Alcoholism, also known as alcoholism, is a term used to describe alcohol dependence. People who suffer from this condition usually have a compulsion for alcoholic beverages, difficulty in stopping drinking and end up developing tolerance to the effects of the substance.
It is a psychiatric disease, considered by the World Health Organization (WHO) as “disease with physical and mental components.” It is because addiction is often purely psychic, but there are also physiological components involved. Most people, by the way, can drink sporadically without having major problems.
Alcoholism is more common in men than in women, but they are not safe from the problem: 30% of alcoholics are female, and the number is growing more and more. The cause of this probably is related to the greater freedom that the women conquered in the modern times, being able to make the consumption of alcoholic beverages without being judged as they would be some decades ago.
Although health is the main factor that is at stake with excessive consumption of alcohol, affective relations and social roles are also affected by it. It is worth remembering. However, that alcohol dependence can be treated and controlled. There are several programs and professionals qualified to help in this challenge, with the best-known group being Alcoholics Anonymous.
For many years, the term “alcoholic” has been widespread as a synonym for alcohol dependence. In recent times, however, many researchers believe that this nomenclature is inadequate.
If we look at the etymology of the word, we will see that alcoholic means, literally, alcohol worshiper. This nomenclature leads one to understand that the individual loves alcohol and chooses to continue drinking for liking so much when in reality there is a chemical dependence on the substance.
People who suffer from addiction are already badly spoken, called “shameless,” and the term alcoholic only makes the situation worse. Therefore, the word is considered stigmatizing and should be avoided when referring to a person who has problems with alcoholic beverages.
Already the term alcoholic has the connotation of disorder, making it clear that the individual is not responsible for his illness, but alcohol. Popularly, the term is still strange and little known, but researchers and health professionals seek to spread it more and more.
Because of the greater diffusion, this text adopts the term “alcoholic” as correct also.
Alcohol is a drug that depresses the nervous system, and although it always has those friends who are sad at parties, that does not mean that it causes sadness. It means that it slows down vital functions.
Have you noticed how that drunken friend talks nothing to anything, has difficulty balancing himself, takes time to react to situations and even complains that he sees double? It is exactly what alcohol does when it depresses the nervous system.
To better understand, we must keep in mind that the central nervous system is formed by neurons, cells that conduct electrical energy and pass “messages” to each other using chemical substances, called neurotransmitters. Each neurotransmitter affects the body, some related to pleasure, others to fear, etc.
It’s these electrical, chemical part messages that make our brains keep our bodies functioning. Make sure that whatever moves you make and any thoughts you have in your head is thanks to the operation of that system!
Anyway, let’s get down to business: how does alcohol change this whole joke?
When it enters the body, the ethanol (a type of alcohol used in the alcoholic drinks) arrives quickly at the brain.
There, it stimulates the release of excitatory neurotransmitters such as serotonin, dopamine, and endorphins, responsible for the sensations of pleasure and well-being. It is at this moment that the people at the bar begin to get excited about the party!
Soon after this, exactly the opposite effect occurs: alcohol stimulates the brain’s main inhibitory neurotransmitter, gamma-aminobutyric acid, better known as GABA. This neurotransmitter connects to neurons and makes them more chatty, making them less receptive to new messages coming from other neurons. In this way, communication between one neuron and another is difficult.
Do you understand now why it is a “depressant” drug of the nervous system? Precisely because it makes the brain less active! And this is what causes the symptoms of drunkenness to appear: slurred speech, lack of motor coordination, difficulties with balance, confusion, and changes in perception are very common.
Curiosity: Why do people do so much wrong when they drink?
You sure have heard stories of acquaintances who did lots of crap while they were drunk. Situations like trying to jump from too high places, giving over a committed person (in front of the boyfriend!) Or staying with someone who would not be so interesting if the individual was sober are very common. But why does this happen?
Studies show that alcohol depressant activity has a potent effect on the prefrontal cortex, the brain area responsible for value judgment and decision making. With activity lagging in this region, our ability to assess risks is hampered, and we end up getting too optimistic.
So, next time, do not judge that friend who drank too much and left paying mizuna: she did not care that she was making a mess!
Most of the alcohol is metabolized by the liver, and the rest is eliminated by the kidneys, skin, and lung. That is why, even after stopping drinking, the person continues to drink alcohol for a few hours.
During metabolism, each gram of alcohol produces 7.1 kcal, just under 1 gram of fat (8 kcal). Therefore, people who wish to lose weight should stay away from alcohol.
Finally, people who drink alcohol frequently get 50% of the daily calories needed through the drink and thus end up having nutritional problems like protein deficiency and B-complex vitamins.
