Alcoholism has long ceased to be a problem for individuals and their loved ones. An entire branch of medicine is studying it and identifies a number of signs of alcoholism as a serious disease:
- With alcoholism, a person loses control over the amount of drinking;
- Drinking alcohol despite severe consequences for the body and negative attitudes of others;
- Degradation of a person as an individual, decreased mental abilities, impaired consciousness, etc.
Physiologically, alcoholism manifests itself in the form of a withdrawal syndrome, similar to drug withdrawal. Its essence lies in the fact that with a sharp refusal of alcohol, a person begins to experience bouts of vomiting, headaches, increased blood pressure, fever and other painful symptoms. But alcoholism has other, no less strong reasons - they lie in the field of psychology. Doctors say that psychological dependence is based on the desire to solve all problems with the help of alcohol. What makes a person pick up a bottle?
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What is alcoholism and alcohol dependence?
Alcoholism is a disease that was first described in the 19th century by scientist Mangus Guse from Sweden.
However, the attitude towards the disease in Russia was ambiguous until the present century. Alcohol dependence was considered a bad habit that did not need to be treated, then - a mental disorder that could only be treated with medication by prescribing the patient heavy psychotropic drugs. Today WHO defines the disease as follows:
“Alcoholism is a set of somatic, cognitive and behavioral changes in which ethyl alcohol begins to occupy an important place in a person’s worldview.”
The pathology is included in the ICD-10 list and is an officially recognized mental disorder.
What are the results of treating patients with alcoholism?
All over the world, the effectiveness of helping people with alcoholism is the same. Help limited to only the first stage (“withdrawal from binge drinking” or “coding”) gives a very low result. But completing a rehabilitation program for patients increases the effectiveness of care by almost 10 times.
After what time can we talk about the reliability of the achieved result?
Experts dealing with the problem of alcoholism agree that the process of psychological and social recovery lasts about 5 years. It is very important that in the future the recovering person does not stop in his psychological and spiritual growth.
Etiology of alcoholism
The nature of ethanol addiction has not yet been fully studied. There are several hypotheses that do not contradict each other. Scientists call alcoholism a polymorphic disease: for some, one factor is enough to become dependent, while others will remain free from cravings for alcohol despite several reasons.
Painful attachment is formed during use. It is impossible to become addicted by abstaining from alcohol. At the same time, a person can become an alcoholic without having predisposing factors, but by drinking often and a lot.
The Ministry of Health, in clinical recommendations for narcologists, identifies the following reasons for the formation of addiction:
- genetic;
- social (influence of environment);
- personal (influence of character, temperament).
Genetic causes are being actively researched nowadays. Scientists are studying the influence of genes on the amount of enzymes produced by the liver to break down ethyl alcohol. If a person tolerates intoxication well and does not experience post-intoxication, his risk of becoming dependent is much higher.
Genes involved in the regulation of self-control are also being studied.
Human behavior depends on the functioning of his neurotransmitter system. Dopamine, which is responsible for the feeling of pleasure, can become a provocateur of illness.
The DRD3 gene encodes D3 type dopamine receptors. In potential alcoholics, the receptors work more intensely. And with an increase in dopamine during intoxication, there is a strong release of beta-endorphin, which is responsible for pleasant sensations.
Carriers of the DRD4 gene also affect D4 receptors. People become alcoholics in company, and drinking alcohol alone does not bring pleasure.
A person inherits the characteristics of the serotonin and GABA systems. They determine behavior during intoxication and withdrawal. This also influences the formation of addiction.
How to behave
The best way to avoid trouble is to avoid contact with a drunk person or to go elsewhere as quickly as possible. Family members of alcoholics do not have this opportunity. You can reduce the likelihood of dangerous consequences using the following techniques:
- Controlling the amount you drink. According to statistics, there is a direct connection between the dose of alcohol and the likelihood of an attack of aggression. If the amount of alcohol can be reduced without the risk of developing a conflict, this is worth taking care of.
- Showing respect. This recommendation is especially relevant for relatives of people suffering from wounded pride. Insufficiently high evaluation of friends and colleagues encourages a person to compensate in the family. In such cases, it is worth recognizing the significance and importance of the efforts of the drunk, his contribution to the general well-being.
