Wikipedia

Bruger:Metalindustrien/Kasse6

< Bruger:Metalindustrien

Diagnosis redigér

  Se også: Addiction medicine.

Definition redigér

 
A man drinking from a bottle of liquor while sitting on a boardwalk, ca. 1905–1914. Picture by Austrian photographer Emil Mayer.

Misuse, problem use, abuse, and heavy use of alcohol refer to improper use of alcohol, which may cause physical, social, or moral harm to the drinker.[1] The Dietary Guidelines for Americans defines "moderate use" as no more than two alcoholic beverages a day for men and no more than one alcoholic beverage a day for women.[2] Some drinkers may drink more than 600 ml of alcohol per day during a heavy drinking period.[3] The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as the amount of alcohol leading to a blood alcohol content (BAC) of 0.08, which, for most adults, would be reached by consuming five drinks for men or four for women over a two-hour period. According to the NIAAA, men may be at risk for alcohol-related problems if their alcohol consumption exceeds 14 standard drinks per week or 4 drinks per day, and women may be at risk if they have more than 7 standard drinks per week or 3 drinks per day. It defines a standard drink as one 12-ounce bottle of beer, one 5-ounce glass of wine, or 1.5 ounces of distilled spirits.[4] Despite this risk, a 2014 report in the National Survey on Drug Use and Health found that only 10% of either "heavy drinkers" or "binge drinkers" defined according to the above criteria also met the criteria for alcohol dependence, while only 1.3% of non-binge drinkers met the criteria. An inference drawn from this study is that evidence-based policy strategies and clinical preventive services may effectively reduce binge drinking without requiring addiction treatment in most cases.[5]

Alcoholism redigér

The term alcoholism is commonly used amongst laypeople, but the word is poorly defined. The WHO calls alcoholism "a term of long-standing use and variable meaning", and use of the term was disfavored by a 1979 WHO expert committee. The Big Book (from Alcoholics Anonymous) states that once a person is an alcoholic, they are always an alcoholic (but others note that many do recover), but does not define what is meant by the term alcoholic in this context. In 1960, Bill W., co-founder of Alcoholics Anonymous (AA), said:

We have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments, or combinations of them. It is something like that with alcoholism. We did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. We always called it an illness, or a malady – a far safer term for us to use.[6]

In professional and research contexts, the term "alcoholism" sometimes encompasses both alcohol abuse and alcohol dependence,[7] and sometimes is considered equivalent to alcohol dependence. Talbot (1989) observes that alcoholism in the classical disease model follows a progressive course: if a person continues to drink, their condition will worsen. This will lead to harmful consequences in their life, physically, mentally, emotionally and socially.[8] Johnson (1980) explores the emotional progression of the addict's response to alcohol. He looks at this in four phases. The first two are considered "normal" drinking and the last two are viewed as "typical" alcoholic drinking.[8] Johnson's four phases consist of:

  1. Learning the mood swing. A person is introduced to alcohol (in some cultures this can happen at a relatively young age), and the person enjoys the happy feeling it produces. At this stage, there is no emotional cost.
  2. Seeking the mood swing. A person will drink to regain that feeling of euphoria experienced in phase 1; the drinking will increase as more intoxication is required to achieve the same effect. Again at this stage, there are no significant consequences.
  3. At the third stage there are physical and social consequences, i.e., hangovers, family problems, work problems, etc. A person will continue to drink excessively, disregarding the problems.
  4. The fourth stage can be detrimental, as Johnson cites it as a risk for premature death. As a person now drinks to feel normal, they block out the feelings of overwhelming guilt, remorse, anxiety, and shame they experience when sober.[8]

Milam & Ketcham's physical deterioration stages redigér

Other theorists such as Milam & Ketcham (1983) focus on the physical deterioration that alcohol consumption causes. They describe the process in three stages:

  1. Adaptive stage – The person will not experience any negative symptoms, and they believe they have the capacity for drinking alcohol without problems. Physiological changes are happening with the increase in tolerance, but this will not be noticeable to the drinker or others.
  2. Dependent stage – At this stage, symptoms build up gradually. Hangover symptoms from excessive drinking may be confused with withdrawal symptoms. Many addicts will maintain their drinking to avoid withdrawal sickness, drinking small amounts frequently. They will try to hide their drinking problem from others and will avoid gross intoxication.
  3. Deterioration stage – Various organs are damaged due to long-term drinking. Medical treatment in a rehabilitation center will be required; otherwise, the pathological changes will cause death.

DSM and ICD redigér

In psychology and psychiatry, the DSM is the most common global standard, while in medicine, the standard is ICD. The terms they recommend are similar but not identical.

Organization Preferred term(s) Definition
APA's DSM-IV "alcohol abuse" and "alcohol dependence"
  • alcohol abuse = repeated use despite recurrent adverse consequences.[9]
  • alcohol dependence = alcohol abuse combined with tolerance, withdrawal, and an uncontrollable drive to drink.[9] The term "alcoholism" was split into "alcohol abuse" and "alcohol dependence" in 1980's DSM-III, and in 1987's DSM-III-R behavioral symptoms were moved from "abuse" to "dependence".[10] It has been suggested that DSM-V merge alcohol abuse and alcohol dependence into a single new entry,[11] named "alcohol-use disorder".[12]
WHO's ICD-10 "alcohol harmful use" and "alcohol dependence syndrome" Definitions are similar to that of the DSM-IV. The World Health Organization uses the term "alcohol dependence syndrome" rather than alcoholism.[13] The concept of "harmful use" (as opposed to "abuse") was introduced in 1992's ICD-10 to minimize underreporting of damage in the absence of dependence.[10] The term "alcoholism" was removed from ICD between ICD-8/ICDA-8 and ICD-9.[14]

The DSM-IV diagnosis of alcohol dependence represents one approach to the definition of alcoholism. In part, this is to assist in the development of research protocols in which findings can be compared to one another. According to the DSM-IV, an alcohol dependence diagnosis is: "maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae."[15] Despite the imprecision inherent in the term, there have been attempts to define how the word alcoholism should be interpreted when encountered. In 1992, it was defined by the National Council on Alcoholism and Drug Dependence (NCADD) and ASAM as "a primary, chronic disease characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking."[16] MeSH has had an entry for "alcoholism" since 1999, and references the 1992 definition.[17]

AA describes alcoholism as an illness that involves a physical allergy[18]:28 (where "allergy" has a different meaning than that used in modern medicine.[19]) and a mental obsession.[18]:23 [20] The doctor and addiction specialist Dr. William D. Silkworth M.D. writes on behalf of AA that "Alcoholics suffer from a "(physical) craving beyond mental control".[18]:xxvi A 1960 study by E. Morton Jellinek is considered the foundation of the modern disease theory of alcoholism.[21] Jellinek's definition restricted the use of the word alcoholism to those showing a particular natural history. The modern medical definition of alcoholism has been revised numerous times since then. The American Medical Association uses the word alcoholism to refer to a particular chronic primary disease.[22]

Social barriers redigér

Attitudes and social stereotypes can create barriers to the detection and treatment of alcohol abuse. This is more of a barrier for women than men. Fear of stigmatization may lead women to deny that they are suffering from a medical condition, to hide their drinking, and to drink alone. This pattern, in turn, leads family, physicians, and others to be less likely to suspect that a woman they know is an alcoholic.[23] In contrast, reduced fear of stigma may lead men to admit that they are suffering from a medical condition, to display their drinking publicly, and to drink in groups. This pattern, in turn, leads family, physicians, and others to be more likely to suspect that a man they know is an alcoholic.[24]

Screening redigér

Screening is recommended among those over the age of 18.[25] Several tools may be used to detect a loss of control of alcohol use. These tools are mostly self-reports in questionnaire form. Another common theme is a score or tally that sums up the general severity of alcohol use.[26]

The CAGE questionnaire, named for its four questions, is one such example that may be used to screen patients quickly in a doctor's office.

