alcohol use disorders (AUD)
Alcohol use disorders (AUD) are considered as one of the most important public health problems resulting from a variety of genetic, psychosocial and environmental factors (1,2,3)
- it account for 4% of the global burden of disease and results in 1.8 million deaths (3.2% of total) each year
- economic cost mainly due to lost productivity and alcohol related crime is estimated to be 20bn pounds sterling each year in the United Kingdom (2)
- it is a condition seldom identified by health and social care professionals (UK GPs routinely identify less than 2% of hazardous or harmful drinkers and less than 5% of alcohol-dependent drinkers)
- estimated to affect approximately 18% of the general population lifetime and 5% annually (4)
- estimated that almost 20% of adult patients in the emergency rooms suffer from AUD and that the incidence of alcohol withdrawal syndrome (AWS) in patients admitted to surgical Intensive Care Unit (ICU) varies from 8 to 40%, and seems to be associated with infectious complications and a higher mortality rate
- up to 50% of AUD patients experience withdrawal symptoms, a minority of whom requires medical treatment.
These disorders cover a wide range of mental health problems as recognised within the international disease classification systems (ICD-10, DSM-IV).
- the Diagnostic and Statistical Manuals of Mental Disorders (DSM)
- DSM IV described two distinct disorders
- alcohol abuse
- alcohol dependence
- DSM 5 integrates the two DSM-IV disorders, alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder (AUD) with mild, moderate, and severe sub-classifications.
- the International Classification of Diseases (ICD)
- harmful use of alcohol
- defined as a pattern of alcohol use that is causing damage to health, and the damage may be physical (as in cases of liver cirrhosis) or mental (as in cases of depressive episodes secondary to heavy consumption of alcohol) (2)
- alcohol dependence (1,3)
Alcohol abstinence improves prognosis across all stages of portal hypertension in alcohol-related cirrhosis, including in patients who have already progressed to high-risk portal hypertension (4)
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