njtynhj

酗酒
	;
	; 《酒王與臣》，約1820年
分类和外部资源
醫學專科	; 精神病学;
; ICD-10;	; F10 .2
; ICD-9-CM;	; 303;
OMIM	; 103780;
MedlinePlus	; 000944;
MeSH	; D000437;
	; [编辑此条目的维基数据];

body.skin-minerva .mw-parser-output table.infobox captiontext-align:center

酗酒（英语：alcoholism），又稱酒精使用疾患（alcohol use disorder, AUD）或酒精依賴症候群（alcohol dependence syndrome），其為飲用酒精所致相關問題的廣義用語^[1]^[2]^[3]，過去將之分成酒精濫用（英语：Alcohol abuse）與酒精依賴兩種主要類型^[1]^[2]。

临床特征与判定

在醫學領域中，酗酒是指當某人出現以下兩種或兩種以上的狀況時：長期飲入大量酒精且難以減量、耗費大量時間取得酒精飲入、強烈渴望酒精、使用酒精後喪失責任能力、使用後造成社交問題、使用酒精而引發健康問題、使用後造成危險的情境、停用酒精後發生戒斷、使用時產生酒精耐受性（英语：Alcohol tolerance）^[2]。使用酒精會影響全身各部位，特別是腦部、心臟、肝臟、胰臟以及免疫系統，進而導致心理疾病、科爾薩科夫氏症候群、心律不整與肝硬化，對於其他疾病則會增加癌症的風險^[4]^[5]。懷孕時飲用酒精會影響胎兒而導致胎兒酒精綜合症^[6]。女性對於酒精造成身體與心理危害作用的感受性往往大於男性^[7]。

醫療上的酗酒定義包含了身體與心理上的病症^[8]^[9]。問卷調查與相關的血液測試可檢測出人們是否酗酒。更多的資訊則需由診斷來確診^[4]。

一般成因

遺傳因子以及環境都有一半的機率互相影響導致酗酒。一個人若有父母或兄弟姊妹其中一位有酗酒情況發生，自己會比一般人高達三至四倍的機率成為酗酒者^[4]。環境因素包含社會、文化與行為上的影響^[10]。高壓狀況、焦慮以及廉價又垂手可得的酒精，會增加酗酒的機率^[4]^[11]。人們會持續維持小部分的飲酒來避免或改善戒酒的後遺症，這種情形會持續數月才能戒酒^[4]。

酗酒人群分布

據世界衛生組織估計，2010年全球有2.08億人酒精中毒（佔15歲以上人口的4.1%^[7]^[12]）。在美國大約有1700萬（7%）的成人和70萬（2.8%）12到17歲的青少年受到影響^[13]。其中男性青壯年居多，中、老年的比例慢慢變少^[4]。酒精中毒者的比率在非洲最低，只有1.1%，而最高是在東歐，有11%^[4]。酒精中毒直接造成的死亡人數，從1990年的11.2萬人提高到2013年的13.9萬人^[14]。

危害

播放媒体

酒精對人體的影響。

一般相信，共330萬個死亡案例（佔所有死亡人數的5.9%）是肇因於酒精^[13]。酒精中毒通常會減少個人10年的預期壽命^[13]。2006年，它造成美國224億美金的經濟損失^[13]。英語中有很多帶貶義的俚語，習用於稱呼酒精中毒者，例如：tippler, drunkard, dipsomaniac和souse等^[15]。1979年，世界衛生組織曾建議用「酒精依賴症」（alcohol dependence syndrome），取代不精確的「酒精中毒」（alcoholism）^[16]。

戒除与治疗

事先預防養成酗酒的習慣可藉由酒類銷售的限制與規範，以及課稅（英语：Alcohol law）來增加購買酒類的成本，以及提供較不昂貴的治療方式^[17]。治療方式會有幾個步驟；因為在戒除的過程中會產生一些如酒精戒斷（英语：Alcohol detoxification）等醫療問題，必須小心控制。一個較普遍的做法是使用如地西泮等苯二氮平類藥物，可用於經核准的醫療保健機構，或可嚴密監控患者的環境中^[18]。若有其它的癮頭或精神上的疾病時，則會讓治療變得更複雜^[19]。在幫助酗酒者遠離酒精的戒酒贊助計畫如集體治療或自助群體（英语：Support group）中^[20]^[21]，匿名戒酒會是經常被使用的方式^[22]。預防再次飲酒也會使用抗癮劑如雙硫侖、阿坎酸（英语：Acamprosate）或那曲酮（英语：Naltrexone）等藥物^[23]。

參見

科爾薩科夫氏症候群

酒精失智症（Alcohol dementia）

高洋

醉酒駕駛

禁酒運動

參考文獻

^ ^1.0^1.1 Hasin, Deborah. Classification of Alcohol Use Disorders. http://pubs.niaaa.nih.gov/. December 2003 [28 February 2015].

