Alcohol dependence and psychiatric comorbidities

Ovisnost o alkoholu je kronična recidivirajuća bolest. Karakteriziraju ju: snažna želja za uporabom alkohola, oslabljena sposobnost kontrole nad konzumacijom, zaokupljenost aktivnostima povezanih s uporabom alkohola, razvoj tolerancije ka istim količinama alkohola te ustezanje prilikom odsustva uporabe alkohola. Rizični čimbenici za razvoj ovisnosti o alkoholu su: okolišni, genetski te psihosocijalni. Ukoliko se ovisnost razvije, potrebno je bolesnika čim prije uključiti u dnevno bolničke programe. Pri tome je nužno uključivanje obitelji u proces liječenja te edukacija članova obitelji i ovisnika vezano za bolest i liječenje. Većina ovisnika o alkoholu ima psihijatrijski komorbiditet. Najčešće se radi o: poremećajima uporabe drugih psihoaktivnih supstanci, anksioznim poremećajima, poremećajima raspoloženja te poremećajima osobnosti. Kada govorimo o poremećajima uporabe drugih psihoaktivnih supstanci, uporaba alkohola najčešće prethodi uporabi supstanci sa sve jačim psihoaktivnim djelovanjem. Budući da alkohol djeluje na sve organske sustave, tjelesni komorbiditeti, a posebice bolesti gastrointestinalnog sustava nisu rijetkost. Jetra je organ koji se najviše oštećuje uporabom alkohola, a dugogodišnjom konzumacijom može se razviti ciroza jetre i hepatocelularni karcinom . Nadalje, povećan je rizik za razvoj karcinoma u čitavoj probavnoj cijevi, ali i pankreasu, dojci i larinksu. Dugotrajna ovisnost o alkoholu dovodi do Wernicke-Korsakovljevog sindroma, centralne pontine mijelinolize i drugih poremećaja. Budući da je bolest izrazito invalidizirajuća, potrebno je spriječiti njezin nastanak. Mjerama primarne prevencije na svim razinama, naročito usmjerenim na djecu, adolescente i mlade, sprječavamo razvoj ovisnosti kao bolesti, a time održavamo i poboljšavamo zdravlje populacije.Alcohol dependence is a chronic relapsing disease. It is characterized by a strong desire to use alcohol, a weakened ability to control consumption; preoccupation with activities related to alcohol use, development of tolerance to the same amounts of alcohol and withdrawal symptoms in the absence of alcohol use. Risk factors for the development of alcohol dependence are environmental, genetic and psychosocial. If addiction develops, the patient should be included in daily hospital programs as soon as possible. Involvement of the family in the treatment process and education of family members and addicts related to the disease and treatment is necessary. Most alcohol addicts have psychiatric comorbidity. These are most often disorders of the use of other psychoactive substances, anxiety disorders, mood disorders and personality disorders. When we talk about disorders of the use of other psychoactive substances, the use of alcohol usually precedes the use of substances with increasing psychoactive effects. Because alcohol acts on all organ systems, bodily comorbidities, especially diseases of the gastrointestinal system are not uncommon. The liver is the organ that is most damaged by the use of alcohol, and long-term consumption can lead to liver cirrhosis and hepatocellular carcinoma. Furthermore, there is an increased risk for the development of cancer in the entire digestive tract, but also in the pancreas, breast and larynx. Long-term alcohol dependence leads to Wernicke-Korsakov syndrome, central pontine myelinolysis, and other disorders. Since the disease is extremely disabling, it is necessary to prevent its occurrence. Primary prevention measures at all levels, especially aimed at children, adolescents and young people, prevent the development of addiction as a disease, and thus maintain and improve the health of the population