What is alcoholism and alcohol dependence: signs at 3 stages

The true reasons for drunkenness lie in the field of psychology: there are usually real or fictitious reasons for alcohol abuse. As time passes and the disease progresses, personal problems begin to appear more and more clearly. That is why psychological assistance during the rehabilitation period is no less important in treatment than drug therapy.

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.

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.

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The concept of "alcoholic"

An alcoholic is a person whose way and meaning of life becomes the use of alcoholic beverages. Unlike a drunkard, he does not stop when a hangover appears, but looks for a new dose that can alleviate his condition. As a rule, an alcoholic (especially at the last stage) does not care what to do with a hangover - any alcohol-containing liquids are used. Due to psychological degradation, he cannot and/or does not want to cope with the addiction on his own, so he needs outside help.

Alcoholism syndromes

Dependence on alcoholic beverages is accompanied by certain conditions, each of which has not only a name, but also a medical code.

10.3, 10.4 Alcohol withdrawal syndrome with or without delirium (hallucinations, delusions).
Pathological changes in the psyche and body, accompanied by weakness, headache, nausea, vomiting and other symptoms of intoxication. It develops not during consumption, but after stopping or reducing long-term intake of alcohol-containing drinks due to the accumulation of toxic metabolic products.
10.2 Dependency syndrome.
The emergence of a painful desire to take alcohol by any possible means. Loss of control over the amount of drinking, one’s own behavior and emotions.
10.6 Amnestic syndrome.
Decreased memory for events of various dates (most often recent ones).

Diseases caused by alcoholism

Alcoholism affects all human organ systems, but the nervous and digestive systems suffer first. Among the diseases caused by alcohol abuse, we can note, for example, the following:

gastritis, ulcer, erosion of the gastric mucosa;
atrophy of the mucous membrane of the digestive tract and, as a result, vitamin deficiency, metabolic disorders;
cirrhosis of the liver;
acute pancreatitis (mortality reaches 70%);
cerebral edema;
nephropathy, renal failure;
cardiomyopathy;
strokes.

People suffering from alcoholism have an increased risk of developing cancer.

Risk factors

Risk factors include a wide variety of circumstances and situations that cause changes in a person’s mental state, forcing them to take alcohol-containing drinks. It can be:

lack of values, life goals;
low self-esteem, uncertainty;
low stress resistance;
state of protest (in the family, at work, in society);
a familiar environment, for example, a childhood spent among drinkers;
laziness, reluctance to do something (study, work, etc.);
early sexual intercourse.

Most often, the development of alcohol dependence is caused by several factors simultaneously.

Faces of alcoholics (photo)

A drinking person experiences not only internal, but also external changes, especially noticeable on the face. The most typical symptom is swelling of the eyelids and wings of the nose. Swollen red eyes, enlarged pores, and a yellow-bluish-red skin tone become more noticeable the longer a person abuses ethyl alcohol. The facial muscles gradually atrophy - losing tone, lips and cheekbones begin to sag. Enlarged pores become a “gateway” for infection, which ultimately leads to the appearance of rashes and pimples.

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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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.

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.

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.

Are a drinker and an alcoholic the same thing?

Rare consumption of alcohol “in occasion” does not classify a person as a drinker, as well as people who do not experience cravings in stressful situations. The drinking part of the population does not suffer from a hangover in the morning, and clearly limits the amount of drinking the day before.

With addiction, frequency, periodicity and even systematicity are observed. Lack of self-control indicates the onset of the disease. The presence of a problem is determined by the constant thought of alcohol and the permissibility of abuse. With such symptoms, a person is classified as an alcoholic.

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.

How to talk to an alcoholic?

In order to understand how to talk with an alcoholic, you need to take into account family ties and the causes of addiction. But here are some basic tips:

Decrees must be avoided . A patient with addiction is stubborn in himself. I am always confident that if I want, I can give up alcohol myself. If you constantly tell him that he needs treatment, that he has a problem, this can cause aggression. There will be no more productive conversation.
You should not leave a person alone with a disease. While the patient is in society, the reason that pushed him to addiction may be forgotten. The person perceives the situation adequately and understands that he should not drink. But as soon as he finds himself alone, anxious thoughts return, and alcohol helps get rid of them. Therefore, you need to constantly have a conversation with the patient, keep him busy.
Be constantly attentive . The fact is that patients' behavior and thoughts are constantly changing. If yesterday the patient agreed to treatment, then today, if this topic arises, he may show aggression.
Don't give in . Alcoholics claim that one drink will not change anything and you can drink once. But it is from one frame that the binge begins. Therefore, it is not worth engaging in such persuasion.
You cannot solve problems for an alcoholic . It's his problem if he loses his job and friends. You can’t cover for him at work or pay off his debts.
should not be allowed to get hungover . It is necessary for the addict to experience all the signs of withdrawal symptoms. Perhaps this will discourage you from drinking further.
Don't threaten him. You cannot shout to a person that you will divorce him, kick him out of the house, take away his apartment. This cannot force the patient to undergo treatment.
You cannot be aggressive , much less get involved in a fight. An alcoholic under the influence of alcohol loses control and can cause serious injuries when intoxicated.

