Alcohol is a psychoactive substance with properties known to cause dependence (or addiction). If compared within the framework of the 1971 Convention on Psychotropic Substances, alcohol would qualify as a dependence-producing substance warranting international control (United Nations, 1977; Ofori-Adjei et al., 2007). Alcohol shares some of its dependence-producing mechanisms with other psychoactive addictive drugs. Although a smaller proportion of the population who consume alcohol become dependent than is the case with some illegal drugs such as cocaine, it is nevertheless a significant problem due to much the larger number of people who consume alcohol (Kandel et al., 1997). People who drank seven to 14 alcoholic drinks a week lowered their life expectancy by about six months, people who drank 14 to 24 drinks a week lowered their life expectancy by one to two years, and consuming more than 24 drinks a week lowered life expectancy by four to five years.

An evidence summary of the results of the meta-analyses can be seen in Table 49. An evidence summary of the results of the meta-analyses can be seen in Table 45 and Table 46. Cognitive behavioural therapies versus other interventions evidence summary (2).

Effects of Alcohol on Your Body

Alcohol affects a wide range of neurotransmitter systems in the brain, leading to the features of alcohol dependence. The main neurotransmitter systems affected by alcohol are gamma-aminobutyric acid (GABA), glutamate, dopamine and opioid (Nutt, 1999). The action of alcohol on GABA is similar to the effects of other sedatives such as benzodiazepines and is responsible for alcohol’s sedating and anxiolytic properties (Krystal et al., 2006). Glutamate is a major neurotransmitter responsible for brain stimulation, and alcohol affects glutamate through its inhibitory action on N-methyl D-aspartate (NMDA)-type glutamate receptors, producing amnesia (for example, blackouts) and sedation (Krystal et al., 1999).

• Using alcohol to self-manage hedonic tone still plays a significant role, but excessive alcohol drinking at social gathertings declines [186] (Fig. 1).
• Patients with schizophrenia show a significantly higher incidence of alcohol use and abuse than people without psychiatric diagnoses [140, 141].
• The separate notions of physical dependence and psychological dependence are artificial and represent a myth regarding addictive behaviors.
• People with alcohol use disorders, however, drink to excess, endangering both themselves and others.

Alcohol dependence is also a category of mental disorder in DSM–IV (APA, 1994), although the criteria are slightly different from those used by ICD–10. For example a strong desire or compulsion to use substances is not included in DSM–IV, whereas more criteria relate to harmful consequences of use. It should be noted that DSM is currently under revision, but the final version of DSM–V will not be published until 2013 (APA, 2010).

Everything You Need to Know About Psychological Dependence

The review team conducted a systematic review of RCTs that assessed the beneficial or detrimental effects of multi-modal therapies in the treatment of alcohol dependence or harmful alcohol use. One trial relating to clinical evidence met the eligibility criteria set by the GDG, providing data on 49 participants. Studies were further excluded because they did not meet methodological criteria (see Chapter 3). When studies did meet basic methodological inclusion criteria, the main reasons for exclusion were that the study was not directly relevant to the review questions, or no relevant alcohol-focused outcomes were available. The review team conducted a systematic review of RCTs that assessed the beneficial or detrimental effects of psychodynamic therapies in the treatment of alcohol dependence or harmful alcohol use.

However, with increasing age, general health issues become more important and require adaptations [186, 187]. Overall alcohol consumption declines in older age, as the ability to metabolize alcohol efficiently declines and also interactions with ageing-related medications emerge [188]. With ageing, there occurs a shift in the self-management use of alcohol [189, 190]. Individuals in adult and old age with pain conditions of various origins use alcohol to ease suffering from pain [162,163,164]. Patients with fibromyalgia who consumed alcohol at moderate to low levels to self-medicate showed lower levels of symptoms and a better physical quality of life than non-drinkers [165, 166].

26.2. Summary of the NCCMH 2008 review

LITT2007 assessed contingency management with network support versus case management (an active control). Coping and social skills training is a variety of CBT that is based on social learning theory of addiction and the relationship between drinking behaviour and life problems (Kadden et al., 1992; Marlatt & Gordon, 1985). Treatment is manual-based (Marlatt & Gordon, 1985) and involves increasing the individual’s ability to cope with high-risk social situations and interpersonal difficulties.

Long-term heavy drinking can also cause permanent changes to the brain, such as problems with understanding, remembering, and thinking logically. People with depression and anxiety might use alcohol to help ease symptoms, but excessive alcohol use can also worsen your mental health. As noted previously, for patients with more severe disorders or symptoms, consult a psychiatrist (one with an addiction specialty, if available) for medication support, as well as a therapist with an addiction specialty for behavioral healthcare.

Approximately two thirds of male prisoners and over one third of female prisoners are hazardous or harmful drinkers, and up to 70% of probation clients are hazardous or harmful drinkers (Singleton et al., 1998). In terms of productivity, alcohol contributes to absenteeism, accidents in the workplace and decline in work performance. Up to 17 million working days are lost annually in the UK due to alcohol-related absences and 58,000 working years are lost https://ecosoberhouse.com/ annually due to premature deaths related to alcohol (Leontaridi, 2003). Alcohol misuse can also lead to job loss and over 38,000 people of working age in England were claiming Incapacity Benefit with a diagnosis of ‘alcoholism’ – nearly 2% of all claimants (Deacon et al., 2007). The holidays can be a difficult time to stay on track with your drinking, but these five strategies can help you achieve your goal and make the most of the holiday season.

However, other therapies (coping skills) were more effective than counselling in reducing amount of alcohol consumed when assessed at 12-month follow-up. Again, this result was based on a single study (ERIKSEN1986B) limiting the ability to generalise physiological dependence on alcohol the findings. However, resulting in a moderate effect size, cognitive behavioural therapies were significantly better than treatment as usual in reducing the number of participants who lapsed and relapsed when assessed at 6-month follow-up.