Alcohol Use Disorder

Alcohol use disorder (AUD) also known as alcoholism is a health condition associated with problematic and uncontrolled drinking. It is also defined as alcohol use habit that involves problems controlling your drinking, continuing to use alcohol even after causing problems, being preoccupied with alcohol, having withdrawal symptoms when you stop or rapidly reduce drinking, or the need to drink more to experience the same effect.

Being an alcoholic means that the most important thing in your life is alcohol and you cannot do without it. Such unhealthy alcohol use puts your safety and health at risk or causes other alcohol-related problems.

World Health Organization reported in 2018 that over 3 million individuals died because of harmful use of alcohol in 2016. It represents 1 in 20 deaths in the world and the effects of alcohol use cause over 5% of the global disease burden. 

The situation is similar in Kenya where 1 in 100 deaths reported in the country in 2016 was as a result of alcohol use disorder. A new survey released by the National Campaign against Drug Abuse (Nacada) in mid-2018 Nairobi is Kenya’s drinking capital as it leads other regions in terms of the prevalence of alcohol use and dependence.

Overall, Nacada report revealed that about 2.8 million Kenyans are struggling with alcohol-related disorders which represent a prevalence rate of 10.4% of the population.

Symptoms

Alcoholism can be mild, moderate or severe based on various symptoms you experience. Signs and symptoms include:

  • Inability to limit or control the amount of alcohol you consume
  • Spending a lot of time drinking, getting alcohol, or recovering from alcohol consumption
  • Feeling a strong urge or craving to drink more alcohol even after taking some
  • Reducing or giving up work and social activities as well as hobbies
  • Continue drinking event after realizing it is causing social, physical, or interpersonal problems
  • Developing a tolerance to alcohol in the sense that you have to drink more to feel its effect
  • Using alcohol in circumstances where it is not safe such as when swimming or driving
  • Experience withdrawal symptoms such as sweating, nausea and shaking when you are not drinking

Alcoholism can include periods of alcohol intoxication which occurs when alcohol quantity increases in your bloodstream and symptoms of withdrawal that include agitation, restlessness, vomiting and nausea, problems sleeping, anxiety, hallucinations, and occasional seizures.

Causes

Alcohol use disorder (AUD) can be caused by psychological, genetic, environmental, and social factors. They define how your drinking affects your behavior and body.

After some time, consuming too much alcohol may alter the normal function of the areas of your brain linked to the experience of judgment, pleasure, and the ability to practice control over your behaviors. It may lead to craving alcohol to attempt to restore good feelings or minimize negative ones.

Risk Factors

Alcohol consumption may start in the adolescent stages, but AUD frequently occurs in the 20s and 30s although it can start at any age.

  • Steady drinking over time: Too much drinking on a regular basis/binge drinking can lead to AUD
  • Family history: The risk is higher for individuals who have a parent or close relative with alcohol use problems
  • Starting at an early age: Individuals who begin drinking at an early age (teenage period) tend to become heavy drinkers in their adulthood
  • History of trauma: Individuals with a history of emotional or other trauma are at increased risk of AUD
  • Depression and other mental health problems
  • Having bariatric surgery
  • Social and cultural factors such as media influence, having a culture of partying regularly, role models being alcoholics, and peer pressure

Diagnosis

  • The doctor may perform a physical exam on you by asking questions concerning your health. Several physical signs indicate complications associated with alcohol use, and thus, the doctor will diagnose the performing physical exam.
  • The doctor will equally ask you numerous questions related to your drinking habits to substantiate the cause of your drinking habit and the symptoms you experience.
  • The doctor may also request for lab tests and imaging tests where abnormalities and amount of alcohol present in the bloodstream may help diagnose the condition.
  • The doctor may complete a psychological assessment by asking questions related to your thoughts, behavior patterns, and feelings.
  • Lastly, the doctor may use DSM-5 criteria to diagnose AUD

Treatment

Treatment of AUD may vary depending on the patient’s needs. It may involve individual or group counseling, brief intervention, an outpatient program, or a residential inpatient stay. Treatment may include detox and withdrawal, psychological counseling, oral medication, learning skills and developing a treatment plan, using injected medications, continuing support (aftercare and support groups), treatment for mental and psychological problems, spiritual practice, and medical treatment for health conditions associated with alcohol use.

In Kenya, the most common injected medication is Vivitrol which is injected once a month while others use it in pill form. Once a person is diagnosed with alcohol use disorder, NACADA recommends joining a rehabilitation center either as an inpatient or outpatient depending on the therapists’ recommendations.

Common rehabilitation centers in Kenya include Freedom from addiction Rehab Centre in Kiambu, SAPTA in Nairobi, Nairobi Place-addiction treatment center (Nairobi Place), Kenyatta National Hospital Rehab Section, Asumbi Treatment Center in Homa Bay, Mewa Rehab Center in Mombasa, and Good Hope Rescue Center in Mtito Andei among others.  

For more information on how you can access treatment, doctors, and facilities near you, download the Uzima Health App.

Sources

https://www.who.int/substance_abuse/publications/global_alcohol_report/en/

https://www.nation.co.ke/news/Every-four-of-100-deaths-in-Kenya-linked-to-alcohol-use/1056-4796096-12fbmm5/index.html

https://nairobinews.nation.co.ke/life/nairobi-kenyas-drinking-capital

https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243

https://www.tuko.co.ke/280533-list-rehabilitation-centres-kenya.html#280533