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Alcohol 

Alcohol
Chapter:
Alcohol
Author(s):

Darius A. Rastegar

and Michael I. Fingerhood

DOI:
10.1093/med/9780190214647.003.0004
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date: 08 April 2020

At low levels, alcohol causes euphoria and disinhibition, but at higher levels it causes sedation, as well as impaired memory and coordination. Overdose is characterized by drowsiness, slurred speech, nausea, vomiting, and respiratory depression. Withdrawal symptoms include tremors, seizures, and delirium tremens and may be life-threatening. Symptom-triggered benzodiazepines are the standard of care for the treatment of withdrawal and to prevent delirium tremens and seizures. Further treatment after detoxification is required for long-term abstinence. Brief advice is effective for problem drinkers. Self-help groups, counseling, and residential treatment appear to be effective for those with more severe problems. There are a number of pharmacotherapies that appear to be modestly effective, including naltrexone, acamprosate, topiramate, and gabapentin. Disulfiram may be effective for selected individuals.

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