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Alcohol dependence

MedGen UID:
1801
Concept ID:
C0001973
Mental or Behavioral Dysfunction
Synonyms: Addictive alcohol use; ALCOHOL DEPENDENCE, PROTECTION AGAINST
SNOMED CT: Alcohol dependence (66590003); Alcoholism (7200002); Persistent alcohol abuse (284591009); Chronic alcohol abuse (284591009); Alcohol dependence syndrome (66590003); Dipsomania (7200002); Alcohol problem drinking (7200002)
 
Genes (locations): ADH1B (4q23); ADH1C (4q23); GABRA2 (4p12); HTR2A (13q14.2); TAS2R16 (7q31.32)
 
HPO: HP:0030955
Monarch Initiative: MONDO:0007079
OMIM®: 103780

Definition

Alcohol use disorder is a diagnosis made when an individual has severe problems related to drinking alcohol. Alcohol use disorder can cause major health, social, and economic problems, and can endanger affected individuals and others through behaviors prompted by impaired decision-making and lowered inhibitions, such as aggression, unprotected sex, or driving while intoxicated.

Alcohol use disorder is a broad diagnosis that encompasses several commonly used terms describing problems with drinking. It includes alcoholism, also called alcohol addiction, which is a long-lasting (chronic) condition characterized by a powerful, compulsive urge to drink alcohol and the inability to stop drinking after starting. In addition to alcoholism, alcohol use disorder includes alcohol abuse, which involves problem drinking without addiction.

Habitual excessive use of alcohol changes the chemistry of the brain and leads to tolerance, which means that over time the amount of alcohol ingested needs to be increased to achieve the same effect. Long-term excessive use of alcohol may also produce dependence, which means that when people stop drinking, they have physical and psychological symptoms of withdrawal, such as sleep problems, irritability, jumpiness, shakiness, restlessness, headache, nausea, sweating, anxiety, and depression. In severe cases, agitation, fever, seizures, and hallucinations can occur; this pattern of severe withdrawal symptoms is called delirium tremens.

The heavy drinking that often occurs in alcohol use disorder, and can also occur in short-term episodes called binge drinking, can lead to a life-threatening overdose known as alcohol poisoning. Alcohol poisoning occurs when a large quantity of alcohol consumed over a short time causes problems with breathing, heart rate, body temperature, and the gag reflex. Signs and symptoms can include vomiting, choking, confusion, slow or irregular breathing, pale or blue-tinged skin, seizures, a low body temperature, a toxic buildup of substances called ketones in the blood (alcoholic ketoacidosis), and passing out (unconsciousness). Coma, brain damage, and death can occur if alcohol poisoning is not treated immediately.

Chronic heavy alcohol use can also cause long-term problems affecting many organs and systems of the body. These health problems include irreversible liver disease (cirrhosis), inflammation of the pancreas (pancreatitis), brain dysfunction (encephalopathy), nerve damage (neuropathy), high blood pressure (hypertension), stroke, weakening of the heart muscle (cardiomyopathy), irregular heartbeats (arrhythmia), and immune system problems. Long-term overuse of alcohol also increases the risk of certain cancers, including cancers of the mouth, throat, esophagus, liver, and breast. Alcohol use in pregnant women can cause birth defects and fetal alcohol syndrome, which can lead to lifelong physical and behavioral problems in the affected child. [from MedlinePlus Genetics]