^ ^2.0^2.1^2.2 Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5. November 2013 [9 May 2015].

^ Jill Littrell. Understanding and Treating Alcoholism Volume I: An Empirically Based Clinician's Handbook for the Treatment of Alcoholism:volume Ii: Biological, Psychological, and Social Aspects of Alcohol Consumption and Abuse.. Hoboken: Taylor and Francis. 2014: 55. ISBN 9781317783145.

^ ^4.0^4.1^4.2^4.3^4.4^4.5^4.6 Association, American Psychiatric. Diagnostic and statistical manual of mental disorders : DSM-5. 5. Washington, D.C.: American Psychiatric Association. 2013: 490–497. ISBN 9780890425541.

^ Alcohol's Effects on the Body. [9 May 2015].

^ Fetal Alcohol Exposure. [9 May 2015].

^ ^7.0^7.1 Global status report on alcohol and health 2014 (PDF). World Health Organization. 2014: s8,51. ISBN 9789240692763.

^ Mersy, DJ. Recognition of alcohol and substance abuse.. American family physician. 1 April 2003, 67 (7): 1529–32. PMID 12722853.

^ HEALTH AND ETHICS POLICIES OF THE AMA HOUSE OF DELEGATES (PDF): 33. June 2008 [10 May 2015]. H-30.997 Dual Disease Classification of Alcoholism: The AMA reaffirms its policy endorsing the dual classification of alcoholism under both the psychiatric and medical sections of the
International Classification of Diseases. (Res. 22, I-79; Reaffirmed: CLRPD Rep. B, I-89; Reaffirmed: CLRPD Rep. B, I-90; Reaffirmed by CSA Rep. 14, A-97; Reaffirmed: CSAPH Rep. 3, A-07) 参数|quote=值左起第184位存在換行符 (帮助)

^ Agarwal-Kozlowski K, Agarwal DP. [Genetic predisposition for alcoholism]. Ther Umsch. April 2000, 57 (4): 179–84. PMID 10804873. doi:10.1024/0040-5930.57.4.179.

^ Moonat, S; Pandey, SC. Stress, epigenetics, and alcoholism.. Alcohol research : current reviews. 2012, 34 (4): 495–505. PMID 23584115.

^ Global Population Estimates by Age, 1950-2050. [10 May 2015].

^ ^13.0^13.1^13.2^13.3 Alcohol Facts and Statistics. [9 May 2015].

^ GBD 2013 Mortality and Causes of Death, Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.. Lancet. 17 December 2014, 385 (9963): 117–71. PMC 4340604. PMID 25530442. doi:10.1016/S0140-6736(14)61682-2.

^ Chambers English Thesaurus. Allied Publishers. : 175. ISBN 9788186062043.

^ WHO. Lexicon of alcohol and drug terms published by the World Health Organization. World Health Organisation.

^ World Health Organization. Alcohol. January 2015 [10 May 2015].

^ Blondell RD. Ambulatory detoxification of patients with alcohol dependence. Am Fam Physician. February 2005, 71 (3): 495–502. PMID 15712624.

^ DeVido, JJ; Weiss, RD. Treatment of the depressed alcoholic patient.. Current psychiatry reports. December 2012, 14 (6): 610–8. PMID 22907336.

^ Morgan-Lopez AA, Fals-Stewart W. Analytic complexities associated with group therapy in substance abuse treatment research: problems, recommendations, and future directions. Exp Clin Psychopharmacol. May 2006, 14 (2): 265–73. PMID 16756430. doi:10.1037/1064-1297.14.2.265.

^ Albanese, AP. Management of alcohol abuse.. Clinics in liver disease. November 2012, 16 (4): 737–62. PMID 23101980.

^ Tusa, AL; Burgholzer, JA. Came to believe: spirituality as a mechanism of change in alcoholics anonymous: a review of the literature from 1992 to 2012.. Journal of addictions nursing. 2013, 24 (4): 237–46. PMID 24335771.

^ Testino, G; Leone, S; Borro, P. Treatment of alcohol dependence: recent progress and reduction of consumption.. Minerva medica. December 2014, 105 (6): 447–66. PMID 25392958.

