CHAPTER TWO

LITERATURE REVIEW

2.1 Theoretical framework

The theoretical framework for this study is based on Self-Efficacy Theory

postulated by Albert Bandura in 1986. It posits that an individual's belief in
their ability to perform tasks and achieve goals strongly influences their
behavior and decision-making. In the context of alcohol abuse among
students in higher institutions, Self-Efficacy Theory suggests that students'
beliefs about their ability to resist alcohol or drink responsibly influence their
behavior (Gabriel, 2023).

Several factors can influence self-efficacy among students in higher

institutions, including past experiences, observing peers, and receiving
feedback. Students who have successfully resisted alcohol or drinking
situations in the past may develop a stronger sense of self-efficacy. On the
other hand, students who have experienced alcohol-related problems may
doubt their ability to control their drinking. Furthermore, self-efficacy can be
influenced by environmental factors, such as the availability and easy
accessibility of alcohol on campus. When there is peer pressure and easy
accessibility of alcohol, students with low self efficacy may feel less confident
in their ability to resist alcohol.

2.2 Conceptual framework

Alcohol abuse is a pervasive issue that affects individuals from all walks of
life, including students in higher Institutions. There is need for a
comprehensive understanding of alcohol abuse and its effects. The review of
literature for this study was done under the following headings: alcohol,
alcohol abuse, short-term and long-term effects of alcohol abuse.

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2.2.1 Alcohol

Alcohol is a chemical substance found in most food and beverages such as

beer, wine, rum, whiskey. It is also found in some medicines, mouthwashes,
household products, and essential oils (scented liquids taken from certain
plants) (National Institutes of Health (NIH), 2024). It is made when yeast
ferments the sugars in grains, fruits, and vegetables while the type of alcohol
used to make alcoholic drinks is called ethyl alcohol (ethanol)
(Commmonwealth of Australia, 2019). Alcohol is one of the most widely
consumed psychoactive drugs in the world and falls under the depressant
category (Custardi et al., 2015). It is classified by the World Health
Organisation (WHO) as a toxic, psychoactive, dependence producing, and
carcinogenic substance (WHO, 2023).

2.2.2 Alcohol abuse

Alcohol abuse is a pattern of drinking that interferes with day-to-day activities

(American Psychological Association, 2012). A person is said to abuse
alcohol when he drinks too much alcohol at a time or too often throughout the
week (Familydoctor, 2024). Alcoholism occurs when a person has formed a
mental reliance on (addiction to) and/or a chemical dependency on alcohol
(Addictionhelp, 2024), but with alcohol abuse a person is not yet physically
dependent on alcohol but still has a serious drinking problem (Buddy, 2023).
The consumption of more than 2 drinks per day on average for men or more
than 1 drink per day on average for women constitutes alcohol abuse (Centers
for Disease Control and Prevention, 2023). Alcohol abuse, also called
problem drinking, occurs when drinking alcohol becomes an issue that creates
negative consequences for a person.
2.2.3 Effects of alcohol abuse
Alcohol abuse can lead to physical harm, mental health issues, and social
problems, which can affect a person’s overall well-being and relationships

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 (Pietrangelo & Raypole, 2023). It can also cause damage to organs, impair
cognitive function and increase the risk of chronic diseases (Rehm, 2011).
2.2.3.1Short-term effects of alcohol abuse

1. Effect on the digestive system

Alcohol abuse can have severe and immediate consequences on the
digestive system and can lead to a range of uncomfortable and potentially
dangerous symptons. One of the primary effects of alcohol on the digestive
system is irritation and inflammation of the stomach lining known as
gastritis. Acute gastritis can occur within hours or days of excessive
alcohol consumption. This can cause nausea and vomiting which can lead
to dehydration (Kivi, 2019). Alcohol abuse can lead to uncomfortable
digestive issues such as bloating and cramping (Seltzer, 2020). Heart burn
and acid reflux are common symptons, as alcohol relaxes the lower
esophagus sphincter and allow stomach acid to flow back up into the
esophagus (Stuart, 2024). In more severe cases, short term effects of
alcohol abuse can lead to the inflammation of the pancreas, known as
pancreatitis (Health Service Executive, 2022).
2. Nutritional deficiency
Alcohol can suppress appetite, which leads to inadequate food intake.
Since alcohol damages the liver, it can also interfere with the absorption
and use of nutrients. Alcohol abuse can cause deficiencies of minerals such
as magnesium and zinc, and certain vitamins, including thiamin
(Bhupathiraju & Hu, 2023). When alcohol is metabolized by the liver it
uses niacin, thiamine (vitamin B1) and other B vitamins, which means that
these vitamins are not available for other essential purposes (Smith, 2012).
Alcohol also interferes with the absorption and storage of the vitamins
B12, folacin and vitamin A. Because alcohol is a diuretic that increases the
output of urine, it can cause the loss of such water-soluble minerals such as
zinc, magnesium and potassium. Zinc status appears to be particularly