Considering that alcoholism occurs at all ages and does not depend on gender, the approach to each person will be slightly different.

Advice for wives of alcoholics

A woman whose husband is faced with an addiction problem can do something simple - leave . But not everyone decides to take such a step. Therefore, you have to figure out how to live with such a person and how to get him to start treatment. First of all, you need to remember that a woman should not become a nanny for a man. Wives often make the same mistakes :

They are overly protective of their husband.
The topic of alcoholism is not brought up in conversation.
They relieve men of responsibility for children, family, and household responsibilities.
They do not force a man to do basic housework, doing everything himself.

Wives of alcoholics often try to hide the problem from others and do not even admit its existence to themselves. They do all the housework themselves, even those that a man is required to do. They don’t take the bottle away from their husband, and they don’t start scandals over alcohol. Wives are stressed and do everything to make sure they simply don’t exist, doing nothing to combat addiction .

In such a situation, no man will give up alcohol. My husband is happy with everything and will continue to drink. Interest in family and home disappears. But even if the alcoholic is quiet and drunk constantly sleeping, sooner or later problems will begin in the form of aggression and assault.

Experts highlight certain tips that will help a woman find an approach to her alcoholic husband. It is important to understand that you cannot support him in drinking, you cannot allow to drink.

Before explaining to a person the need for treatment, it is important to learn to follow certain rules :

Don't threaten.
Don't argue or humiliate.
Do not have long conversations, do not become boring.
Always remain calm, confident, and do not allow yourself to relax in front of him.
Do not try to take away alcohol, do not stop the patient if he wants to leave the house.

By following simple rules you can find an approach to a man. Only then will it be possible to persuade him to undergo treatment.

What to do if a child drinks?

If alcoholism affects a daughter or son, it is all the more important to find a way out of the situation and help the child. Some advice from a psychologist is highlighted on how to behave with an alcoholic in the family.

Initially, the mother must admit that the child is an alcoholic and that help is needed. But at the same time, it is important to push maternal instincts into the background. The son or daughter must be aware that they cannot cope with the problem on their own and that they have allowed the disease to develop.

When communicating with a child, it is forbidden to shout , blackmail, restrict a person’s access to a TV, computer, or take away phones and other gadgets. If your son is lying drunk, you don’t need to constantly hover around him, catering to his whims. A child, no matter how old he is, must understand that now he is an adult and he will have to solve his problem himself.

You need to talk smoothly, without aggression , and even more so you cannot shout at a person because you raised him, and the child responded with problems. It is important to convey to the patient that there is a problem and it can be solved if treatment is taken wisely. As soon as the child sobers up, you can begin to advise him to see a doctor and explain why the condition is dangerous.

What to do if a friend drinks?

Alcoholism affects not only families, but also close friends. Especially if your friends have not encountered this bad habit. If a friend has gone on a drinking binge, you cannot indulge him. It is prohibited to hide from employers why a person did not show up for work. The patient must realize who is responsible for him and no one is obliged to cover for him.

You can't follow the lead of an addict. Never run to buy alcohol for your best friend, no matter how bad he feels. It is better to call a narcologist to your home and carry out treatment to relieve withdrawal symptoms. Don't take it away from the bar if your friend has had too much alcohol more than once. This way you relieve him of responsibility.

All conversations should be conducted in a soft manner. No aggression, no decrees. Only advice and an explanation that the problem can be solved. This will make the patient think that he has support.

Behavior with an alcoholic wife

It is not always the husband who drinks in the family. Today, alcoholism is increasingly being detected in women. They also need a certain approach. The first question concerns why the woman decided to go on a drinking binge. It is necessary to find the reasons for the change in behavior and only by eliminating them will it be possible to achieve an improvement in the condition.

There are several useful tips:

Avoid loneliness, which pushes a woman to drink alcohol.
Avoid places where alcohol may be present. You can temporarily stop visiting.
You should never drink with your wife.
Try to avoid communicating with friends who drink alcohol.
Provide reliable support. This will help the woman understand that she is not alone.
Access to finance can be reduced. A woman is unlikely to go to her neighbors to ask for money for drinks.
There should be no alcohol at home.

If your wife does not show aggression, you need to carefully talk to her about the fact that today alcoholism is easily treated. That it is enough to choose a doctor and take the course, and anonymously, that is, no one will know about the problem. Women are more purposeful, so treatment can be carried out at home.

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.

Don't limit yourself forever

Life attitudes play an important role in the fight against any disease. Alcoholism is no exception in this matter. To achieve success, it is important to properly motivate your own consciousness. You shouldn’t think in global categories - that’s it, I’m an alcoholic and this is forever. Such thoughts create fear and aggravate depression, which already depresses the body. It is important not to limit yourself to attitudes and not to be afraid of the future. Everything can be fixed; addiction can be overcome. After recovery, there is a risk of returning to the alcoholic past, but it will clearly be less if you manage to take control of the situation and reduce the level of internal pressure.