Common Health Issues

Alcohol Abuse

• By Rich Health Editorial Team
• November 12, 2021

If you have good control of your diabetes, it probably won’t hurt you to have a drink every now and then with your meals. But if you drink too much alcohol, are unable to stop drinking or abstain when you want to, or drink even when it interferes with your family, friends, job or social standing, then you may have an alcohol abuse problem.

 

ALCOHOL ABUSE SYMPTOMS

The first step in dealing with alcoholism is to admit you have a problem. This is probably the most difficult step. It can sometime seem like a fine line between social drinking or having a drink or two after work to unwind to considering yourself an alcoholic. In the early stages, alcohol abuse may be difficult to recognize, even by relatives or close friends. If you have an alcohol abuse problem, you may also be reluctant to admit it. If you have more than two of the following symptoms listed below, then it is very likely that you have a serious alcohol abuse problem. Even if only one or two symptoms apply to you, you may be at risk of becoming dependent on alcohol:

 

• You tend to want to drink more or longer than the rest of the crowd. At a party, you may look for a refill right away when you finish a drink instead of waiting to be offered one. Or you might pour yourself a little more than others seem to be drinking

 

 

• You become preoccupied with drinking. You might often drink two or more alcoholic drinks when alone, either at home or in a bar, or feel a need to have a drink at a certain time each day, such as right after work. You feel a need to have at least one alcoholic drink each day and feel physically deprived if you don’t. you look for a drink when you are feeling pressured or stressed. You may even crave a drink in the morning

 

 

• Your drinking may trigger family arguments or your arguments may occur mostly when you have been drinking

 

• You begin to hide alcohol or sneak drinks. When questioned about your drinking, you may tend to be less than honest or try to stretch the truth

 

• You sometimes miss appointments and work, or are late for work, because of your drinking

 

• You sometimes have blackouts, in which you forget what happened while you were drinking the night before

 

 

• You notice an increasing tolerance to alcohol. You can “hold your liquor”

 

• You deny that you have a problem, even if you show many of the signs listed above

 

 

ALCOHOL ABUSE RISKS

Drinking too much alcohol, can be a problem for anyone. It can interfere with work, family life, and day-to-day living. Some people who are alcoholics are frequently intoxicated and often have a problem controlling their behavior. Others may manage to function in one area of their lives, but other areas suffer. In addition, alcohol abuse can also damage the body. It can lead to inflammation of the esophagus, which sometimes progresses to cancer, can cause anemia and birth defects when it occurs in pregnant women, can cause stomach problems, liver disease, heart problems, high blood pressure, atherosclerosis, stroke, inflammation of the pancreas, nerve damage, and brain damage.

If you have diabetes, alcohol abuse can be even more dangerous. It can worsen many of the complications of diabetes, especially nerve damage, eye disease, high blood pressure, kidney disease, and cardiovascular disease. It can also damage the liver, which is where your body stores glucose. When your liver is damaged, your blood glucose levels can be difficult to control. Also, if you have an alcohol abuse problem, you are much less likely to be able to give your diabetes care the attention you need to. If you are intoxicated, you may be unable or unwilling to test your blood glucose level and take the steps to treat high or low blood glucose levels.

 

Hypoglycemia is much more common among people with diabetes who have alcohol abuse problems. When your blood glucose levels drop too low, the liver releases glucose, which is stored there as glycogen. But if you have too much alcohol in your body, the liver is too busy trying to get rid of the alcohol, which it sees as a toxin, and does not release glucose efficiently. As a result, your blood glucose levels can drop dangerously low. You could risk coma or even death.

 

What You Should Do About Alcohol Abuse

The first step, of course, is to recognize there is a problem. Unfortunately, this is also the most difficult step. The is one situation where you can’t expect anyone to do it for you or nag you into better behavior. You have to want to stop drinking to excess and you yourself have to take the steps to recovery. Even if your drinking problem is in its early stages, you have to be the motivating force behind curtailing your alcohol intake.

