Alcoholism

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Alcoholism

Healthylife Pharmacy27 December 2016|4 min read

Australia has a well-established drinking culture. Weddings, parties, sporting events and a range of occasions in between are all celebrated or commiserated with alcohol. While many Australians enjoy a drink, for some drinking can slip into excess, causing harm and dependence.

Alcoholism is an illness

Alcoholism can be divided into two categories: abuse and dependence. 

Alcohol abuse. A person with alcohol abuse often has dangerous drinking habits and may be referred to as “problem drinkers”. They have the urge to drink every day and will often binge drink. Many issues can arise from alcohol abuse including work-related and relationship problems.

Alcohol dependence is a severe form of alcoholism, with tolerance and withdrawal symptoms. Tolerance refers to consuming increased amounts of alcohol to achieve intoxication. Symptoms of withdrawal occur when alcohol is discontinued or intake is decreased.

Those dependant on alcohol spend a great deal of time obtaining and drinking alcohol. They suffer from more severe problems and have a greater compulsion to drink. Those with alcohol abuse or dependency return to drinking despite evidence of physical or psychological problems. This level of consumption interferes with both physical and mental health; and social, family and occupational responsibilities.

Neurotransmitter imbalances

Alcoholism is associated with low-levels of our feel-good transmitters - serotonin, GABA, dopamine and endorphins; while excitatory neurotransmitters such as glutamate, adrenaline and noradrenaline are overexpressed.

This predisposes an individual to self-medicate in external ways (such as drinking alcohol) to increase levels of these feel-good transmitters. The imbalance intensifies as drinking increases, rendering the body unable to correct the imbalance. As symptoms increase the need to consume more alcolhol intensifies. 

Risk factors/causes

Major risk factors and causes that contribute to the incidence of alcoholism include:

  • Stress
  • Genetics
  • Alcohol consumption from an early age
  • Pre-existing psychiatric disorders

Indicators of alcoholism

  • Lack of control in reducing or discontinuing alcohol intake
  • Drinking alone
  • Daily or frequent use of alcohol for daily function
  • Loss of appetite and food intake
  • Neglect of physical appearance
  • Nausea and vomiting, body shaking (particularly in the hands) and confusion
  • Abdominal pain, pancreatitis and/or hepatitis

Diet and lifestyle

Alcoholics often eat poorly and suffer from malnutrition. As such regular meals should be consumed dense in vitamins and minerals. This can be obtained from eating fruits, vegetables and wholegrain cereals.

Protein is particularly important and can be obtained in the diet from fresh fish, chicken, pork, beef, lamb, eggs, legumes, lentils and dairy. Natural biodynamic yoghurt can help restore healthy digestive function and repopulate healthy bacteria.

Essential fatty acids are usually lacking in the diet of an alcoholic and can be obtained from fish, flaxseeds, walnuts, almonds, dark green leafy vegetables and olive oil.

Regular exercise and other stress management techniques such as meditation, yoga and breathing exercises may be useful in reducing anxiety levels and improving mood.

Nutritional deficiencies

B complex

Alcoholics generally have an increased need for all nutrients as levels can be severely depleted from excessive alcohol consumption and poor diet. Although thiamine and vitamin B6 are depleted the most it is advised to take a B complex with all the B vitamins present. B vitamins can help support a healthy nervous system, reduce anxiety, manage addictions and improve mood. A good quality multivitamin can be supplemented to ensure are wide range of nutritional needs are being met.

  • Thiamine. Levels of thiamine are often depleted in alcoholics. Thiamine, also referred to as Vitamin B1 is important in carbohydrate metabolism and biosynthesis of neurotransmitters such as GABA. Food sources of thiamine include beef, pork, fish, liver, wheatgerm, wholegrain cereals, peas, milk and yeast-extract spreads.
     
  • Vitamin B6. The needs for vitamin B6 increases significantly with alcohol intake and is required for a wide range of metabolic reactions. Deficiency can cause depressive illness, impaired immune function and reduced synthesis of GABA in the central nervous system. Food sources include wholegrain cereals, organ meats, legumes, eggs and vegemite.

Magnesium

This mineral can be used to support healthy neurobiology to reduce cravings, manage withdrawals and support healthy mood. It can help if insomnia is also present.

Support liver detoxification

St Mary’s thistle

This the most important herb for liver detoxification and to help reduce liver enzyme levels which are commonly elevated in alcoholics. It helps support phase I and phase II liver detoxification and can be combined with Schisandra, Green tea, Rosemary and Turmeric for additional support. 

N-acetylcysteine (NAC)

N-acetylcysteine (NAC) can be helpful as it supports liver detoxification of alcohol, while also providing potent anti-inflammatory, antioxidant and neuro-protective activity. NAC is only available through your Doctor or Naturopath.

Providing further nervous system support

It is crucial to provide support to the underlying reasons of alcohol abuse and dependence. Herbs can be helpful to act as mild sedatives, they can help us adapt to stress and support the adrenals. Specific herbs include:

  • St John’s Wort
  • Passion flower
  • Kava
  • Skullcap
  • Zizyphus
  • Withania
  • Siberian ginseng

GABA is the primary inhibitory neurotransmitter in the CNS. Stimulating GABA receptors is shown to be beneficial in treating addictive disorders, managing mood and insomnia and supporting abstinence from alcohol. GABA is only available through your Doctor or Naturopath.

Getting help

There are many organisations and health care professionals that can offer assistance to alcoholics. You can speak to your GP, local health service or call a helpline such as drug info, youth substance abuse service, family drug helpline or lifeline. Alcohol Drug Information Service (ADIS) offer information, advice, referral, intake, assessment and support 24hrs a day for individuals, families and health practitioners.

Detoxification for a person severely affected by alcohol can produce dangerous withdrawal symptoms and should be monitored closely by trained professionals, usually in a hospital setting. There are many rehabilitation facilities within Australia and abroad that offer rehabilitation and recovery programs following detoxification to maintain abstinence from alcohol. These centres usually offer counselling, psychological support, group sessions and medical care. Progression to transition and half-way houses can provide ongoing support to maintain abstinence.

Alcoholics Anonymous is a self-help group for recovering alcoholics that offer emotional support in a group setting. It is an effective model of abstinence for people who are recovering from alcohol dependence.

References

  1. https://drinkwise.org.au
  2. http://www.mayoclinic.org/diseases-conditions/alcoholism/basics/definition/CON-20020866?p=1
  3. Banerjee N. Neurotransmitters in alcoholism: A review of neurobiological and genetic studies. Indian J Hum Genet. 2014 Jan-Mar;20(1):20-31 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065474/
  4. Hechtman L (2014). Clinical Naturopathic Medicine. Churchill Livingstone, Australia
  5. Vedder LC, et al. Interactions between chronic ethanol consumption and thiamine deficiency on neural plasticity, spatial memory, and cognitive flexibility. Alcohol Clin Exp Res. 2015 Nov;39(11):2143-53 https://www.ncbi.nlm.nih.gov/pubmed/26419807
  6. Krystal JH, et al. Gamma-aminobutyric acid type A receptors and alcoholism: intoxication, dependence, vulnerability, and treatment. Arch Gen Psychiatry. 2006 Sep;63(9):957-68 https://www.ncbi.nlm.nih.gov/pubmed/16952998
  7. Vargas-Mendoza N, et al. Hepatoprotective effect of silymarin. World J Hepatol. 2014 Mar 27;6(3):144-9 https://www.ncbi.nlm.nih.gov/pubmed/24672644