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MedGenMed : Medscape General Medicine Jan 2006Almost 19 million Americans require treatment for an "alcohol problem"; however, only 2.4 million have been diagnosed and just 139,000 receive medication to treat it....
Almost 19 million Americans require treatment for an "alcohol problem"; however, only 2.4 million have been diagnosed and just 139,000 receive medication to treat it. Chronic heavy drinking contributes to cardiovascular illnesses, liver disease, cancer, and psychiatric disorders. Imaging studies demonstrate structural changes in the human brain with prolonged exposure to alcohol. Alcoholism can thus be described as an acquired brain dysfunction with specific neurochemical and neuroanatomic pathways. There is a need to intervene early because the average age of alcohol experimentation is 11-13 years--delaying onset reduces the rate of alcoholism. A survey sponsored by the Community Anti-Drug Coalitions of America (CADCA) set out to measure the attitudes and misperceptions of 1000 adults from the general population plus 300 physicians and 503 individuals in recovery from alcohol use disorder (AUD) to better understand approaches toward alcohol treatment. In these surveys, 74% of the general public indicated that alcoholism affects their daily lives, with 41% reporting having to encourage a loved one to seek help for an alcohol problem. The vast majority (= 80%) indicated a stigma toward alcoholics. Denial or refusal to admit severity and fear of social embarrassment were the top 2 reasons for not seeking help. The majority of the general population believes that alcoholism is caused partly by moral weakness. The survey revealed that most Americans are open to medications to treat alcoholism if physician-recommended and if it could reduce alcohol cravings and maintain abstinence. In the past 55 years, only 3 medications (disulfiram, naltrexone, and acamprosate) have been US Food and Drug Administration (FDA)-approved for the treatment of AUD, each with unique mechanisms of action.
Topics: Adult; Alcoholism; Attitude; Humans; Middle Aged; Surveys and Questionnaires
PubMed: 16915132
DOI: No ID Found -
Alcohol Research & Health : the Journal... 1999The use of medications as an adjunct to alcoholism treatment is based on the premise that craving and other manifestations of alcoholism are mediated by neurobiological... (Review)
Review
The use of medications as an adjunct to alcoholism treatment is based on the premise that craving and other manifestations of alcoholism are mediated by neurobiological mechanisms. Three of the four medications approved in the United States or Europe for treating alcoholism are reported to reduce craving; these include naltrexone (ReVia), acamprosate, and tiapride. The remaining medication, disulfiram (Antabuse), may also possess some anticraving activity. Additional medications that have been investigated include ritanserin, which has not been shown to decrease craving or drinking levels in humans, and ondansetron, which shows promise for treating early onset alcoholics, who generally respond poorly to psychosocial treatment alone. Use of anticraving medications in combination (e.g., naltrexone plus acamprosate) may enhance their effectiveness. Future studies should address such issues as optimal dosing regimens and the development of strategies to enhance patient compliance.
Topics: Alcohol Deterrents; Alcoholism; Behavior, Addictive; Humans
PubMed: 10890816
DOI: No ID Found -
Biochemistry and Cell Biology =... Apr 2018Alcohol consumption during pregnancy remains a significant cause of preventable birth defects and developmental disabilities; however, the mechanism of toxicity remains... (Review)
Review
Alcohol consumption during pregnancy remains a significant cause of preventable birth defects and developmental disabilities; however, the mechanism of toxicity remains unclear. Methanol is present as a congener in many alcoholic beverages and is formed endogenously. Because ethanol is preferentially metabolized over methanol, it has been found in the sera and cerebro-spinal fluid of alcoholics. Toxicity resulting from methanol has been attributed to formic acid. Formic acid is present in significantly higher quantities in the biofluids of alcoholics. These higher levels can be cytotoxic and cause neuronal cell death. However, the adverse effects can be mitigated by adequate levels of hepatic folic acid, because formic acid elimination depends on folic acid. During pregnancy, folate concentrations are at least 2-fold higher in cord blood then in maternal blood, owing to increased folate requirements. The reverse has been demonstrated in pregnancies with alcohol abuse, suggesting downregulation of folate transporters and low fetal folate levels. Moreover, formic acid can cross the placenta and its adverse effects can be mitigated by folic acid. Thus, the combination of low fetal folate levels and presence of formic acid form a potent cytotoxic combination that may play a significant role in the etiology of fetal alcohol spectrum disorder.
