Alcohol Abuse

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Differential Diagnosis

To diagnose alcohol abuse, the clinician must rule out medical problems that cause symptoms similar to intoxication and withdrawal, such as the following conditions:

• Brain trauma
• Hypoglycemia
• Electrolyte imbalance
• Diabetic acidosis and ketoacidosis
• Meningitis
• Neurological conditions such as multiple sclerosis
• Pneumonia
• Stroke

If a patient has one of these conditions, he or she may be disoriented, unable to hold a conversation, have a short attention span, or may have trouble walking or maintaining balance. In the case of brain trauma and stroke, the patient may be unconscious.

Diagnosis also includes evaluations for depression and anxiety disorders, which often coexist with alcoholism. Abuse of other intoxicants, such as benzodiazepines and barbiturates, is common. The presence of a mixed drug and alcohol problem must be determined.

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