Alcohol Dependence: Symptoms, Complaints, Signs

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
  • 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 ‰).

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.