Topics: Alcoholism; Animals; Female; Fetal Alcohol Spectrum Disorders; Folic Acid; Formates; Humans; Mothers
PubMed: 28793200
DOI: 10.1139/bcb-2017-0079 -
Alcohol Research & Health : the Journal... 2008Human studies have found alcoholics to have a smaller brain size than moderate drinkers; however, these studies are complicated by many uncontrollable factors, including... (Review)
Review
Human studies have found alcoholics to have a smaller brain size than moderate drinkers; however, these studies are complicated by many uncontrollable factors, including timing and amount of alcohol use. Animal experiments, which can control many factors, have established that alcohol can cause damage to brain cells (i.e., neurons), which results in their loss of structure or function (i.e., neurodegeneration) in multiple brain regions, similar to the damage found in human alcoholics. In addition, animal studies indicate that inhibition of the creation of neurons (i.e., neurogenesis) and other brain-cell genesis contributes to alcoholic neurodegeneration. Animal studies also suggest that neurodegeneration changes cognition, contributing to alcohol use disorders. Risk factors such as adolescent age and genetic predisposition toward alcohol consumption worsen neurodegeneration. Mild impairment of executive functions similar to that found in humans occurs in animals following binge alcohol treatment. Thus, animal studies suggest that heavy alcohol use contributes to neurodegeneration and the progressive loss of control over drinking. Despite the negative consequences of heavy drinking, there is hope of recovery with abstinence, which in animal models can result in neural stem-cell proliferation and the formation of new neurons and other brain cells, indicative of brain growth.
Topics: Alcohol Drinking; Alcoholism; Animals; Binge Drinking; Brain; Humans; Models, Animal; Neurodegenerative Diseases; Neurons; Recovery of Function
PubMed: 23584011
DOI: No ID Found -
Alcohol Health and Research World 1997Children of alcoholics (COA's) are at increased risk for behavioral and emotional problems, including alcoholism. Research has helped guide the design of prevention and... (Review)
Review
Children of alcoholics (COA's) are at increased risk for behavioral and emotional problems, including alcoholism. Research has helped guide the design of prevention and intervention programs aimed at reducing this risk. Currently, most such programs for COA's use a short-term, small-group format, often conducted within schools. Broad-based community programs are another promising option, but have not been sufficiently studied. Generally, interventions include alcoholism education, training in coping skills and social competence, social support, and healthy alternative activities. Increased interaction between basic research and intervention may lead to improved services for COA's.
Topics: Alcoholism; Behavior, Addictive; Child; Child Behavior; Humans; Self-Help Groups
PubMed: 15706776
DOI: No ID Found -
British Medical Journal Jun 1956
Topics: Alcoholics; Alcoholism; Humans
PubMed: 13316195
DOI: 10.1136/bmj.1.4981.1483 -
Alcohol (Fayetteville, N.Y.) Nov 2019Chronic alcohol consumption renders the lung more susceptible to infections by disrupting essential alveolar macrophage functions. Emerging evidence suggests that these... (Review)
Review
Chronic alcohol consumption renders the lung more susceptible to infections by disrupting essential alveolar macrophage functions. Emerging evidence suggests that these functional deficits are due, in part, to a suppression of GM-CSF signaling, which is believed to compromise monocyte growth and maturation in the lung. However, in addition to controlling monocyte behaviors, GM-CSF also regulates surfactant homeostasis. For example, mice with targeted deletion of the gene for GM-CSF accumulate large amounts of surfactant phospholipids in their lungs. Moreover, decreased GM-CSF signaling in humans has been linked to the development of pulmonary alveolar proteinosis (PAP), a rare disorder in which surfactant lipids and proteins accumulate in alveolar macrophages and the lung exhibits enhanced susceptibility to infection. Consistent with parallel mechanisms in the PAP and alcoholic lung, we have recently reported that levels of intrapulmonary lipids, specifically triglycerides and free fatty acids, are increased in BAL fluid, whole lung digests and alveolar macrophages of chronically alcohol exposed rats. Additionally, we showed that uptake of saturated fatty acids alone could induce phenotypic and functional changes in alveolar macrophages that mimicked those in the alcohol-exposed rat and human lung. Herein, we discuss the role of GM-CSF in surfactant homeostasis and highlight the evidence that links decreased GM-CSF signaling to alveolar macrophage dysfunction in both the PAP and alcohol-exposed lung. Moreover, we discuss how lipid accumulation itself might contribute to altering alveolar macrophage function and propose how targeting these mechanisms could be employed for reducing the susceptibility to pulmonary infections in alcoholics.
