What is to drink a lot, how to drink in moderation or not to drink at all - what to choose?
There is an ambivalent attitude towards alcohol and its consumption in our society: on the one hand, "drinking harms your health! ", and on the other, "who doesn't drink now? ". In our opinion, this is due to the fact that alcohol consumption is often considered by medicine from two extreme angles: the norm (sobriety) and the disease (alcohol dependence). At the same time, abstainers are a minority in society: from 40% of the total population (including minors and the elderly) to 10-15% of the adult population. In this regard, many people ask themselves the following question: "Is the consumption of alcohol so harmful, if it is so common, and the doctors themselves, constantly talking about its harm, are they notabstainers? " Therefore, the purpose of this article is not only to talk about the real dangers and harms of excessive alcohol consumption, but also what constitutes its consumption with minimal health risk.
Alcohol abuse
Let's start with some important definitions. What is Alcohol Use, Abuse and Dependence? In itself, the consumption of alcohol, like many other substances, 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. Thus, alcohol is qualified as psychoactive substances (acting on the psyche), which also includes drugs (opioids, psychostimulants and cannabis), psychotropics (barbiturates, benzodiazepines) and toxic substances (glue, gasoline, solvents). Alcohol and most psychoactive substances can lead to abuse and dependence in people. Abuse is understood as a type of consumption that harms a person's physical (increased pressure, damage to the liver, heart and nerves) and mental health (insomnia, depression, anxiety), and can also disruptthe professional activities (dismissal), family (divorces, scandals) and public life (arrests, drunk driving) of a person.
Abuse is already a painful condition and requires the intervention of a doctor, but importantly, at this stage, it can also be a general therapist or a neurologist who has short-term intervention skills. 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 - a narcologist or a psychotherapist.
Alcohol dependence includes a combination of disturbances in behavior, thinking, and physical body functions that develop after repeated consumption of alcohol. The main symptoms of alcohol dependence are a strong compulsion to "drink" ("craving"); violation of the ability to control alcohol intake (the beginning and end of drinking and the dose) ("no brakes, binges"); desire or unsuccessful attempts to reduce or control alcohol consumption; a state of withdrawal (withdrawal syndrome, "wasting") when you stop or reduce alcohol consumption and alleviate this state by drinking; tolerance - a gradual increase in the dose of alcohol consumed; ignoring other interests and increasing drinking time; and, finally, the continued consumption of alcohol with its obvious harmful effects on health. A diagnosis of dependence may be made if three or more of these signs are present in the past month (for example, weekly heavy drinking on a Friday after work or four weeks of heavy drinking peryear).
If in society 5-10% of the population abuses alcohol, and 4% of the population (2% of women and 6% of men) are dependent on alcohol, then among the remaining part of the population, about 10 to 20% more detect excessive alcohol consumption. According to the WHO definition, excessive alcohol consumption (hazardous or risky) is considered to be those levels or types of alcohol which, if continued, will cause harm to health (i. e. say, which will later become an abuse).
It is now believed that the amount of alcohol consumed directly determines the likelihood of developing various alcohol problems (hazardous drinking, abuse and dependence), after which withdrawal from excessive drinking may be necessary. Non-alcoholic adults have been shown to consume no more than 20g of ethyl alcohol per day to minimize the risk of developing problems. At the same time, alcohol consumption should not exceed 5 days per week with 2 mandatory sobriety days. According to the WHO, 10 g of ethyl alcohol is equivalent to 1 standard unit (dose) of alcohol. A dose of alcohol is contained in 330 ml. 5% beer; in 140ml. dry wine (9-11%); in 70ml. fortified wine (18%); and in 35 ml of spirits (40%). To calculate the amount of ethyl alcohol in grams in an alcoholic drink, multiply the volume of the drink by its strength and by a conversion factor of 0. 79 (each milliliter of pure ethyl alcohol contains 0. 79 g).
However, in certain situations, even taking one or two doses of alcohol a day is undesirable: if you drive a vehicle, if you are pregnant or breastfeeding, if you take certain medications, if you suffer from manyillnesses, if you cannot control your drinking. (i. e. you show one of the signs 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.
A low risk of alcohol problems is observed with 3-4 drinks per day for men (20 per week) and 2-3 for women (15 drinks per week). The average risk of problems is seen with 25-35 doses per week for men and 15-25 doses for women. A high risk of alcohol problems is observed when drinking more than 35 drinks per week for men and more than 25 for women. A further increase in consumption indicates abuse and sharply increases (by 6. 5 times) the risk of developing alcohol dependence and associated somatic diseases. Thus, you can calculate the amount of alcohol consumed over the past 7 days, which can be considered an indicator of the average alcohol consumption in general. And then you can assess the risk that your alcohol consumption brings you, and also if it is already painful.