Clinical features

From HPO
Alcohol dependence
MedGen UID:
1801
Concept ID:
C0001973
Mental or Behavioral Dysfunction
Alcohol use disorder is a diagnosis made when an individual has severe problems related to drinking alcohol. Alcohol use disorder can cause major health, social, and economic problems, and can endanger affected individuals and others through behaviors prompted by impaired decision-making and lowered inhibitions, such as aggression, unprotected sex, or driving while intoxicated.\n\nAlcohol use disorder is a broad diagnosis that encompasses several commonly used terms describing problems with drinking. It includes alcoholism, also called alcohol addiction, which is a long-lasting (chronic) condition characterized by a powerful, compulsive urge to drink alcohol and the inability to stop drinking after starting. In addition to alcoholism, alcohol use disorder includes alcohol abuse, which involves problem drinking without addiction.\n\nHabitual excessive use of alcohol changes the chemistry of the brain and leads to tolerance, which means that over time the amount of alcohol ingested needs to be increased to achieve the same effect. Long-term excessive use of alcohol may also produce dependence, which means that when people stop drinking, they have physical and psychological symptoms of withdrawal, such as sleep problems, irritability, jumpiness, shakiness, restlessness, headache, nausea, sweating, anxiety, and depression. In severe cases, agitation, fever, seizures, and hallucinations can occur; this pattern of severe withdrawal symptoms is called delirium tremens.\n\nThe heavy drinking that often occurs in alcohol use disorder, and can also occur in short-term episodes called binge drinking, can lead to a life-threatening overdose known as alcohol poisoning. Alcohol poisoning occurs when a large quantity of alcohol consumed over a short time causes problems with breathing, heart rate, body temperature, and the gag reflex. Signs and symptoms can include vomiting, choking, confusion, slow or irregular breathing, pale or blue-tinged skin, seizures, a low body temperature, a toxic buildup of substances called ketones in the blood (alcoholic ketoacidosis), and passing out (unconsciousness). Coma, brain damage, and death can occur if alcohol poisoning is not treated immediately.\n\nChronic heavy alcohol use can also cause long-term problems affecting many organs and systems of the body. These health problems include irreversible liver disease (cirrhosis), inflammation of the pancreas (pancreatitis), brain dysfunction (encephalopathy), nerve damage (neuropathy), high blood pressure (hypertension), stroke, weakening of the heart muscle (cardiomyopathy), irregular heartbeats (arrhythmia), and immune system problems. Long-term overuse of alcohol also increases the risk of certain cancers, including cancers of the mouth, throat, esophagus, liver, and breast. Alcohol use in pregnant women can cause birth defects and fetal alcohol syndrome, which can lead to lifelong physical and behavioral problems in the affected child.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAlcohol dependence

Conditions with this feature

Alcohol dependence
MedGen UID:
1801
Concept ID:
C0001973
Mental or Behavioral Dysfunction
Alcohol use disorder is a diagnosis made when an individual has severe problems related to drinking alcohol. Alcohol use disorder can cause major health, social, and economic problems, and can endanger affected individuals and others through behaviors prompted by impaired decision-making and lowered inhibitions, such as aggression, unprotected sex, or driving while intoxicated.\n\nAlcohol use disorder is a broad diagnosis that encompasses several commonly used terms describing problems with drinking. It includes alcoholism, also called alcohol addiction, which is a long-lasting (chronic) condition characterized by a powerful, compulsive urge to drink alcohol and the inability to stop drinking after starting. In addition to alcoholism, alcohol use disorder includes alcohol abuse, which involves problem drinking without addiction.\n\nHabitual excessive use of alcohol changes the chemistry of the brain and leads to tolerance, which means that over time the amount of alcohol ingested needs to be increased to achieve the same effect. Long-term excessive use of alcohol may also produce dependence, which means that when people stop drinking, they have physical and psychological symptoms of withdrawal, such as sleep problems, irritability, jumpiness, shakiness, restlessness, headache, nausea, sweating, anxiety, and depression. In severe cases, agitation, fever, seizures, and hallucinations can occur; this pattern of severe withdrawal symptoms is called delirium tremens.\n\nThe heavy drinking that often occurs in alcohol use disorder, and can also occur in short-term episodes called binge drinking, can lead to a life-threatening overdose known as alcohol poisoning. Alcohol poisoning occurs when a large quantity of alcohol consumed over a short time causes problems with breathing, heart rate, body temperature, and the gag reflex. Signs and symptoms can include vomiting, choking, confusion, slow or irregular breathing, pale or blue-tinged skin, seizures, a low body temperature, a toxic buildup of substances called ketones in the blood (alcoholic ketoacidosis), and passing out (unconsciousness). Coma, brain damage, and death can occur if alcohol poisoning is not treated immediately.\n\nChronic heavy alcohol use can also cause long-term problems affecting many organs and systems of the body. These health problems include irreversible liver disease (cirrhosis), inflammation of the pancreas (pancreatitis), brain dysfunction (encephalopathy), nerve damage (neuropathy), high blood pressure (hypertension), stroke, weakening of the heart muscle (cardiomyopathy), irregular heartbeats (arrhythmia), and immune system problems. Long-term overuse of alcohol also increases the risk of certain cancers, including cancers of the mouth, throat, esophagus, liver, and breast. Alcohol use in pregnant women can cause birth defects and fetal alcohol syndrome, which can lead to lifelong physical and behavioral problems in the affected child.
Myoclonic dystonia 11
MedGen UID:
331778
Concept ID:
C1834570
Disease or Syndrome
SGCE myoclonus-dystonia (SGCE-M-D) is a movement disorder characterized by a combination of rapid, brief muscle contractions (myoclonus) and/or sustained twisting and repetitive movements that result in abnormal postures (dystonia). The myoclonic jerks typical of SGCE-M-D most often affect the neck, trunk, and upper limbs with less common involvement of the legs. Approximately 50% of affected individuals have additional focal or segmental dystonia, presenting as cervical dystonia and/or writer's cramp. Non-motor features may include alcohol abuse, obsessive-compulsive disorder (OCD), and anxiety disorders. Symptom onset is usually in the first decade of life and almost always by age 20 years, but ranges from age six months to 80 years. Most affected adults report a dramatic reduction in myoclonus in response to alcohol ingestion. SGCE-M-D is compatible with an active life of normal span.
Sporadic porphyria cutanea tarda
MedGen UID:
357391
Concept ID:
C1867968
Disease or Syndrome
De Verneuil et al. (1978) classified porphyria cutanea tarda (PCT), the most common type of porphyria, into 2 types: type I, or 'sporadic' type, associated with approximately 50% level of uroporphyrinogen decarboxylase (UROD; 613521) in liver (Elder et al., 1978; Felsher et al., 1982), and type II, or 'familial' type (176100), characterized by 50% deficient activity of the same enzyme in many tissues (Kushner et al., 1976; Elder et al., 1980). Type I is the most common form of PCT, comprising 70 to 80% of cases. The causes of the deficiency are often unclear and are probably multifactorial (review by Lambrecht et al., 2007).

