What is drinking a lot, how do you drink in moderation or should you not drink at all – what should you choose?
In our society, there is an ambivalent attitude towards alcohol and its consumption: on the one hand, "Drinking is harmful to health! ", on the other hand "who doesn't drink anymore? ". In our opinion, this is because alcohol consumption is often viewed by medicine from two extreme positions: the norm (sobriety) and the disease (alcohol addiction). 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 alcohol consumption so harmful when it is so common and the doctors themselves, who constantly talk about its harms, are hardly ever abstainers? ""As such, this article aims to talk not only 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 Addiction? In itself, alcohol consumption, like many other substances, is a type of human behavior. The difference between alcohol (and tobacco) and many other foods is related to its ability to affect a person's mental activity: emotions, behavior, thinking. Alcohol is therefore classified as a psychoactive (mental) substance, which also includes drugs (opioids, psychostimulants and cannabis), psychotropic drugs (barbiturates, benzodiazepines) and toxic substances (glue, gasoline, solvents). Alcohol and most psychoactive substances can cause abuse and addiction in humans. Abuse is understood to mean a form of consumption that harms a person's physical (increased pressure, damage to the liver, heart and nerves) and mental (insomnia, depression, anxiety) and professional (dismissal), family (divorces, scandals) and public health(arrests, drunk driving) life 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 neurologist who has short-term intervention skills for alcohol problems. Alcohol addiction is already a disease, just like anxiety or depression, in which a person needs the help of other doctors - a narcologist or a psychotherapist.
Alcohol dependence includes a combination of disorders in behavior, thinking and the physical functioning of the body that develops after repeated alcohol consumption. The main symptoms of alcohol addiction are a strong compulsion to "drink" ("craving"); Violation of the ability to control alcohol consumption (starting and stopping drinking and the dose) ("no brakes, binges"); desire or unsuccessful attempts to reduce or control drinking; a state of withdrawal (withdrawal syndrome, "wasting"), if you stop or reduce alcohol consumption and relieve this condition with drinking; tolerance - a gradual increase in the dose of alcohol consumed; ignore other interests and increase drinking time; and finally the continuation of drinking, with its obvious harm to health. A diagnosis of addiction may be made if three or more of these signs are present within one month of the past year (e. g. , one day of weekly heavy drinking on a Friday after work, or four weeks of binge drinking per year).
In society, if 5-10% of the population abuse alcohol and another 4% of the population (2% of women and 6% of men) are alcohol dependent, then the remaining part of the population will be around 10-20% more aware of excessive alcohol consumption. According to the WHO definition, excessive (dangerous or risky) alcohol consumption is defined as quantities or types of alcohol that lead to health damage if continued (i. e. later lead to abuse).
It is now believed that the amount of alcohol consumed directly determines the likelihood of developing various alcohol problems (hazardous use, abuse and dependence), after which binge withdrawal may be required. Alcohol-free adults have been shown to consume no more than 20g of ethyl alcohol per day to minimize the risk of problems. At the same time, alcohol consumption should not be more than 5 days a week with a mandatory 2 days of soberness. According to the WHO, 10 g of ethyl alcohol is equivalent to 1 standard unit (dose) of alcohol ingested. A 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 spirits (40%). To calculate the amount of ethyl alcohol in grams in an alcoholic beverage, the volume of the beverage must be multiplied by its strength and a conversion factor of 0. 79 (each milliliter of pure ethyl alcohol contains 0. 79 g).
However, in some situations, even drinking a can or two of alcohol a day is undesirable: when driving, when pregnant or breastfeeding, when taking certain medications, for many illnesses, and when you cannot control your alcohol consumption (ie. you have any of the signs of addiction).
What problems does alcohol cause?
Alcohol problems are not only harmful to health and psyche, but also to various professional, family and social consequences of excessive drinking.
A low risk of alcohol problems is seen with 3-4 drinks per day for men (20 drinks per week) and 2-3 for women (15 drinks per week). The average risk of problems is seen at 25-35 doses per week for men and 15-25 doses for women. A high risk of alcohol problems is observed with more than 35 drinks per week in men and more than 25 in women. A further increase in consumption indicates abuse and greatly increases (by 6. 5 times) the risk of developing alcohol dependence and related somatic diseases. This allows you to calculate the amount of alcohol consumed in the last 7 days, which can be taken as an indicator of average alcohol consumption in general. And then you can assess how risky your drinking is and whether it's painful.
