What is drinking 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 is harmful to health! ", and on the other, "who doesn't drink now? ". In our opinion, this is due to the fact that alcohol consumption is usually considered by medicine from two extreme positions: 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 have a question: "Is it so harmful to drink alcohol, if it is so common, and the doctors themselves, constantly talking about its harm, are not teetotalers? "Therefore, the purpose of this article is not not only talk about the real dangers and harms of binge drinking, but also about what constitutes drinking with minimal health risk.
Alcohol abuse
Let's start with some important definitions. What is Alcohol Consumption, Abuse and Alcohol 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 their 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 dependence in people. Abuse is understood as a type of consumption that harms a person's physical health (increased blood pressure, damage to the liver, heart and nerves) and mental health (insomnia, depression, anxiety), and can also disrupt professional life ( 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 physician, but more importantly, at this stage it may also be a general therapist or 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 other doctors - a narcologist or a psychotherapist.
Alcohol dependence includes a combination of disturbances in behavior, thinking, and physical bodily functions 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 consumption and dosage) ("no brakes, binge"); desire or unsuccessful attempts to reduce or control alcohol consumption; a state of withdrawal (withdrawal syndrome, "waste") when alcohol intake is stopped or reduced and this condition is relieved by drinking; tolerance - a gradual increase in the dose of alcohol consumed; ignoring other interests and increasing drinking time; and, finally, the continuation of the drink with its obvious damage 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 (eg, binge drinking one day a week on Fridays after work, or four weeks of binge drinking). alcohol per year).
If in society from 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 remaining part of the population, about 10 -20% more detect excessive alcohol consumption. According to the WHO definition, excessive (dangerous or risky) alcohol consumption is considered to be those levels or types of alcohol that, if continued, will lead to harm to health (that is, what will later become 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 it may be necessary to withdraw from binge eating. Nonalcoholic 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 intake should be no more than 5 days a week with 2 mandatory days of sobriety. 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. beer with a strength of 5%; in 140 ml. dry wine (9-11%); in 70 ml. fortified wine (18%); and in 35 ml of liqueurs (40%). To calculate the amount of ethyl alcohol in grams in an alcoholic beverage, it is necessary to multiply the volume of the beverage by its proof and by a conversion factor of 0. 79 (each milliliter of pure ethyl alcohol contains 0. 79 g).
However, in some situations, even drinking one or two doses of alcohol per day is undesirable: if you are driving a vehicle, pregnant or nursing, taking certain medications, with many illnesses, and when you cannot control your alcohol intake. (ie 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 seen 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. Therefore, you can calculate the amount of alcohol consumed in the last 7 days, which can be considered an indicator of the average alcohol consumption in general. And then you can assess how much risk your drink brings you, and also if it's already painful.
In addition to the amount of alcohol consumed, the likelihood that an individual will develop 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 (3- to 4-fold increased risk) and other addictions (drug addiction, a 4- to 5-fold increased risk, and maternal smoking, 2 to 3 times). Currently, many genes have been identified that are responsible for the development of alcohol dependence, however, they determine only 30-40% of the risk of its occurrence. Those. 60-70% of the risk of alcoholism depends on the person's personality and their 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 I get completely drunk"; b) accelerated development of tolerance - "does not drink vodka"; c) altered 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 onset of alcohol consumption, young age (16-19 years), life outside of marriage (single, divorced or widowed), low income, lack of work, retirement. Psychological problems that tend to predispose to the development of alcohol dependence at an early age (before the age of 25) are emotional instability (mood swings, irritability, aggressive behavior), altered binge drinking, hyperactivity, and risk behaviors (drinking behavior). stimulation seeking - pathological gambling, having many partners), as well as higher levels of alcohol consumption at an early age.
Psychological problems that often predispose to the development of alcohol dependence in adulthood (from the age of 30) are high levels of anxiety and depression, impaired communication skills (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), breakdown of structure and function of the family (incomplete - for women).
What can be advised to a person who drinks alcohol moderately, but has risk factors for developing alcohol dependence, that is, can he become an alcoholic?
In these people, even drinking at the moderate risk level can cause the same problems as low-risk drinking in people without these factors. Therefore, they must prevent the development of alcohol abuse and dependence, 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 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 drinks alcohol moderately and has no risk factors for developing alcohol dependence, but is still at risk of becoming an alcoholic? In such people, maintaining the same level of alcohol consumption, the risk of developing addiction is minimal. However, if they are exposed to unfavorable external (dismissal, divorce, retirement) or internal factors (illness, anxiety and depression), and if they allow alcoholic excesses (drinking large amounts of alcohol - more than 5 doses per 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 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 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 alcohol fasting days: two or three or even four days a week are better. Try not to get into high-risk situations where you can lose control: on campaigns, with friends, after work, on vacation, after pay, on weekends. Try not to drink when you are bored or alone, you are irritated, tense and in a bad mood, with insomnia and anxiety; and if you find yourself in such a situation, go away, refuse. Try other forms of entertainment and recreation; and, most importantly, learn to refuse. It is important to find those who drink in moderation and who are ready to support you in your efforts to solve your alcohol problems.
The last question that this article will try to answer is: what should a person and their relatives do with an existing alcohol dependence (alcoholism)?
The cessation of consumption is necessary if you experience a frequent desire to drink (even if it is for the purpose of relaxation, de-stressing, having fun); you can't control how much you drink; you suffer from a hangover the day after drinking a lot 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 suffer from high blood pressure (alcohol does not cure pressure, but instead increases the risk of hypertensive crises and strokes), liver disease, pancreatitis and taking drugs incompatible with alcohol ( antibiotics, heart medications, blood pressure medications, etc. ). If you cannot quit smoking on your own, do not despair, now there are enough qualified specialists - psychotherapists and narcologists who, anonymously: without any registration, job advertisement and deprivation of a driver's license, will provide you with effective assistance. 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 in company like everyone else is 100 grams again", but the effective preservation of sobriety for a long time. weather.