Two "yes" responses indicate that the respondent should be investigated further.

The questionnaire asks the following questions:

  1. Have you ever felt you needed to Cut down on your drinking?
  2. Have people Annoyed you by criticizing your drinking?
  3. Have you ever felt Guilty about drinking?
  4. Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?[27][28]
The CAGE questionnaire has demonstrated a high effectiveness in detecting alcohol-related problems; however, it has limitations in people with less severe alcohol-related problems, white women and college students.[29]

Other tests are sometimes used for the detection of alcohol dependence, such as the Alcohol Dependence Data Questionnaire, which is a more sensitive diagnostic test than the CAGE questionnaire. It helps distinguish a diagnosis of alcohol dependence from one of heavy alcohol use.[30] The Michigan Alcohol Screening Test (MAST) is a screening tool for alcoholism widely used by courts to determine the appropriate sentencing for people convicted of alcohol-related offenses,[31] driving under the influence being the most common. The Alcohol Use Disorders Identification Test (AUDIT), a screening questionnaire developed by the World Health Organization, is unique in that it has been validated in six countries and is used internationally. Like the CAGE questionnaire, it uses a simple set of questions – a high score earning a deeper investigation.[32] The Paddington Alcohol Test (PAT) was designed to screen for alcohol-related problems amongst those attending Accident and Emergency departments. It concords well with the AUDIT questionnaire but is administered in a fifth of the time.[33] Certain blood tests may also indicate possible alcoholism.[34]

Urine and blood tests redigér

There are reliable tests for the actual use of alcohol, one common test being that of blood alcohol content (BAC).[35] These tests do not differentiate alcoholics from non-alcoholics; however, long-term heavy drinking does have a few recognizable effects on the body, including:[36]

With regard to alcoholism, BAC is useful to judge alcohol tolerance, which in turn is a sign of alcoholism.[34] Electrolyte and acid-base abnormalities including hypokalemia, hypomagnesemia, hyponatremia, hyperuricemia, metabolic acidosis, and respiratory alkalosis are common in alcoholics.[37]

However, none of these blood tests for biological markers is as sensitive as screening questionnaires.

Prevention redigér

Yderligere information: Alcohol education

The World Health Organization, the European Union and other regional bodies, national governments and parliaments have formed alcohol policies in order to reduce the harm of alcoholism.[38][39] Targeting adolescents and young adults is regarded as an important step to reduce the harm of alcohol abuse. Increasing the age at which licit drugs of abuse such as alcohol can be purchased, the banning or restricting advertising of alcohol has been recommended as additional ways of reducing the harm of alcohol dependence and abuse. Credible, evidence based educational campaigns in the mass media about the consequences of alcohol abuse have been recommended. Guidelines for parents to prevent alcohol abuse amongst adolescents, and for helping young people with mental health problems have also been suggested.[40]

Management redigér

Treatments are varied because there are multiple perspectives of alcoholism. Those who approach alcoholism as a medical condition or disease recommend differing treatments from, for instance, those who approach the condition as one of social choice. Most treatments focus on helping people discontinue their alcohol intake, followed up with life training and/or social support to help them resist a return to alcohol use. Since alcoholism involves multiple factors which encourage a person to continue drinking, they must all be addressed to successfully prevent a relapse. An example of this kind of treatment is detoxification followed by a combination of supportive therapy, attendance at self-help groups, and ongoing development of coping mechanisms. The treatment community for alcoholism typically supports an abstinence-based zero tolerance approach; however, some prefer a harm-reduction approach.[41]

Detoxification redigér

  Hovedartikel: Alcohol detoxification.

Alcohol detoxification or 'detox' for alcoholics is an abrupt stop of alcohol drinking coupled with the substitution of drugs, such as benzodiazepines, that have similar effects to prevent alcohol withdrawal. Individuals who are only at risk of mild to moderate withdrawal symptoms can be detoxified as outpatients. Individuals at risk of a severe withdrawal syndrome as well as those who have significant or acute comorbid conditions are generally treated as inpatients. Detoxification does not actually treat alcoholism, and it is necessary to follow up detoxification with an appropriate treatment program for alcohol dependence or abuse to reduce the risk of relapse.[42] Some symptoms of alcohol withdrawal such as depressed mood and anxiety typically take weeks or months to abate while other symptoms persist longer due to persisting neuroadaptations.[43] Alcoholism has serious adverse effects on brain function; on average it takes one year of abstinence to recover from the cognitive deficits incurred by chronic alcohol abuse.[44]

Psychological redigér

 
A regional service center for Alcoholics Anonymous.

Various forms of group therapy or psychotherapy can be used to deal with underlying psychological issues that are related to alcohol addiction, as well as provide relapse prevention skills. The mutual-help group-counseling approach is one of the most common ways of helping alcoholics maintain sobriety.[45] Alcoholics Anonymous was one of the first organizations formed to provide mutual, nonprofessional counseling, and it is still the largest. Others include LifeRing Secular Recovery, SMART Recovery, Women for Sobriety, and Secular Organizations for Sobriety.[46] Alcoholics Anonymous and twelve-step programs appear more effective than cognitive behavioral therapy or abstinence.[47]

Moderate drinking redigér

Rationing and moderation programs such as Moderation Management and DrinkWise do not mandate complete abstinence. While most alcoholics are unable to limit their drinking in this way, some return to moderate drinking. A 2002 US study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7 percent of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. This group, however, showed fewer initial symptoms of dependency.[48]

A follow-up study, using the same subjects that were judged to be in remission in 2001–2002, examined the rates of return to problem drinking in 2004–2005. The study found abstinence from alcohol was the most stable form of remission for recovering alcoholics.[49] There was also a 1973 study showing chronic alcoholics drinking moderately again,[50] but a 1982 follow-up showed that 95% of subjects were not able to moderately drink over the long term.[51][52] Another study was a long-term (60 year) follow-up of two groups of alcoholic men which concluded that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence."[53] Internet based measures appear to be useful at least in the short term.[54]

Medications redigér

In the United States there are four approved medications for alcoholism: acamprosate, two methods of using naltrexone and disulfiram.[55]