- Switching attention. If the drinker begins to show aggression, you should try to distract him. You can ask about something he is proud of, turn on some nice music, switch to talking about good shared memories. If anger cannot be “extinguished,” it can be redirected by mentioning an abstract topic that offends the person or an absent enemy.
- Listening carefully. For insecure, introverted people, drinking alcohol can feel like almost the only opportunity to speak out. In such cases, it is better to listen carefully and ask in time: “Why?” and agree with any point of view expressed.
- Control your behavior. Drunk people sometimes react sharply to primitive signals: loud speech, harsh intonations, looking straight into the eyes, overly active gestures. It is better to speak quietly, calmly and softly. There is no need to demonstrate behavior that a person might perceive as rejection, insult or ridicule.
strictly forbidden to mix sleeping pills or sedatives into food and drinks. Ethanol and drugs enhance each other's effects, the result of the interaction is unpredictable. Possible disturbances of consciousness, coma and respiratory depression until it stops completely. If a person is uncontrollable, it is necessary to leave the house so as not to expose oneself to danger.
Physical dependence on alcohol
Ethanol dissolves and penetrates the brain. By contacting the receptors of the nervous system, it causes a change in state, so an intoxicated person feels euphoria, relaxation, and a surge of strength.
With regular alcohol intoxication, the body is forced to defend itself. It integrates alcohol into metabolic processes. This forms the second stage of addiction, and giving up alcohol leads to severe withdrawal syndrome, which is accompanied by:
- dyspeptic disorders;
- imbalance of the autonomic system;
- acute mental disorders.
Withdrawal syndrome or abstinence is an addictive state that causes an acute craving for ethanol and a sharp deterioration in well-being when quitting alcohol.
Alcohol dependence manifests itself in binge drinking and complications. Treatment often begins at the stage of physical dependence. When it is difficult for the patient’s loved ones to ignore the problem, and for the addict himself to deny it.
Content:
- Alcoholics: who are they 1.1 Psychological problems in alcoholics 1.2 Physical disorders characteristic of an alcoholic 1.3 An alcoholic and his social status
- The main differences between an alcoholic and someone who simply drinks
- Treatment of alcoholics
The generally accepted definition of an alcoholic is a person dependent on alcohol. Medicine recognizes people who have fallen under the influence of intoxicating drinks as sick.
Since the processes occurring in the body as a result of exposure to ethyl alcohol and its breakdown products cannot be controlled by the victim. All changes at the mental and physiological level, formed against the background of abuse, are abnormal and manifest themselves individually in each person. Moreover, not all addicts drink strong alcohol; there are also beer alcoholics. And the course and severity of the disease depends on the characteristics of the body, age, gender and intensity of drinking.
Psychological dependence on alcohol
In modern narcology, the main attention is paid to the psychological aspect of alcoholism. Abstinence (hangover, withdrawal syndrome) and disorders of the neurotransmitter system are corrected with medication. And changing the behavioral patterns formed by an alcoholic requires time and hard work on oneself.
The basis of any addiction is psychological problems. Depression and anxiety, dissatisfaction with life and feelings of uncertainty force a person to look for a source of good emotional well-being from the outside. This source is not always alcohol and drugs. The objects of addiction are gambling and computer games, overeating, impulsive purchases, and extreme hobbies.
Addiction changes the personality of the patient. Human thoughts, emotions and behavior are the result of formed neural connections. The brain strives to conserve energy, therefore it creates stable “rails” along which consciousness moves. Most of the time a person acts automatically.
By moving the light switch from one place to another. The hand will reach to the previous place on the wall. Not finding it, a person will experience anxiety and irritation. This phenomenon was described by scientists Pavlov (dynamic stereotype) and Ukhtomsky (dominant principle).
An alcoholic develops patterns that push him into a bad habit. He drinks unconsciously. Control over actions goes away.
The main part of the alcohol treatment program is rehabilitation. Together with psychologists, consultants and addictologists, the patient destroys destructive neural connections and gradually forms new ones.
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How does a session with a psychotherapist go?
