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Alcohol Abuse: How do you assess a problem?

Alcoholism Gene Factors Show Up in Very Young

Negative Effects of Alcohol Abuse on Women

Negative Effects of Alcohol Abuse on Adolescents and the Elderly

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The Negative Effects of Alcohol Abuse on Women 

Effects of Alcohol Abuse on Women: 

The effects of alcohol abuse on women are much less predictable than with men. While women are much more likely to abstain from alcohol and drink less than men, when they do drink, the effects of alcohol abuse are known to be very different. Problem drinking among women is much more likely to lead to or be associated with mood disorders such as depression, anxiety and somatic symptoms. Alcoholic women are much more likely to point to negative emotions and interpersonal conflicts to be antecedents to their problem drinking then do men. These findings are consistent with epidemiological studies which indicate that women are much more likely than men to have concurrent mood disorders along with their alcohol abuse.  Also, it is more common for their mood disorders to precede their problem drinking. The effects of alcohol abuse on women are also very different in terms of the context of their problem drinking. 

Effects of alcohol abuse on women: Negative versus positive profiles 

Alcoholic behavior among women is much more likely to result in a negative drinking profile than with men, who seem to drink within more of a positive context. Women seem to exhibit a much more negative drinking profile than men, frequently characterized by solitary drinking resulting in a greater severity of alcohol dependence.  Men frequently seem to have a more positive profile in that they drink socially and more in the context of positive emotions. Studies on alcoholic women have also found that they are usually significantly older than men when a variety of alcoholic markers begin to emerge such as regular drunkenness, loss of control over drinking, to relieve withdrawal symptoms, first attempt to stop drinking, and the realization that they are abusing alcohol.  Women also seem to exhibit a more rapid progression than men between the time of first regular intoxication and the need for alcohol treatment. 


Effects of alcohol abuse and metabolism in women: 

Another significant effect of alcohol abuse on women is that their smaller average body mass results in higher blood alcohol levels in response to a specific consumption level.  It is also believed, that additionally, less first-pass metabolism due to less gastric oxidation of ethanol may also contribute to the higher blood levels obtained by women following the same equivalent dosage of ethanol.  Women alcoholics, when compared to men, are also at greater risk of comorbid drug abuse and dependence.  Probably due to these factors, women also have a tendency to seek alcohol treatment earlier in the course of the disorder than do men. 

Pregnancy, childbearing, and the effects of alcohol abuse: 

Alcohol abuse appears to be most prevalent during the childbearing years, resulting in important public health concerns related to prenatal alcohol exposure and possible fetal alcohol effects.  While all the effects of alcohol abuse on women have not been identified, there does appear to be a variety of adverse outcomes related to heavy drinking in pregnant women.  Heavy drinking over a period of time has been known to produce malnutrition in both the mother and fetus, as well as sometimes resulting in spontaneous abortion, preterm delivery and intrauterine growth retardation.  The birth defects related to alcohol are estimated to be as high as 1 in 100 live births.  The most severe manifestation of alcohol-related birth defects is fetal alcohol syndrome, resulting in a constellation of morphological and developmental defects resulting from prenatal alcohol exposure of high dosage.  Fetal alcohol syndrome is estimated to occur in 1 in 1000 to 1 in 300 live births.  Prenatal or postnatal growth retardation, central nervous system involvement and characteristic facial dysmorphology are necessary for diagnosis of fetal alcohol syndrome. 

Assessment of the effects of alcohol abuse: 

The effects of alcohol abuse should be evaluated among alcoholic pregnant women and should routinely include questions about alcohol and other substances used.  Screening with an instrument such as the AUDIT or the T-ACE in addition to questions related to drug use may be extremely useful in understanding the effects of alcohol abuse on pregnant alcoholic women.  Women who are known to drink heavily and use drugs should be designated as "high-risk" and should be given specialized, comprehensive perinatal care, including rehabilitation and appropriate attention to related psychosocial disabilities to limit the effects of alcohol abuse on themselves and their babies.

From DSM-IV-TR Mental Disorders: Diagnosis, Etiology and Treatment by Michael B. First and Allan Tasman

Additional Information and webpage by Paul Susic  Ph.D. Licensed Psychologist   (Health and Geriatric Psychologist)

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