Topics: Alcoholism; Animals; Granulocyte-Macrophage Colony-Stimulating Factor; Homeostasis; Lung; Macrophages, Alveolar; Pulmonary Alveolar Proteinosis; Pulmonary Surfactants
PubMed: 31229291
DOI: 10.1016/j.alcohol.2018.07.006 -
Alcohol Research & Health : the Journal... 2000Studies have shown that long-term alcohol abuse produces serious, harmful effects on a variety of the body's organ systems. Parts of the human body most affected include... (Review)
Review
Studies have shown that long-term alcohol abuse produces serious, harmful effects on a variety of the body's organ systems. Parts of the human body most affected include the liver and the immune, cardiovascular, and skeletal systems. Current research has examined some of these effects in an effort to better understand the medical consequences of alcohol use and abuse and to ultimately develop more effective treatments for responding to alcohol-induced bodily damage. This article discusses some of those findings.
Topics: Alcoholism; Bone Diseases; Breast Neoplasms; Cardiomyopathies; Female; Health Status; Humans; Inflammation; Liver Cirrhosis, Alcoholic; Male
PubMed: 11199271
DOI: No ID Found -
American Journal of Physiology. Lung... Apr 2007Epidemiological evidence gathered only in the past decade reveals that alcohol abuse independently increases the risk of developing the acute respiratory distress... (Review)
Review
Epidemiological evidence gathered only in the past decade reveals that alcohol abuse independently increases the risk of developing the acute respiratory distress syndrome by as much as three- to fourfold. Experimental models and clinical studies are beginning to elucidate the mechanisms underlying this previously unrecognized association and are revealing for the first time that chronic alcohol abuse causes discrete changes, particularly within the alveolar epithelium, that render the lung susceptible to acute edematous injury in response to sepsis, trauma, and other inflammatory insults. Recent studies in relevant animal models as well as in human subjects are identifying common mechanisms by which alcohol abuse targets both the alveolar epithelium and the alveolar macrophage, such that the risks for acute lung injury and pulmonary infections are inextricably linked. Specifically, chronic alcohol ingestion decreases the levels of the antioxidant glutathione within the alveolar space by as much as 80-90%, and, as a consequence, impairs alveolar epithelial surfactant production and barrier integrity, decreases alveolar macrophage function, and renders the lung susceptible to oxidant-mediated injury. These changes are often subclinical and may not manifest as detectable lung impairment until challenged by an acute insult such as sepsis or trauma. However, even otherwise healthy alcoholics have evidence of severe oxidant stress in the alveolar space that correlates with alveolar epithelial and macrophage dysfunction. This review focuses on the epidemiology and the pathophysiology of alcohol-induced lung dysfunction and discusses potential new treatments suggested by recent experimental findings.
Topics: Alcoholism; Angiotensin II; Granulocyte-Macrophage Colony-Stimulating Factor; Humans; Lung; Macrophages, Alveolar; Oxidative Stress; Pulmonary Alveoli; Respiratory Distress Syndrome; Signal Transduction
PubMed: 17220370
DOI: 10.1152/ajplung.00348.2006 -
Public Health Reports (Washington, D.C.... 1988Sensitivity to gender issues in the research community has generated a modest but growing amount of data on the biological effects of alcohol consumption on women. Data... (Comparative Study)
Comparative Study Review
Sensitivity to gender issues in the research community has generated a modest but growing amount of data on the biological effects of alcohol consumption on women. Data generally indicate that the same amounts of alcohol have greater effects on women and that women develop more severe alcohol problems than men over shorter drinking histories. Despite a number of studies, however, there are no clear differences between women and men in the impact of alcohol consumption on cognitive processes. Although the findings are mixed, the data point toward greater physiological deterioration among women as compared with men who have similar drinking histories. These differences may be related to the differences in patterns of social recognition and reaction that occur in instances of alcoholism among women. Such differences are confirmed by other data that indicate greater social isolation and general disorganization among female alcoholics than among male alcoholics. The risks of fetal alcohol syndrome that are associated with heavy alcohol consumption among women during pregnancy have been established, and a complex of other relationships between alcohol consumption and reproductive-related systems and behaviors exists. Linkages between sexual dysfunction, sexual satisfaction, and alcohol consumption appear to exist, but have not yet become clearly understood. It appears that alcohol may be used as a self-medication to cope with perceived problems of sexuality. It also appears that heavy alcohol consumption can contribute to sexual dysfunction and dissatisfaction. A growing body of sophisticated experimental research has established relationships between patterns of alcohol metabolism and phases of the menstrual cycle, with this literature offering some of the clearest indications of distinctive differences between the sexes in the biological consequences and correlates of alcohol consumption.
Topics: Alcoholism; Cognition; Ethanol; Female; Humans; Libido; Longevity; Male; Menstruation Disturbances; Pregnancy; Reproduction
PubMed: 3141957
DOI: No ID Found