In addition to the amount of alcohol consumed, a person's likelihood of developing alcohol abuse and dependence is also influenced by hereditary, personal, and social factors; they are also called risk factors. Hereditary (genetic) risk factors include parental alcohol addiction (the risk increases by 3-4 times) and other addictions (drug addiction - an increase in risk by 4-5 times and mother's smoking - by 2-3 times). Currently, many genes responsible for the development of alcohol addiction have been identified, but they determine only 30-40% of the risk of its occurrence. This. The alcohol risk depends 60-70% on the personality of the person and his environment.
Genetic differences also affect people's physiological and psychological traits related to alcohol consumption. The following features were revealed: a) unusual (slow or accelerated) metabolism (processing) of ethanol - "I get drunk easily or completely drunk"; b) accelerated tolerance development - "does not take vodka"; c) altered reactions to alcohol (irritability, aggression and depression).
What characteristics of a person increase the risk of developing alcohol dependence? The most important are male gender, early drinking, young age (16-19 years), life outside marriage (single, divorced or widowed), low income, lack of work, retirement. Psychological problems that often predispose to the development of alcohol dependence at a young age (before 25 years) are emotional instability (mood swings, irritability, aggressive behavior), altered intoxication, hyperactivity and risky behavior (stimulus-seeking behavior - gambling, many sexual partners), as well as increasedalcohol consumption at a young age.
Mental health problems that often lead to the development of alcohol dependence in adulthood (after the age of 30) Existence and prospects. Social risk factors for alcoholism include high family stress for women and work-related 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 can be recommended to a person who drinks alcohol moderately, but has risk factors for developing alcohol dependence, i. e. H. can you become an alcoholic
In these individuals, 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 abuse and addiction, which can only be achieved by constantly observing the limits of moderate alcohol consumption. Even single doses of high doses of alcohol (more than 5 doses per day) can contribute to the development of alcohol problems associated with poisoning - poisoning, injury, accidents, 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 people who do not have these hereditary, personal and social risk factors. Therefore, for them, overdoses are unacceptable.
What advice can be given to someone who drinks moderately and has no risk factors for developing alcohol dependence but is still at risk of becoming an alcoholic? In such people, with consistent alcohol consumption, the risk of developing an addiction is minimal. However, if they are exposed to unfavorable external (dismissal, divorce, retirement) or internal factors (illness, anxiety and depression) and allow alcoholic excesses (consumption of large amounts of alcohol - more than 5 doses per day for 3-7 days) or the amount ofIf you increase the amount of alcohol you consume regularly, addiction and abuse can develop within a short period of time.
Finally, what is the advice for someone who consumes alcohol in dangerous or harmful 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 beverages, replace alcohol with soft drinks; Eat before and after drinking. Try taking your mind off the glass and drinking more slowly; do something else to drink less; Start later than usual; Avoid fasting days: 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 campaigns, with friends, after work, on holidays, after paying, on weekends. Try not to drink when you are bored, lonely, irritable, 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 consume in moderation and are willing to support you in your efforts to solve your drinking problems.
The final question this article seeks to answer is: What should a person and their loved ones with a pre-existing alcohol addiction (alcoholism) do?
Cessation of consumption is required if you experience frequent cravings for alcohol (including for the purpose of relaxation, stress relief, fun); Can't control how much you drink Suffering from a hangover the day after heavy drinking and need a drink to improve your well-being; It takes more and more alcohol to get drunk or to get "normal" again. It is also necessary to stop drinking if you have hypertension (alcohol does not cure blood pressure, but on the contrary increases the risk of hypertensive crisis and stroke), liver diseases, inflammation of the pancreas and taking drugs incompatible with it, alcohol suffers (antibiotics, heart drugs, pressure drugs, etc. ) If you can not stop on your own, then do not despair, now there are enough qualified specialists - psychotherapists andNarcologists who will provide you with effective help anonymously: without registration, job posting and driver's license suspension. The main thing is that alcoholism is curable, but the result of its treatment is not the restoration of "the ability to drink again in the company, like all the other 100grams" but the effective maintenance of sobriety for a long time.