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 affected by alcohol and zinc deficiency interferes with the ability to taste
and smell, further limiting dietary intake (Smith, 2012).
3. Effect on the circulatory system
The short term effect of alcohol abuse includes vasodilation (expansion of
the blood vessels). This can cause a decrease in blood pressure, which
leads to dizziness and lightheadedness (Cleveland Clinic, 2022). Alcohol
intake can also cause an increase in heart rate and potentially lead to
palpitations (Coniferpark, 2024). Alcohol abuse can also increase the risk
of heart problems as alcohol consumption can cause cardiac arrhythmias,
or irregular heartbeats, which can be dangerous for those with underlying
heart conditions (Watts, 2024). In addition, alcohol can temporarily thin
the blood, increasing the risk of bruising and bleeding in the event of an
injury or accident (Bottaro, 2023).
4. Liver problems
The damaging short-term effects of alcohol on liver tissue appear
whenever one consumes more than a single drink in a given hour. The first
problem to arise is typically an alteration of the organ’s average chemical
balance. If the abuser habitually drinks in excessive amounts, the frequent
presence of alcohol in your system will lead to a significant reduction of
your liver’s ability to process fat (another one of its crucial jobs).
Eventually, this short-term effect can lead to the onset of alcoholic fatty
liver disease, which occurs when fat builds up abnormally inside the organ
(The Right Step, 2022). Another short-term effect is alcohol-induced
hepatitis, characterized by liver inflammation and cell damage. This is
typically short-lived but can recur and lead to severe problems if untreated
(The Right Step, 2022). Additionally, alcohol abuse can cause the liver to
become overloaded with toxins; this can lead to impaired detoxification
and increased risk of liver damage (Patel & Mueller, 2023).
5. Effect on the central nervous system

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 Alcohol abuse has significant short-term effects on the central nervous
system (CNS). Initially, alcohol acts as a depressant, it slows down neural
communication which causes delayed responses which can be dangerous
when driving or operating machinery (Brandon, 2024). Being a depressant,
it can cause drowsiness and sedation, this can result in mild relaxation,
deep sleep or unconsciousness depending on the amount consumed
(Santos-Longhurst, 2020). Temporary effects of alcohol abuse also include
poor coordination which results to unsteady movements (O'Connell, 2024).
This makes tasks requiring precision such as writing, typing more difficult.
Alcohol abuse also causes temporary slow or slurred speech as it can also
affect areas of the brain responsible for speech production (Pietrangelo &
Raypole 2023). Excessive alcohol consumption can cause short-term
memory loss and blackouts (loss of consciousness), a situation where the
individual cannot recall events that occurred while intoxicated (NIAAA,
2023). The effect of alcohol on the central nervous system can make it
difficult for the individual to feel the severity of their injuries or physical
conditions (Brandon, 2024).
6. Effect on reproductive/sexual health
Alcohol abuse can heighten libido (sexual desire and arousal) due to its
disinhibiting effects (Santos-Longhurst, 2019). Both men and women can
also experience a decrease in sexual desire and arousal due to its
depressant effects on the brain (Salari et al, 2023). It can also delay or
inhibit orgasm in both men and women (Palamar et al, 2018). Excessive
alcohol consumption can also increase the risk of engaging in risky sexual
behavior such as having unprotected sex or sex with multiple partners
(Brown et al, 2016). This increases the risk of unwanted pregnancies and
contraction of sexually transmitted diseases. Alcohol abuse can lead to
poor sexual decision making. The impaired judgment and decreased ability
to consent due to alcohol consumption can increase the risk of sexual
assault and coercion (Fitzgerald & Barton, 2023). In addition, alcohol