Psychological coding methods are applied to alcoholics at any stage of the disease. Psychologists use various techniques for changing personality. First, the psychologist conducts a personal conversation with the patient, finds out his personality type, character traits, and behavior. Based on the results obtained, the specialist chooses the most effective method of influence for a particular person. The conversation usually takes place in a closed office, without outsiders. The patient must feel trust in the specialist; this will be the first step towards a successful result of psychological influence.
Who is an alcoholic: motives for drinking
An alcohol addict is a person with signs of dependence who experiences a pathological craving for alcoholic beverages.
At the same time, attraction can be disguised under different motives.
Pleasure is a hedonistic motive.
If alcohol intoxication causes pronounced euphoria, a person strives to obtain pleasant sensations. He claims that “there are few pleasures in life” or “there is no point in limiting yourself.”
This motive has neurophysiological reasons. In 1952, an experiment was carried out with the implantation of an electrode into the brain of rats. Through it, the pleasure center could be stimulated by pressing the pedal. The rats forgot about sleep, food and reproduction. They pressed the pedal until they died.
Relaxation is an ataractic motive.
Alcoholics who suffer from anxiety abuse alcohol to achieve relaxation. The addict justifies the illness with a stressful life, objective problems, and great responsibility. At the same time, alcoholism worsens anxiety over time, so the dose of alcohol is constantly increasing.
Demonstration of a certain lifestyle is a pseudo-cultural motive.
The addict consumes large doses of expensive and high-quality alcohol, considering himself a connoisseur. He attends sommelier courses, is interested in the history of wines and the technology of their creation, and also makes other attempts to “legalize” the consumption of alcohol.
Improving well-being is a vital motive.
This category includes drinking alcohol to increase appetite, prevent colds, disinfect the gastrointestinal tract, etc.
Regardless of the motives used by the patient, he is addicted when drinking alcohol has a specific purpose - to affect his well-being and emotional state.
This matter is not so simple.
Here and below are stills from the mini-series “Prikup”
Sometimes it happens that your bright side (which is responsible for your work, has great relationships and generally lives a normal life) collides with your dark side - drunk you. This is the very facet of your personality that thinks that eight cheeseburgers is a normal dinner, stuffing the offender’s face is the right way out of a conflict situation, and this girl you just met will definitely not infect you with anything.
It turns out that while intoxicated, you try to destroy everything that you built while sober. However, there is an old proverb that says: “The truth is in the wine.” Following it, it turns out that when you are drunk, is this the real you who broke out from under the shackles of sober oppression? Or is it a negative transformation, which is more like a mutation that destroys your brain and sanity?
To understand this problem, we have provided seven main answers to questions about alcohol intoxication, which will once and for all help you figure out what happens to your personality while drinking.
Signs of alcoholism at 3 clinical stages
There are 3 stages in the development of alcohol dependence. The clinical picture and symptoms depend on the stage.
The first stage is characterized by:
- finding a reason to drink;
- minor memory loss after sobering up;
- showing interest when mentioning alcohol – Zavilyansky syndrome.
The stage can last for years. In rare cases, alcoholism develops to stage II in 1-2 years (more often in adolescents and people over 65 years of age).
At the second stage there are:
- increased tolerance to ethanol;
- the appearance of withdrawal symptoms and binge drinking;
- isolated somatic and mental complications.
The patient's personality gradually changes: he becomes withdrawn or aggressive. The sense of humor often changes: jokes become flat and vulgar.
At the third stage occurs:
- decreased tolerance;
- severe complications;
- personality degradation.
The terminal stage of alcohol dependence is often accompanied by dementia, which complicates the prognosis and complicates treatment.
This system of stages was adopted in Russia in 1973 according to the description of Portnov and Pyatnitskaya. There are other classifications, but the order of appearance of certain symptoms coincides with this system.
Literature:
- Socio-psychological portrait of a group with alcohol addiction [Electronic resource]: educational manual / Kotelevtsev N. A., Denisova P. Yu., Shuklina O. I.; Ministry of Education and Science of the Russian Federation, Federal State Budgetary Educational Institution of Higher Education "Kursk State University". - Kursk: Kursk State. University, 2016
- Psychological features of antisocial behavior of men with alcohol addiction: monograph / R. V. Bisaliev, A. D. Marselin, O. N. Gomyranova; Astrakhan state technical university - Astrakhan: ASTU Publishing House, 2013. - 139 p.
