Increasing Alcohol Dependence and Rise in the number of cases with Alcoholic Liver Disease

  1. The number of cases of liver cirrhosis hasn’t gone down; the attention from it has taken a back seat because non-alcoholic liver cirrhosis has risen.
  2. Alcohol not only causes liver problems but also social, mental and familial issues.
  3. Dr Sanjay Garg said that alcoholism in India is treated as a Moral Problem. The first thing to be understood is that addiction not a moral disorder but a brain disorder and today there are enough evidences to prove that there are certain circuits in the brain that are damaged and different for people who are prone to addiction.
  4. The brain has three circuits – reward circuit, arousal circuit and the stress circuit. Initially on consumption of alcohol there is a positive reinforcement. The arousal circuit gets activated and you feel euphoric. As the consumption continues the other circuits get involved. The dependence becomes grave and any excuse becomes a reason for consumption – not enough sleep, work stress, financial stress. This develops into alcoholism.
  5. There are a group of people who are diagnosed with liver disease, liver cirrhosis and liver cancer because of alcohol. Along with medical assistance it is of utmost importance that these patients refrain from any amount of alcohol consumption or else the progress with be in vain.
  6. Dr. Debasis Datta, Director of the Department of Gastroenterology and Dr. Sanjay Garg, Consultant of the Department of Mental Health and Behavioral Sciences at Fortis Hospital Anandapur have come to an arrangement wherein patients who suffer from liver diseases owing to alcohol are also given mental counseling to give it up.
  7. Usually patients give up alcohol easily within the first month. However, once they begin recuperating from medical assistance, they tend to relapse.
  8. Dr. Debasis Datta and Dr Sanjay Garg are working with patients of liver cirrhosis who have a tendency to relapse.
  9. Relapse prevention –
    • First identify the motivation for drinking
    • Fighting the withdrawal – Regular consumption causes neurological changes called neurological adaptations and the brain develops tolerance and withdrawal. On leaving alcohol there are certain withdrawal problems like shaky hands, sleeplessness, irritability, loss of appetite, inability to do work etc.  During this phase counselling is important to overcome it and provide a mental strength
    • Develop alternate strategies. One of the strategies is distraction technique where the patient develops a hobby.
    • Identifying social support
  10. Liver has a huge capacity to regenerate. Thereby giving up alcohol will cure alcoholic liver cirrhosis if detected in Stage 1 and Stage 2. Detection at Stage 3 requires a liver transplant.
  11. Not all patients need counselling. It depends on a few factors – degree of addiction, reason for motivation, family etc

 

Dr. Debasis Datta, Director of the Department of Gastroenterology, Fortis Hospital Anandapur & Dr. Sanjay Garg, Consultant of the Department of Mental Health and Behavioral Sciences, Fortis Hospital Anandapur

 

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