What does drinking a lot mean, how should we drink in moderation or not drink at all - what should we choose?
There is an ambivalent attitude towards alcohol and its consumption in our society: on the one hand, "drinking is harmful to health! ", on the other hand, "who doesn't drink now? ". In our opinion, the reason for this is that medical science often views alcohol consumption from two extreme positions: the norm (sobriety) and the disease (alcohol addiction). At the same time, hookers are a minority in society: from 40% of the total population (including minors and the elderly) to 10-15% of the adult population. In connection with this, many people ask the question: "Is alcohol consumption so harmful if it is so common, and the doctors themselves, who keep talking about the harm, are they hardly dieters? ""Therefore, the purpose of this article is not only to talk about the real dangers and harms of excessive alcohol consumption, but also about what constitutes minimal health risk consumption.
Let's start with some important definitions. What is alcohol consumption, abuse and alcohol dependence? In itself, alcohol consumption, like many other drugs, is a type of human behavior. The difference between alcohol (and tobacco) and many other food products is related to its ability to influence a person's mental activity: emotions, behavior, thinking. Therefore, alcohol is called a psychoactive (psychoactive) substance, which includes narcotics (opioids, psychostimulants, and cannabis), psychotropic agents (barbiturates, benzodiazepines), and toxic substances (glue, gasoline, solvents). Alcohol and most psychoactive substances can lead to abuse and dependence in humans. By abuse we mean a form of consumption that damages an individual's physical (increased pressure, liver, heart and nerve damage) and mental health (insomnia, depression, anxiety) and can disrupt professional (dismissal), family (divorces, scandals)and his public life (arrests, drunk driving).
Abuse is already a painful condition and requires medical intervention, but it is important to have a general therapist or neurologist at this stage who can provide short-term intervention for alcohol problems. Alcohol addiction is already a disease, like anxiety or depression, in the presence of which a person needs the help of other doctors - narcologist or psychotherapist.
Alcohol dependence involves a combination of disturbances in behavior, thinking, and physical functions of the body that develop after repeated use of alcohol. The main symptom of alcohol addiction is a strong "drinking" compulsion ("craving"); violation of the ability to control alcohol consumption (the beginning and end of drinking, as well as the dose) ("no brakes, drinking"); desire or unsuccessful attempts to reduce or control drinking; a state of withdrawal (withdrawal syndrome, "wasting") when you stop or reduce alcohol consumption and relieve this state while drinking; tolerance - gradually increasing the amount of alcohol consumed; neglecting other interests and increasing drinking time; and finally the continuation of drinking with its obvious harmful effects on health. An addiction diagnosis can be established if three or more of these symptoms appear within one month of the past year (e. g. one day a week of heavy drinking on Friday after work, or four weeks of excessive alcohol consumption each year).
If in society 5-10% of the population consumes alcohol, and another 4% of the population (2% of women and 6% of men) are dependent on alcohol, then in the rest of the population approx. 10-20% more. detect excessive alcohol consumption. According to the WHO definition, excessive (dangerous or risky) alcohol consumption is defined as the amount or type that, if continued, leads to health damage (that is, which later becomes abuse).
It is now believed that the amount of alcohol consumed directly determines the likelihood of developing various alcohol problems (dangerous consumption, abuse and addiction), after which withdrawal from excess may be necessary. Alcohol-free adults have been shown to consume up to 20g of ethyl alcohol per day to minimize the risk of developing problems. At the same time, alcohol consumption must not exceed the mandatory 2 sober days on 5 days a week. According to the WHO, 10 g of ethyl alcohol is taken in an amount corresponding to 1 standard unit (dose) of alcohol. One serving of alcohol contains 330 ml. 5% strength beer; in 140 ml. dry wine (9-11%); in 70 ml. fortified wine (18%); and 35 ml in spirits (40%). To calculate the amount of ethyl alcohol in an alcoholic drink in grams, multiply the volume of the drink by its strength and a conversion factor of 0. 79 (each milliliter of pure ethyl alcohol contains 0. 79 g).
However, in certain situations, even one or two servings of alcohol a day is not desirable: if you drive a car, if you are pregnant or breastfeeding, if you take certain medications, suffer from many diseases, and if you cannot control your drinking. (i. e. one of the symptoms of addiction).
What problems does alcohol cause?
Alcohol problems are not only harmful to health and psyche, but also various professional, family and social consequences of excessive alcohol consumption.
The risk of alcohol problems is low if men consume 3-4 drinks per day (20 drinks per week) and women 2-3 drinks per day (15 drinks per week). The average risk of problems can be seen at 25-35 doses per week for men and 15-25 doses for women. A high risk of alcohol problems is observed when men consume more than 35 drinks and women consume more than 25 drinks per week. A further increase in consumption indicates abuse and sharply increases (by 6. 5 times) the risk of developing alcohol dependence and related somatic diseases. In this way, the amount of alcohol consumed in the last 7 days can be calculated, which can generally be considered as an indicator of average alcohol consumption. And then you can assess the risk of drinking and whether it is already painful.