Diagnosis of alcoholism - how is the diagnosis made?
According to WHO diagnostic recommendations, a person with addiction must have repeatedly experienced:
- withdrawal;
- development of tolerance;
- strong craving for alcohol;
- ignoring the dangers of habit;
- loss of self-control when drinking alcohol;
- changes in behavior when drunk and sober.
The diagnosis is made based on a history examination. Laboratory, functional and instrumental studies are carried out to assess the condition of the body and identify complications associated with alcohol consumption.
A specific test for identifying addiction is CDT - a marker of chronic alcohol load. Normally, transferrin protein is present in the blood in the form of tetrasialotransferrin, but in an alcoholic, the analysis will show other transferrin isoforms. False-positive results occur when taking alcohol or antidepressants 1.5-2 days before the test.
The effect of alcohol on the human body
Alcohol from the stomach enters the bloodstream two minutes after consumption. The blood carries it to all cells of the body. The cells of the cerebral hemispheres are primarily affected. The conditioned reflex activity of a person worsens, the formation of complex movements slows down, and the ratio of excitation and inhibition processes in the central nervous system changes. Under the influence of alcohol, voluntary movements are impaired, and a person loses the ability to control himself.
The effect of alcohol on the nervous system
Signs of alcohol dependence begin to form due to the peculiarities of its effect on the nervous system. The penetration of alcohol into the cells of the frontal lobe of the cortex liberates a person’s emotions, unjustified joy, stupid laughter, and ease of judgment appear. Following increasing excitation in the cerebral cortex, a sharp weakening of inhibition processes occurs. The cortex ceases to control the work of the lower parts of the brain. A person loses restraint, modesty, he says and does things that he would never say or do if he were sober. Each new portion of alcohol increasingly paralyzes the higher nerve centers, as if connecting them and not allowing them to interfere with the activity of the lower parts of the brain: coordination of movements is disrupted, for example, eye movement (objects begin to double), and an awkward, staggering gait appears. Disruption of the nervous system and internal organs is observed with any alcohol consumption: one-time, episodic and systematic. It is known that disorders of the nervous system are directly related to the concentration of alcohol in a person’s blood. When the amount of alcohol is 0.04-0.05 percent, the cerebral cortex turns off, a person loses control over himself, and loses the ability to reason rationally. At a blood alcohol concentration of 0.1 percent, the deeper parts of the brain that control movement are inhibited. A person’s movements become uncertain and are accompanied by causeless joy, animation, and fussiness. However, in 15 percent of people, alcohol can cause depression and a desire to fall asleep.
As the alcohol content in the blood increases, a person’s ability to hear and visual perception is weakened, and the speed of motor reactions is dulled. An alcohol concentration of 0.2 percent affects areas of the brain that control emotional behavior. At the same time, base instincts awaken and sudden aggressiveness appears. With a blood alcohol concentration of 0.3 percent, a person, although conscious, does not understand what he sees and hears. This condition is called alcoholic stupor. A blood alcohol concentration of 0.4 percent causes loss of consciousness. The person falls asleep, his breathing becomes uneven, and involuntary emptying of the bladder occurs. There is no sensitivity. At a blood alcohol concentration of 0.6-0.7 percent, death can occur. As a result of episodic drinking of alcohol, a painful addiction and uncontrollable craving for alcohol often develops - alcoholism.
Types of alcoholism
The clinical picture of ethyl addiction is not the same. It depends on the age and gender of the patient, motives for drinking and even the strength of the alcohol.
Domestic alcoholism - it all begins with it
Another name for the prodromal (preceding) stage, at which a person is not yet formally an alcoholic, but already drinks regularly, for example, in company. The condition can develop into true addiction, but with an effort of will a person is still able to stop drinking without the help of a doctor.
Vodka alcoholism
Dependence on strong drinks, more often vodka. It develops more rapidly than beer addiction, but has pronounced clinical signs, so the patient has a chance of getting to a narcologist in a timely manner. The downside of vodka alcoholism is the risk of consuming low-quality products and severe poisoning.
