tissues in wide variety of systems. Liver and the brain are affected the most.
Signs of liver damage
Signs of liver damage show after the development of liver cirrhosis. Cirrhosis is usually seen in people with severe alcohol abuse. Signs of cirrhosis are Yellowish discoloration of the body, especially the eyes Increased redness of the palms Bulging in the jaw (enlarged parotid glands), Clubbing of the nails, Muscle wasting, Enlarged abdomen due to fluid retention
In addition, men may present with reduced body hair, abnormal enlargement of the breasts and testicular atrophy. Women may have menstrual irregularities. Alcohol abuse is associated with increased blood pressure and increased risk of stroke as well.
Signs of nervous system damage are
* Feeling of pins and needles in fingers and toes (due to toxic effects to the nerves)
* Unsteadiness in walking and standing
* Various psychiatric problems (discussed later)
Taking alcohol during the pregnancy is associated with fetal alcohol syndrome. It is characterized by abnormalities in the new born face, low birth weight, low intelligence and childhood over activity (ADHD).
What are the mental signs a person may show?
These can occur due to intoxication of alcohol, withdrawal of alcohol and due to associated psychiatric disorders. Intoxication signs are related to the concentration of alcohol in the blood. Most common signs are repeated falls, respiratory depression, and vomiting and decreased body temperature.
In addition, memory blackouts and short term memory loss can occur, frequently following alcohol intoxication. In memory blackouts person forgets the things he/she has done during the intoxicated period.
Signs of withdrawal occur in people who are dependent on alcohol. Some signs, due to withdrawal of alcohol can be quite severe.
Delirium tremens: – Usually occur 48 hours after the last drink. Characterized by disorientation, hallucinations, illusions, restlessness, agitation, sweating and fever. This condition needs specialized medical care. Other less severe signs of withdrawal are tremors, sweating, craving for alcohol and sleep disturbances.
Some patients who abuse alcohol for long period may get alcoholic dementia.
Other mental problems that are associated with alcohol are
* Delusional jealousy
* Suicidal behavior
* Alcoholic hallucinosis
What are the social signs of alcohol abuse?
Family problems: – Family disharmony, divorce, domestic violence and behavioral problems in children are common. In addition, work related problems and road traffic accidents are also common with people who abuse alcohol. Excessive alcohol consumption is also associated with crime and legal problems.
Oxford short textbook of psychiatry