In addition to the amount of alcohol consumed, hereditary, personal and social factors also influence the likelihood of an individual's alcohol consumption and alcohol addiction; also called risk factors. Hereditary (genetic) risk factors include parents' alcohol addiction (risk increases 3-4 times) and other addictions (drug addiction - 4-5 times increased risk and mother's smoking - 2-3 times). Currently, many genes have been identified that are responsible for the development of alcohol dependence, however, they only determine the risk of developing alcohol dependence in 30-40%. Those. 60-70% of the risk of alcoholism depends on a person's personality and environment.
Genetic differences also affect people's physiological and psychological characteristics in relation to alcohol consumption. The following characteristics were revealed: a) unusual (slow or accelerated) ethanol metabolism (processing) - "I get drunk quickly or completely drunk"; b) accelerated development of tolerance - "doesn't take vodka"; c) altered reactions to alcohol (irritability, aggression and depression).
Which characteristics of a person increase the risk of developing alcohol dependence? The main ones are male gender, early first alcohol consumption, young age (16-19 years), life outside of marriage (single, divorced or widowed), low income, lack of work, pension. Psychological problems that often predispose to the development of alcohol addiction at a young age (before the age of 25) are emotional instability (mood swings, irritability, aggressive behavior), altered drunkenness, hyperactivity and risky behavior (stimulus-seeking behavior - gambling, a lot of sex life). partners), as well as higher levels of alcohol consumption at a young age.
Psychological problems that often predispose to the development of alcohol addiction in adulthood (after 30 years), increased anxiety and depression, decreased ability to communicate (shyness), difficulties with change, fear of abandonment, avoidance of problems, lack of reason. existence and prospects. Social risk factors for alcoholism include family stress for women, work stress for men, low social status of the family (poverty, poor housing conditions), disruption of the structure and functioning of the family (incomplete - for women).
What advice can be given to someone who drinks alcohol moderately but has risk factors for the development of alcohol addiction, e. g. can he be an alcoholic?
In these people, even moderate-risk drinking can cause the same problems as low-risk drinking in people without these factors. Therefore, they must prevent the development of alcohol consumption and addiction, and this can only be achieved by continuously observing the limits of moderate alcohol consumption. Even a single dose of large doses of alcohol (more than 5 doses per day) can contribute to the development of alcohol-related problems - poisoning, injury, accident, violence; and long-term consumption of even small amounts of alcohol (3-5 drinks per day) increases the risk of addiction by 2-3 times compared to those who do not have these hereditary, personal and social risk factors. Therefore, excessive doses are unacceptable for them.
What can we advise someone who drinks alcohol moderately and has no risk factors for developing alcohol dependence, but is at risk of alcoholism? In such people, while maintaining the same level of alcohol consumption, the risk of developing addiction is minimal. However, if they are exposed to adverse external (dismissal, divorce, retirement) or internal factors (illness, anxiety and depression) and allow excessive alcohol consumption (consumption of large amounts of alcohol - more than 5 servings 3-7 times a day) or increase theregularly consumed amount of alcohol, dependence and abuse may develop within a short time.
And finally, what advice can we give to someone who consumes alcohol in dangerous or harmful amounts? What should be said to such a patient? The advice is pretty simple - try drinking less, or if that doesn't work, stop drinking. How to drink less? Dilute alcoholic drinks, replace alcohol with soft drinks; eat before and after drinking. Try to distract yourself from the glass and drink more slowly; do something else to drink less; start later than usual; abstain from alcohol: two to three or even four days a week is better. Try not to get into risky situations where you might lose control: in campaigns, with friends, after work, on holidays, after paychecks, on weekends. Try not to drink if you are bored or lonely, irritable, tense and suffering from bad mood, insomnia and anxiety; and if you find yourself in such a situation - leave it, refuse it. Try other forms of entertainment and recreation; and most importantly, learn to say no. It is important to find people who drink in moderation and are willing to support you in solving your alcohol problems.
The last question that this article tries to answer is: what should a person and their relatives do with alcohol dependence (alcoholism) that already exists?
It is necessary to stop drinking if you feel a frequent desire to drink (even if for relaxation, stress relief, entertainment); you can't control how much of a hangover you get the day after heavy drinking and you need a drink to boost your well-being; You need more and more alcohol to get drunk or get back to "normal. "You should also stop drinking if you suffer from high blood pressure (alcohol does not cure the pressure, but on the contrary, increases the risk of hypertensive crises and strokes), liver disease, pancreatitis, and if you take drugs that are incompatible with alcohol(antibiotics, cardiac drugs, antihypertensive drugs, etc. ). If you can't quit on your own, don't despair, there are now enough qualified professionals - psychotherapists and narcologists, who will provide you with effective help anonymously: without registration, job advertisement or license suspension. The most important thing is not to forget that alcoholism can be cured, but the result of its treatment is not the ability to "re-drink 100 grams socially like everyone else", but the effective preservation of sobriety for a long time.