The first thing to do if you show any of the symptoms listed above or feel that you are drinking too much is to cut down on the amount of alcohol you drink. If you have a drink or two every night, cut back to drinking every other night or only on weekends. If you only drink on weekends, but tend to drink to excess, stop after one drink. If you can’t do this, because you feel either a psychological or physical need to drink, then you need professional help right away. Talk to your doctor or call your local chapter of Alcoholics Anonymous (AA)

 

If you have been drinking for a long time, you may experience symptoms of withdrawal if you try to quit cold turkey. If you have decided to end your alcohol abuse, you should do so under a doctor’s supervision. If you quit abruptly, within 12 to 48 hours you may experience symptoms of withdrawal, such as tremor, weakness, sweating, or nausea. 

 

Heavier drinkers may also hallucinate and hear voices. This stage can last for days, but it can be controlled with antipsychotic drugs. If untreated, alcohol withdrawal may progress to delirium tremens, a more serious condition that usually appears 2 to 10 days after you stop drinking. Initial anxiety may give way to confusion, sleeplessness, nightmares, excessive sweating, and deep depression. Your pulse may quicken and you may have a fever. You may also experience hallucinations, restlessness, and terror. If untreated, delirium tremens can be fatal.

If you have a serious alcohol abuse problem, your best bet is to be treated in an inpatient detoxification program at a clinic or hospital. There, your symptoms of withdrawal will be monitored and treated with medications such as benzodiazepines or antipsychotic drugs. You may even need intravenous fluids, sedatives, and antifever drugs. You should be closely supervised at all times.

 

Once you are through the symptoms of withdrawal and detoxification, you can begin a program of rehabilitation. Without help, most alcoholics relapse within a few weeks. Treatment in a group setting seems to be the most successful. You may want to seriously consider a long-term inpatient rehabilitation program at your local hospital. Ask your doctor how to go about arranging this. Usually this is coordinated along with detoxification.

 

The AA program has helped many people. When you are ready to begin your rehabilitation program, have you doctor put you in touch with your local AA chapter. You may also want to join AA even if you have been through a long-term detoxification and rehabilitation program in a clinical setting. If AA is not your style, check into other local support groups for alcoholics or any program run by your local hospital or community health center. Once you leave the hospital, make sure you seek counseling or support in one setting or another to continue your sobriety.

Even with detoxification and rehabilitation, some recovering alcoholics may still have trouble staying sober. If this happens to you, you want to ask your doctor about drug therapy. One drug called disulfram (Antabuse) is taken on a regular basis. If you drink alcohol while on disulfram, acetaldehyde, a by-product of alcohol metabolism, will build up in your bloodstream and cause a violent reaction. 

 

Acetaldehyde is a toxin to your body and causes facial flushing, throbbing headache, rapid heartbeat, rapid breathing, and sweating within 5 to 15 minutes of drinking alcohol. This adverse reaction is usually enough to keep you from drinking alcohol again. You should only take this route if you really and truly want to stop drinking. It should not be given within 7 days of your last drink and should not be takin if you have another serious illness or are pregnant. People with diabetes should not take disulfram without a doctor’s supervision.

 

Another drug therapy, naltrexone, can help people refrain from alcohol. It should only be used as part of a comprehensive treatment program that includes counselling or some sort of group therapy. Naltrexone alters the effect of alcohol on the brain. Its big advantage is that it will not make you sick and may be safer for people with diabetes. However, because it doesn’t make you sick, you may continue to drink. If you have liver disease or hepatitis, you should not take naltrexone.

 

Ending alcohol abuse can be tricky for anyone, but even more so for someone with diabetes. If you suspect you have a problem, talk to your doctor and carefully review your options. Your doctor and other members of your health care team can help guide you on your road to recovery.

 

Sources and References

The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette

Effects of Alcohol on Plasma Glucose and Prevention of Alcohol-Induced Hypoglycemia in Type 1 Diabetes-A Systematic Review with GRADE by R Tetzschner, K Nørgaard and A Ranjan   

Advances in The Science and Treatment of Alcohol Use Disorder by K Witkiewitz, R Litten and L Leggio