What causes a person to drink? Or worse: what causes a person to continue drinking, even if it has already affected their health, career, and relationships? It is a rather complicated question that has no clear answer. The fact is that it is a disease – not a choice – with obscure causes but well-defined risk factors :
Some factors may favor the emergence of alcohol dependence. Check out:
Ease of access
One of the biggest risk factors for alcoholism is, of course, the ease of access. Being part of a society in which alcohol consumption is seen as something positive and fun, it is not surprising to see how affordable the drug is.
It is worth noting that people who have never drunk alcohol can not become alcoholics, because alcoholism happens with the chronic use of the drink, which in turn is favored and encouraged in our culture.
The consumption of alcoholic beverages is often associated with several modern social rituals: parties, bars, ballads, fun evenings, among others.
The more people drink around the individual, the greater the chance of drinking. It is because we are social beings and we need to be part of groups with which we have something in common.
By attending these places and participating in such situations, the individual becomes more and more exposed to the drug, increasing the chances of developing tolerance and dependence.
However, drinking socially does not mean that you will become an alcoholic, but doing so often is certainly a risk factor for the development of the disease.
There is evidence that there is a genetic factor involved in alcoholism, which can be sought by analyzing the family history of several alcohol-dependent patients.
Children of alcoholic parents are more likely to develop the disease. When a univitelino twin (equal) manifests dependence, most likely the other will manifest as well.
Problems with mental health
Because of the need for escapism, impulses, and difficulties in dealing with what one feels and thinks, people with mental disorders are more likely to become dependent on alcohol and other drugs, including illicit drugs.
Several theories of psychology also believe that the habit of drinking is associated with bad experiences in childhood, especially during breastfeeding, when the child’s pleasure was about the sensations received in his mouth. These traumas also have repercussions on several traits of the personality of the individual and, often, alcoholism is only a consequence.
Early contact with alcohol
A large portion of people has their first contact with alcohol as a teenager.
Researchers at the National Institute on Alcohol Abuse and Alcoholism(NIAAA) found that people who started drinking before age 15 were 50 percent more likely to become dependent on alcohol in adulthood.
Similar results were found for those who started drinking between the ages of 15 and 17.
Alcoholism is more common in men, although it affects women as well.
It is believed that this is due to cultural aspects, such as repression for women not to drink, and physical – women, because they have lower body mass, tend to feel more negative effects of alcohol use, which reduces the chance of developing tolerance.
Alcoholism, as well as several diseases, has phases. The first one is the quiet one, and many of us have passed. It starts to complicate when we go to the second. Understand:
Immediately after the first contact with the alcoholic beverage, the adaptation phase occurs. It is in her that one begins to drink to socialize, to be part of the Galera, finally, to use the drink as a crutch to have a social life.
Many teenagers take full advantage of this phase because of the inhibitory effects of alcohol, which help them alleviate the anxiety and distress of this phase of life.
When the central nervous system adapts to alcohol, the individual does not feel much of its effects. It is the case of that guy who always fills his face and never gets drunk, besides bragging that he is not knocked over by the drink.
For it is well at this stage that erasures appear, or blackout syndrome, characterized by amnesia of the moments in which it was under the effect of alcohol.
Addiction and withdrawal syndrome
At this stage, there are physical withdrawal symptoms when you spend too much time without drinking. Thus, the individual continues drinking to get rid of these symptoms, is a true drug dependent. It is at this stage that physical, mental and social deterioration begins in a more visible way.
In general, it is at this stage that health problems related to excessive alcohol consumption begin to appear.
Like any disease, alcoholism also brings with it symptoms. Often, these symptoms are only noticed by the people who live with the dependent, who tends to deny their need.
In general, alcoholics:
- They drink alone and for no apparent reason;
- They continue to drink, even if they are losing important things: family, employment, among others;
- They lose their job or school year;
- They get aggressive when they drink;
- They can not go a day without drinking alcohol;
- Having started drinking, has difficulty stopping;
- They drink more and more to keep the concentration of alcohol in the body;
- They may present with paranoia and hallucinations;
- They always have an excuse to drink;
- They move away from friends, family, and social events to drink;
- They avoid going places where they can not drink;
- They try to hide the exaggerated consumption of alcohol;
- They eat poorly, or they stop eating;
- Have tremors and withdrawal symptoms when they spend a lot of time without drinking alcohol;
- They lose memory.
If you have noticed any of these behaviors in a friend, family or acquaintance, try to talk openly about this problem without repression. Offer help, but do not force it.
Chronic drinkers suffer from severe symptoms if they stay too long without drinking. It is because to compensate for the depressant effect of alcohol, the brain increases activity in excitatory circuits.
By spending a lot of time without drinking, the brain overloads with the excitatory activity of these circuits, which do not find the resistance of the alcohol depressant action, and can cause numerous symptoms. Are they:
- Nausea and vomiting;
- Excessive sweating;
- Insomnia ;
- Increased body temperature.
