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This paper reviews and discusses basic knowledge of biochemical mechanisms of action of ethanol upon the central nervous system, the emphasis being on effects upon cerebral membrane structures and processes as well as mechanisms of chemical synaptic transmission. Results of detailed studies into material and steric changes in membranes, ion-dependent adenosine triphosphatases, variations in ion balance, effects upon cyclic nucleotides, influences on special transmitter systems, and mechanisms of formation of morphine-analogous condensation products are presented. In addition, open questions are derived and formulated in problem complexes.

The incidence and prevalence of alcoholism in the elderly population are tendentially underestimated. There are some reasons for this fact. The pathway to the diagnosis of alcoholism may be considerably compromised in the often comorbid or multimorbid patient. To live up to an advanced age seems to be a good argument against chronic substance abuse. Elderly people and their relatives are often still more reluctant to report about socially stigmatizing disorders. On top of that, the amount of social control is reduced after the end of employment and upon entering retirement. Yet, if alcohol-withdrawal symptoms occur, e.g., following an admission of the addicted patient to a hospital, the missed diagnosis of alcoholism means a delay of the correct interpretation of such complications and of the necessary treatment. Aged patients with reduced physical and mental reserve capacity are at special risk of developing further serious complications. Progressive, sometimes irreversible decay of the cognitive functions in long lasting delirious states or, as an aftermath of withdrawal, epileptic seizures are of particular importance.

For alcohol withdrawal during hospitalization, often a medication as means for withdrawal needs to be chosen. Modern, score-controlled processes that can be used by the nursing staff after instruction by physicians are frequently not used and even unknown in hospitals. One reason for this is that some of the scores require checking several criteria and are therefore more time-consuming and complicated than use of a fixed-dosage strategy. The SAB-P and HAES are short with only 6 items that can be checked by the nursing staff.Safety of the Hamburg Alcohol Withdrawal Scale (Hamburger Alkoholentzugs-Skala (HAES)) was analyzed retrospectively and prospectively with regard to score-controlled alcohol-withdrawal treatment after rating by the nurse staff (Scoregesteuerte Alkoholentzugsbehandlung nach Rating durch das Pflegepersonal (SAB-P)).Incidence of complications in patients treated with SAB-P and HAES was nearly similar with 1% start of delirium and 3% seizures (SAB-P) and 0.5 to 1.5% start of delirium and 0 to 0.5% seizures in the HAES group. With both scales it was possible to start medical treatment while still under falling alcohol levels (0.93 and 0.91%, respectively). Medication dosage was initially higher using the HAES, so that the time needed to monitor withdrawal symptoms could be reduced (3.8 vs. 3.1 days).Using a score-controlled strategy for alcohol withdrawal leads to a lower complication rate than found in literature. The structured procedure was helpful for the nursing staff as well as for the physicians. SAB-P as well as HAES made withdrawal for the patients more comfortable and led to fewer complaints. Because of rapid reaction and faster symptom reduction of HAES, there was less time necessary for monitoring. Simple handling, clomethiazol, oxazepam or diazepam as applicable medication and clear documentation are the advantages of HAES.

In a total of forty-five cases of masturbation practiced by children EEG derivations were made before, during, and after anticonvulsive treatment. The results obtained confirm the clinical experience showing that the observed seizure-like phenomena have no relation whatever to forms of epilepsy.

The etiopathology of absinthe dependence was previously attributed to the effects of the wormwood constituent thujone. Current research proves otherwise. Foremost, it must be considered that the wormwood plant shows a very large variance in quantity of thujone (0 - 70 % in essential oil) dependent on chemo type and cultivation area. Thus, absinthe does not contain thujone in general. Experimental production of absinthes and analyses of vintage absinthes (1900 - 1930) consistently showed that they contained only relatively low concentrations of thujone below today's maximum limits. Scientific literature contains no proof that historic absinthes may have contained thujone in concentrations able to produce toxic effects. The current state of research considers absinthism to be a type of alcoholism with thujone playing none or only a secondary role.