Encyclopedia of Health and Medicine

320 Substance Abuse
diagnosis on the basis of the aggregate findings,
including the best determination of the person’s
drinking patterns and history.
Treatment Options and Outlook
Alcoholism is a chronic, lifelong condition that
requires ongoing management to maintain complete
abstinence from alcohol. DETOXIFICATION—the
process the body goes through to completely eliminate
alcohol—takes 5 to 7 days. Medications to
ease the symptoms of WITHDRAWAL SYNDROME may
include BENZODIAZEPINES and NALTREXONE, which
calm anxiety and reduce cravings for alcohol,
respectively. After the body is free of alcohol,
maintaining sobriety often requires a combination
of approaches that may include
• medications such as disulfiram, which prevents
the body from metabolizing alcohol, and naltrexone
to mitigate alcohol cravings
• individual PSYCHOTHERAPY to gain insight and
understanding of the factors that contribute to
the desire to drink
• group therapy or SUPPORT GROUPS such as Alcoholics
Anonymous to provide opportunity to
talk about alcoholism with others who have the
condition and to reinforce behaviors to remain
drink free
For nearly everyone who has alcoholism, maintaining
sobriety (absolute abstinence) requires
continued diligence. It is important to seek appropriate
intervention to return to sobriety as quickly
as possible when relapses do occur. Most alcohol
treatment centers and programs also offer support
groups and sometimes counseling for family members.
Risk Factors and Preventive Measures
Persistent, regular drinking is the most significant
risk for developing alcoholism, because over time
the body acquires both alcohol TOLERANCE and alcohol
DEPENDENCE. Additive risks include beginning to
drink at a young age, family history of alcoholism,
genetic composition (separate from family history),
and history of psychologic conditions such as ATTEN-
TION DEFICIT HYPERACTIVITY DISORDER (ADHD), DEPRES-
SION, and BIPOLAR DISORDER. As well, three in four
people who have alcoholism are men.
See also ALCOHOLIC HALLUCINOSIS; DELIRIUM
TREMENS; FETAL ALCOHOL SYNDROME; HEPATITIS; SUB-
STANCE ABUSE PREVENTION; SUBSTANCE ABUSE TREAT-
MENT.
alkyl nitrites Inhaled drugs that rapidly relax
smooth MUSCLE and dilate the BLOOD vessels. The
alkyl nitrite with therapeutic application is amyl
nitrite, a treatment for ANGINA PECTORIS (CHEST PAIN
resulting from constriction of the CORONARY ARTER-
IES). Amyl nitrite requires a physician’s prescription
in the United States. Other alkyl nitrites have
legitimate uses in products such as room deodorizers,
adhesive removers, and various types of
cleaners. Medicinal amyl nitrite comes in small
glass ampules encased in fabric. To use the vial the
person snaps or pops the vial within its protective
fabric, releasing and breathing the vapors.
As substances of abuse, alkyl nitrites produce
euphoria, reduced inhibition, and a sensation of
excitement. Inhaled alkyl nitrites also are reputed
to intensify sexual experiences because they relax
sphincter muscles such as those in the VAGINA and
the ANUS. The primary users of alklyl nitrites are
adults between the ages of 30 and 50. Abuse of
alkyl nitrites has moderate risk for psychologic
DEPENDENCE. OVERDOSE of alkyl nitrites can result in
ARRHYTHMIA (irregular heartbeat). Alkyl nitrites
may aggravate HYPERTENSION (high BLOOD PRESSURE)
or intensify the effects of nitrite-based medications
to treat cardiovascular conditions such as hypertension
and HEART FAILURE.
COMMON ALKYL NITRITES
amyl nitrite
butyl nitrite
cyclohexyl nitrite
ethyl nitrite
isobutyl nitrite
isopropyl nitrite
methyl nitrite
pentyl nitrite
Long-term use of alkyl nitrites can cause METHE-
MOGLOBINEMIA, a condition in which the HEMOGLO-
BIN cannot properly bind with oxygen. Ingestion
or injection of alkyl nitrites carries high risk for
death. Because alkyl nitrites use tends to encourage
high-risk sexual behavior their use results in
increased risk for HEPATITIS and SEXUALLY TRANSMIT-
TED DISEASES (STDS) including HIV/AIDS, though alkyl
nitrites do not directly cause such infections.
Long-term, chronic alkyl nitrites abuse also causes