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 abuse can lead to relationship issues which can negatively impact sexual
desire and function (Buffo, 2024).
7. Effects on muscular system
Alcohol abuse can cause temporary muscle weakness and fatigue due to its
depressant effects on the central nervous system. This can lead to a
decrease in muscle strength, which makes it challenging to perform
physical tasks (Pietrangelo & Raypole 2023). It can also affect ones
coordination and balance, this increases the risk of injuries and accidents
(Taylor et al, 2010). Furthermore, alcohol consumption decreases muscle
reflexes as a result the individual fails to respond quickly to stimuli
(reaction time) (Vigorito & Chang, 2024). Excessive alcohol consumption
also impairs muscle contract thereby reducing the ability of muscles to
generate power and perform physical tasks efficiently (Alleyne & Dopico,
2021).
8. Effect on medication
Alcohol can interfere with the absorption and metabolism of various
medication thereby reducing their effectiveness. Particularly, Alcohol can
also reduce the effectiveness of antibiotics and increase the risk of side
effects like nausea, vomiting, and dizziness (Anderson, 2024). Alcohol
abuse can amplify the sedative effects of some medications, such as
drowsiness or dizziness (Health direct, 2022). Some medications can have
toxic reactions when combined with alcohol. Alcohol can interact with
medications used to treat hypertension or heart conditions and cause
dangerous fluctuations in blood pressure (Anderson, 2024).
9. Effect on mental health
Alcohol can cause rapid changes in mood, leading to irritability,
aggression, or sadness. This can affect the abuser’s relationship with others
(Valentin, 2020). One of the primary effects of alcohol abuse on mental
health is the exacerbation of anxiety and depression. Excessive alcohol
consumption can lead to increased feelings of anxiety, panic attacks, and

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 depressive episodes (Watson & Mitchell, 2024). Furthermore alcohol can
cause significant cognitive impairment, including confusion,
disorientation, impulsivity which results in poor decision-making (Wilson,
2021). Alcohol abuse can also increase the risk of suicidal thoughts and
behaviors, particularly among individuals who struggle with underlying
mental health conditions (Harmer et al, 2024).
2.2.3.2Long-term effects of alcohol

Physical Effects

Drinking too much alcohol on a single occasion or over time can cause health
problems, including:

1. Inflammatory and liver problems:

Alcohol is catabolized by the liver and changes the chemical environment
which is responsible for the processing of various chemicals in the blood
(National Institute on Alcohol Abuse and Alcoholism (NIAAA), 2022). As
a result of heavy alcohol consumption, the liver does not clear dead red
blood cells. This results in a build up of bilirubin which then manifests
itself as a jaundice appearance (Tholey, 2023). The liver stores and
processes vitamins such as vitamin A, D, E, K and B12 (Newman, 2023).
Heavy alcohol consumption disrupts the intake and storage of these
important vitamins (Buddy, 2020). Alcohol also inhibits liver production
of certain proteins, blood clotting factors and substances which aid in the
production of white blood cells (Jain et al, 2020).
The liver helps break down and remove toxins and harmful substances
(including alcohol) from the body. Long-term alcohol use interferes with
this process. It also increases the risk for alcohol-related liver disease and
chronic liver inflammation. Specifically, excessive intake can cause
increased fat in the liver (hepatic steatosis) and inflammation of the liver
(alcoholic hepatitis). Over time, excessive drinking can cause chronic liver
inflammation, which can result in scarring or cirrhosis. When scar tissue

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 forms, it may permanently damage your liver. Alcohol-related liver disease
is a potentially life-threatening condition that leads to toxins and waste
buildup in your body.
According to National Health Service (2022), signs and symptoms of liver
involvement may include nausea, vomiting, and right upper quadrant pain
and tenderness. Patients may present with ascities. It has been noted that
the development of dupuytrens contracture may occur as a result of liver
disease (Jackson, 2023).
2. Digestive problems
Alcohol alters the digestive system by irritating cells in the stomach lining
causing inflammation, impacting stomach acid production and reducing the
stomach’s ability to destroy bacteria that enter the stomach, which can
allow potentially harmful bacteria to enter the upper small intestine
(Alcoholthinkagain, 2023). Continuous alcohol abuse can have serious
effects on the digestive system. It can result in inflammation of the
stomach lining (gastritis). Complaints of epigastric pain, nausea and
vomiting may be indicative of gastritis (Mayo Clinic Staff, 2024). It can
also interfere with the body’s ability to get enough B vitamins and other
nutrients.
Heavy drinking can damage your pancreas or lead to inflammation of the
pancreas (pancreatitis). Subjective complains of a steady, dull epigastric
pain that may radiate to the back may indicate pancreatitis (Tang, 2021).
Furthermore, heavy drinking can also lead to: gas, bloating, a feeling of
fullness in your abdomen, diarrhea or painful stools, ulcers, or
haemorrhoids (due to dehydration and constipation). Enhanced intestinal
motility is often seen with heavy drinkers which contributes to diarrhea
(Kassel, 2019). It can also cause stomach and esophageal ulcers. Ulcers
can cause dangerous internal bleeding, which can sometimes be fatal
without prompt diagnosis and treatment (Ferguson, 2023).

