Alcohol Use Disorder

Alcohol abuse, a historical public health concern, is gaining increased interest among medical professionals and analysts. Developing assessments are unveiling the significance of an alcohol crisis despite overshadowing drug epidemics.

An estimated 88,000 people die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States. The prevalence of alcohol in our society is generating alarming statistics of abuse and death that can’t be ignored. According to the 2015 National Survey on Drug Abuse and Health, 15 million adults over 18 and 600,000 12-17-year-olds have an alcohol use disorder.

Alcohol Use Disorder (AUD) is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using. AUD diagnosis is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), and its severity is categorized from mild to moderate or severe. In efforts to identify an individual suffering from AUD, the following symptoms may be present:

  • Inability to limit the amount of alcohol consumed
  • An increased time limit for drinking, getting alcohol, or recovering from alcohol use
  • Feeling a strong craving or urge to drink alcohol
  • Failing to fulfill major obligations at work, school, or home due to repeated alcohol use
  • Eliminating or reducing social and work activities, or hobbies
  • Developing a tolerance to alcohol, causing an increased need for more to feel its effect or experiencing a reduced effect from the same amount
  • Subjected to withdrawal symptoms—such as nausea, sweating, and shaking when not drinking and often drinking to avoid these symptoms

AUD is more prone to develop during an individual’s early to mid-adult life, although the disorder’s onset can begin at any age.

Alcohol is currently a regulated and licit substance in the United States and Canada; therefore, it is imperative to adhere to the safe drinking recommendations put forth by health organizations monitoring its usage. According to the Center for Disease Control (CDC), the recommended alcohol consumption for women is up to 1 drink a day, and for men, up to 2 drinks a day. If you are under the age of 21, may be pregnant, or have other health problems —abstaining from drinking is strongly advised. In efforts to elaborate on moderating drinking, understanding what constitutes a “drink” is crucial.

Defining A “Drink”

  • 12-ounces of beer (5% alcohol content)
  • 8-ounces of malt liquor (7% alcohol content)
  • 5-ounces of wine (12% alcohol content)
  • 1.5-ounces of 80 proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey)

Binge Drinking

Binge drinking is defined as a drinking pattern that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or above. This type of intoxication generally occurs when men consume 5 or more drinks, or women consume 4 or more drinks in 2 hrs.

Heavy Drinking

Heavy alcohol use is defined as binge drinking on 5 or more days within a month.

The Importance of Utilizing Alcohol Assessment Tools

Administering evaluative tools in efforts to assess risky drinking behaviours properly can be a useful tactic. However, self-report reliability can become questionable –utilizing additional evidence-based measurements can help depict the true magnitude of one’s drinking behaviours. Several studies have reported difficulties in measuring alcohol-related dependence using self-reporting tools due to respondents’ misinterpretation, lack of specificity, and misperception of AUD symptoms such as after-effects and acute intoxication.

An estimated 16 million people in the United States have AUD. Incorporating detection methods to assist in identifying individuals exhibiting indicators of destructive drinking can create an effective awareness about AUD –a crisis that affects so many today.  There are many ways to test for risky drinking behaviours with long-term alcohol biomarkers.

Fingernail-Ethyl Glucuronide (EtG)-window of detection is ~3 months prior to collection.

Hair-Ethyl Glucuronide (EtG)-window of detection is ~3 months prior to collection.

Blood-Phosphatidylethanol (PEth)-window of detection is ~2-4 weeks prior to collection.

*Urine, blood, and saliva are considered dynamic specimens with short-term biomarkers (window of detection is ~1-3 days) and are more indicative of recent use, not necessarily risky long-term use. PEth in the blood is not considered short-term because it accumulates in the red blood cell membrane and is not dissolved in the blood itself.

Relevant Event:

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Title: Tox Talk Live – Phosphatidylethanol: Recent Developments 

Host: USDTL

Date/Time: December 8th at 1 pm CST. 

Duration: 30-minute discussion followed by a live Q&A session

Presenter: Dr. Joseph Jones will be discussing 

Topic: Phosphatidylethanol (PEth):

  • the impact of Alcohol Consumption during COVID-19, 
  • ethanol-based hand sanitizers & mouthwash, 
  • and the effect of hematocrit on PEth.

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