  • Acamprosate may stabilise the brain chemistry that is altered due to alcohol dependence via antagonising the actions of glutamate, a neurotransmitter which is hyperactive in the post-withdrawal phase.[56] By reducing excessive NMDA activity which occurs at the onset of alcohol withdrawal, acamprosate can reduce or prevent alcohol withdrawal related neurotoxicity.[57] Acamprosate reduces the risk of relapse amongst alcohol-dependent persons.[58][59]
  • Naltrexone is a competitive antagonist for opioid receptors, effectively blocking the effects of endorphins and opioids. Naltrexone is used to decrease cravings for alcohol and encourage abstinence. Alcohol causes the body to release endorphins, which in turn release dopamine and activate the reward pathways; hence in the body reduces the pleasurable effects from consuming alcohol.[60] Evidence supports a reduced risk of relapse among alcohol-dependent persons and a decrease in excessive drinking.[59] Nalmefene also appears effective and works in a similar manner.[59]
  • The Sinclair method is another approach to using naltrexone or other opioid antagonists to treat alcoholism by having the person take the medication about an hour before they drink alcohol and only then.[61][62] The medication blocks the positive reinforcement effects of ethanol and hypothetically allows the person to stop drinking or drink less.[62]
  • Disulfiram prevents the elimination of acetaldehyde, a chemical the body produces when breaking down ethanol. Acetaldehyde itself is the cause of many hangover symptoms from alcohol use. The overall effect is discomfort when alcohol is ingested: an extremely fast-acting and long-lasting, uncomfortable hangover.

Several other drugs are also used and many are under investigation.

  • Benzodiazepines, while useful in the management of acute alcohol withdrawal, if used long-term can cause a worse outcome in alcoholism. Alcoholics on chronic benzodiazepines have a lower rate of achieving abstinence from alcohol than those not taking benzodiazepines. This class of drugs is commonly prescribed to alcoholics for insomnia or anxiety management.[63] Initiating prescriptions of benzodiazepines or sedative-hypnotics in individuals in recovery has a high rate of relapse with one author reporting more than a quarter of people relapsed after being prescribed sedative-hypnotics. Those who are long-term users of benzodiazepines should not be withdrawn rapidly, as severe anxiety and panic may develop, which are known risk factors for relapse into alcohol abuse. Taper regimes of 6–12 months have been found to be the most successful, with reduced intensity of withdrawal.[64][65]
  • Calcium carbimide works in the same way as disulfiram; it has an advantage in that the occasional adverse effects of disulfiram, hepatotoxicity and drowsiness, do not occur with calcium carbimide.[66]
  • Ondansetron and topiramate are supported by tentative evidence in people with certain genetics.[67][68] Evidence for ondansetron is more in those who have just begun having problems with alcohol.[67]

Evidence does not support the use of selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), antipsychotics, or gabapentin.[59]

Dual addictions and dependences redigér

Alcoholics may also require treatment for other psychotropic drug addictions and drug dependences. The most common dual dependence syndrome with alcohol dependence is benzodiazepine dependence, with studies showing 10–20 percent of alcohol-dependent individuals had problems of dependence and/or misuse problems of benzodiazepine drugs such as diazepam or clonazepam. These drugs are, like alcohol, depressants. Benzodiazepines may be used legally, if they are prescribed by doctors for anxiety problems or other mood disorders, or they may be purchased as illegal drugs. Benzodiazepine use increases cravings for alcohol and the volume of alcohol consumed by problem drinkers.[69] Benzodiazepine dependency requires careful reduction in dosage to avoid benzodiazepine withdrawal syndrome and other health consequences. Dependence on other sedative-hypnotics such as zolpidem and zopiclone as well as opiates and illegal drugs is common in alcoholics. Alcohol itself is a sedative-hypnotic and is cross-tolerant with other sedative-hypnotics such as barbiturates, benzodiazepines and nonbenzodiazepines. Dependence upon and withdrawal from sedative-hypnotics can be medically severe and, as with alcohol withdrawal, there is a risk of psychosis or seizures if not properly managed.[70]

Epidemiology redigér

 
Disability-adjusted life year for alcohol use disorders per million inhabitants in 2012.
     234-806      814-1,501      1,551-2,585      2,838      2,898-3,935      3,953-5,069      5,168      5,173-5,802      5,861-8,838      9,122-25,165
 
Alcohol consumption per person 2016.[71]

The World Health Organization estimates that as of 2010 there are 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age).[72][73] Substance use disorders are a major public health problem facing many countries. "The most common substance of abuse/dependence in patients presenting for treatment is alcohol."[41] In the United Kingdom, the number of 'dependent drinkers' was calculated as over 2.8 million in 2001.[74] About 12% of American adults have had an alcohol dependence problem at some time in their life.[75] In the United States and Western Europe, 10 to 20 percent of men and 5 to 10 percent of women at some point in their lives will meet criteria for alcoholism.[76] Estonia had the highest death rate from alcohol in Europe in 2015 at 8.8 per 100,000 population.[77] In the United States, 30% of people admitted to hospital have a problem related to alcohol.[78]

Within the medical and scientific communities, there is a broad consensus regarding alcoholism as a disease state. For example, the American Medical Association considers alcohol a drug and states that "drug addiction is a chronic, relapsing brain disease characterized by compulsive drug seeking and use despite often devastating consequences. It results from a complex interplay of biological vulnerability, environmental exposure, and developmental factors (e.g., stage of brain maturity)."[22] Alcoholism has a higher prevalence among men, though, in recent decades, the proportion of female alcoholics has increased.[79] Current evidence indicates that in both men and women, alcoholism is 50–60 percent genetically determined, leaving 40–50 percent for environmental influences.[80] Most alcoholics develop alcoholism during adolescence or young adulthood.[81] 31 percent of college students show signs of alcohol abuse, while six percent are dependent on alcohol. Under the DSM's new definition of alcoholics, that means about 37 percent of college students may meet the criteria.[82]

Prognosis redigér

 
Alcohol use disorders deaths per million persons in 2012
     0–0      1–3      4–6      7–13      14–20      21–37      38–52      53–255

Alcoholism often reduces a person's life expectancy by around ten years.[83] The most common cause of death in alcoholics is from cardiovascular complications.[84] There is a high rate of suicide in chronic alcoholics, which increases the longer a person drinks. Approximately 3–15 percent of alcoholics commit suicide,[85] and research has found that over 50 percent of all suicides are associated with alcohol or drug dependence. This is believed to be due to alcohol causing physiological distortion of brain chemistry, as well as social isolation. Suicide is also very common in adolescent alcohol abusers, with 25 percent of suicides in adolescents being related to alcohol abuse.[86] Among those with alcohol dependence after one year, some met the criteria for low-risk drinking, even though only 25.5 percent of the group received any treatment, with the breakdown as follows: 25 percent were found to be still dependent, 27.3 percent were in partial remission (some symptoms persist), 11.8 percent asymptomatic drinkers (consumption increases chances of relapse) and 35.9 percent were fully recovered – made up of 17.7 percent low-risk drinkers plus 18.2 percent abstainers.[87] In contrast, however, the results of a long-term (60-year) follow-up of two groups of alcoholic men indicated that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence."[88] There was also "return-to-controlled drinking, as reported in short-term studies, is often a mirage."

