Avoiding relapse – a fundamental step to combat rise in alcoholism leading to liver cirrhosis
Given our social construct in the modern age, alcohol consumption has become a new fad. It is no longer looked down upon. In fact, not engaging in drinking is considered “uncool”. Alcoholism, a niche problem among adults has now trickled down among youths as well. It is a known fact that continued alcohol consumption can lead to liver cirrhosis.
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. In India between 10 to 75 yrs old – 14.6 % of the population uses alcohol which is equivalent to 16 cr people; and almost 5.2% of the general population have a drinking problem which is equivalent to 5.7 cr people. In West Bengal 20% alcoholics have liver problems out of which 10% have liver cirrhosis. After Uttar Pradesh, West Bengal is 2nd in India in terms of people consuming alcohol equivalent to 1.4 cr of the population. The worrying part is that the proportion of children reporting alcohol usage in West Bengal is 2nd highest in India at 3.9%.
Dr Sanjay Garg, Consultant, Dept of Mental Health and Behavioural Sciences said, “Alcoholism in India is treated as a Moral Problem. The first thing to be understood is that addiction is 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. 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.”
Dr. Debasis Datta, Director of the Department of Gastroenterology said, “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. Usually patients give up alcohol easily within the first month. However, once they begin recuperating from medical assistance, they tend to relapse.”
In order to avoid a relapse doctors at Fortis Anandapur have provided the following preventive measures:
- 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
Not all patients need counselling. It depends on a few factors – degree of addiction, reason for motivation, family etc.
“Liver has a capacity to regenerate. Thereby giving up alcohol will improve alcoholic liver cirrhosis if detected in Stage 1 and Stage 2. Detection at Stage 3 requires a liver transplant”, added Dr. Debasis Datta.