What to drink a lot, how to drink in moderation, or you can not drink at all - what should you choose?
There is an ambivalent attitude towards alcohol and its use in our society: on the one hand, "drinking is dangerous to health! ", and on the other hand, "who does not drink now? ". In our opinion, this is due to the fact that alcohol consumption is often considered by medicine from two extreme positions: the norm (pleasure) and the disease (alcohol dependence). At the same time, teetotalers 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 have a question: "Is drinking alcohol very dangerous, if it is common, and doctors themselves, always talking about its dangers, are almost not teetotalers? "Therefore, the purpose of this article is not only to talk about the real dangers andthe harm of excessive alcohol consumption, but also about what constitutes its use with minimal health risks.
Alcohol abuse
Let's start with some important definitions. What is Alcohol Use, Abuse and Alcohol Dependence? In itself, alcohol use, like many other substances, is a form 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, thoughts. Therefore, alcohol is referred to as a psychoactive substance (acting on the soul), which also includes drugs (opioids, psychostimulants and cannabis), psychotropic drugs (barbiturates, benzodiazepines) and toxic substances (glue, petrol, solvents). Alcohol and most psychoactive substances can cause abuse and dependence in people. Abuse is understood as a type of use that harms one's physical (increased stress, damage to the liver, heart and nerves) and mental health (insomnia, depression, anxiety), and can also disrupt professionals (dismissal), family (divorce, scandals) and lifepublic (arrest, drunk driving) of a person.
Abuse is already a painful condition and requires the intervention of a doctor, but, importantly, at this stage it may also be a general therapist or a neurologist who has skills in short-term intervention for alcohol problems. Alcohol addiction is already a disease, just like anxiety or depression, in the presence of which a person needs the help of another doctor - narcologist or psychotherapist.
Alcohol dependence includes a combination of disturbances in behavior, thinking and physical functioning of the body that develop after repeated use of alcohol. The main symptom of alcoholism is a strong compulsion to "drink" ("desire"); violation of the ability to control alcohol intake (start and end of drinking and dosage) ("no brakes, party"); desire or unsuccessful attempts to reduce or control drinking; withdrawal state (withdrawal syndrome, "withdrawal") when you stop or reduce alcohol consumption and reduce this state when drinking; tolerance - a gradual increase in the dose of alcohol used; ignoring other interests and increasing drinking time; and, finally, the continuation of drinking with obvious danger to health. A diagnosis of addiction can be made if three or more of these signs are present within one month of the past year (eg, heavy drinking one day per week on Friday after work, or heavy drinking for four weeks each year).
If in society 5 to 10% of the population abuse alcohol and another 4% of the population (2% of women and 6% of men) are dependent on alcohol, then among the rest of the population, about 10-20% more. detect excessive alcohol consumption. According to the WHO definition, excessive (harmful or risky) alcohol consumption is considered a level or type of alcohol that, if continued, will lead to damage to health (that is, what will then become abuse).
It is now believed that the amount of alcohol consumed directly determines the likelihood of developing various alcohol problems (harmful use, abuse and dependence), after which withdrawal from the binge may be necessary. Non-alcoholic adults have been shown to consume no more than 20 g of ethyl alcohol per day to minimize the risk of developing problems. At the same time, alcohol consumption should not be more than 5 days a week with mandatory 2 sober days. According to the WHO, 10 g of ethyl alcohol is equivalent to 1 standard unit (dose) of alcohol. One dose of alcohol is contained in 330 ml. beer with a strength of 5%; in 140 ml. dry wine (9-11%); in 70 ml. fortified wine (18%); and in 35 ml of spirit (40%). To calculate the amount of ethyl alcohol in grams in an alcoholic drink, it is necessary to 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 some situations, even taking one or two doses of alcohol per day is undesirable: if you drive a vehicle, if you are pregnant or breastfeeding, while you are taking certain medications, with many diseases, and when you cannot control your drinking. (ie you have one of the signs of addiction).
What problems does alcohol cause?
Alcohol problems are not only dangerous to health and soul, but also various professional, family and social consequences due to excessive drinking.
A low risk of alcohol problems is seen with 3-4 drinks a day for men (20 a week) and 2-3 for women (15 drinks a 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 use indicates abuse and dramatically (by 6. 5 times) increases the risk of alcohol dependence and related somatic diseases. Therefore, you can calculate the amount of alcohol consumed in the past 7 days, which can be considered as an average indicator of alcohol consumption in general. And then you can assess how much risk your drink brings, and also whether it is already painful.