In addition to the amount of alcohol consumed, the likelihood of an individual developing alcohol abuse and dependence is also affected by hereditary, personal and social factors; they are also called risk factors. Hereditary (genetic) risk factors include parental alcohol dependence (risk increases 3-4 times) and other addictions (drug addiction - risk increases 4-5 and maternal smoking -2 to 3 times). Currently, many genes responsible for the development of alcohol dependence have been identified, but they determine only 30-40% of the risk of occurrence. Those. 60-70% of the risk of alcoholism depends on the personality of the person and his environment.
Genetic differences also affect the physiological and psychological characteristics of people in relation to alcohol consumption. The following characteristics were revealed: a) unusual (slow or accelerated) metabolism (processing) of ethanol - "I get drunk quickly or completely drunk"; b) accelerated development of tolerance - "don't take vodka"; c) impaired reactions to alcohol (irritability, aggressiveness and depression).
What characteristics of a person increase the risk of developing alcohol dependence? The main ones are male sex, early alcohol consumption, young age (16-19 years), life outside marriage (single, divorced or widowed), low income, unemployment, retirement. Psychological problems often predisposing to the development of alcohol dependence at a young age (before 25) are emotional instability (mood swings, irritability, aggressive behavior), impaired drunkenness, hyperactivity andrisky behaviors (seeking stimulation - gambling, having many sexual partners), as well as higher levels of alcohol consumption at a young age.
Psychological problems that often predispose to the development of alcohol dependence in adulthood (after age 30) are increased levels of anxiety and depression, impaired ability to communicate (shyness), difficulty inchange, fear of being abandoned, avoidance of problems, lack of meaning for Existence and prospects. Social risk factors for alcoholism include high levels of family stress for women and work stress for men, low family social status (poverty, poor housing conditions), structural disruption andthe functioning of the family (incomplete - for women).
What can be advised to a person who consumes alcohol moderately, but who has risk factors for developing alcohol dependence, ie: can become an alcoholic?
In these people, even alcohol consumption at a moderate risk level can cause the same problems as low-risk alcohol consumption in people without these factors. Therefore, they need to prevent the development of alcohol abuse and dependence, which can only be achieved by constantly adhering to the limits of moderate alcohol consumption. Even single doses of alcohol in high doses (more than 5 doses per day) can contribute to the development of alcohol-related intoxication problems - poisoning, injuries, accidents, violence; and long-term consumption of even small amounts of alcohol (3-5 drinks per day) increases the risk of dependence 2-3 times compared to those without these hereditary, personal and social risk factors. Therefore, for them, excessive doses are unacceptable.
What can be advised to a person who consumes alcohol in moderation and who has no risk factors for developing alcohol dependence, but who is still at risk of becoming an alcoholic? In these people, while maintaining the same level of alcohol consumption, the risk of developing an addiction is minimal. However, if they are exposed to adverse external (dismissal, divorce, retirement) or internal (illness, anxiety and depression) factors, and if they allow alcoholic excesses (heavy alcohol consumption - more than 5 doses per dayfor 3 to 7 days) or increase the amount of alcohol consumed regularly, dependence and abuse can develop in a short time.
And finally, what advice can be given to a person who consumes alcohol in dangerous or harmful quantities? What to say to such a patient? The advice is quite simple - try to drink less, or if that doesn't work, stop drinking alcohol. How to drink less? Dilute alcoholic beverages, replace alcohol with carbonated drinks; eat before and after drinking. Try distracting yourself from the glass and drinking more slowly. do something else to drink less; start later than usual; do alcohol fast days: two or three or even four days a week is better. Try not to find yourself in high-risk situations where you can lose control: in the countryside, with friends, after work, on vacation, after pay, on weekends. Try not to drink when you are bored or lonely, irritated, tense and in a bad mood, with insomnia and anxiety; and if you find yourself in such a situation - leave, refuse. Try other forms of entertainment and recreation; and, above all, learn to refuse. It's important to find people who drink moderately and who are willing to support you in your efforts to solve your drinking problems.
The last question that this article will try to answer is: what should a person and his relatives do with an already existing addiction to alcohol (alcoholism)?
Stopping drinking is necessary if you feel a frequent desire to drink (even if it is for the purpose of relaxation, de-stressing, pleasure); you cannot control how much you drink suffer from a hangover the day after heavy drinking and need a drink to improve your well-being; You need more and more alcohol to get drunk or get back to "normal". It is also necessary to stop drinking if you have high blood pressure (alcohol does not cure pressure, but on the contrary increases the risk of hypertensive crises and strokes), liver disease, pancreatitis, and if you are taking any medications that are incompatible with alcohol (antibiotics, heart medications, blood pressure medications, etc. ). If you can't stop on your own, don't despair, now there are enough qualified specialists - psychotherapists and narcologists who, anonymously: without any registration, job advertisement and deprivation of driving license, will provide you witheffective support. The main thing to remember is that alcoholism is curable, but the result of its treatment is not the restoration of "the ability to drink again in the company as everyone is 100 grams", but the preservationeffective sobriety for a long time.