THE LAST 7 SYMPTOMS, INDICATIVE OF ALCOHOL USE DISORDER (AUD)

In our previous article on Alcohol, we looked at 4 symptoms indicating that your drinking is becoming a problem and may get out of hand ,if not addressed soonest possible; These symptoms or criteria are based on DSM- 5 ( Diagnostic Statistical Manual on mental disorders, published by the American Psychiatric Association).This document provides clear and highly detailed standards which helps in assessing the impact of alcohol and other drugs on our brain,thoughts,feelings and behavior.Accordingly,Kenya has borrowed heavily from this criterion as contained in the National Protocol for Treatment of Substance Use Disorders in Kenya; 2017.

The 1^st 4 symptoms focused on whether you are taking larger amount than you meant to and for longer, wanting to cut down or stop using alcohol but not managing, spending a lot of time getting, using or recovering from alcohol use and experiencing cravings and urges to drink.

The next 7 symptoms have to do with your failure and inability to fulfill your duties and obligations at home, school and work, problems in your relationships, spending your leisure and recreation time drinking, putting yourself in danger, suffering physical and psychological problems and needing more and more amount to get any effect as well as developing withdrawal syndromes.

5^th symptom

Have you failed to fulfill and meet your obligation as a parent at home due to repeated alcohol use? These could be your failure to pick your child from school or even being an absentee parent. As a student, your studies may be so much affected that you fail to attend classes and finally you don’t graduate on time. What about at work? There are situations when one fails to report to work habitually and end up facing disciplinary action.

6^th symptom

Are you continuing to drink even when it causes problems in relationships? Remember alcohol is a psychoactive substance that affects your behavior. Sometimes the effects are so bad that you end up using abusive language and becoming violent towards your partner.Definately, this damages your relationship.

 

7^th symptom

Have you given up important social, occupational or recreational activities due to your drinking? When you began drinking, it was as way of relaxing with your friends after a hard day’s work, however, with time; alcohol takes over all your time. You forget that long awaited graduation of your dear friend. What about your cousin’s wedding? Such social occasions no longer interest you. At his point in your drinking, you have now become addicted to alcohol as indicated in the diagrams that follows;

8^th symptom

Are you drinking again and again, even when it puts you in danger? This could involve you getting injuries as you stagger home, and falling in ditches. What about when you drink and drive? You could get involved in car crashes, causing injuries and even death of other drivers.

Globallyroad traffic injuries are the 8^th leading causes of death;, Currently data from the National Transport Safety Authority in  (NTSA) on road traffic deaths, 1-35million people are killed in road crashes, while about 50 million are injured around the world.Most of those killed are youth – aged 5-29 years. These road crashes results in long lasting emotional, psychological, and financial impacts.

9^th symptom

Are you continuing to use, even when you are aware of having a physical or mental problem which could have been caused by your use or made worse by your drinking? It is important to note that sometimes one may get into drinking to cope with an existing mental problem or disorder. There are situations where one could be suffering from depression or bipolar, or anxiety, phobia among others. These mental issues can drive one to alcohol use.

On the other hand, prolonged use can cause brain damage, causing you to develop a mental disorder. We are also aware that alcohol does cause health problems such as liver disease, pancreatitis,  a weakened heart among others.

10^th symptom

Have now developed a tolerance for alcohol? Tolerance is a situation where you need to drink more in order to feel its effects or when you drink, the effect is less. Previously, you may have been drinking 5 bottles to feel drunk but now you don’t feel any effect from the 5 bottles; you need at least 8 bottles to feel drunk. This is very dangerous. According to the National protocol, it is described as “needing more of the substance to get the effect you want”.

Sometimes you may think that now you have gotten used to the substance, that you no longer get drunk aimlessly even after drinking too much, that you have conquered your drinking. No, this is a danger signal.

11^th symptom

Are you experiencing withdrawal symptoms? What happens when you all of a suddenly stop taking alcohol? Remember when you were drinking alcohol ,your body got so much used to having alcohol in the blood stream such that once you stops your body reacts negatively; you now suffer alcohol withdrawal syndromes. According to the National Protocol for Treatment of Substance Use Disorder in Kenya (2017), alcohol withdrawal occurs when a person with AUD stops or significantly reduces their alcohol intake. The symptoms may appear  from hours to several days after the last drink.

Withdrawal symptoms are usually the opposite of the positive effects which you felt when you take the substance. As is the case with alcohol, immediately you start drinking, you feel relaxed and jovial. When you stop taking, the opposite happens; you are stressed and sad. Some of the immediate symptoms are mild and include;

• lack of sleep and nightmares,
• Tremors or shaking/trembling,
• Anxiety and restlessness,
• Headache and nausea
• Poor appetite and excessive sweating among others.

When you experience these symptoms if you are really not determined to stop drinking, you may find yourself drinking (relapsing).

But if you persist in completely stopping drinking, you now start experiencing severe alcohol withdrawal symptoms which include;

• Seizures (fits)-convulsing as if you are suffering from epilepsy
• Hallucinations, where you see things that do not exist (vivid visual hallucinations),you see people who are not there, and  hear voices
• Mood changes-anxiety and depression
• Dehydration
• Hypertension
• Delirium tremens (DT)-these are characterized by tremors,hallucinations,agitation,confusion ,disorientation, excessive sweating.DT is a life threatening condition that occurs in about 5% of the patients with alcohol withdrawal.

Can one recover from AUD? The answer is “Yes”. But how? You may ask. Through medication and counselling; also referred to as pharmacology and psychotherapy. We shall discuss these in our next article.