In addition to the amount of alcohol consumed, the likelihood of an individual experiencing alcohol abuse and dependence is also influenced by hereditary, personal and social factors; it is also called a risk factor. Hereditary (genetic) risk factors include alcohol dependence in parents (risk increases 3-4 times) and other addictions (drug addiction - increased risk by 4-5 and maternal smoking - by 2-3 times). Currently, many genes have been identified that are responsible for the development of alcohol dependence, however, they only determine 30-40% of the risk of its occurrence. That. 60-70% of the risk of alcohol addiction depends on a person's personality and environment.
Genetic differences also affect the physiological and psychological characteristics of people related to alcohol consumption. The following characteristics have been revealed: a) abnormal metabolism (processing) of ethanol (slow or accelerated) - "I get drunk quickly or completely drunk"; b) the development of accelerated tolerance - "do not take vodka"; c) altered response to alcohol (irritation, aggression and depression).
What characteristics of a person increase the risk of alcohol dependence? The main ones are male sex, early early drinking, young age (16-19 years old), life outside marriage (single, divorced or widowed), low income, less work, retired. Psychological problems that often predispose to the development of alcohol dependence at a young age (before 25 years) are emotional instability (mood changes, irritability, aggressive behavior), changes in drunkenness, hyperactivity and risky behavior (stimulation-seeking behavior - gambling, having a lotsexual relations. 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 30 years) are increased levels of anxiety and depression, impaired ability to communicate (shame), difficulty changing, fear of abandonment, avoiding problems, lack of meaning for existence and prospects. Social risk factors for alcoholism include high levels of stress in the family for women and stress at work for men, low social status of the family (poverty, poor housing conditions), disruption of family structure and function (incomplete - for women).
What can be advised to someone who drinks alcohol in moderation, but has risk factors for developing alcohol dependence, i. e. can be an alcoholic?
In these people, even moderate-risk alcohol consumption 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, and this can only be achieved by always observing moderate alcohol consumption limits. Even a single dose of a high dose of alcohol (more than 5 doses per day) can contribute to the development of alcohol-related problems related to intoxication - poisoning, injuries, accidents, violence; and long-term use even in small quantities (3-5 drinks a 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, for them, overdose is unacceptable.
What can be advised to someone who drinks alcohol moderately and has no risk factors for developing alcohol dependence, but is still at risk of becoming an alcoholic? In such people, while maintaining the same level of alcohol consumption, the risk of addiction is minimal. However, if they are exposed to external factors (dismissal, divorce, retirement) or unfavorable internal factors (illness, anxiety and depression), and if they allow excess alcohol (taking a large amount of alcohol - more than 5 doses a day for 3-7 days) or increase the amount of alcohol consumed regularly, addiction and abuse can develop in a short time.
And, finally, what advice can be given to someone who consumes alcohol in harmful or dangerous amounts? 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 drinks, replace alcohol with soft drinks; eat before and after drinking. Try to divert your attention from the glass and drink more slowly; do something else to drink less; starts later than usual; do fasting days from alcohol: two or three or even four days a week is better. Try not to get into high-risk situations where you can lose control: in a campaign, with friends, after work, on holidays, after pay, on weekends. Try not to drink when you are bored or lonely, you are 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, most importantly, learn to refuse. It is important to find people who use moderately and are willing to support you in your efforts to solve your alcohol problem.
The last question that this article will try to answer is: what should a person and his relatives do with an existing dependence on alcohol (alcoholism)?
Discontinuation of use is necessary if you experience a frequent desire to drink (even for the purpose of relaxation, stress relief, fun); can't control how much you drink get hungover the day after drinking a lot and need a drink to boost your well-being; You need more alcohol to get drunk or get back to "normal". It is also necessary to stop drinking if you suffer from high blood pressure (alcohol does not cure pressure, but, on the contrary, increases the risk of hypertensive crisis and stroke), liver disease, pancreatitis, and take drugs that are incompatible with alcohol (antibiotics, heart drugs, drugsfor stress, etc. ). If you cannot stop on your own, then do not despair, now there are qualified specialists - psychotherapists and anonymous narcologists: without any registration, job announcements and loss of driver's license, will provide you with effective help. The main thing to remember is that alcoholism can be cured, but the result of treatment is not the restoration of "the ability to drink again in the company of others is 100 grams", but the preservation of effective sobriety for a long time.