ALCOHOL DEPENDENCE SYNDROME

Hello people, I feel ecstatic to come your way after a long period of absence. It’s time for another refining lecture on a mental disorder troubling a lot of energetic young men out there. Alcohol Dependence Syndrome. As usual, this shall be narrated in the form of a story.

Who loves Mondays?  I sure don’t!  What’s worse than hauling yourself out of bed and mourning the death of a fun- filled weekend? Mondays can however be very busy days at the Department of Psychiatry. A bustling day we have an influx of novel patients with varying complaints which are predominantly mental.

As I took my seat, a referral form was handed to me. “This man has taken alcohol for the past 15 years and has the desire to quit”. “Oh this is going to be easy” I say to myself, as I reposition myself by adjusting my seat, furthering myself from the patient. Social     Distancing

“What brings you here Sir?” literally throwing away the content of the referral form. I ask. “I have been experiencing generalized body pains and weakness for the past six months. And Doc I can’t eat. My stomach is full even after taking a just a spoonful of rice” This middle aged man mutters under his breath. A fleeting look at him revealed he was in an oversized shirt. Or was it an undersized torso? I definitely do not know. But there was a clear mismatch of his shirt to his body. This was most likely due to a recent weight loss.

As he pulled his mask down to speak, there was a stain of nicotine on the prominent aspect of his teeth. His fingers were burned with stains of soot. A blacksmith or coalmine worker? A question for his future self.

Seated a few meters from him was a young man in his twenties I assumed was his son. He listened intently as his eardrums were filled with melodies of symptoms of physical illness. He sharply interjected when the threshold of the barrel to his patience was lowered and words flowed freely with a loose tongue. “He takes alcohol!! That’s why he’s here!!”

I acted surprised and motioned to the middle aged man why he hadn’t revealed this to me yet, for which he suddenly went mute; most likely out of shame.

What I had to do next was to redirect the conversation by enjoining him to tell me about his drinking habits with the hope of establishing the exact duration of this complaint of drinking excessively. This was to ascertain the best measures we could employ to help him. However, the silence that accompanied my questioning was so deafening I had to scurry for a secluded place to interact with my patient, as gestures he demonstrated clearly indicated he was not comfortable with the setting; being positioned so close to another young man who was simultaneously being interviewed by a colleague. He might as well have asked for a hospital bed to share with this ‘friend’ just because he literally knew everything about him.

“I started drinking 15 years ago” He let out, after the ambience was changed to incorporate just three people. I distinctly could not see why this could be a stand- alone problem because he was not the only person who gulped down alcohol, and neither had he been boozing for long. Because 15 years was a relatively short duration.

Some people drink leisurely, others drink only on occasions. Others drink to retract themselves from a stressful experience. And a minority do consume alcohol just because it’s readily available; the commercial that hit their TV sets resurfaced their appetite by intoxicating their hippocampus with cravings for a jolly filled bottle with sweat and tears on the outside. But how does this become problematic?

In the words of Paracelsus,

All substances are poisons; there is none which is not a poison. The right dose differentiates a poison and a remedy.

Drinking serves as a means to be enhance sociability and provide a route for escape to diverse forms of problems. Some people are able to achieve an expected outcome of alleviating misgivings with ease.

But what is more problematic than the serious psychological symptoms encountered by savoring bottles of alcohol, which includes depression and anxiety.

What is more precarious than being tipped into a neurological condition called Wernicke encephalopathy due to the thiamine deficiency caused by your intestine’s incapability to absorb Vitamin B1 adequately.

Or the perilous effects rendered to your liver by infiltration of fatty soldiers? Typically manifesting as abdominal pain and jaundice?

And lastly, your increased predisposition to cancers of the head, neck, oesophagus, lungs, liver, stomach and colon because of your drinking habits? A risk factor you could totally avoid?

I am not being an agent to spell doom here because I know someone who knows someone who knows someone who consumes alcohol and I know deep in our cabinets and closets we bury decorated bottles of varying degrees of alcohol.

BUT…

The role of the psychiatrist comes in when there is significant impairment or distress to a person’s life, as characterized by

His failure to fulfill major obligations at work or school. Evidenced by the inability of my middle aged friend to attend work every day, culminating in his sub optimal performance as a car mechanic in apprenticeship.

His oblivion to realize in the setting of full knowledge, it could be required of him to take a healing car for a test drive and still showed up at work every day heavily intoxicated with alcohol; risking his precious life and the lives of others by the decision to push the car into the seventh gear when on a highway.

His affection for a bottle which has become his happily wedded spouse after his drinking habits push away his wife of 18 years to her matrimonial home. His children follow the trail blaze of their mother’s hurried steps to their grandparents’ home with an attitude of scorn for their father.

His tolerance for alcohol as he jumped from a bottle of beer a day, to five bottles of whiskey a session, to achieve the imagined desired response of curbing his apprehension.

His symptoms of headaches, nausea, tremors, anxiety and seizures which typically occurred following cessation of his drinking habits after listening to a sermon on a TV set.

His strong cravings to devour a beer bottle manifesting as his intense desire to say “Good morning” to a cruet of alcohol under his pillow; on opening his eyes.

His irrationality to recognize it was illogical to fund his drinking habits by using a structured lie of admission of his second daughter.

