What is heavy drinking, how to drink in moderation, or shouldn't drink at all - what should you choose?
In our society, people have conflicting attitudes towards alcohol and its consumption: on the one hand, "drinking is bad for health! ", on the other hand, "who doesn't drink now? ". In our opinion, this is because medicine often considers drinking from two extreme positions: normalcy (soberness) and disease (alcohol dependence). At the same time, alcoholics are a minority in society: from 40% of the general population (including minors and seniors) to 10-15% of the adult population. In response, many people have a question: "Is drinking so harmful, if it is so common, and doctors themselves constantly talk about its harm, aren't alcoholics? " Therefore, the purpose of this article is not only to talk aboutThe real dangers and harms of excessive drinking also lie in the discussion of what constitutes the least harmful health effects of drinking.
Let's start with some important definitions. What is alcohol consumption, abuse and alcohol dependence? Like many other substances, drinking alcohol is a human behavior in itself. The difference between alcohol (and tobacco) and many other foods has to do with its ability to affect a person's mental activity: mood, behavior, thinking. For this reason, alcohol is known as a psychoactive (mind-acting) substance, which also includes drugs (opioids, psychostimulants, and marijuana), psychotropic substances (barbiturates, benzodiazepines), and toxic substances(glue, gasoline, solvents). Alcohol and most psychoactive substances cause people to abuse and become dependent. Abuse is understood as a type of consumption that damages the body (increased stress, damage to the liver, heart and nerves) and mental health (insomnia, depression, anxiety), and may also disrupt careers (dismissals), families (divorce, scandals) andA person's public life (arrest, DUI).
Abuse is already a distressing condition that requires intervention by a doctor, but importantly, at this stage, it may also be a general therapist or neurologist with short-term skills in intervening with alcohol problems. Alcohol addiction is already a disease, and like anxiety or depression, a person needs the help of other doctors - an anaesthetist or a psychotherapist.
Alcohol dependence includes a range of behavioral, mental, and physical dysfunctions that occur after repeated use of alcohol. The main symptoms of alcohol addiction are a strong urge to "drink" ("craving"); violation of the ability to control alcohol intake (start and end of drinking and dosage) ("unbrake, overeating"); reduce or control alcohol consumptiondesires or unsuccessful attempts; withdrawal states when you stop or reduce alcohol intake and relieve the condition while drinking (withdrawal syndrome, "wasting"); tolerance - gradually increasing alcohol intake; neglectOther interests, increasing drinking time; and finally, continuing to drink has obvious health hazards. An addiction diagnosis can be made if three or more of these signs have occurred within one month of the past year (for example, heavy drinking one Friday after get off work every week, or binge drinking for four weeks per year).
If 5% to 10% of the population in a society abuse alcohol and another 4% of the population (2% women and 6% men) are dependent on alcohol, then in the remaining part of the population there will be approximately 10-20% moreDetect excessive drinking. Excessive (dangerous or risky) drinking, as defined by the World Health Organization, is considered to be the level or type of alcohol that would lead to health damage (ie, later abuse) if continued drinking.
It is now believed that the amount of alcohol consumed directly determines the likelihood of developing various alcohol problems (dangerous drinking, abuse and dependence), after which abstinence may be required. Non-alcoholic adults have been shown to consume no more than 20 grams of ethanol per day to minimize the risk of problems. Also, drink no more than 5 days a week and must be sober on 2 days. According to the World Health Organization, 10 grams of ethanol is equivalent to 1 standard unit (dose) of alcohol. 330ml contains one dose of alcohol. 5% beer; 140 ml. Dry wine (9-11%); at 70 ml. Fortified wine (18%); and 35ml spirits (40%). To calculate the alcohol content (in grams) in an alcoholic beverage, multiply the volume of the beverage by the alcohol concentration and a conversion factor of 0. 79 (0. 79 grams per milliliter of pure alcohol).
However, even one or two daily doses of alcohol are not advisable in certain situations: if you drive, are pregnant or breastfeeding, take certain medications, have multiple medical conditions, and if you cannot control your drinking (i. e. you have signs of addiction)one).
What problems can alcohol cause?
Alcohol problems are not only detrimental to health and psychology, but also have a variety of occupational, family, and social consequences for excessive drinking.
3-4 drinks per day (20 drinks per week) for men and 2-3 drinks per week (15 drinks per week) for women are associated with a lower risk of alcohol problems. Men taking 25-35 doses per week and women taking 15-25 doses per week had an average risk of problems. A high risk of alcohol problems occurs when men drink more than 35 drinks per week and women drink more than 25 drinks per week. Further increases in consumption indicate abuse and sharply (6. 5-fold increase) the risk of alcohol dependence and related medical disorders. So you can calculate your alcohol consumption over the past 7 days, which can be considered an indicator of your average alcohol consumption in general. You can then assess the risks your drinking poses to you and whether it is already distressing.