Female alcoholism
The mechanism of development of alcohol dependence in women is identical to the male pattern of the disease. But the causes of the disease are more often social and psychological reasons than genetic ones. Women are less likely to experience addiction due to reduced production of alcohol-breaking enzymes and poor tolerance to alcohol. However, over the past 30 years, female addiction statistics have increased dramatically.
Beer alcoholism
A common form of addiction among young people is unfairly considered harmless. The patient drinks liters of beer, so the total amount of ethanol entering the blood does not differ from the degree of intoxication of a vodka alcoholic. Due to the gradual entry of alcohol into the digestive system, signs of poisoning are mild. Therefore, addicts refuse to see a narcologist.
Social alcoholism
Not all alcohol addicts are antisocial individuals. Successful people with high incomes and education levels also fall victim to the disease. At an early stage, they continue to observe standards of decency, so it is difficult to recognize them as alcoholics. But the disease inevitably leads to personality degradation, changes in appearance and loss of reputation over time.
Teenage alcoholism
Addiction in minors progresses quickly. However, recovery with the right approach and timely consultation with a doctor occurs faster. A feature of addiction is the use of low-quality surrogate drinks, which cause severe poisoning and toxic damage to internal organs and the nervous system.
Chronic alcoholism
Chronic alcoholism is the constant use of alcohol when a person is continuously in the acute stage. Unlike a binge addict, who can go without alcohol for several weeks, months and even years, he drinks every day.
There is also a classification of alcoholism based on frequency of use:
- alpha alcoholism - drinking ethanol in small doses daily;
- beta alcoholism – drinking alcohol regularly;
- gamma alcoholism - drinking alcohol rarely, but in large quantities.
The study of subtypes of the disease is not applied, but theoretical: scientists study statistics, draw up preventive and clinical recommendations, etc.
Aggression in men and women
Representatives of the stronger sex are generally more aggressive. Lack of control over your behavior makes the problem worse. As a result, drunken men swear and fight more often than women. Possible options include hostility towards others, baseless jealousy and intense anger over little things. There is an unreasonable feeling of danger and the emergence of fragmentary ideas of persecution.
Drinking alcohol in men provokes not only emotional and psychological, but also physical aggression. Drunken fights break out. Husbands beat their wives and children.
In women, aggressive behavior is observed less frequently and manifests itself in the form of endless arguments and causeless irritation with others. Extravagance and demonstrative protests towards drinking buddies can lead to leaving home at night, accidents, and getting into criminal situations. Sometimes women get into fights or beat their children.
Alcohol is one of the causes of sexual violence . In half of the cases, the offender, the victim, or both participants had previously consumed alcohol. Theoretically, both a woman and a man can be a victim, but in practice, in the vast majority of cases, it is the fairer sex who suffer. Men predominate not only among rapists, but also among murderers who commit crimes while intoxicated.
Complications and physical consequences of alcoholism
Nervous system – impaired cognitive functions, loss of social skills, decreased performance.
Cardiovascular system – decreased vascular tone, cardiac arrhythmia. Risk of stroke and thromboembolism.
The respiratory system is a lung disease associated with disruption of other body systems.
Digestive system – pathologies of the stomach, pancreas, liver. Internal bleeding.
Genitourinary system – impotence, infertility and the risk of having children with genetic pathologies. Decreased filtration capacity of the kidneys.
Immune system – development of autoimmune aggression on internal organs, decreased protective ability against antigens.
The list of pathologies developing in ethyl addicts cannot be given in full, since the organ is a single system, chronic intoxication of which can cause any consequences.
Prevention of alcohol use
Prevention of alcoholism is a set of measures designed to:
- those who have never experienced addiction - primary prevention;
- those who already suffer from addiction – secondary prevention;
- those who have undergone treatment for alcoholism - tertiary prevention.
Reducing the number of addicts is a task set by WHO and the Ministry of Health. In Russia, progress was made with the emergence of accessible anonymous help, as well as restrictions on advertising of alcohol in the media and the time of its sale.
