What is drinking a lot, like drinking in moderation or you shouldn't drink at all - what should you choose?
There is an ambivalent attitude towards alcohol and its consumption in our society: on the one hand, "drinking is bad for 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 viewed by medicine from two extreme positions: norm (sobriety) and disease (alcohol addiction). 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 have a question: "Is drinking alcohol so harmful, if it is so common, and the doctors themselves, who are constantly talking about its harm, are certainly not abstainers? " Therefore, the purpose of this article is not alone to talk about the real dangers and harms of excessive alcohol consumption, but also about what constitutes its consumption with minimal risk to health.
Let's start with some important definitions. What is alcohol consumption, alcohol 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 food products is related to its ability to influence a person's mental activity: emotions, behavior, thinking. Therefore, alcohol is referred to as psychoactive substances (acting on the psyche), which also include 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 people. Abuse is understood as a type of consumption that damages a person's physical (increased pressure, liver, heart and nerve damage) and mental health (insomnia, depression, anxiety) and can also disrupt professional work (dismissal) , family (divorces, scandals) and public life (arrests, drunk driving) of a person.
Abuse is already a painful condition and requires medical attention, but importantly, at this stage it may also be a general therapist or neurologist who has expertise in short-term intervention for alcohol problems. Alcohol addiction is already a disease, the same as anxiety or depression, in the presence of which a person needs the help of other doctors - a narcologist or a psychotherapist.
Alcohol addiction includes a combination of behavioral, thinking, and physical body function disorders that develop after repeated alcohol use. The main symptoms of alcohol addiction are a strong compulsion to "drink" ("craving"); violation of the ability to control alcohol intake (the beginning and end of alcohol consumption and the dose) ("no brakes, binge eating"); unsuccessful desire or attempts to reduce or control alcohol consumption; a state of withdrawal (withdrawal syndrome, "denial") when you stop or reduce your alcohol intake and relieve this condition when 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 their obvious damage to health. An addiction diagnosis can be made if three or more of these signs are present within a month of the past year (eg, a weekly alcoholic day on Friday after work, or binge drinking for four weeks a year ).
If in society 5 to 10% of the population abuses alcohol and another 4% of the population (2% of women and 6% of men) is dependent on alcohol, then in the remaining part of the population, about 10-20% of the population plus detect excessive alcohol consumption. According to the WHO definition, excessive (dangerous or risky) alcohol consumption means those levels or types of alcohol which, if continued, will cause damage to health (i. e. what will later become abuse).
It is now believed that the amount of alcohol consumed directly determines the likelihood of developing various alcohol problems (dangerous drinking, abuse and addiction), after which withdrawal from bingeing 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 intake should not exceed 5 days a week with 2 sober days mandatory. According to the WHO, 10 g of ethyl alcohol equal to 1 standard unit (dose) of alcohol is consumed. 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 alcohol (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 a day is undesirable: if you drive a vehicle, if you are pregnant or breastfeeding, when you are taking certain medications, with many diseases and when you cannot control the alcohol consumption (i. e. you have 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 seen 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 significantly increases (by 6. 5 times) the risk of developing alcohol dependence and associated somatic diseases. Therefore, you can calculate the amount of alcohol consumed in the past 7 days, which can be considered an indicator of the average alcohol consumption in general. And then you can evaluate how much risk the drinking brings and even if it is already painful.
In addition to the amount of alcohol consumed, an individual'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 alcohol addiction in parents (risk increases by 3-4 times) and other addictions (drug addiction - an increase in risk of 4-5, and mother's smoking - by 2-3 times). Currently, many genes responsible for the development of alcohol addiction have been identified, however they only determine 30-40% of the risk of it occurring. Those. 60-70% of the risk of alcoholism depends on the person's personality and their environment.
Genetic differences also affect people's physiological and psychological characteristics in relation to alcohol consumption. The following characteristics were noted: a) unusual (slow or accelerated) metabolism (processing) of ethanol - "I get drunk quickly or completely drunk"; b) accelerated development of tolerance - "does not take vodka"; c) altered reactions to alcohol (irritability, aggression and depression).
What characteristics of a person increase the risk of developing alcohol addiction? The main ones are male sex, first alcohol consumption, 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 addiction at a young age (before age 25) are emotional instability (mood swings, irritability, aggressive behavior), impaired drunkenness, hyperactivity and risky behaviors (looking behavior of stimuli - gambling, having many sexual intercourse 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 age 30) are increased levels of anxiety and depression, reduced ability to communicate (shyness), difficulty in changing, fear of being abandoned, avoidance of problems , lack of meaning for existence and prospects. Social risk factors for alcoholism include a high level 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 recommended to a person who drinks alcohol moderately, but has risk factors for the development of alcohol addiction, eg. can become an alcoholic?
In these people, even drinking alcohol at a moderate risk level can cause the same problems as drinking low-risk alcohol in people without these factors. Therefore, they must prevent the development of alcohol abuse and addiction, and this can only be achieved by consistently adhering to 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 intoxication - poisoning, injuries, 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 those without these hereditary, personal and social risk factors. Therefore, for them, excessive doses are unacceptable.
What can be advised for a person who drinks alcohol moderately and has no risk factors for developing alcohol addiction, but still risks becoming an alcoholic? In these people, while maintaining the same level of alcohol consumption, the risk of developing addiction is minimal. However, if they are exposed to unfavorable external factors (dismissal, divorce, retirement) or internal (illness, anxiety and depression) and if they allow excess alcohol (large amounts of alcohol - more than 5 doses per day for 3-7 days) o increasing the amount of alcohol consumed regularly, addiction 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 drinking 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 to distract yourself from the glass and drink more slowly; do something else to drink less; start 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 the countryside, 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 those people who use moderate use and are ready to support you in your efforts to solve your alcohol problems.
The last question this article will try to answer is: what should a person and their relatives do with an already existing addiction to alcohol (alcoholism)?
The cessation of consumption is necessary if there is a frequent desire to drink (even if for the purpose of relaxation, de-stressing, having fun); you can't control how much you drink you have a hangover the day after drinking a lot and you 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 blood pressure, but, on the contrary, increases the risk of hypertensive crisis and stroke), liver disease, pancreatitis, and you are taking drugs incompatible with alcohol ( antibiotics, heart medications, blood pressure medications, etc. ). If you can't stop on your own, don't despair, there are now enough qualified specialists - psychotherapists and narcologists who anonymously: without any registration, job posting and driving license deprivation, they will provide you with effective assistance. The main thing to remember is that alcoholism is treatable, but the result of its treatment is not the restoration of the "ability to drink again in company like everyone else is 100 grams", but the effective preservation of sobriety for long time.