In addition to the amount of alcohol consumed, an individual's likelihood of developing alcohol abuse and dependence is influenced by genetic, personal and social factors; they are also known as risk factors. Genetic (genetic) risk factors include parental dependence on alcohol (3-4 times increased risk) and other addictions (drug use - 4-5 times increased risk and maternal smoking - 2-3 times increased risk). Currently, many genes that contribute to the development of alcohol dependence have been identified, however, they only determine 30-40% of the risk of its occurrence. Those ones. 60-70% of the risk of binge drinking depends on the personality and circumstances of the individual.
Genetic differences can also affect people's physical and psychological characteristics associated with alcohol consumption. The following features were revealed: a) abnormal (slow or accelerated) metabolism (processing) of ethanol - "I'm drinking fast or totally drunk"; b) accelerated development of tolerance - "no vodka"; c)Altered responses to alcohol (irritability, aggression, and depression).
What characteristics of a person increase the risk of alcohol dependence? Mainly male, first-time drinker, young (16-19), living outside of marriage (single, divorced or widowed), low income, lack of work, retirement. Psychological problems that predispose to developing alcohol dependence at a young age (before age 25) are mood instability (mood swings, irritability, aggressive behavior), changes in intoxication, hyperactivity, and risky behaviors (thrill-seeking behavior - gambling, manysex) partners), and higher alcohol consumption at a young age.
Psychological problems that often contribute to the development of alcohol dependence in adulthood (after age 30) are increased levels of anxiety and depression, impaired communication (shyness), difficulty changing, fear of abandonment, problem avoidance, and lack of meaningful presence and prospects. Social risk factors for alcoholism include high family stress in women, high work stress in men, low family social status (poverty, poor housing conditions), and disruption of family structure and function (incomplete-female).
What can be advised to someone who drinks in moderation but has risk factors for alcohol dependence, i. e. can 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 need to prevent the development of alcohol abuse and dependence, which can only be achieved by consistently adhering to the limits of moderate drinking. Even a single dose of high-dose alcohol (more than 5 per day) can lead to the development of intoxication-related alcohol problems—intoxication, injury, accident, violence; compared with people without these genetic, personal, and social risk factors, Even a small amount of alcohol (3-5 drinks per day) increases the risk of addiction by 2-3 times over the long term. Therefore, for them, an excessive dose is unacceptable.
What is the advice for people who drink moderately and do not have risk factors for alcohol dependence but are still at risk of becoming an alcoholic? Among these people, the risk of developing addiction was small while maintaining the same level of alcohol consumption. However, if they are exposed to unfavorable external factors (fire, divorce, retirement) or internal factors (illness, anxiety and depression), and if they allow alcoholism (in large quantities - more than 5 doses per day for 3-7 days) orAddiction and abuse may develop within a short period of time by increasing the amount of regular alcohol consumption.
Finally, what advice can be offered to people whose alcohol consumption is dangerous or harmful? What would you say to such a patient? The advice is simple - try drinking less, or if that doesn't work, stop drinking. How to drink less? Dilute alcoholic beverages and replace alcohol with soft drinks; eat before and after drinking. Try to distract yourself from the cup and drink slowly; do something else to drink less alcohol; start later than usual; abstinence days: two, three or even four days a week is better. Try not to get into high-risk situations where you can get out of control: at events, with friends, after get off work, on holidays, after paychecks, on weekends. Try not to drink when you are bored or lonely, irritable, nervous, in a bad mood, insomnia and anxious; if you find yourself in this situation - leave, say no. Try other forms of entertainment; and, most importantly, learn to say no. It's important to find people who use it in moderation and who are willing to support you with your alcohol problems.
The final question this article will attempt to answer is: How should a person and their relatives cope with pre-existing alcohol dependence (alcoholism)?
If you often have the urge to drink (even to relax, de-stress, have fun), you must stop drinking; can't control how much you drink a lot the day after hangover, need a drink to improve your health; you needMore and more alcohol is required to get drunk or to return to "normal". If you have high blood pressure (alcohol does not cure stress, but increases the risk of hypertensive crisis and stroke), liver disease, pancreatitis, and are taking alcohol (antibiotics, heart medications, stress medications, etc. ). If you can't quit smoking on your own, don't despair, there are now enough qualified specialists - psychotherapists and anaesthetists anonymous: without any registration, job announcements and deprivation of your driver's license, you will be effectively helped. The main thing to remember is that alcoholism is curable, but the result of its treatment is not restoring "the ability to drink again in company like everyone else is 100 grams", but effective long-term sobriety.