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3. Problems with the circulatory system
Chronic alcohol consumption can affect the heart and lungs, raising your
risk of developing heart-related health issues. Circulatory system
complications due to alcohol include high blood pressure, difficulty
pumping blood through the body, stroke, heart attack, heart disease, and
heart failure, as well as difficulty absorbing vitamins and minerals from
food, which can result in fatigue and anaemia, a condition where a person
has a low red blood cell count. Even a single binge of alcohol can cause
serious irregular heartbeats (arrhythmia) called atrial fibrillation
(Pietrangelo & Raypole 2023).
For persons who drink in excess, alcohol poses potentially harmful effects
on the cardiovascular system. Drinking a lot over a long time or too much
on a single occasion can damage the heart, causing problems including:
cardiomyopathy – Stretching and drooping of heart muscle, arrhythmias –
irregular heart beat (NIAAA, 2024).
4. Sugar level and diabetes complications
The pancreas helps regulate how the body uses insulin and responds to
glucose. Alcohol interferes with the release of glucose from the liver. If the
pancreas and liver don’t function properly due to pancreatitis or liver
disease, it increases the risk of having low blood sugar (hypoglycemia).
This is dangerous if the person has diabetes and is already taking insulin or
some other diabetes medications to lower their blood sugar level. A
damaged pancreas can also prevent your body from producing enough
insulin to use sugar. This can lead to hyperglycemia, or too much sugar in
the blood. If your body cannot manage and balance your blood sugar
levels, you may experience greater complications and side effects related
to diabetes. Experts recommend avoiding excessive amounts of alcohol if
you have diabetes or hypoglycemia (Pietrangelo & Raypole 2023).

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5. Neurological and central nervous system problems
Alcohol use, whether in excess or moderation, can have major effects on
both the central nervous system and peripheral nervous system (Carmona,
2023). Alcoholism is the second leading cause of organic brain syndrome
(Johnson et al., (2017). Alcohol rapidly crosses the blood brain barrier
which causes blood alcohol and brain concentrations to equilibrate
(Carrino et al., 2021). Excessive intake of alcohol can cause thiamine
deficiency which can result to deterioration of the caudate and thalamic
areas of the brain (De la Monte & Kril, 2014). Increased alcohol intake is
associated with damage to brain regions including the frontal lobe, limbic
system, and cerebellum (Sutherland, 2014), with widespread cerebral
atrophy, or brain shrinkage caused by neuron degeneration (Nutt et al,
2021). According to Cherry (2022), long-term alcohol abuse can lead to
various forms of alcohol dementia, among them is Wernicke-Korsakoff
syndrome, a serious neurological disorder linked to alcohol use that does
result in the loss of brain neurons. The syndrome is characterized by
memory problems, amnesia, and lack of muscle coordination. The loss of
neurons is caused by a deficiency in an important B vitamin called
thiamine, which is common among those who misuse alcohol (Cherry,
2022). Since alcohol affects a large portion of the brain, many different
kinds of cognitive impairment can occur as a result of heavy drinking,
including problems with verbal fluency and verbal learning, processing
speed, working memory, attention, problem solving, spatial processing,
and impulsivity (Stavro et al., 2012).
One major impact of alcohol abuse is how it affects the central nervous
system. For example, slurred speech, a key sign of intoxication, happens
because alcohol reduces communication between the brain and body. This
makes speech and coordination—think reaction time and balance more
difficult. This is one major reason why no one should drive after drinking.
Over time, alcohol can cause damage to the central nervous system. It may