Professional guidelines

PubMed

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Curated

UK NICE Clinical Guideline CG192, Antenatal and postnatal mental health: clinical management and service guidance, 2020

Recent clinical studies

Etiology

Andrews SJ, Goate A, Anstey KJ
Alzheimers Dement 2020 Feb;16(2):345-353. Epub 2020 Jan 4 doi: 10.1016/j.jalz.2019.09.086. PMID: 31786126Free PMC Article
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Int Rev Neurobiol 2010;91:53-94. doi: 10.1016/S0074-7742(10)91003-9. PMID: 20813240Free PMC Article

Diagnosis

Andrews SJ, Goate A, Anstey KJ
Alzheimers Dement 2020 Feb;16(2):345-353. Epub 2020 Jan 4 doi: 10.1016/j.jalz.2019.09.086. PMID: 31786126Free PMC Article
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Therapy

McDonell MG, Skalisky J, Burduli E, Foote A Sr, Granbois A, Smoker K, Hirchak K, Herron J, Ries RK, Echo-Hawk A, Barbosa-Leiker C, Buchwald D, Roll J, McPherson SM
Addiction 2021 Jun;116(6):1569-1579. Epub 2021 Jan 14 doi: 10.1111/add.15349. PMID: 33220122Free PMC Article
Cheng HY, McGuinness LA, Elbers RG, MacArthur GJ, Taylor A, McAleenan A, Dawson S, López-López JA, Higgins JPT, Cowlishaw S, Lingford-Hughes A, Hickman M, Kessler D
BMJ 2020 Nov 25;371:m3934. doi: 10.1136/bmj.m3934. PMID: 33239318Free PMC Article
Bogenschutz MP, Forcehimes AA, Pommy JA, Wilcox CE, Barbosa PC, Strassman RJ
J Psychopharmacol 2015 Mar;29(3):289-99. Epub 2015 Jan 13 doi: 10.1177/0269881114565144. PMID: 25586396
Rösner S, Hackl-Herrwerth A, Leucht S, Lehert P, Vecchi S, Soyka M
Cochrane Database Syst Rev 2010 Sep 8;(9):CD004332. doi: 10.1002/14651858.CD004332.pub2. PMID: 20824837
Kennedy WK, Leloux M, Kutscher EC, Price PL, Morstad AE, Carnahan RM
Expert Opin Drug Metab Toxicol 2010 Mar;6(3):363-80. doi: 10.1517/17425251003641975. PMID: 20163323

