The following symptoms and complaints may indicate alcohol-related disorder (modified from):
- Alcohol odor
- Habitus
- Beer belly; contrasting with atrophy of the shoulder and or leg muscles.
- Face
- Reddened conjunctivae of the eyes
- Bloated (edematous) face, often reddened, with telangiectasias (vascular dilatation just below the skin surface), but also sallow (facies alcoholica)
- Rhinophyma (reddened, bulbous thickening of the tip of the nose).
- Skin
- Typical skin changes (e.g., vascular spiders, palmar erythema, “bill skin“/comparing the skin of the liver patient to the relatively rough surface of a dollar bill, skin aging, psoriasis, nail psoriasis).
- Cardial (cardiovascular)
- Pulse acceleration
- Gastrointestinal (gastrointestinal tract)
- Morning nausea, lack of appetite.
- Nervous system and psyche
- Vegetative lability, especially increased sweating (wet hands).
- Increased irritability, decreased impulse control and stress tolerance.
- Gait unsteadiness (somewhat wide-legged, clumsy).
- Insomnia (sleep disturbances)
- Lack of concentration, forgetfulness
- Sexual appetence disorders (desire for sexuality) and erectile dysfunction (ED; erectile dysfunction).
- Tremor (shaking)
- Impaired performance (subjective and objective).
- Reduced general condition
The following symptoms and complaints may indicate alcohol dependence:
- Strong urge for alcohol
- Reduced ability to control
- Conflicts in relationship and profession
- Tolerance development
- Physical symptoms such as trembling or sweating
- Neglect of family, friends, job and interests
It is noticeable that women are usually more likely than men to drink secretly.
The following symptoms may indicate alcohol intoxication:
Excitation stage (excitation stage) (1-2 ‰).
- Excitement, disinhibition
- Prolonged reaction time
- Hyperventilation (a lung ventilation/breathing increased above the need).
Intoxication stage (2-2.5 ‰).
- Disturbance of consciousness
- Speech disorders
- Coordination disorders
- Respiratory inhibition
- Decreased pain perception
- Dry warm skin
- Hypoglycemia (low blood sugar)
- Nausea (nausea), vomiting.
Narcosis stage (2.5-4 ‰).
- Coma
- Hypothermia – lowering of body temperature to values below 34 °C.
- Incipient shock
Asphyxia stage (> 4 ‰)
- Deep coma, no reflexes
- Shock
- Cardiovascular failure
The following symptoms may indicate alcohol withdrawal:
Withdrawal syndrome without delirium (state of confusion).
- Nausea (nausea), vomiting.
- Arterial hypertension (high blood pressure), tachycardia (heartbeat too fast: > 100 beats per minute).
- Insomnia (sleep disorders)
- Sweating
- Facial redness
- Mydriasis (dilated pupils)
- Fever
- Tremor (shaking)
- Speech disorders
- Epileptic seizure
- Restlessness, anxiety
- Depression
Withdrawal syndrome with delirium* (from 2nd/3rd day after alcohol withdrawal).
- Disorientation
- Fleeting hallucinations
- Severe agitation with stranger/self endangerment
- Nesting
* In addition to the withdrawal symptoms listed above.