Skip to main content Accessibility help
×
Home
Hostname: page-component-5d6d958fb5-z6b88 Total loading time: 0.984 Render date: 2022-11-27T03:24:52.932Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "displayNetworkTab": true, "displayNetworkMapGraph": false, "useSa": true } hasContentIssue true

113 - Alcohol neurotoxicity

from PART XV - TRAUMA AND TOXIC DISORDERS

Published online by Cambridge University Press:  05 August 2016

Ivan F. Diamond
Affiliation:
Ernest Gallo Clinic and Research Center, Emeryville, CA, USA
Steven L. McIntire
Affiliation:
Ernest Gallo Clinic and Research Center, Emeryville, CA, USA
Arthur K. Asbury
Affiliation:
University of Pennsylvania School of Medicine
Guy M. McKhann
Affiliation:
The Johns Hopkins University School of Medicine
W. Ian McDonald
Affiliation:
University College London
Peter J. Goadsby
Affiliation:
University College London
Justin C. McArthur
Affiliation:
The Johns Hopkins University School of Medicine
Get access

Summary

Alcoholism and alcohol abuse

Alcoholism is a chronic disease characterized by addiction to ethanol; the alcoholic craves and consumes alcoholic beverages without apparent satiation. Alcoholics are remarkably tolerant to the intoxicating effects of ethanol. When drinking is discontinued, however, they exhibit the neurological symptoms and signs of alcohol withdrawal; this is considered to be evidence of physical dependence on ethanol. Addiction to ethanol also occurs as a secondary complication in patients with specific neuropsychiatric disorders, but the vast majority of alcoholics do not have an antecedent history of major psychiatric disease; they are considered to have primary alcoholism. Alcohol abuse is characterized by prodigious drinking without evidence of physical dependence upon withdrawal. Such individuals continue to drink excessively, sometimes as binge drinkers for several days at a time, despite considerable personal socioeconomic hardship and serious medical complications.

Epidemiology

Almost two-thirds of Americans older than 14 years of age drink alcoholic beverages. The per capita ethanol consumption in this group is the equivalent of nearly 90 gallons of beer, 31 gallons of wine, or 10 gallons of whisky per year (Seventh Special Report to the US Congress on Alcohol and Health, 1990). However, only 7% of Americans are heavy drinkers. This small group accounts for approximately 50% of the alcohol consumed in the USA and probably most of the socioeconomic and medical complications of alcoholism and alcohol abuse. These alcohol-related complications are not trivial; in 1990, the annual cost to US society is estimated to have been $136 billion (Seventh Special Report to the US Congress on Alcohol and Health, 1990). The prevalence of alcoholic disorders among hospitalized patients is about 25%.

Clinical pharmacology of ethanol

Ethanol is rapidly and completely absorbed from the gastrointestinal tract into the circulation within minutes after drinking (Goldstein, 1983). It is then widely distributed to all organs and fluid compartments in the body, readily equilibrates into total body water, and intercalates into biologic membranes. Ninety to 98% of ethanol is removed by metabolism in the liver, and the remainder is excreted by the kidneys, lungs and skin. An important rate-limiting step in ethanol metabolism is oxidation to acetaldehyde by alcohol dehydrogenase in the liver. Acetaldehyde is then converted to acetate by aldehyde dehydrogenase, a metabolic step with significant clinical ramifications.

Type
Chapter
Information
Diseases of the Nervous System
Clinical Neuroscience and Therapeutic Principles
, pp. 1814 - 1826
Publisher: Cambridge University Press
Print publication year: 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)
4
Cited by

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×