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 cause numbness and tingling in the feet and hands. Too much drinking can
also affect a person’s ability to: create long-term memories; think clearly;
make rational choices; and regulate emotions. In addition, drinking can
also damage your frontal lobe, the part of the brain responsible for
executive functions like abstract reasoning, decision making, social
behaviour, and performance.
6. Issues with sexual and reproductive health
Too much intake of alcohol can prevent sex hormone production, lower
one’s sexual drive, and make it difficult to achieve orgasm. Heavy drinking
can cause men to have difficulty maintaining an erection (erectile
dysfunction) (Santos-Longhurst, 2019). No amount of alcohol is
considered safe for pregnant women, this is because drinking during
pregnancy does not only affect one’s health. It can lead to miscarriage,
stillbirth, or premature delivery (Bailey & Sokol, 2011). Alcohol can
disrupt the balance of reproductive hormones which can affect short-term
fertility in both men and women. In men, alcohol can reduce sperm
production and quality while In women, alcohol can disrupt menstrual
cycle and ovulation (Mayo Clinic Staff, 2022).
Children exposed to alcohol in the womb may experience a range of
complications after birth, including learning difficulties, long-term health
issues, increased emotional problems, and developmental issues. It may
also cause foetal alcohol spectrum disorders (FASDs). FASDs can cause a
child to be born with physical and developmental problems that last a
lifetime (Mayo Clinic Staff, 2024).
Similarly, NIAAA (2022) added that prenatal alcohol exposure can cause
brain damage, leading to a range of developmental, cognitive, and
behavioral problems, which can appear at any time during childhood.
Alcohol can disrupt fetal development at any stage during a pregnancy—
including at the earliest stages and before a woman knows she is pregnant.

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7. Weak immune system
Excessive alcohol use can weaken one’s natural immune system. A
weakened immune system has a harder time protecting you from germs
and viruses, which makes it harder for the body to resist disease and
increases the risk of various illnesses (Ries, 2020). According to
Pietrangelo and Raypole (2023), people who drink heavily over a long
period of time are also more likely to develop pneumonia or tuberculosis
than the general population. In 2022, the World Health Organisation
(WHO) linked about 8.1 percent of all tuberculosis cases worldwide to
alcohol consumption. Frequent drinking can increase the risk of
developing mouth, throat, breast, oesophagus, colon, or liver cancer. Even
moderate drinking can increase the risk of breast cancer (Pietrangelo &
Raypole, 2023).
8. Skeletal and muscle problems
Alcohol may interfere with making new bones. Bone loss can lead to
thinning bones (osteoporosis) and an increased risk of fractures when one
falls (Davis, 2010). Weakened bones may also heal slower. Alcohol can
also damage bone marrow, which makes blood cells. This can cause a low
platelet count, which may result in bruising and bleeding (Mayo Clinic
Staff, 2022). Drinking alcohol can also lead to muscle weakness,
cramping, and eventually atrophy (Pietrangelo & Raypole, 2023).
9. Eye problems
According to Mayo Clinic Staff (2022), over time, heavy drinking can
cause involuntary rapid eye movement (nystagmus) as well as weakness
and paralysis of your eye muscles due to a deficiency of vitamin B-1
(thiamin). A thiamin deficiency can result in other brain changes, such as
irreversible dementia, if not promptly treated.
10.Reduced medication effects
Some medications interact with alcohol, increasing its toxic effects.
Alcohol intoxication adversely affects many medications. Mixing alcohol

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 with certain medications can cause nausea and vomiting, headaches,
drowsiness, fainting, or loss of coordination (NIAAA, 2023). It also can
put you at risk for internal bleeding, heart problems, and difficulties in
breathing (NIAAA, 2023). Acute alcohol intoxication can slow down
hepatic metabolism of certain medications which can cause an increase in
the drug level (Mehta, 2022). Chronic alcohol intoxication, however, can
increase hepatic metabolism, thereby adversely accelerating drug clearance
(Osna et al., 2017). Some people may have adverse reactions to
medications while intoxicated that require admission to hospitals (Ayalew
et al., 2019).
11.Effect on skin
Prolonged heavy drinking can increase a person’s risk of more serious
conditions, such as skin cancer and skin infections (Fletcher, 2023).
Bacterial and fungal infections are more likely to occur in people who
drink alcohol excessively. This is because alcohol weakens the immune
system and can decrease the body’s ability to absorb nutrients (Fletcher,
2023). People are also more likely to get injured while drinking alcohol,
which can lead to skin infections. It can also cause skin changes resulting
from alcoholic liver disease (Fletcher, 2023). The increased risk of skin
cancer is also due to alcohol weakening the immune system, lowering the
body’s natural defense against diseases (Fletcher, 2023). Brand et al.
(2021) also suggests that drinking alcohol can worsen the effects of
ultraviolet light on a person’s skin, causing more damage than usual. Skin
changes due to liver disease may include yellowing of the skin, darker skin
around the eyes, visible blood vessels on the face, neck, and chest and
itchy skin. According to Fletcher (2023), regular alcohol consumption can
cause or aggravate several different skin conditions, including: rosacea,
psoriasis, seborrheic dermatitis, porphyria cutanea tarda, discoid eczema.