History redigér

 
Adriaen Brouwer, Inn with Drunken Peasants, 1620s
 
1904 advertisement describing alcoholism as a disease.

Historically the name "dipsomania" was coined by German physician C.W. Hufeland in 1819 before it was superseded by "alcoholism".[89][90] That term now has a more specific meaning.[91] The term "alcoholism" was first used in 1849 by the Swedish physician Magnus Huss to describe the systematic adverse effects of alcohol.[92] Alcohol has a long history of use and misuse throughout recorded history. Biblical, Egyptian and Babylonian sources record the history of abuse and dependence on alcohol. In some ancient cultures alcohol was worshiped and in others, its abuse was condemned. Excessive alcohol misuse and drunkenness were recognized as causing social problems even thousands of years ago. However, the defining of habitual drunkenness as it was then known as and its adverse consequences were not well established medically until the 18th century. In 1647 a Greek monk named Agapios was the first to document that chronic alcohol misuse was associated with toxicity to the nervous system and body which resulted in a range of medical disorders such as seizures, paralysis, and internal bleeding. In 1920 the effects of alcohol abuse and chronic drunkenness boosted membership of the temperance movement and led to the prohibition of alcohol in the United States, a nationwide constitutional ban on the production, importation, transportation, and sale of alcoholic beverages that remained in place until 1933; this policy resulted in the decline of death rates from cirrhosis and alcoholism.[93] In 2005 alcohol dependence and abuse was estimated to cost the US economy approximately 220 billion dollars per year, more than cancer and obesity.[94]

Society and culture redigér

  Se også: List of deaths through alcohol.

The various health problems associated with long-term alcohol consumption are generally perceived as detrimental to society, for example, money due to lost labor-hours, medical costs due to injuries due to drunkenness and organ damage from long-term use, and secondary treatment costs, such as the costs of rehabilitation facilities and detoxification centers. Alcohol use is a major contributing factor for head injuries, motor vehicle injuriess (27%), interpersonal violence (18%), suicides (18%), and epilepsy (13%).[95] Beyond the financial costs that alcohol consumption imposes, there are also significant social costs to both the alcoholic and their family and friends.[96] For instance, alcohol consumption by a pregnant woman can lead to an incurable and damaging condition known as fetal alcohol syndrome, which often results in cognitive deficits, mental health problems, an inability to live independently and an increased risk of criminal behaviour, all of which can cause emotional stress for parents and caregivers.[97][98] Estimates of the economic costs of alcohol abuse, collected by the World Health Organization, vary from one to six percent of a country's GDP.[99] One Australian estimate pegged alcohol's social costs at 24% of all drug abuse costs; a similar Canadian study concluded alcohol's share was 41%.[100] One study quantified the cost to the UK of all forms of alcohol misuse in 2001 as £18.5–20 billion.[74][101] All economic costs in the United States in 2006 have been estimated at $223.5 billion.[102]

The idea of hitting rock bottom refers to an experience of stress that is blamed on alcohol misuse.  There is no single definition for this idea, and people may identify their own lowest points in terms of lost jobs, lost relationships, health problems, legal problems, or other consequences of alcohol misuse.[103]  The concept is promoted by 12-step recovery groups and researchers using the transtheoretical model of motivation for behavior change.[103]  The first use of this slang phrase in the formal medical literature appeared in a 1965 review in the British Medical Journal,[103] which said that some men refused treatment until they "hit rock bottom", but that treatment was generally more successful for "the alcohol addict who has friends and family to support him" than for impoverished and homeless addicts.[104]

Stereotypes of alcoholics are often found in fiction and popular culture. The "town drunk" is a stock character in Western popular culture. Stereotypes of drunkenness may be based on racism or xenophobia, as in the fictional depiction of the Irish as heavy drinkers.[105] Studies by social psychologists Stivers and Greeley attempt to document the perceived prevalence of high alcohol consumption amongst the Irish in America.[106] Alcohol consumption is relatively similar between many European cultures, the United States, and Australia. In Asian countries that have a high gross domestic product, there is heightened drinking compared to other Asian countries, but it is nowhere near as high as it is in other countries like the United States. It is also inversely seen, with countries that have very low gross domestic product showing high alcohol consumption.[107] In a study done on Korean immigrants in Canada, they reported alcohol was even an integral part of their meal, and is the only time solo drinking should occur. They also believe alcohol is necessary at any social event as it helps conversations start.[108]

Caucasians have a much lower abstinence rate (11.8%) and much higher tolerance to symptoms (3.4±2.45 drinks) of alcohol than Chinese (33.4% and 2.2±1.78 drinks respectively). Also, the more acculturation there is between cultures, the more influenced the culture is to adopt Caucasians drinking practices.[109] Peyote, a psychoactive agent, has even shown promise in treating alcoholism. Alcohol had actually replaced peyote as Native Americans’ psychoactive agent of choice in rituals when peyote was outlawed.[110]

Research redigér

Topiramate redigér

Topiramate, a derivative of the naturally occurring sugar monosaccharide D-fructose, has been found effective in helping alcoholics quit or cut back on the amount they drink. Evidence suggests that topiramate antagonizes excitatory glutamate receptors, inhibits dopamine release, and enhances inhibitory gamma-aminobutyric acid function. A 2008 review of the effectiveness of topiramate concluded that the results of published trials are promising, however, as of 2008, data was insufficient to support using topiramate in conjunction with brief weekly compliance counseling as a first-line agent for alcohol dependence.[111] A 2010 review found that topiramate may be superior to existing alcohol pharmacotherapeutic options. Topiramate effectively reduces craving and alcohol withdrawal severity as well as improving quality-of-life-ratings.[112]

Baclofen redigér

Baclofen, a GABAB receptor agonist, is under study for the treatment of alcoholism.[113] A 2019 systematic review concluded that there is insufficient evidence to draw any conclusions about the safety and efficacy because the evidence is of low quality and insufficient.[114] In 2018 baclofen received a Marketing Authorization for use in alcoholism treatment from the French drug agency ANSM if all other treatments are not effective.[115]

Ondansetron redigér

Ondansetron, a 5HT3 antagonist, appears to have promise as a treatment.[116]

LSD redigér

According to a retrospective analysis of six studies from the 1960s and 1970s LSD-assisted psychotherapy has potential as a treatment for alcoholism.[117][118] Bill Wilson, the founder of Alcoholics Anonymous, believed LSD might help alcoholics achieve sobriety.[119]

