Alcohol and Neuropathy in Chronic Users
According to the Textbook of Peripheral Neuropathy, the term neuropathy refers to nerve damage or a problem with the nerves.
Typically, neuropathy refers to damage to the peripheral nerves, which are nerves outside the central nervous system (the brain and spinal cord). The peripheral nervous system is responsible for transmitting signals between the body and brain through the spinal cord. Peripheral nerves are responsible for a large number of voluntary and involuntary actions. Three types of nerves can be involved in neuropathy:
- Motor nerves: These nerves function in movement. Neuropathy in motor nerves is experienced as weakness, particularly in the feet and hands.
- Sensory nerves: These nerves control sensation. When these are involved in neuropathy, it is experienced as pain, tingling, numbness, or weakness in the feet and hands.
- Autonomic nerves: These are nerves that control certain body systems that act without voluntary control, such as the bladder, cardiovascular system (e.g., the heart), stomach, etc. Neuropathy here can result in changes in heart rate, changes in blood pressure, sweating, etc.
In addition, a single nerve can be affected (a condition known as mononeuropathy) or multiple nerves can be affected (a condition known as polyneuropathy).
Causes of Neuropathy
According to the book Peripheral Neuropathy Causes and Treatments,there are number of different conditions that can result in neuropathy. Some of these include the following:
- The most common cause of neuropathy is diabetes. People who have diabetes and maintain high blood sugar levels will inevitably damage their nerves.
- There are a number of drugs that are known to cause neuropathy. These include drugs designed to treat HIV and chemotherapy medicines.
- Certain vitamin deficiencies, such as B12 deficiencies, can lead to neuropathy.
- The presence of cancer can lead to neuropathy.
- Diseases of the kidney and liver can result in neuropathy.
- Certain toxins, such as insecticides, solvents, and exposure to other chemicals, can result in the development of neuropathy.
- Injuries, such as broken bones, can put pressure on the nerves, leading to neuropathy.
- Infections, hereditary diseases, and connective tissue issues, such as rheumatoid arthritis or systemic lupus erythematosus, are also known to cause neuropathy.
- Nearly a third of people diagnosed with neuropathy are diagnosed with idiopathic neuropathy, meaning that there is no known cause.
- Excess use of alcohol that leads to high levels of alcohol in the blood can result in nerve damage, and this can lead to the development of neuropathy.
Neuropathy Caused by Excess Alcohol Use
Alcoholic neuropathy, or neuropathy caused by excess alcohol use is typically experienced as pain and tingling in the hands or feet. Alcohol is a toxin, and at high levels, it literally destroys the very small and sensitive peripheral nerves in the body, and it affects other nerves and tissues, such as the connections in the central nervous system. The symptoms associated with alcoholic neuropathy include:
- Numbness, burning and tingling, prickly sensations, muscle weakness, cramps and muscle spasms, a loss of movement, and even muscle atrophy in the arms and legs
- Issues with the excretory system, such as incontinence or difficulty starting urination, constipation, diarrhea, or the sensation that the bladder has not been fully emptied once one is finished urinating
- Other potential symptoms associated with alcoholic neuropathy in different body systems, such as sexual dysfunction, difficulty swallowing, speech impairments (slurred speech or dysarthria, which is a condition where speech is difficult to enunciate), reduced tolerance for heat, and dizziness or lightheadedness
Treating Alcoholic Neuropathy
The goals of treatment are typically to:
- Prevent the neuropathy from worsening
- Control the current symptoms
- If possible, reverse any underlying causes of neuropathy
The issue with treating neuropathy is that once the nerves are damaged, they may not return to their former level of functioning.
There is no specific treatment for neuropathy, and the goal is often to get to the underlying cause of the neuropathy and prevent further damage while managing the current situation.
According to the Handbook of Clinical Neurology, a number of medications can be used to address numbness, tingling, and neuropathic pain. These include:
- Anticonvulsant medications, such as Neurontin, Lyrica, and Tegretol
- Antidepressant medications, such as Cymbalta and Effexor, that focus on the neurotransmitters norepinephrine and serotonin
- Tricyclic antidepressant medications that focus on a broader spectrum of neurotransmitters, such as Elavil and Pamelor
- Certain opioid medications for the treatment of pain, such as OxyContin and tramadol (These need to be used with discretion in individuals with chronic alcohol abuse.)
- Topical treatments, such as Lidoderm patches
Other treatments can be targeted at specific symptoms. In addition, supplementary treatment approaches can be used, such as:
- Nutrition: Because certain types of neuropathy may be exacerbated by nutritional deficiencies, the use of vitamin supplements to improve the health of the nerves can be used. These include such supplements as B6, B12, vitamin E, and other vitamins.
- Specialized medications for incontinence: Medications for bowel and bladder issues and for sexual dysfunction may be needed in some cases.
- Special appliances: Orthopedic aids, such as braces and other appliances to help with movement, can help. Using stabilizing safety gear, such as special types of footwear in order to prevent potential injuries, is common.
- Therapy: Physical therapy to strengthen the muscles in cases where there is atrophy to certain skeletal muscles can be useful.
- Compression stockings: These stockings can help with circulation problems in the legs.
Of course, the best approach to treating neuropathy in individuals who have alcohol abuse problems is to treat the underlying cause of neuropathy. Any person diagnosed with alcoholic neuropathy will be asked to curtail their drinking. This means a complete cessation of the use of alcoholic beverages under medical supervision. Individuals who need to address their drinking in order to treat other medical conditions, such as the development of neuropathy, will need to become involved in a formal treatment program that addresses all other issues associated with their alcohol use. The program should include:
- Medically assisted treatment to negotiate the withdrawal process, curb cravings, and address any other medical issues that can exacerbate alcohol use
- A formal treatment program consisting of therapy for an alcohol use disorder
- Participation in social support groups, such as Alcoholics Anonymous
Addressing the problematic use of alcohol will result in other health benefits, including exacerbating any neuropathy. For individuals who develop alcoholic neuropathy, it is clear that the use of alcohol has become dysfunctional. These individuals will need a long-term recovery program to address the alcohol use disorder as well as a specific program to target issues associated with their neuropathy.