And lastly, his persistent desire and unsuccessful attempts to cut down his consumption of alcohol; just like a hooked parasite to his brain, draining him psychologically, physically, financially and mentally!

Based on a constellation of all these symptoms, a diagnosis of Alcohol Dependence Syndrome was made for which therapy strongly indicated he had sessions with the psychologist to assess his readiness to quit his drinking habits and pharmacotherapy – which employed the use of medications to either control abrupt symptoms experienced, by willingly discontinuing the use of alcohol or psychotic symptoms experienced by prolonged use of alcohol.

Irrespective of the duration of treatment, patients together with their relatives have to be optimistic there is hope for even the person who will like to put on a bottle instead of a shirt when going to work, and with patience, persistence and time, this patient would be brought back to his toes.

This patient would be seen in a subsequent review in the company of a relative to ascertain the efficacy of our treatment modalities instituted and the need for any adjustment if expectations were not met.

It’s high time we stopped the stigma against people who are seen dazed in gutters on a bright Monday morning, and realize this is a desperate call for help, because he/she could be a relative to a very prominent person you see clad in kente frequently.

Supporting those with alcohol use problems, especially those with alcohol dependence, risky alcohol behaviour, injury from alcohol or alcohol poisoning, has indisputable benefits. These benefits extend beyond the individual to their families, work places and society.

If a friend or a member of your family is using alcohol in a risky fashion, then their alcohol problem needs to be addressed by a doctor.

It is important that members of the general public know how to recognize when a person is either intoxicated or heavily dependent on alcohol and how to help them if the situation arises.

Helping an intoxicated individual can be challenging. Often, the person may be confrontational, argumentative and uncooperative. The individual may also be emotionally unstable and require some emotional support. While it is important to help an intoxicated person stay safe, the first priority must always be your personal safety. If an intoxicated individual becomes violent, then you should leave the scene and call the police.

If you suspect that you or someone you know has developed an alcohol dependency, it is very important that medical advice is sought. People who see a doctor for help to cut down on their alcohol consumption may benefit from the following:

Your doctor will help you work out a drinking goal. It may take time to completely cut down, so it may be helpful to gradually cut down by setting weekly goals;

Some people may benefit from seeing an addiction specialist;

Some people may benefit from seeing a mutual help group; and

For people highly dependent on alcohol, detoxification and medically-managed withdrawal may be necessary.

Let’s make the world a better place and fight against Alcohol Dependence.

Even if you would want to drink, try to drink moderately and do not drink and drive because we need us all alive.

Thanks for reading and have a lovely day!

Eliezer.

12 Comments Add yours

  1. This is so Brilliant.
    “The best thing about this piece is how you make such a boring topic so interesting to read and have me yearning for more”.

    Like

    1. Eliezer says:

      The way you say boring topic. Like the kinda topic that gives you headaches. Thanks for reading Lorie

      Like

  2. rosealissa says:

    I really enjoyed reading this post. I can relate to this because I was drinking day and night. I used alcohol to cope with my anxiety and depression. The last time I was intoxicated, it was horrible. I decided to stop and I been sober for a year and eight months. Of course I have my challenges and cravings but when I do I think about the kind of person I was while drinking and I don’t want to go back.

    Like

    1. Eliezer says:

      I am glad you have decided to stay sober after going through such a stressful experience. Bear in mind you are stronger than the cravings you experience. You will morph into that strong person you have always desired to be. Thanks for reading Rose!

      Like

      1. rosealissa says:

        You’re Welcome! & Thank you for your encouraging words.

        Liked by 1 person

  3. phinciknows says:

    It good to have you back…. Been a while. Great piece as usual. Alcohol addiction is so devastating not only to the psyche of the drinker but his immediate social setting and significant others. First hand witness.

    Like

    1. Eliezer says:

      I have seen the effects that reek which would have resulted in a far different outcome if they were avoided/reduced. Thanks for passing through Phinci

      Like

  4. RuthOA says:

    Fantastic read as always. I missed the lectures.

    Like

    1. Eliezer says:

      Hahaha… thanks for reading Boss

      Like

  5. James Azam says:

    This was very educational. Thanks for helping people with some of these addictions, which initially are born out of habit or some desire to fit in but end up being a burden on them and their families. I don’t think it’s a problem only with men, though. Well, maybe, in Ghana. Here in South Africa, I see both young men and women equally drink themselves to stupor day in and day out and it’s really sad to watch. If you don’t drink alcohol here, you’re perceived as uncool. People look to alcohol as a source of entertainment and most people cannot imagine having fun sober. So yes, this is a canker that will be hard to nip in the bud without looking at the root causes. Maybe, the government will have to place some very strict restrictions on how alcohol is used, sold, and advertised but you know this is very political because they earn a lot of revenue from selling alcohol. Anyway, I think I ended up saying more than I intended.

    Like

    1. Eliezer says:

      This input was just everything! Thanks for reading and making your voice known about your abhorrence for alcohol dependence.

      Liked by 1 person

  6. Sarah says:

    Rehabilitation centers are doing very good job they operate on a simple belief that the spirit, mind, and body have a deep connection. and this is essential for therapy. Keep in mind that with drug addiction all these three areas of human life are affected.

    Liked by 1 person

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