Prognosis

Hesselbrock MN, Hesselbrock VM, Chan G, Del Boca F, Chartier K
Alcohol Clin Exp Res 2020 Aug;44(8):1658-1665. Epub 2020 Jul 23 doi: 10.1111/acer.14398. PMID: 32701168Free PMC Article
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Bogenschutz MP, Forcehimes AA, Pommy JA, Wilcox CE, Barbosa PC, Strassman RJ
J Psychopharmacol 2015 Mar;29(3):289-99. Epub 2015 Jan 13 doi: 10.1177/0269881114565144. PMID: 25586396
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Clinical prediction guides

Crozier ME, Farokhnia M, Persky S, Leggio L, Curtis B
BMJ Ment Health 2023 Nov 22;26(1) doi: 10.1136/bmjment-2023-300852. PMID: 37993282Free PMC Article
Buckfield C, Sinclair JMA, Glautier J
Addiction 2021 Apr;116(4):759-768. Epub 2020 Aug 27 doi: 10.1111/add.15210. PMID: 32725645
Johnson EC, Sanchez-Roige S, Acion L, Adams MJ, Bucholz KK, Chan G, Chao MJ, Chorlian DB, Dick DM, Edenberg HJ, Foroud T, Hayward C, Heron J, Hesselbrock V, Hickman M, Kendler KS, Kinreich S, Kramer J, Kuo SI, Kuperman S, Lai D, McIntosh AM, Meyers JL, Plawecki MH, Porjesz B, Porteous D, Schuckit MA, Su J, Zang Y, Palmer AA, Agrawal A, Clarke TK, Edwards AC
Psychol Med 2021 May;51(7):1147-1156. Epub 2020 Jan 20 doi: 10.1017/S0033291719004045. PMID: 31955720Free PMC Article
Andrews SJ, Goate A, Anstey KJ
Alzheimers Dement 2020 Feb;16(2):345-353. Epub 2020 Jan 4 doi: 10.1016/j.jalz.2019.09.086. PMID: 31786126Free PMC Article
Sanchez-Roige S, Palmer AA, Fontanillas P, Elson SL; 23andMe Research Team, the Substance Use Disorder Working Group of the Psychiatric Genomics Consortium, Adams MJ, Howard DM, Edenberg HJ, Davies G, Crist RC, Deary IJ, McIntosh AM, Clarke TK
Am J Psychiatry 2019 Feb 1;176(2):107-118. Epub 2018 Oct 19 doi: 10.1176/appi.ajp.2018.18040369. PMID: 30336701Free PMC Article

Recent systematic reviews

Agabio R, Saulle R, Rösner S, Minozzi S
Cochrane Database Syst Rev 2023 Jan 13;1(1):CD012557. doi: 10.1002/14651858.CD012557.pub3. PMID: 36637087Free PMC Article
Popova S, Dozet D, Akhand Laboni S, Brower K, Temple V
Drug Alcohol Rev 2022 May;41(4):759-777. Epub 2021 Dec 28 doi: 10.1111/dar.13425. PMID: 34963039Free PMC Article
Cheng HY, McGuinness LA, Elbers RG, MacArthur GJ, Taylor A, McAleenan A, Dawson S, López-López JA, Higgins JPT, Cowlishaw S, Lingford-Hughes A, Hickman M, Kessler D
BMJ 2020 Nov 25;371:m3934. doi: 10.1136/bmj.m3934. PMID: 33239318Free PMC Article
Nadkarni A, Endsley P, Bhatia U, Fuhr DC, Noorani A, Naik A, Murthy P, Velleman R
Drug Alcohol Rev 2017 May;36(3):389-399. Epub 2016 Jun 21 doi: 10.1111/dar.12440. PMID: 27325204
Rösner S, Hackl-Herrwerth A, Leucht S, Lehert P, Vecchi S, Soyka M
Cochrane Database Syst Rev 2010 Sep 8;(9):CD004332. doi: 10.1002/14651858.CD004332.pub2. PMID: 20824837

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NICE, 2020
      UK NICE Clinical Guideline CG192, Antenatal and postnatal mental health: clinical management and service guidance, 2020

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