Delirium tremens: withdrawal with hallucinations
Delirium tremens is the name given to a kind of psychotic episode caused by abstinence from alcohol in alcoholic patients. It usually occurs about 3 days after the first withdrawal symptoms, and the episode can last for several days.
The main symptom of delirium tremens, which differs from the common abstinence crisis, is mental confusion. In these cases, the alcoholic can present:
- Disorientation temporal space;
- Intense anxiety;
- Delusions (unreal and irrational beliefs);
- Visual, tactile and auditory hallucinations;
When a patient is in this state, he should be taken to a hospital for medical care. It is often treated with anxiolytic medications with anticonvulsive properties, such as benzodiazepines and barbiturates, and anticonvulsants.
This episode is most often seen in people who quit after consuming large amounts of alcohol for more than a month.
Mortality during the state of delirium tremens ranges from 15% to 40%. In most cases, this is due to convulsions, which can be very violent.
According to the speed at which the person drinks and the amount of alcohol consumed, it accumulates in the bloodstream, initiating the process of intoxication. The real name of drunkenness is “alcohol intoxication.” That is, every time you go out with your friends to drink and “go crazy,” you are going out to intoxicate your body with a drug. Does not sound so cool.
Intoxication occurs when the levels of ethanol in the body pass from a certain point, which generates their effects. Symptoms depend largely on the amount of alcohol ingested, but the most common are:
- Difficulties with motor coordination;
- Facial flushing;
- Speaks swept;
- Difficulty to assess situations and risks well (impulsivity);
- Nausea and vomiting;
- Diarrhea ;
- Headache ;
- Difficulty breathing;
- Altered perception.
Alcoholic amnesia ( blackout syndrome )
After a long night of drinking, your friends keep talking about the things you did last night, and you do not remember anything. Sound familiar?
It is blackout syndrome, a kind of amnesia caused by alcohol intoxication. This is because the substance interferes precisely in the circuits of neurons responsible for storing new information. The brain stops recording what happens.
Various effects of ethanol depending on the concentration of the substance in the blood. The more alcohol, the more dangerous its consequences. Below is an explanation of the drunkenness stage and its consequences.
It is worth remembering that some people need less and others to reach a certain stage.
When there is between 0.1 and 0.3 g / L of alcohol in the blood, the individual has a subclinical picture – with no health consequences – and normal behavior.
Occurs when the blood alcohol concentration is 0.3 and 0.9g / L. At this stage, the individual presents a slight euphoria, becomes more talkative and friendly.
There is an increase in self-confidence, disinhibition, decreased attention, judgment, and a little bit of control over oneself. Here begins the impairment in motor coordination, giving that slight sensation of dizziness.
The peak of excitatory activity after alcohol consumption occurs at a concentration of 0.09 and 1.8 g / L. There is an attenuation of the inability to judge, in addition to already there are damages in the memory, understanding, and perception of the things around.
The individual has a less sensitive response, i.e., feels less physical sensations, and reactive responses (ability to react to some event) slow down. The peripheral vision is smaller, and the person tends to see blurred or double.
Balance and motor coordination are affected; there is greater difficulty in standing up and making precise movements. At the end of this stage, drowsiness starts to show.
The period of confusion is between 1.8 and 2.7 g / L of alcohol in the blood. It is characterized by disorientation, mental confusion, and sometimes numbness. Emotions are exaggerated, visual perception of shape, color, and size is impaired, and there is worsening of motor coordination.
The speech is drawn, and it becomes difficult to understand what the individual is saying. Also, it may present apathy and lethargy.
This stage approaches the loss of consciousness, with motor functions extremely impaired. There may be vomiting, urinary and fecal incontinence, and poor response to stimuli. Often, the individual can not even stand, who will say walk. The stupor happens in concentrations between 2.7 and 4.0g / L.
Characterized by loss of consciousness, coma occurs at concentrations of 4.0 and 5.0g / L in the blood. The reflexes are so few that they do not seem to exist, body temperature is below normal, there are incontinence and impairment of breathing and blood circulation.
It is the last stage before death.
At concentrations above 5.0g / L, death occurs through central respiratory blockage: the brain stops sending messages to the lungs to breathe.
We know that it is very difficult to diagnose the alcoholic, not because the symptoms are unclear, but because they are very reluctant to admit that they have a problem and seek help. Unfortunately, some people need a complication to occur before running after their health. It is the case with many alcoholics.
No laboratory or imaging exam is capable of diagnosing the disease. Instead, many psychiatrists use questionnaires and are based on the diagnostic criteria of the International Code of Diseases (ICD).