Henvisninger redigér

  1. ^ American Heritage Dictionaries (2006). The American Heritage dictionary of the English language (4 udgave). Boston: Houghton Mifflin. ISBN 978-0-618-70172-8. To use wrongly or improperly; misuse: abuse alcohol
  2. ^ "Dietary Guidelines for Americans 2005". health.gov. 2005. Arkiveret fra originalen 1 juli 2007. Hentet 28 november 2009.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link) Dietary Guidelines
  3. ^ See question 16 of the Severity of Alcohol Dependence Questionnaire.
  4. ^ "Young Adult Drinking". Alcohol Alert (68). april 2006. Arkiveret fra originalen 13 februar 2013. Hentet 18 februar 2013.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  5. ^ Esser, Marissa B.; Hedden, Sarra L.; Kanny, Dafna; Brewer, Robert D.; Gfroerer, Joseph C.; Naimi, Timothy S. (20 november 2014). "Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011". Preventing Chronic Disease. 11: E206. doi:10.5888/pcd11.140329. PMC 4241371. PMID 25412029.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  6. ^ McGovern, Thomas F.; White, William L. (2003). Alcohol Problems in the United States: Twenty Years of Treatment Perspective. Routledge. s. 7–. ISBN 978-0-7890-2049-9. Hentet 17 april 2010.{{cite book}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  7. ^ Skabelon:DorlandsDict
  8. ^ a b c Thombs, Dennis L (1999). Introduction To Addictive Behaviors 2ed. London: The Guildford Press. s. 64-65.
  9. ^ a b VandenBos, Gary R. (2006). APA dictionary of psychology. Washington, DC: American Psychological Association. ISBN 978-1-59147-380-0.
  10. ^ a b "Diagnostic Criteria for Alcohol Abuse and Dependence – Alcohol Alert No. 30-1995". Arkiveret fra originalen 27 marts 2010. Hentet 17 april 2010.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  11. ^ Martin, CS; Chung, T; Langenbucher, JW (august 2008). "How Should We Revise Diagnostic Criteria for Substance Use Disorders in the DSM–V?". J Abnorm Psychol. 117 (3): 561-75. doi:10.1037/0021-843X.117.3.561. PMC 2701140. PMID 18729609.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  12. ^ "Proposed Revision | APA DSM-5". Arkiveret fra originalen 25 marts 2010. Hentet 17 april 2010.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  13. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet ladtpwho
  14. ^ "A System to Convert ICD Diagnostic Codes for Alcohol Research". Arkiveret fra originalen 24 april 2009. Hentet 17 april 2010.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  15. ^ Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association. 1994. ISBN 978-0-89042-025-6.
  16. ^ Morse, RM; Flavin, DK (august 1992). "The definition of alcoholism. The Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine to Study the Definition and Criteria for the Diagnosis of Alcoholism". JAMA: The Journal of the American Medical Association. 268 (8): 1012-14. doi:10.1001/jama.1992.03490080086030. ISSN 0098-7484. PMID 1501306.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  17. ^ Skabelon:MeshName
  18. ^ a b c The first 100 members of AA (2001) [1939]. Alcoholics Anonymous: the story of how many thousands of men and women have recovered from alcoholism. New York: Alcoholics Anonymous World Services. xxxii, 575. ISBN 978-1-893007-16-1. Arkiveret fra originalen 30 april 2017. {{cite book}}: Ukendt parameter |nopp= ignoreret (|no-pp= foreslået) (hjælp)
  19. ^ Kay, AB (2000). "Overview of 'allergy and allergic diseases: with a view to the future'". Br. Med. Bull. 56 (4): 843-64. doi:10.1258/0007142001903481. ISSN 0007-1420. PMID 11359624.
  20. ^ "The Big Book Self Test". intoaction.us. Arkiveret fra originalen 23 november 2007. Hentet 19 februar 2008.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  21. ^ "October 22 Deaths". todayinsci.com. Arkiveret fra originalen 7 februar 2008. Hentet 18 februar 2008.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  22. ^ a b Volkow, Nora. "Science of Addiction" (PDF). American Medical Association. Arkiveret (PDF) fra originalen 29 juni 2011.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  23. ^ Blum, Laura N.; Nielsen, Nancy H.; Riggs, Joseph A.; Council on Scientific Affairs, American Medical Association (september 1998). "Alcoholism and alcohol abuse among women: report of the council on scientific affairs". Journal of Women's Health. 7 (7): 861-70. doi:10.1089/jwh.1998.7.861. PMID 9785312. {{cite journal}}: Ugyldig |ref=harv (hjælp)CS1-vedligeholdelse: Dato automatisk oversat (link)
  24. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet Karrol Brad R. 2002 337–356
  25. ^ US Preventive Services Task, Force.; Curry, SJ; Krist, AH; Owens, DK; Barry, MJ; Caughey, AB; Davidson, KW; Doubeni, CA; Epling JW, Jr; Kemper, AR; Kubik, M; Landefeld, CS; Mangione, CM; Silverstein, M; Simon, MA; Tseng, CW; Wong, JB (13 november 2018). "Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: US Preventive Services Task Force Recommendation Statement". JAMA. 320 (18): 1899-1909. doi:10.1001/jama.2018.16789. PMID 30422199.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  26. ^ Kahan, M (april 1996). "Identifying and managing problem drinkers". Can Fam Physician. 42: 661-71. PMC 2146411. PMID 8653034.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  27. ^ Ewing, JA (oktober 1984). "Detecting alcoholism. The CAGE questionnaire". JAMA: The Journal of the American Medical Association. 252 (14): 1905-07. doi:10.1001/jama.1984.03350140051025. ISSN 0098-7484. PMID 6471323.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  28. ^ "CAGE questionnaire – screen for alcohol misuse" (PDF). Arkiveret fra originalen (PDF) 28 juli 2011.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  29. ^ Dhalla, S; Kopec, JA (2007). "The CAGE questionnaire for alcohol misuse: a review of reliability and validity studies". Clin Invest Med. 30 (1): 33-41. doi:10.25011/cim.v30i1.447. PMID 17716538.
  30. ^ Raistrick, D.; Dunbar, G.; Davidson, R. (1983). "Alcohol Dependence Data Questionnaire (SADD)". European Monitoring Centre for Drugs and Drug Addiction. Arkiveret fra originalen 21 juli 2016.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  31. ^ "Michigan Alcohol Screening Test". The National Council on Alcoholism and Drug Dependence. Arkiveret fra originalen 6 september 2006.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  32. ^ Babor, Thomas F.; Higgins-Biddle, John C.; Saunders, John B.; Monteiro, Maristela G. (2001). "The Alcohol Use Disorders Identification Test; Guidelines for Use in Primary Care" (PDF). World Health Organization. Arkiveret fra originalen (PDF) 2 maj 2006.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  33. ^ Smith, SG; Touquet, R; Wright, S; Das Gupta, N (september 1996). "Detection of alcohol misusing patients in accident and emergency departments: the Paddington alcohol test (PAT)". Journal of Accident and Emergency Medicine. 13 (5): 308-12. doi:10.1136/emj.13.5.308. ISSN 1351-0622. PMC 1342761. PMID 8894853.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  34. ^ a b Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet DSM5
