What Is Involved in a Diagnosis of Alcoholism?

Alcoholism, commonly known as drunkenness, refers to the abnormal state of the body that occurs after a patient drinks a large amount of alcohol (ethanol) at one time, and the damage to the nervous system and liver is most serious. It is medically divided into two types, acute poisoning and chronic poisoning. The former can cause great harm to patients in a short time, and can even cause death directly or indirectly. The latter brings cumulative harm to patients, such as alcohol dependence, mental disorders, alcoholic cirrhosis and the induction of certain cancers (oral, tongue, esophageal, liver cancer).

TA says

Drink too much, why is it broken? 2018-08-17 13:08

The greedy cup finally reaches you unconscious, when you wake up from bed the next day, will you occasionally recall what happened that night, thinking about the process of life, and by the way, why is it fragmented? How does alcohol cause memory loss? Even if the amount of alcohol is the same, why are only some people fragmented? Does this fragmentation phenomenon imply other risk factors, or does it imply greater risks? ... more

Basic Information

nickname: Drunk, acute alcoholism
English name: acute alcoholism
Visiting department: Emergency Department

Common locations: Nervous system, liver
Common causes: Drink heavily
Common symptoms: More manifestations of abnormal behavior and consciousness, severe cases can be lethargic or even comatose
Contagious: no

Causes of acute alcoholism

1. Alcohol metabolism and general harm

Alcohol metabolism in the body after absorption is mainly divided into three steps: first it is converted to acetaldehyde by the liver metabolic enzyme system ethanol dehydrogenase, and then acetaldehyde dehydrogenase catalyzes the oxidation to generate acetic acid, and finally it is metabolized and decomposed into carbon dioxide and water. Among them, acetaldehyde can stimulate the secretion of epinephrine, norepinephrine, etc. At this time, the patient showed flushing complexion and rapid heartbeat. Alcohol has direct neurotoxicity, cardiotoxicity, and liver toxicity. Therefore, after poisoning, patients have a series of abnormal neurological performance, even coma and shock, and heart disease, hypoglycemia, and metabolic acidosis can also occur.

2. The lethal effects of alcohol are as follows

(1) Choking Alcoholism coma loses its self-protection function. If it is in the supine position or vomit blocks the respiratory tract, it can lead to asphyxia and hypoxia.

(2) Inducing heart disease Alcohol can induce coronary spasm and malignant arrhythmias, which can lead to sudden cardiac death.

(3) Inducing cerebral hemorrhage, alcohol can excite the sympathetic nerve, causing a sharp rise in blood pressure, which in turn causes cerebral hemorrhage. According to statistics, 110,000 people die of cerebral hemorrhage caused by alcoholism in China every year, accounting for 1.3% of total deaths.

(4) Other alcohols can induce pancreatitis, hypoglycemic coma, and metabolic disorders, all of which are related to patient death.

Clinical manifestations of acute alcoholism

Simple drunk

Also known as ordinary drunkenness, refers to acute poisoning caused by heavy drinking at one time. The severity of poisoning is related to the patient's drinking speed, alcohol consumption, blood alcohol concentration, and individual tolerance. Clinical is usually divided into excitement, ataxia and lethargy. Mild patients develop psychiatric disorders after drinking alcohol, such as talkative, irritable, flushing or pale, eye congestion, increased heart rate, dizziness, headache, etc. With the progress of the disease, the patient appeared unstable gait, awkward movements, vague speech, incoherent speech, blurred vision and ghosting, and may have nausea and vomiting. Patients with severe poisoning were drowsy, pale, lip bluish, wet and cold skin, decreased body temperature, superficial breathing, and dilated pupils. Severe cases fall into a deep coma, decreased blood pressure, slow breathing, and increased heart rate until failure to death.

2. Complexity drunk

Refers to the sudden strong psychomotor excitement and severe confusion in patients during or after heavy drinking. At this time, the patient's consciousness is more severe, and the psychomotor excitement is more intense and lasts longer. It is therefore prone to violent acts such as retaliatory harm, homicide and sexual crimes. The patient has only a vague understanding of the surrounding conditions, and after the episode, partially or completely forgets the episode.

Acute alcoholism test

Exhalation and blood alcohol tests showed a certain concentration of alcohol.

Diagnosis of acute alcoholism

The diagnosis of acute alcoholism is not very difficult. The patient had a history of drinking alcohol and related symptoms. At the same time, the breath exhaled had a taste of alcohol. Exhalation and blood alcohol test results showed a certain concentration of alcohol.

Differential diagnosis of acute alcoholism

Pay attention to distinguish it from diseases such as sleeping pills poisoning, carbon monoxide poisoning and stroke.

Acute alcoholism treatment

1. Treatment of mild (conscious) patients

(1) If you feel uncomfortable after drinking a large amount of alcohol, you should immediately induce vomiting repeatedly. This is the most effective measure to prevent alcoholism, which can greatly reduce the pain and injury of patients, and achieve twice the result with half the effort. However, if you drink alcohol for more than 1 hour, the effect of gastric lavage will be greatly reduced, because most of the alcohol consumed is absorbed within 1 hour. Therefore, gastric lavage is not recommended if more than 1 hour after drinking.

(2) Patients with mild poisoning do not need treatment, and can appropriately eat some sugar-rich foods such as apples, bananas, oranges, honey, etc., as well as foods rich in vitamin C and vitamin B, and encourage patients to drink more water to promote urination. Those who are restless can be restrained appropriately to protect their head and face to avoid injury.

2. Treatment for coma patients

(1) Patients who are drowsy and unconscious, and those with cardiovascular disease should be sent to the hospital for examination and treatment. Before arriving at the hospital, the patient should be placed in a side-lying position, and care should be taken to keep the patient's airway open.

(2) Not all patients with alcoholism must go to the hospital. If the patients are generally better, sometimes they do not need to go to the hospital. For patients who do not go to the hospital, the most important thing is that they must be attended to by the patient until the patient is awake. Do not let him sleep alone, otherwise the patient may suffocate due to vomiting while sleeping, and similar tragedies are endless.

(3) The treatment of critically ill patients in the hospital is mostly to closely observe vital signs, it is best to implement ECG monitoring, while rehydration and sugar and maintain water and electrolyte balance to prevent complications. For patients with deep coma, naloxone can be used for awakening treatment, and for manic patients, diazepam can be used for treatment. Some traditional Chinese medicine adjuvant therapies can also be used, as reported in the medical literature. Drinkers of the Chinese medicine pueraria soda are helpful to patients with alcoholism, so they can be tried out.

3. About hangover remedies

There are many folk hangover methods, such as drinking vinegar, sugar water, coffee and tea, etc. Although these methods can be tried, there is no medical evidence that these methods are effective for alcoholism. So don't expect the effects of these methods.