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Alcohol abuse and addiction is drug addiction. Due to the acceptance of the “social drink” in society, individuals often consider it to be an acceptable drug. When alcohol intake becomes uncontrolled, a preoccupation or compulsive drinking becomes a problem. Alcohol consumption disorder is diagnosed. Alcoholism is classically defined as more than three drinks per day or seven per week for women. For men, that’s four or more drinks a day or 14 a week. Although today, alcoholism is often seen as a drink that is recognized as out of control. People who use hard liquor, wine or beer can become alcoholics.
Some individuals are considered alcoholics even though they drink far less than the defined amounts. Some drink only on weekends, usually classified as drunks; however, there is still the worry of weekend anticipation or an uncontrollable ability to stop once started. Others are high functioning in that they maintain a job and a lifestyle that does not equate to the stereotypical alcoholic as being unable to cope with the demands of daily life. However, they are anticipating alcohol or overreacting when presented with alcohol. This can sometimes be referred to as functional alcoholism or a ‘dry drunk’, as the amount of alcohol consumed after hours stays in the body until consumption is resumed. Others keep their alcohol hidden at work or at home just to pretend they’re drinking less than they really are.
Poisoning often plays a role in brain injury or spinal cord injury from trauma or disease. Intoxication occurs in 50% of these at the time of the traumatic brain injury. Alcohol is a risk factor for hemorrhagic stroke. If you’ve already had an ischemic (blood clot) or hemorrhagic (bleeding in the brain) stroke, you have a significant risk of having a second stroke with alcohol consumption. It is estimated that one third of people who suffer a spinal cord injury are intoxicated at the time of the trauma. This can be from chronic alcohol abuse or a one-off binge at the wrong time.
One of the key problems in all addictions, especially alcoholism, is the lack of awareness of the situation. A person may justify drinking alcohol based on how it makes them feel. At first they may experience some euphoria, relief from problems, relaxation and disregard for worries and concerns. Although the individual is extremely aware of what they are doing, the desire to escape from the reality of life can be overwhelming. They may not be able to resolve their craving for alcohol with its effects on their body and life.
Recognizing alcoholism in a person’s life is a challenge. Human bodies react differently as they metabolize alcohol. Some individuals are less able to metabolize alcohol than others. Some do not care for the taste or effects of alcohol and refuse to drink it. Others crave the taste and effects. People with alcoholism have difficulty controlling their consumption. It can be a desire to drink or a compulsion to have another drink. They may not recognize concerns about their own behavior or how their drinking affects those around them.
Symptoms of alcohol abuse include changes in mental status, blackouts, tremors, sweating, aggression, agitation, poor judgment, self-abusive or self-destructive behavior, physical or emotional harm to others, compulsivity, guilt, loneliness, isolation, nausea and vomiting, delirium, incoordination, distortion, or tremors. You may have all, some, or only some symptoms with varying degrees of intensity.
For people with central nervous system (CNS) injuries, such as brain injury, stroke, or spinal cord injury from trauma or disease, symptoms of alcoholism can exacerbate existing problems. Mental acuity can be dulled. The inability to sweat can lead to overheating of the body temperature. If judgment is a concern, poor judgment is further enhanced. The seizure threshold is lowered. Movement is less controlled. The fall increases. The tone (spasms) may or may not decrease initially, but then increase greatly. Alcohol reduces the desire to take care of oneself. The high sugar content in alcohol increases the risk of diabetes and urinary incontinence, which increases pressure injury and infection. Bowel control decreases, causing incontinence. High calories in alcohol lead to weight gain, which makes transfers less independent. Alcohol can cause brain injury or further injury to the brain and central nervous system.
After a brain or spinal cord injury, your body is more sensitive to alcohol. As with any drug use, progress in rehabilitation is slower and outcomes are poorer for people who abuse alcohol. Stopping alcohol consumption after central nervous system trauma is recommended because it increases the risks of bodily harm from falls, poor judgment, depression, and delays or may even stop nervous system recovery.
Alcohol can interfere with medications needed after a central nervous system injury. Because alcohol and many drugs are metabolized in the liver, the competition to metabolize alcohol and drugs is confounded. These medications include antibiotics, antidepressants, antihistamines, muscle relaxants, non-narcotic pain relievers and some narcotics, anti-inflammatories, opioids, and the blood thinner warfarin, among many others.
It is very difficult to recognize alcoholism in yourself, especially if you have been abusing it for a long time. Individuals typically rationalize their consumption as they go along. Some individuals rationalize that if they only drink on weekends, in social situations, or limit themselves to wine or beer, they are not alcoholics. You should pay attention to the people who love and care for you, as well as to your health professionals if they express concern about your drinking.
If you think you may have a problem with alcohol, if it’s suggested to you, or if you want to verify that you don’t have a problem, check with your health care provider. You can also take inventory of your drink by honestly answering the questions here. The Substance Abuse and Mental Health Services Administration, through the US Department of Health and Human Services, has a wealth of information on a variety of alcohol and drug abuse topics.
Self-medication with alcohol does not treat underlying problems such as central nervous system injury or depression. In fact, it makes both issues worse. If you have mental health problems, seek help from your doctor. Mental health problems are chemical imbalances in the brain. They can be helped. Alcohol is not a cure and can further affect your mental health.
There are prescription medications that can be used to help you resist drinking. These include naltrexone (blocks brain receptors), acamprosate (prevents the negative feelings that encourage people to drink), and disulfiram (causes nausea and vomiting in response to alcohol consumption).
Treatment programs include Alcoholics Anonymous, Sobriety Management, and Smart Recovery. Each of these programs works differently, so see which program might work best for you.
Stay away from people who allow you to drink. This can be difficult if you have carers or rely on family support. Some people bully their carers and families into providing them with alcohol and drugs they can no longer get for themselves. This harassment by the individual is usually given in by the enablers, as the belligerence is too intolerable or they too are addicts. Family members give up because they feel sorry for the person. Injury to the central nervous system is not the end of life. You can be successful without the harm of alcohol or other drugs. Use the advice to help you and any facilitator look for opportunities to change strategies. Alcoholism is a family problem, even if only one person drinks.
Never drink and drive or ride with someone who has been drinking.
Remember that stopping an addiction is a process. It takes dedication and determination. If you make a mistake, acknowledge that fact and correct it immediately. You can be successful. Nurse Linda
Pediatric consideration:
Underage drinking is a concern. It can be a challenge for parents to keep up with children and teenagers, especially when they meet their peers. Most children do not drink alcohol, but there is the temptation of peer pressure or the thought that it will make their situation easier. The brain is still developing until about age 25. Drinking can affect this development. It can make learning difficult.
Talking about alcohol and drug use in the home is effective against abuse. Teaching children about the effects of alcohol and drugs as well as demonstrating behavior is a good lesson for everyone. Nurse Linda
Linda Schultz has been a rehabilitation nursing leader, teacher, and provider for over 30 years. In fact, Nurse Linda worked closely with Christopher Reeve in his recovery and has since championed the Reeve Foundation.
In our community, Nurse Linda is a blogger where she focuses on providing functional advice, providing the “how to” for integrating various health improvements into daily life, and answering your specific questions. Read their blogs here.
And if you want more of Nurse Linda, sign up for her monthly webinars here. Don’t worry, we’ve archived their answers so you can refer back and check out their advice. Consider it Nurse Linda on Demand!
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