WHAT IS ALCOHOL DEPENDENCE?
A. Liver transplantation (LT) patients with alcoholic liver disease (ALD) often have the comorbid psychiatric disorder of alcohol dependence (AD).
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Not all patients with AD will develop ALD. 2. Most, but not all patients, with ALD will be AD.
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Approximately 75-80% of ALD LT patients have AD.
B. Diagnostic criteria of alcohol use disorders.
- Alcohol abuse. a. Clinically important impairment or distress repeatedly in one or more of the following items in a 12-month period.
i. Failure to fulfill major obligations (e.g., absences/ suspension from work, neglecting household duties).
ii. Physically hazardous (e.g., driving while intoxicated).
iii. Legal problems (e.g., disorderly conduct, arrest for driving while intoxicated).
iv. Social/interpersonal problems (e.g., arguments with spouse about drinking, physical fights).
b. Approximately 60% continue with abuse; only 10% go on to develop AD.
- Diagnostic criteria of AD. a. Clinically important impairment or distress in 3 or more of the following in a 12-month period.
i. Tolerance (e.g., increased amount needed for effect, diminished effect).
ii. Withdrawal (e.g., autonomic hyperactivity, tremor, or use to avoid withdrawal).
iii. Larger amounts/longer period than intended. iv. Persistent desire/unsuccessful attempts to cut down.
v. Excessive time spent with alcohol (e.g., spending