Beyond Pain, Fear, Withdrawal-Findings, And Problems Involving Change - Treatment and Application for A Chronic Addiction on Alcohol Do Not End

Published in:

 2(1). DDIPIJ.MS.ID.000130. DOI: 10.32474.DDIPIJ.2018.02.000130.

Authors:

Loai Aljerf and Nuha AlMasri

Abstract:
Alcohol use disorders (AUD) involving hazardous, harmful and addictive misuse of alcohol are widespread in most parts of the world. The aim of this study was to review the effect of the common inhibitors in the treatment of patients with AUD, taking into consideration, the short- and long- terms abstinence. An extensive literature search conducted in MEDLINE, PubMed, Scopus and CINAHL databases identified 776 articles, which were then evaluated for pre‐specified criteria for relevance and quality assurance. A total of 38 articles, including 36 human studies and 2 animal studies, were selected for this review. Many inhibitors used in the treatment of alcoholism and some were considered of effective medication when their intakes are supervised by an expert. However, their therapeutic efficacies vary widely; for instance, disulfiram is a pro‐drug that requires its transformation into an active form and because it shows a wide range of secondary effects, it often prevents the use of doses that ensure full therapeutic effectiveness. Sex hormones play an important role in establishing sex-distinctive brain structural and functional variations that could contribute to the sex differences in alcohol consumption behavior. Existing evidence supports the association of increased testosterone level and increased risk for alcohol use and AUD in males. In contrast, the evidence supports the association of increased estrogen level and increased alcohol use in females. Much less is known about the impact of progestins on alcohol use and misuse in human subjects. Future observational and experimental studies conducted in both sexes with a comprehensive hormone panel are needed to elucidate the impact of the interplay between various sex hormone levels during various developmental stages on alcohol use-related phenotypes and AUD. On the other hand, alcohol withdrawal-especially delirium tremens (DT)-is a potentially life-threatening condition. While short-term treatment regimens and factors that predispose to more severe symptomatology have been extensively studied, little attention has been paid to the clinical epidemiology and long-term care of the chronic medical, addictive, psychiatric, and psychosocial problems faced by these patients. Chronic alcoholic patients are frequently suffering from specific micronutrient deficiencies, including vitamins involved in one carbon metabolism. The deficiencies commonly involve folate, vitamin B6, thiamine, and vitamin A. Inadequate dietary intake is a major cause of the vitamin deficiency. As a consequence of chronic alcohol intake, could lead to metabolic disruption and potentially to hyperhomocysteinemia. Alcoholism can affect the absorption, storage, metabolism, and activation of many of these vitamins.

Keywords:

Chronic Addiction; Alcohol Use Disorders; Alcoholism; Micronutrient deficiencies; Psychiatric Treatment; Physiological Disturbances; Therapeutic Armamentarium

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