Introduction: Alcohol use disorder has a chronic relapsing course. Various biological, psychological, environmental, and psychosocial factors play a major role in maintaining abstinence and determining relapse in patients. The COVID-19 pandemic has caused significant changes in every person's life. It is important to assess how this situation has determined alcohol use in the patients who had utilized deaddiction services in the past. Aim: The aim of this study is to assess the pattern of alcohol use, perceived stress, and quality of life (QOL) during COVID-19 in patients who had utilized deaddiction services for alcohol use disorder in the preceding 1 year. Materials and Methods: A cross-sectional design was employed in the study. After obtaining consent, telephonic interviewing of patients who had utilized deaddiction services during January–December 2019 was done, and questionnaires including sociodemographic details, Severity of Alcohol Dependence Questionnaire, Brief Substance Craving Scale, Perceived Stress Scale-10, and WHOQOL-BREF scale were administered to assess the pattern of alcohol use, stress levels, and QOL. Comparisons were carried out on different variables using SPSS version 20. Results: A total of 122 patients were inducted into the study. About 70.5% of the relapsed individuals belonged to joint families. There was a significant association between the poor QOL and relapse status of the individuals. High levels of stress were reported among the individuals who have relapsed compared to nonrelapsed individuals. Conclusion: High rates of relapse and higher stress levels were found in our study. This study has helped us to understand the pattern of alcohol use in individuals during this pandemic. It is important to address the factors contributing to relapse in individuals so as to focus on developing and implementing feasible and accessible interventions to help the individuals.

Impact of Covid-19 pandemic on quality of life in persons with alcohol use disorder - A cross-sectional study

Alcoholic liver disease (ALD) is a globally prevalent chronic liver disease caused by chronic or binge consumption of alcohol. The therapeutic efficiency of current therapies for ALD is limited, and there is no FDA-approved therapy for ALD at present. Various strategies targeting pathogenic events in the progression of ALD are being investigated in preclinical and clinical trials. Recently, mesenchymal stem cells (MSCs) have emerged as a promising candidate for ALD treatment and have been tested in several clinical trials. MSC-released factors have captured attention, as they have the same therapeutic function as MSCs. Herein, we focus on current therapeutic options, recently proposed strategies, and their limitations in ALD treatment. Also, we review the therapeutic effects of MSCs and those of MSC-related secretory factors on ALD. Although accumulating evidence suggests the therapeutic potential of MSCs and related factors in ALD, the mechanisms underlying their actions in ALD have not been well studied. Further investigations of the detailed mechanisms underlying the therapeutic role of MSCs in ALD are required to expand MSC therapies to clinical applications. This review provides information on current or possible treatments for ALD and contributes to our understanding of the development of effective and safe treatments for ALD.

/pdf/current-therapeutic-options-and-potential-of-mesenchymal-25mp2bz4.pdf

Current Therapeutic Options and Potential of Mesenchymal Stem Cell Therapy for Alcoholic Liver Disease

Background: Relapse is an important but difficult phase of the management of alcohol dependence syndrome (ADS). Objective: To study the prevalence and characteristics of relapse in patients with ADS. Methods:This is a descriptive cross-sectional study on the patients with ADS presenting at the Department of Psychiatry, Patan Academy of Health Sciences, for the period of one year (June 2016 - May 2017). Data on the demographic and relapse characteristics were collected. Data were entered and analyzed in Microsoft Excel (MS Office 365, Microsoft Corporation, Washington, United States). Numerical variables were summarized with the median (Inter-Quartile Range [IQR]) and the categorical variables with proportions. Results: Altogether, 105 patients with ADS were studied, among which 59 patients had a relapse (56.1%). All of them were male with a median age of 42 years (Interquartile range (IQR) 35 to 52). The majority were married (55, 93.22%), manual labor as an occupation (32, 54.24%), were Janjati by ethnicity (37, 62.71%), and had received secondary education (19, 32.20%). The median age of starting alcohol consumption was 18 years (IQR 15 to 20) and the median duration of consumption was 22 years (IQR 15 to 30). The most common reason for relapse was peer pressure (25, 42.37%). The majority had relapsed once before (26, 44.07%). Mostly relapsed after abstinence of 1 to 3 months (22, 37.29%) and abstinence maintained by self-motivation (30, 50.85%). Comorbidity and family history of substance use was present in higher proportions. Conclusion: A high rate of relapse was found in our patients with peer pressure as the most common reason for the relapse. 

pdf/prevalence-and-characteristics-of-relapse-in-patients-with-39ri7r3p0q.pdf

Prevalence and characteristics of relapse in patients with Alcohol Dependence Syndrome

Unravelling the Risk Factors for Alcohol Dependence Relapse in Southern India: A Survival Analysis Approach

Abstract Background Alcohol related liver disease (ARLD) is one of the major chronic liver diseases worldwide. This review aimed to describe the global prevalence, incidence, and outcomes of ARLD. Methods Medline, Embase, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched from inception to May 31, 2022. The language was restricted to English or Chinese. According to the criteria, articles describing the basic characteristics of the population were selected. Two reviewers extracted the data independently. Results A total of 372 studies were identified: 353 were used for prevalence analysis, 7 were used for incidence analysis, and 114 were used to for outcome analysis. The prevalence of ARLD worldwide was 4.8%. The prevalence in males was 2.9%, which was higher than female (0.5%). Among the ethnic groups, the percentage was highest in Caucasians (68.9%). Alcoholic liver cirrhosis comprised the highest proportion in the disease spectrum of ARLD at 32.9%. The prevalence of ascites in ARLD population was highest (25.1%). The ARLD population who drinking for &gt; 20 years accounted for 54.8%, and the average daily alcohol intake was 146.6 g/d. About 59.5% of ARLD patients were current or former smokers, and 18.7% were complicated with hepatitis virus infection. The incidence was 0.208/1000 person-years. The overall mortality was 23.9%, and the liver-related mortality was 21.6%. Conclusion The global prevalence of ARLD was 4.8% and was affected by sex, region, drinking years, and other factors. Therefore, removing the factors causing a high disease prevalence is an urgent requisite. Trial registration PROSPERO Nr: CRD42021286192 

https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-023-15749-x

Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis

Introduction In patients with alcoholic liver disease, abstinence from alcohol is an important aspect of treatment. Once abstinence is achieved, the challenge is to avoid relapse of alcohol use. This study aims to analyse the significant risk factors for alcohol relapse thereby identifying the patients with high risk for recidivism to have an early social and medical intervention. Methodology This was an observational and a retrospective type of study. Patients with chronic liver disease and had alcohol use relapse after abstinence were classified into Group A. Patients who did not have relapse after abstinence were classified into Group B. The two groups were compared for various social and personal and disease related factors. Student "t" test was used for raw data and Chi square test was used for consolidated data to find significant difference between variables. Results Overall nine factors were analysed. The factors which were found to be significant for predicting relapse are quantity of alcohol consumption per week, duration of abstinence, associated smoking, marital status, severity of liver disease (Child-Pugh scoring system). The other factors like age of starting alcohol consumption, duration of alcohol consumption, family history of alcohol intake and MELD score were not statistically significant. Conclusion This study identifies the risk factors associated with alcohol relapse in patients with alcoholic liver disease. The data from this study can be used to identify individuals who are high risk for relapse and treat them with pharmacological and psychosocial methods to prevent relapse.

Risk factors for alcohol use relapse after abstinence in patients with alcoholic liver disease.

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Risk factors for alcohol use relapse after abstinence in patients with alcoholic liver disease.