News - Melbourne Medibrain Centre

Australian Family Physician, Vol. 40, No. 8. August 2011

Alcohol Dependence

Table 1. Problems associated with excessive alcohol use“
Nutritional
Protein deficiency, vitamin deficiency syndromes (especially thiamine and folic acid), obesity
Metabolic Ketoacidosis, hypoglycemia or hyperglycemia, electrolyte problems (i.e. Low magnesium or sodium)
Neurological
Alcohol withdrawal symptoms (including seizures and delirium tremens). Wernicke encephalopathy and Korsakoff symptoms, cerebella degeneration, dementia, peripheral neuropathy.
Psychological
Insomnia, fatigue, anxiety disorders, depression, suicide and suicidal ideation, exacerbation of existing mental health problems.
Behavioural
Disinhibition including unplanned sex, violence, trauma, sexually transmissible infection, use of other licit or elicit substances.
Muscular
Myopathy
Gastrointestinal
Fatty liver, alcoholic hepatitis, cirrhosis, pancreatitis (chronic or clinically acute), gastroesophagael reflux disease, gastritis, chronic diarrhoea, malabsorption.
Metabolic and endocrine
High uric acid/gout, low testosterone/impotence/testicular atrophy, gynaecomastia, irregular menstrual periods, osteoporosis, sexual dysfunction.
Blood related
Macrocytosis, anaemia, leukopenia, destruction of platelets, coagulopathy (especially 2º to liver disease).
Cardiac
Hypertension, arrhythmias, dilated cardimyopathy.
Pulmonary
Increased risk of pneumonia, tuberculosis; aspiration
Social
Marital problems, workplace absenteeism, child abuse/neglect, road safety issues
How much is too much?
Recently updated National Health and Medical Research Council (NHMRC) guidelines suggest that for both men and women, drinking no more than two standard drinks on each occasion, even if the drinking is daily, keeps the lifetime risk of death from alcohol related disease or injury to a low level. The risk of health problems rises steadily above these levels. If people drink more than four standard drinks on any one occasion, even episodically, they place themselves at risk of injury or other harm. For some people, not drinking at all is the safest option. This is the case for those who are pregnant, those who have an illness that is exacerbated by alcohol, or those who have in the past been dependent on (addicted to alcohol).