  35. ^ Jones, AW (2006). "Urine as a biological specimen for forensic analysis of alcohol and variability in the urine-to-blood relationship". Toxicol Rev. 25 (1): 15-35. doi:10.2165/00139709-200625010-00002. PMID 16856767.
  36. ^ Das, SK; Dhanya, L; Vasudevan, DM (2008). "Biomarkers of alcoholism: an updated review". Scand J Clin Lab Invest. 68 (2): 81-92. doi:10.1080/00365510701532662. PMID 17852805.
  37. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet NIHHx
  38. ^ World Health Organization (2010). "Alcohol". Arkiveret fra originalen 26 februar 2010.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  39. ^ "Alcohol policy in the WHO European Region: current status and the way forward" (PDF). World Health Organization. 12 september 2005. Arkiveret fra originalen (PDF) 23 januar 2010.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  40. ^ Crews, F; He, J; Hodge, C (februar 2007). "Adolescent cortical development: a critical period of vulnerability for addiction". Pharmacol Biochem Behav. 86 (2): 189-99. doi:10.1016/j.pbb.2006.12.001. PMID 17222895.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  41. ^ a b Gabbard, Glen O. (2001). Treatments of psychiatric disorders (3 udgave). Washington, DC: American Psychiatric Press. ISBN 978-0-88048-910-2.
  42. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet Blondell-2005
  43. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet pmid20148778
  44. ^ Stavro, K; Pelletier, J; Potvin, S (januar 2012). "Widespread and sustained cognitive deficits in alcoholism: a meta-analysis". Addict Biol. 18 (2): 203-13. doi:10.1111/j.1369-1600.2011.00418.x. PMID 22264351.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  45. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet Morgan-Lopez-2006
  46. ^ Smith, M.A., Melinda; Saisan, M.S.W., Joanna (2016). "Self-Help Groups for Alcohol Addiction". Arkiveret fra originalen 21 maj 2015.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  47. ^ Kelly JF, Humphreys K, Ferri M (2020). "Alcoholics Anonymous and other 12‐step programs for alcohol use disorder". Cochrane Database of Systematic Reviews (Systematic review). 3: CD012880. doi:10.1002/14651858.CD012880.pub2. PMC 7065341. PMID 32159228.
  48. ^ Dawson, DA; Grant, BF; Stinson, FS; Chou, PS; Huang, B; Ruan, WJ (2005). "Recovery from DSM-IV alcohol dependence: United States, 2001–2002". Addiction. 100 (3): 281-92. doi:10.1111/j.1360-0443.2004.00964.x. PMID 15733237. Arkiveret fra originalen 19 juli 2011.
  49. ^ Dawson, DA; Goldstein, RB; Grant, BF (2007). "Rates and correlates of relapse among individuals in remission from DSM-IV alcohol dependence: a 3-year follow-up". Alcoholism: Clinical and Experimental Research. 31 (12): 2036-45. doi:10.1111/j.1530-0277.2007.00536.x. PMID 18034696.
  50. ^ Sobell, Mark B.; Sobell, Linda C. (1973). "Individualized behavior therapy for alcoholics". Behavior Therapy. 4: 49-72. doi:10.1016/S0005-7894(73)80074-7.
  51. ^ Pendery, M.; Maltzman, I.; West, L. (1982). "Controlled drinking by alcoholics? New findings and a reevaluation of a major affirmative study". Science. 217 (4555): 169-175. Bibcode:1982Sci...217..169P. doi:10.1126/science.7089552. PMID 7089552.
  52. ^ "Alcoholism Study Under New Attack". The New York Times. 28 juni 1982. The new article will say that, 10 years later, four of the 20 had died from alcohol-related causes. Eight others were still drinking excessively, six were abstinent but in most cases after multiple hospitalizations, and one was drinking moderately. The alcohol dependence of that last case was also questioned. Another subject, who could not be found, was reported gravely disabled.{{cite news}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  53. ^ Vaillant, GE (2003). "A 60-year follow-up of alcoholic men". Addiction. 98 (8): 1043-51. doi:10.1046/j.1360-0443.2003.00422.x. PMID 12873238. S2CID 12835128.
  54. ^ Riper, H; Hoogendoorn, A; Cuijpers, P; Karyotaki, E; Boumparis, N; Mira, A; Andersson, G; Berman, AH; Bertholet, N; Bischof, G; Blankers, M; Boon, B; Boß, L; Brendryen, H; Cunningham, J; Ebert, D; Hansen, A; Hester, R; Khadjesari, Z; Kramer, J; Murray, E; Postel, M; Schulz, D; Sinadinovic, K; Suffoletto, B; Sundström, C; de Vries, H; Wallace, P; Wiers, RW; Smit, JH (december 2018). "Effectiveness and treatment moderators of internet interventions for adult problem drinking: An individual patient data meta-analysis of 19 randomised controlled trials". PLOS Medicine. 15 (12): e1002714. doi:10.1371/journal.pmed.1002714. PMC 6298657. PMID 30562347.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  55. ^ "Alcohol and Other Drugs". Alcohol Alert. National Institute on Alcohol Abuse and Alcoholism (76). juli 2008. Arkiveret fra originalen 28 juli 2013. Hentet 11 juli 2013.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  56. ^ Mason, BJ; Heyser, CJ (januar 2010). "The neurobiology, clinical efficacy and safety of acamprosate in the treatment of alcohol dependence". Expert Opin Drug Saf. 9 (1): 177-88. doi:10.1517/14740330903512943. PMID 20021295.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  57. ^ Mason, BJ; Heyser, CJ (marts 2010). "Acamprosate: A prototypic neuromodulator in the treatment of alcohol dependence". CNS Neurol Disord Drug Targets. 9 (1): 23-32. doi:10.2174/187152710790966641. PMC 2853976. PMID 20201812.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  58. ^ Rösner, S; Hackl-Herrwerth, A; Leucht, S; Lehert, P; Vecchi, S; Soyka, M (2010). Rösner, Susanne (red.). "Acamprosate for alcohol dependence". Cochrane Database of Systematic Reviews (Submitted manuscript). 128 (9): 379. doi:10.1002/14651858.CD004332.pub2. PMID 20824837.
  59. ^ a b c d Jonas, DE; Amick, HR; Feltner, C; Bobashev, G; Thomas, K; Wines, R; Kim, MM; Shanahan, E; Gass, CE; Rowe, CJ; Garbutt, JC (14 maj 2014). "Pharmacotherapy for Adults With Alcohol Use Disorders in Outpatient Settings". JAMA. 311 (18): 1889-900. doi:10.1001/jama.2014.3628. PMID 24825644.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  60. ^ Soyka, M; Rösner, S (november 2008). "Opioid antagonists for pharmacological treatment of alcohol dependence – a critical review". Curr Drug Abuse Rev. 1 (3): 280-91. doi:10.2174/1874473710801030280. PMID 19630726.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  61. ^ Anderson, Kenneth (28 juli 2013). "Drink Your Way Sober with Naltrexone". Psychology Today. Arkiveret fra originalen 20 juni 2014. Hentet 18 juli 2016.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  62. ^ a b Sinclair, JD (2001). "Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism". Alcohol and Alcoholism. 36 (1): 2-10. doi:10.1093/alcalc/36.1.2. PMID 11139409.