12.Malnutrition

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 Malnutrition can involve a deficiency, excess or imbalance of nutrients,
resulting in adverse effects on body composition, function and health
outcomes (Saunders & Smith, 2010). Alcohol must be processed by the
digestive system, which creates competition for limited nutritional
resources that would normally nourish the body (Smith, 2012). Alcohol
irritates the gastro-intestinal system; it increases acid secretion by the
stomach which can injure the lining of the small intestine and interfere
with the ability to absorb vital nutrients (Smith, 2012). Excessive alcohol
consumption can satisfy caloric requirements, but easily leads to
malnutrition. Although alcohol in small doses is an appetite stimulant,
larger amounts suppress hunger, which doubly deprives the body of
nutrients (Smith, 2012). In addition, an excess intake of alcohol can
damage the tissues in the digestive tract, preventing this intestines from
digesting food and absorbing nutrients and vitamins properly, in the long
run, this damage can cause malnutrition (Pietrangelo & Raypole 2023).

Psychological effects

According to Pietrangelo and Raypole (2023), long-term alcohol use can lead
to changes in the brain that can affect one’s memory and concentration,
impulse control, emotions, mood, and personality. Regular drinking can also
affect overall mental health and well-being because alcohol may worsen the
symptoms of certain mental health conditions, including anxiety, depression,
and bipolar disorder. The person might also notice feelings of anxiety and a
hangover.
Alcohol-induced mental health conditions
Alcohol abuse can factor into mental health symptoms that are very much like
those of other mental health conditions. According to Pietrangelo amd
Raypole (2023), the latest edition of The Diagnostic and Statistical Manual of
Mental Disorders (DSM-5), which mental health professionals use to
diagnose mental health conditions, includes diagnostic criteria for: alcohol-

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induced bipolar disorder, alcohol-induced psychotic disorder, alcohol-induced
sleep disorder, alcohol-induced depressive disorder, and alcohol-induced
anxiety disorder. With these conditions, the symptoms will only be noticed
during alcohol intoxication or withdrawal. These symptoms typically improve
quickly when alcohol use stops (Pietrangelo & Raypole, 2023).

Dependence

Some people who drink eventually develop a tolerance for alcohol. As a

result, they eventually need to drink more to notice the same effects they once
did. Drinking alcohol on a regular basis can also lead to dependence, which
means the body and brain have grown used to alcohol’s effects.

When a person stops drinking, he might notice a range of physical, emotional,

or mental health symptoms that ease as soon as he drinks. Symptoms of
dependence include cravings, withdrawal, drinking more over time, having
difficulty stopping after one drink, the inability to stop drinking, continuing to
drink alcohol even when it has a negative impact on the person’s health or
daily life, and spending a lot of time on activities related to alcohol use
(American Psychological Association, 2012; Pietrangelo & Raypole, 2023).

Alcohol withdrawal

Alcohol withdrawal is not a specific condition but a term used for a set of
signs and symptoms that can occur following a reduction in alcohol use after a
period of excessive use. Alcohol withdrawal can be difficult and, in some
cases, life-threatening. Depending on how often and how much the person
drinks, they may need support from a healthcare professional to stop drinking.
It is always best to consult a doctor before quitting alcohol. Symptoms of
alcohol withdrawal include anxiety, nervousness, nausea, tremors, high blood
pressure, an irregular heartbeat, heavy sweating, seizures, hallucinations, and
delirium, which may occur in severe cases of withdrawal. Medical
detoxification helps to stop drinking safely (Canver et al, 2024).

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