Fast Five Quiz: Alcohol Use Disorder

Medscape

4 hours ago

Alcohol use disorder remains a significant public health challenge in the United States, affecting more than 29 million individuals and contributing to more than 140,000 deaths each year. Despite its high prevalence and devastating health consequences, alcohol use disorder often goes underdiagnosed and undertreated. A widely accepted heuristic framework conceptualizes alcohol use disorder as a 3-stage cycle, binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation, offering clinicians a lens through which to understand its complex neurobiological underpinnings and diverse clinical presentations.
Although effective behavioral therapies and several US Food and Drug Administration-approved medications are available for the treatment of alcohol use disorder, these interventions remain markedly underused, contributing to a substantial treatment gap.
How much do you know about alcohol misuse and alcohol use disorder? Test your knowledge with this quick quiz.
Alcohol misuse in alcohol use disorder can vary, from a pattern of intermittent episodes of binge drinking, to a pattern of prolonged heavy drinking over longer periods of time, to a continual drinking pattern due to fear of alcohol withdrawal. A heavy drinking day is defined as consuming 4 or more drinks for females and 5 or more drinks for males in a single day. In the United States, a standard drink is defined as 12 oz of beer, 5 oz of wine, and 1.5 oz of a distilled beverage. This definition helps identify patterns of alcohol misuse that might indicate alcohol use disorder.
Learn more about alcoholism guidelines.
Alcohol use disorder is more common in males, although the gap is narrowing. Although males are more likely to engage in frequent and heavy consumption, have a greater consumption of spirits, and experience higher rates of alcohol use mortality, females are at greater risk for certain health complications from alcohol, such as liver damage and experiencing higher blood alcohol concentrations at the same level of intake.
Learn more about alcoholism presentation.
The most frequent central nervous system consequence of persistent alcohol consumption is alcoholic cerebellar degeneration. This condition results from alcohol toxicity leading to damage of the cerebellum, the brain area responsible for coordination and balance. It commonly presents with gait instability, and balance problems, affecting 10%-25% of individuals with chronic alcohol use.
Wernicke's encephalopathy is an acute, reversible condition caused by thiamine deficiency; it is not the most frequent long-term central nervous system consequence of alcohol consumption. Korsakoff syndrome is a chronic neuropsychiatric disorder that often follows untreated Wernicke's encephalopathy and is caused by malnutrition in combination with prolonged drinking. Although chronic alcohol use can lead to alcohol-related dementia, it occurs less frequently than alcoholic cerebellar degeneration.
Learn more about Wernicke-Korsakoff syndrome.
Alcoholic polyneuropathy, caused by prolonged alcohol use and often associated with nutritional deficiencies like thiamine deficiency, typically presents as a symmetrical sensory neuropathy. Females have a greater rate of alcoholic polyneuropathy. The most common symptoms of alcoholic polyneuropathy are ataxia, pain, and paresthesia. Other frequent symptoms include burning pain in the arms, soles of the feet and toes, and cramping in the calves and hands. Skin alterations do occur in alcoholic polyneuropathy, but they are considered secondary or less common symptoms compared with the hallmark neurological signs. The muscle weakness seen in alcoholic polyneuropathy primarily affects distal muscles, like the feet and hands. Hair loss can happen as a minor trophic change, but it is not a defining or common symptom of alcoholic polyneuropathy.
Learn more about alcoholic neuropathy.
Benzodiazepines are the recommended class of medication for treating alcohol withdrawal syndrome because they are effective in preventing severe complications of alcohol withdrawal syndrome, such as seizures and delirium tremens, and are considered the criterion standard treatment due to their fast onset, long duration, and safety profile.
Selective serotonin reuptake inhibitors do not target the GABAergic or glutamatergic systems involved in alcohol withdrawal syndrome, making them ineffective for managing withdrawal symptoms. Beta-blockers can help control some autonomic symptoms like tremors or tachycardia but do not prevent seizures or delirium tremens, so they are not appropriate as primary treatment. N-methyl-D-aspartate receptor antagonists can modulate glutamate activity but lack enough evidence to be first-line therapy for alcohol withdrawal syndrome.
Learn more about alcohol withdrawal syndrome.