  63. ^ Lindsay, S.J.E.; Powell, Graham E., red. (28 juli 1998). The Handbook of Clinical Adult Psychology (2nd udgave). Routledge. s. 402. ISBN 978-0-415-07215-1. {{cite book}}: Cite har en ukendt tom parameter: |chapterurl= (hjælp)CS1-vedligeholdelse: Dato automatisk oversat (link)
  64. ^ Gitlow, Stuart (2006). Substance Use Disorders: A Practical Guide (2nd udgave). Lippincott Williams & Wilkins. s. 52, 103-21. ISBN 978-0-7817-6998-3.
  65. ^ Kushner, MG; Abrams, K; Borchardt, C (marts 2000). "The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings". Clin Psychol Rev. 20 (2): 149-71. doi:10.1016/S0272-7358(99)00027-6. PMID 10721495.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  66. ^ Ogborne, AC (juni 2000). "Identifying and treating patients with alcohol-related problems". CMAJ. 162 (12): 1705-08. PMC 1232509. PMID 10870503.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  67. ^ a b Soyka, M; Müller, CA (august 2017). "Pharmacotherapy of alcoholism – an update on approved and off-label medications". Expert Opinion on Pharmacotherapy. 18 (12): 1187-99. doi:10.1080/14656566.2017.1349098. PMID 28658981.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  68. ^ Cservenka, A; Yardley, MM; Ray, LA (august 2017). "Review: Pharmacogenetics of alcoholism treatment: Implications of ethnic diversity". The American Journal on Addictions. 26 (5): 516-25. doi:10.1111/ajad.12463. PMC 5484746. PMID 28134463.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  69. ^ Poulos, CX; Zack, M (november 2004). "Low-dose diazepam primes motivation for alcohol and alcohol-related semantic networks in problem drinkers". Behav Pharmacol. 15 (7): 503-12. doi:10.1097/00008877-200411000-00006. ISSN 0955-8810. PMID 15472572.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  70. ^ Johansson, BA; Berglund, M; Hanson, M; Pöhlén, C; Persson, I (november 2003). "Dependence on legal psychotropic drugs among alcoholics" (PDF). Alcohol and Alcoholism. 38 (6): 613-18. doi:10.1093/alcalc/agg123. ISSN 0735-0414. PMID 14633651. Arkiveret fra originalen 20 februar 2009.
  71. ^ "Alcohol consumption per person". Our World in Data. Hentet 5 marts 2020.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  72. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet WHO2014
  73. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet Pew2015
  74. ^ a b "Alcohol misuse: How much does it cost?" (PDF). Cabinet Office Strategy Unit. september 2003. Arkiveret fra originalen (PDF) 15 maj 2011.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  75. ^ Hasin, DS; Stinson, FS; Ogburn, E; Grant, BF (2007). "Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States". Archives of General Psychiatry. 64 (7): 830-42. doi:10.1001/archpsyc.64.7.830. PMID 17606817.
  76. ^ "alcoholism". Encyclopædia Britannica. 2010. Arkiveret fra originalen 2 december 2010.{{cite encyclopedia}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  77. ^ Ballas, Dimitris; Dorling, Danny; Hennig, Benjamin (2017). The Human Atlas of Europe. Bristol: Policy Press. s. 73. ISBN 978-1-4473-1354-0.
  78. ^ Vonghia, Luisa; Leggio, Lorenzo; Ferrulli, Anna; Bertini, Marco; Gasbarrini, Giovanni; Addolorato, Giovanni; Alcoholism Treatment Study Group (december 2008). "Acute alcohol intoxication". European Journal of Internal Medicine. 19 (8): 561-67. doi:10.1016/j.ejim.2007.06.033. ISSN 1879-0828. PMID 19046719.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  79. ^ Walter, H; Gutierrez, K; Ramskogler, K; Hertling, I; Dvorak, A; Lesch, OM (november 2003). "Gender-specific differences in alcoholism: implications for treatment". Archives of Women's Mental Health. 6 (4): 253-58. doi:10.1007/s00737-003-0014-8. PMID 14628177.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  80. ^ Dick, DM; Bierut, LJ (april 2006). "The genetics of alcohol dependence". Current Psychiatry Reports. 8 (2): 151-57. doi:10.1007/s11920-006-0015-1. ISSN 1523-3812. PMID 16539893.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  81. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet Enoch-2006
  82. ^ "About 37 percent of college students could now be considered alcoholics". Emerald Media. Arkiveret fra originalen 17 oktober 2013.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  83. ^ Fodnotefejl: Ugyldigt <ref>-tag; ingen tekst er angivet for referencer med navnet Schu2014
  84. ^ Zuskin, E; Jukić, V; Lipozencić, J; Matosić, A; Mustajbegović, J; Turcić, N; Poplasen-Orlovac, D; Bubas, M; Prohić, A (december 2006). "[Alcoholism – how it affects health and working capacity]". Arh Hig Rada Toksikol. 57 (4): 413-26. PMID 17265681.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  85. ^ American Psychiatric Association practice guidelines for the treatment of psychiatric disorders. Arlington, VA: American Psychiatric Association. 2006. s. 1346. ISBN 978-0-89042-385-1. Arkiveret fra originalen 29 maj 2016.{{cite book}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  86. ^ O'Connor, Rory; Sheehy, Noel (29 januar 2000). Understanding suicidal behaviour. Leicester: BPS Books. s. 33-37. ISBN 978-1-85433-290-5.{{cite book}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  87. ^ The National Institute on Alcohol Abuse and Alcoholism; U.S. Department of Health and Human Services, NIH News (18 januar 2005). "2001–2002 Survey Finds That Many Recover From Alcoholism". National Institutes of Health. Arkiveret fra originalen 18 august 2006.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  88. ^ Vaillant, GE (august 2003). "A 60-year follow-up of alcoholic men". Addiction. 98 (8): 1043-51. doi:10.1046/j.1360-0443.2003.00422.x. ISSN 0965-2140. PMID 12873238. S2CID 12835128.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  89. ^ Peters, Uwe Henrik (2007). Lexikon Psychiatrie, Psychotherapie, Medizinische Psychologie. Urban Fischer bei Elsev. ISBN 978-3-437-15061-6.
  90. ^ Valverde, Mariana (1998). Diseases of the Will. Cambridge: Cambridge University Press. s. 48. ISBN 978-0-521-64469-3.
  91. ^ Tracy, Sarah J. (2005). Alcoholism in America: from reconstruction to prohibition. Baltimore: Johns Hopkins University Press. s. 31-52. ISBN 978-0-8018-8119-0.