Psychology in the rehabilitation program
Rational psychotherapy plays an important role in rehabilitation. Without working through the reasons that led to drunkenness and understanding the problem, it will not be possible to say goodbye to addiction for a long time. After rehabilitation, there is always a risk of relapse. If an addict has strengthened his desire with the help of an experienced psychologist, then his conviction will become the first assistant in maintaining a sober lifestyle. A person with strong convictions is minimally susceptible to relapse.
Cost of treatment
Complex Cost 70,000 rubles per month Additional sessions with a psychologist are paid separately
| Name | plan |
| 4-5 bed accommodation | + |
| 4 meals a day | + |
| Diagnostic examination by a general practitioner | + |
| Diagnostic examination by a psychiatrist | — |
| Psychological diagnostics by a clinical psychologist | primary upon request |
| Individual consultations with the program director | on request |
| Individual therapy with a psychologist | 2 lessons per month |
| Family consultation with a psychologist | — |
| Information seminars and trainings | 20 lessons per month |
| Group Art Therapy sessions | 4 lessons per month |
| Psychocorrectional groups with a psychologist | 4 lessons per month |
| Transformation games | 1 lesson per month |
| Individual yoga lesson | — |
| Group yoga classes | 4 lessons per month |
| Diagnostic massage/problem area | 1 time per month |
| Written analytical assignments | 8 lessons per month |
| Individual support using a self-analysis diary | — |
| Monitoring progress, adjusting dynamics | At every stage of the program |
| Fitness group | 4 times a month |
| Outdoor leisure event | 1 time per month |
| Transfer support | — |
| Family program “12 basics” | + |
| Program work logs | 5 notebooks |
| Bed linen, towels set | + |
Complex Cost 100,000 rubles per month
| Name | plan |
| 4-5 bed accommodation | + |
| 4 meals a day | + |
| Diagnostic examination by a general practitioner | + |
| Diagnostic examination by a psychiatrist | Monthly upon request |
| Psychological diagnostics by a clinical psychologist | Quarterly |
| Individual consultations with the program director | on request |
| Individual therapy with a psychologist | 8 lessons per month |
| Family consultation with a psychologist | Quarterly |
| Information seminars and trainings | 20 lessons per month |
| Group Art Therapy sessions | 4 lessons per month |
| Psychocorrectional groups with a psychologist | 4 lessons per month |
| Transformation games | 1 lesson per month |
| Individual yoga lesson | — |
| Group yoga classes | 4 lessons per month |
| Diagnostic massage/problem area | 2 times a month |
| Written analytical assignments | 8 lessons per month |
| Individual support using a self-analysis diary | — |
| Monitoring progress, adjusting dynamics | At every stage of the program |
| Fitness group | 4 times a month |
| Outdoor leisure event | 1 time per month |
| Transfer support | + |
| Family program “12 basics” | + |
| Program work logs | 5 notebooks |
| Bed linen, towels set | + |
Complex Cost 150,000 rubles per month
| Name | plan |
| 2-3 bed accommodation | + |
| 4 meals a day | + |
| Diagnostic examination by a general practitioner | + |
| Diagnostic examination by a psychiatrist | Monthly upon request |
| Psychological diagnostics by a clinical psychologist | Quarterly |
| Individual consultations with the program director | Weekly |
| Individual therapy with a psychologist | 12 lessons per month |
| Family consultation with a psychologist | Monthly |
| Information seminars and trainings | 20 lessons per month |
| Group Art Therapy sessions | 4 lessons per month |
| Psychocorrectional groups with a psychologist | 4 lessons per month |
| Transformation games | 1 lesson per month |
| Individual yoga lesson | 1 time per month |
| Group yoga classes | 4 lessons per month |
| Diagnostic massage/problem area | 4 times a month |
| Written analytical assignments | 8 lessons per month |
| Individual support using a self-analysis diary | + |
| Monitoring progress, adjusting dynamics | Monthly |
| Fitness group | 4 times a month |
| Outdoor leisure event | 1 time per month |
| Transfer support | + |
| Family program “12 basics” | + |
| Program work logs | 5 notebooks |
| Bed linen, towels set | + |
