contd. from

Exams and Tests

The diagnosis of alcoholism is generally made by reviewing the person's behavior except when the person has symptoms of withdrawal or damage to organs as a result of alcohol consumption.

Alcoholism, as defined, is the consumption of alcohol to the point at which it interferes with the individual's life from an occupational, social, or health standpoint. It follows that behavior exhibited by an alcoholic can be interpreted in different ways by different people. This often makes the diagnosis of alcoholism somewhat difficult.

• Several screening tests are routinely employed by many health care professionals to identify people at risk for alcoholism. Such tests usually consist of 1 or more questionnaires. Commonly used tests are the Michigan Alcoholism Screening Test (MAST), the TACE questionnaire, and the CAGE questionnaire.
  • The CAGE questionnaire, for example, asks the following 4 questions. "Yes" answers to 2 or more of these questions indicate a high likelihood of alcoholism.
    • Have you felt you should Cut down on your drinking?
    • Have people Annoyed you by criticizing your drinking?
    • Have you felt bad or Guilty about your drinking?
    • Have you ever had to drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?
  • The TACE questionnaire is very similar. It also asks 4 questions. The more "yes" answers a person has to these questions, the higher the likelihood of this person drinking excessively.
    • How many drinks does it Take to get you high?
    • Have people Annoyed you by criticizing your drinking?
    • Have you ever felt you ought to Cut down on your drinking?
    • Have you ever had a drink first thing in the morning to steady your nerves (Eye opener)?
• The doctor may draw blood to evaluate it for liver functions, anemia, and electrolyte levels (blood chemistry levels). Alcoholics often have elevated liver function tests, which indicate liver damage. Gamma glutamyl transferase is the most sensitive liver function test. It can be elevated after only a few weeks of excess alcohol consumption. Alcoholics may also have anemia (low blood count), as well as electrolyte disturbances including low potassium, low magnesium, and low calcium.
• Often the initial visit with a doctor is for medical or surgical complications of alcohol consumption. In those cases the doctor will perform and order additional tests depending on the symptoms (for example, abdominal pain, heart failure, alcohol withdrawal, or cirrhosis).

Alcoholism Treatment

Self-Care at Home

Alcoholism is best treated by professionals trained in addiction medicine. Physicians and other health care workers are best suited to manage alcohol withdrawal and the medical disorders associated with alcoholism.

In fact, home therapy without supervision by a trained professional may be life threatening because of complications from alcohol withdrawal syndrome. Usually an alcoholic will experience alcohol withdrawal 6-8 hours after cutting down or stopping alcohol consumption.

Several levels of care are available to treat alcoholism. Medically managed hospital-based detoxification and rehabilitation programs are used for more severe cases of dependence that occur with medical and psychiatric complications. Medically monitored detoxification and rehabilitation programs are used for people who are dependent on alcohol and who do not require more closely supervised medical care. The purpose of detoxification is to safely withdraw the alcoholic from alcohol and to help him or her enter a treatment program. The purpose of a rehabilitation program is to help the alcoholic accept the disease, begin to develop skills for sober living, and get enrolled in ongoing treatment and self-help programs. Most detoxification programs last just a few days. Most medically managed or monitored rehabilitation programs last less than 2 weeks.

Many alcoholics benefit from longer-term rehabilitation programs, day treatment programs, or outpatient programs. These programs involve education, therapy, addressing problems contributing to or resulting from the alcoholism, and learning skills to manage the alcoholism over time.

These skills include, but are not limited to, the following:

• Learning to identify and manage cravings to drink alcohol
• Resisting social pressures to engage in substance use
• Changing health care habits and lifestyle (for example, improving diet and sleep hygiene, and avoiding high-risk people, places, and events)
• Learning to challenge alcoholic thinking (thoughts such as, I need a drink to fit in, have fun, or deal with stress)
• Developing a recovery support system and learning how to reach out for help and support from others (for example, from members of self-help programs)
• Learning to deal with emotions (anger, anxiety, boredom, depression) and stressors without reliance on alcohol
• Identifying and managing relapse warning signs before alcohol is used
• Anticipating the possibility of relapse and addressing high-risk relapse factors

continue page 4

Reviewed: 01/2006

top . pages 1 2 3 4 . send to friend . addictions site map