  92. ^ Alcoholismus chronicus, eller Chronisk alkoholssjukdom. Stockholm und Leipzig. 1852. Hentet 19 februar 2008.{{cite book}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  93. ^ Blocker, Jack S. (februar 2006). "Did Prohibition Really Work? Alcohol Prohibition as a Public Health Innovation". American Journal of Public Health. 96 (2): 233-43. doi:10.2105/AJPH.2005.065409. PMC 1470475. PMID 16380559. Nevertheless, once Prohibition became the law of the land, many citizens decided to obey it. Referendum results in the immediate post-Volstead period showed widespread support, and the Supreme Court quickly fended off challenges to the new law. Death rates from cirrhosis and alcoholism, alcoholic psychosis hospital admissions, and drunkenness arrests all declined steeply during the latter years of the 1910s, when both the cultural and the legal climate were increasingly inhospitable to drink, and in the early years after National Prohibition went into effect.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  94. ^ Potter, James V. (2008). Substances of Abuse. Vol. 2. AFS Publishing Co. s. 1-13. ISBN 978-1-930327-46-7.
  95. ^ "Alcohol and health" (PDF). WHO. Hentet 3 maj 2020.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  96. ^ McCully, Chris (2004). Goodbye Mr. Wonderful. Alcohol, Addition and Early Recovery. London: Jessica Kingsley Publishers. ISBN 978-1-84310-265-6. Arkiveret fra originalen 21 november 2009.{{cite book}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  97. ^ Streissguth, Ann Pytkowicz (2018). Fetal alcohol syndrome: a guide for families and communities. Baltimore: Paul H Brookes Pub. ISBN 978-1-55766-283-5.
  98. ^ Gerberding, Julie Louise; Cordero, José; Floyd, R. Louise (maj 2005). "Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis" (PDF). US Centers for Disease Control and Prevention. Arkiveret (PDF) fra originalen 11 juni 2014.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  99. ^ "Global Status Report on Alcohol 2004" (PDF). World Health Organization. Arkiveret (PDF) fra originalen 30 december 2006. Hentet 3 januar 2007.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  100. ^ "Economic cost of alcohol consumption". World Health Organization Global Alcohol Database. Arkiveret fra originalen 18 januar 2008. Hentet 3 januar 2007.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  101. ^ "Q&A: The costs of alcohol". BBC. 19 september 2003. Arkiveret fra originalen 19 oktober 2006.
  102. ^ Bouchery, EE; Harwood, HJ; Sacks, JJ; Simon, CJ; Brewer, RD (2011). "Economic Costs of Excessive Alcohol Consumption in the U.S., 2006" (PDF). American Journal of Preventive Medicine. 41 (5): 516-24. CiteSeerX 10.1.1.460.5582. doi:10.1016/j.amepre.2011.06.045. PMID 22011424. Arkiveret fra originalen (PDF) 21 juli 2018. Hentet 12 december 2017.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  103. ^ a b c Kirouac, Megan; Witkiewitz, Katie (15 oktober 2017). "Identifying "Hitting Bottom" among Individuals with Alcohol Problems: Development and Evaluation of the Noteworthy Aspects of Drinking Important to Recovery (NADIR)". Substance Use & Misuse. 52 (12): 1602-1615. doi:10.1080/10826084.2017.1293104. ISSN 1082-6084. PMC 6107067. PMID 28557550.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  104. ^ "Treatment of Alcohol Addiction". British Medical Journal. 2 (5455): 184-185. 24 juli 1965. doi:10.1136/bmj.2.5455.184. ISSN 0007-1447. PMC 1846501. PMID 20790596.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  105. ^ "World/Global Alcohol/Drink Consumption". Finfacts Ireland. 2009. Arkiveret fra originalen 12 maj 2015.
  106. ^ Stivers, Richard (2000). Hair of the dog: Irish drinking and its American stereotype. New York: Continuum. ISBN 978-0-8264-1218-8.
  107. ^ Chen, CC; Yin, SJ (2008). "Alcohol abuse and related factors in Asia". International Review of Psychiatry. 20 (5): 425-33. doi:10.1080/09540260802344075. PMID 19012127.
  108. ^ Wooksoo, K (2009). "Drinking Culture of Elderly Korean Immigrants in Canada: A Focus Group Study". Journal of Cross-Cultural Gerontology. 24 (4): 339-53. doi:10.1007/s10823-009-9104-z. PMID 19823926.
  109. ^ Li, H Z; Rosenblood, L (1994). "Exploring factors influencing alcohol consumption patterns among Chinese and Caucasians". Journal of Studies on Alcohol. 55 (4): 427-33. doi:10.15288/jsa.1994.55.427. PMID 7934050.
  110. ^ French, L (2008). "Psychoactive agents and Native American spirituality: Past and present". Contemporary Justice Review. 11 (2): 155-63. doi:10.1080/10282580802058270.
  111. ^ Olmsted, CL; Kockler, DR (oktober 2008). "Topiramate for alcohol dependence". Ann Pharmacother. 42 (10): 1475-80. doi:10.1345/aph.1L157. ISSN 1060-0280. PMID 18698008. S2CID 27071889.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  112. ^ Kenna, GA; Lomastro, TL; Schiesl, A; Leggio, L; Swift, RM (maj 2009). "Review of topiramate: an antiepileptic for the treatment of alcohol dependence". Curr Drug Abuse Rev. 2 (2): 135-42. doi:10.2174/1874473710902020135. PMID 19630744.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  113. ^ Leggio, L; Garbutt, JC; Addolorato, G (marts 2010). "Effectiveness and safety of baclofen in the treatment of alcohol dependent patients". CNS & Neurological Disorders Drug Targets. 9 (1): 33-44. doi:10.2174/187152710790966614. PMID 20201813.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  114. ^ Liu, Jia; Wang, Lu-Ning (6 november 2019). "Baclofen for alcohol withdrawal". The Cochrane Database of Systematic Reviews. 2019 (11). doi:10.1002/14651858.CD008502.pub6. ISSN 1469-493X. PMC 6831488. PMID 31689723.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  115. ^ "Autorisation du baclofène : des conditions d'utilisation trop restrictives ? - A la une". Destination Santé (fransk). 25 oktober 2018.{{cite web}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  116. ^ Kenna, GA (2010). "Medications acting on the serotonergic system for the treatment of alcohol dependent patients". Current Pharmaceutical Design. 16 (19): 2126-35. doi:10.2174/138161210791516396. PMID 20482508.
  117. ^ Frood, Arran (9 marts 2012). "LSD helps to treat alcoholism". Nature. doi:10.1038/nature.2012.10200. ISSN 1744-7933.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  118. ^ Garcia-Romeu, Albert; Davis, Alan K; Erowid, Fire; Erowid, Earth; Griffiths, Roland R; Johnson, Matthew W (14 maj 2019). "Cessation and reduction in alcohol consumption and misuse after psychedelic use". Journal of Psychopharmacology (engelsk). 33 (9): 1088-1101. doi:10.1177/0269881119845793. ISSN 0269-8811. PMID 31084460.{{cite journal}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
  119. ^ Hill, Amelia (23 august 2012). "LSD could help alcoholics stop drinking, AA founder believed". The Guardian.{{cite news}}: CS1-vedligeholdelse: Dato automatisk oversat (link)
Hentet fra "https://da.wikipedia.org/w/index.php?title=Bruger:Metalindustrien/Kasse6&oldid=10757347"