外部链接

英国“关注酒精”组织

[NIH2003-1] 1.0^1.1 Hasin, Deborah. Classification of Alcohol Use Disorders. http://pubs.niaaa.nih.gov/. December 2003 [28 February 2015].

[NIH2013-2] 2.0^2.1^2.2 Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5. November 2013 [9 May 2015].

[3] Jill Littrell. Understanding and Treating Alcoholism Volume I: An Empirically Based Clinician's Handbook for the Treatment of Alcoholism:volume Ii: Biological, Psychological, and Social Aspects of Alcohol Consumption and Abuse.. Hoboken: Taylor and Francis. 2014: 55. ISBN 9781317783145.

[DSM5-4] 4.0^4.1^4.2^4.3^4.4^4.5^4.6 Association, American Psychiatric. Diagnostic and statistical manual of mental disorders : DSM-5. 5. Washington, D.C.: American Psychiatric Association. 2013: 490–497. ISBN 9780890425541.

[NIHHx-5] Alcohol's Effects on the Body. [9 May 2015].

[6] Fetal Alcohol Exposure. [9 May 2015].

[WHO2014-7] 7.0^7.1 Global status report on alcohol and health 2014 (PDF). World Health Organization. 2014: s8,51. ISBN 9789240692763.

[8] Mersy, DJ. Recognition of alcohol and substance abuse.. American family physician. 1 April 2003, 67 (7): 1529–32. PMID 12722853.

[9] HEALTH AND ETHICS POLICIES OF THE AMA HOUSE OF DELEGATES (PDF): 33. June 2008 [10 May 2015]. H-30.997 Dual Disease Classification of Alcoholism: The AMA reaffirms its policy endorsing the dual classification of alcoholism under both the psychiatric and medical sections of the
International Classification of Diseases. (Res. 22, I-79; Reaffirmed: CLRPD Rep. B, I-89; Reaffirmed: CLRPD Rep. B, I-90; Reaffirmed by CSA Rep. 14, A-97; Reaffirmed: CSAPH Rep. 3, A-07) 参数|quote=值左起第184位存在換行符 (帮助)

[Agarwal-Kozlowski-2000-10] Agarwal-Kozlowski K, Agarwal DP. [Genetic predisposition for alcoholism]. Ther Umsch. April 2000, 57 (4): 179–84. PMID 10804873. doi:10.1024/0040-5930.57.4.179.

[11] Moonat, S; Pandey, SC. Stress, epigenetics, and alcoholism.. Alcohol research : current reviews. 2012, 34 (4): 495–505. PMID 23584115.

[Pew2015-12] Global Population Estimates by Age, 1950-2050. [10 May 2015].

[NIH2015Stats-13] 13.0^13.1^13.2^13.3 Alcohol Facts and Statistics. [9 May 2015].

[GDB2013-14] GBD 2013 Mortality and Causes of Death, Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.. Lancet. 17 December 2014, 385 (9963): 117–71. PMC 4340604. PMID 25530442. doi:10.1016/S0140-6736(14)61682-2.

[15] Chambers English Thesaurus. Allied Publishers. : 175. ISBN 9788186062043.

[ladtpwho-16] WHO. Lexicon of alcohol and drug terms published by the World Health Organization. World Health Organisation.

[17] World Health Organization. Alcohol. January 2015 [10 May 2015].

[Blondell-2005-18] Blondell RD. Ambulatory detoxification of patients with alcohol dependence. Am Fam Physician. February 2005, 71 (3): 495–502. PMID 15712624.

[19] DeVido, JJ; Weiss, RD. Treatment of the depressed alcoholic patient.. Current psychiatry reports. December 2012, 14 (6): 610–8. PMID 22907336.

[Morgan-Lopez-2006-20] Morgan-Lopez AA, Fals-Stewart W. Analytic complexities associated with group therapy in substance abuse treatment research: problems, recommendations, and future directions. Exp Clin Psychopharmacol. May 2006, 14 (2): 265–73. PMID 16756430. doi:10.1037/1064-1297.14.2.265.

[21] Albanese, AP. Management of alcohol abuse.. Clinics in liver disease. November 2012, 16 (4): 737–62. PMID 23101980.

[22] Tusa, AL; Burgholzer, JA. Came to believe: spirituality as a mechanism of change in alcoholics anonymous: a review of the literature from 1992 to 2012.. Journal of addictions nursing. 2013, 24 (4): 237–46. PMID 24335771.

[23] Testino, G; Leone, S; Borro, P. Treatment of alcohol dependence: recent progress and reduction of consumption.. Minerva medica. December 2014, 105 (6): 447–66. PMID 25392958.

搜尋此網誌