clinical features

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Characteristic behaviours include a tendency to gulp drinks, to have extra drinks before going to social events, drink on their own, lie about how much alcohol they consume, drink on the way home, and to keep alcohol with them.

The following symptoms and signs of alcohol abuse may be seen in patients and often they are treated repeatedly without recognition of the underlying problem:

  • recurrent intoxication, nausea, sweating, tachycardia
  • amnesic episodes (blackouts)
  • mood swings, depression, anxiety, insomnia, chronic fatigue
  • grand mal seizures, hallucinations, delirium tremens
  • dyspepsia, diarrhea, bloating, hematemesis, jaundice
  • tremor, unsteady gait, paraesthesia, memory loss, erectile dysfunction
  • other substance abuse (e.g., cannabis, cocaine, heroin, amphetamines, sedatives, hypnotics, and anxiolytics
  • unexpected medication response (drug interactions)
  • poor nutrition and personal neglect
  • recurrent absenteeism from work or school
  • frequent falls or minor trauma (particularly in the elderly) (1)

Features of alcohol dependence include:

  • a fixed daily routine of drinking in order to avoid withdrawal
  • priority of drinking over other activities
  • increased tolerance to alcohol
  • repeated withdrawal symptoms such as tremor, sweating and agitation
  • relief of withdrawal symptoms by further drinking
  • subjective awareness of the compulsion to drink
  • rapid relapse (reinstatement) if drinking is resumed after abstinence


Last reviewed 01/2018