These criteria is geared toward separating individuals whose use of a substance is hazardous (dependence) from those who use is merely harmful (abuse). The distinction is not always clear, and considerable overlap exists between dependence and abuse. These disorders are probably better thought of as lying along a continuum of severity.
Alcohol-Related disordersNearly two-thirds of American adults occasionally drink alcoholic beverages, whereas 12% are heavy drinkers. The lifetime prevalence for alcohol dependence is almost 14%; in any given 6-month period, 5% of persons will meet criteria for lifetime alcohol dependence. There are about 2 to three alcoholic men for each alcoholic woman. Onset in men occurs earlier than in women., although the medical complications ofalcoholism progress more rapidly in women. Classification ;Type I alcoholic persons are characterized by an adult onset; gradually increasing consumption; personality characteristics of guilt. Worry, dependency, and introversion; little or no family history of alcoholism; equal prevalence in men and women; and better response to treatment. Type II – characterized by early onset; personality characteristics of impulsivity, distractability, and recklessness; presence of antisocial personality disorder; a strong family history of alcoholism; male gender; and poor treatment response. Diagnosis – alcohol use disorder can usually be diagnosed on the basis of a careful history and mental status examination.CAGEtest is a simple screen test for the presence of alcohol abuse or dependence. A positive or overly defensive answer suggest that a problem exist.Blood alcohol concentration can be useful in detecting alcohol abuse or dependence. It can be roughly correlated to level of intoxication. 0.08 g per 100 ml, equivalent to 80 mg/dl is considered legal level in many jurisdiction. Alcohol Breath test standard part of roadside assessment for driving impairment. In the hospital, blood alcohol level is used.Clinical findings:There is no standard or general clinical picture of the alcoholic person.In its earliest stages, subtle change in work habits or productivity lateness or unexplained absences or minor personality changes such as irritability or moodiness.As alcoholism progresses, minor physical changes begin to occur, including development of acne rosacea, palmar erythema, painless enlargement of the liver consistent with fatty infiltration the earliest form of alcoholic liver disease. Advancing signs of liver disease includes jaundice orascites, testicular atrophy, gynecomastia and Dupuytren’s contractures may also occur. Complications:Alcoholism can affect a person’s medical and emotional health and lead to a broad range of social problems. This includes -Wernicke-Korsakoff syndrome occurs when cognitive and memory impairment endures, although it may be reversible in one-third of patients. It involves an anterograde amnesia characterized by the presence of confabulation in which a patient invents stories to fill in memory gaps.