Diagnostic criteria of ICD-10
According to the 10th edition of the ICD, the diagnosis of alcohol dependence is given when the individual has felt or exhibited at least 3 of the following conditions in the last 12 months:
- A strong desire or compulsion to consume alcohol;
- Difficulty controlling the behavior of consuming alcoholic beverages in terms of beginning, end or levels of consumption;
- State of physiological abstinence by ceasing or reducing the use of the substance or its use to relieve withdrawal symptoms;
- Evidence of tolerance: the individual increasingly needs larger doses to achieve the effects of alcohol;
- Progressive abandonment of activities and other interests to the detriment of the drink, besides the greater amount of time necessary to recover from the effects of the same;
- Persistence in alcohol consumption, even with clear evidence that this is harming your health, your mood, and cognition.
The CAGE questionnaire
One of the questionnaires to diagnose alcoholism is CAGE, developed by Mayfield et al. The acronym CAGE is related to the key words of each question. In all, there are 4 questions:
- Have you tried lowering or cutting (” cut down”) the drink?
- Have you ever been bothered or angry ( ” the annoyed”) with others for criticizing their way of drinking?
- Have you ever felt guilty (” g uilty”) for your drinking?
- Have you had to drink to ease the nerves (stress/strain) or reduce the effects of a hangover ( ” and eye-opener”)?
If there are positive answers, even though there is only one, there are signs that one can have problems with alcohol — the more positive responses, the greater the chances of being alcoholism.
Michigan Detection of Alcoholism Test, short version
Developed by Pokorny and coworkers, the short version of the Michigan Alcoholism Detection Test consists of 10 questions that can be answered “yes” or “no” and receive a score. Check the table below:
|Do you consider yourself to be a normal drinker?||0 points||2 points|
|Do your friends or relatives think you drink normally?||0 points||2 points|
|Have you ever been to an Alcoholics Anonymous (AA) meeting?||5 points||0 points|
|Have you lost friends or boyfriend/girlfriend because of the drink?||2 points||0 points|
|Have you ever had work/employment problems because of drinking?||2 points||0 points|
|Have you abandoned your obligations, your family or your job for 2 or more days then because of the drink?||2 points||0 points|
|Have you ever had delirium tremens, tremors, heard voices, seen things that were not there after drinking too much?||2 points||0 points|
|Have you ever looked for some help because of the drink?||5 points||0 points|
|Have you ever been hospitalized for drinking?||5 points||0 points|
|Have you ever been arrested or fined for drunk driving?||2 points||0 points|
If in answering all these questions, the sum is less than or equal to 3, there is nothing to worry about. If the sum is 4, there are signs of problems with alcohol – but not yet alcoholism – and above 5, one can think of alcoholism.
Unfortunately, alcoholism has no cure. There is the only remission of symptoms, but the alcoholic can never take a sip of alcohol. The treatment process is complex and time-consuming but can be done safely when accompanied by trained professionals. Know more:
The first stage of treatment is detoxification, in which the patient enters a period of alcohol withdrawal. It should be done with the follow up of a psychiatrist and may need hospitalization.
During this period, the physical and mental damages of the consumption of alcohol in great amount and by so much time are evaluated.
Sometimes your doctor may prescribe medications to aid in detoxification. They work by controlling impulsivity and giving unpleasant sensations when consuming alcohol, for example.
After detoxification, psychotherapy is the next step in remission of symptoms. The most used approach in these cases is Cognitive-Behavioral Therapy (CBT), which involves learning techniques to avoid relapses, as well as helping to change habits and thoughts that can trigger drunkenness.
Other psychotherapeutic approaches such as psychoanalysis and gestalt therapy may also help, especially if the drinking habit is associated with other mental disorders.
Although individual psychotherapy helps, some studies show that group therapy is more effective in preventing relapse, changing habits and social situations. There are many clinics and programs specialized in recovering alcoholics.
Perhaps the largest organization for alcoholism recovery in the world, Alcoholics Anonymous (AA) is a volunteer community that promotes meetings of abstinent alcoholics to achieve and maintain sobriety.
Born in the United States, AA is easily found in many cities around the world, under the premise of maintaining sobriety and anonymity. The institution is maintained through donations from its members and does not accept funding from any other source.
To help in the detoxification phase, your doctor may recommend some medications. Are they:
- Disulfiram : This drug promotes an unpleasant sensation if the individual ingests any minimal amount of alcohol, creating an aversion to alcoholic beverages;
- Naltrexone: Helps reduce compulsivity and the urge to drink;
- Acamprosate: The mechanism of action of this drug is not exactly known, but it is believed that it restores the chemical balance impaired by the use of alcohol;
- Sodium oxybate Improves the neurotransmission of GABA and lowers glutamate levels, aiding in the detoxification period.
NEVER self-medicate or stop using medicine without first consulting a doctor. Only he can tell which medication, dosage and duration of treatment are most appropriate for your specific case. The information contained in this site is intended only to inform, not intended in any way to replace the guidelines of a specialist or serve as a recommendation for any treatment.
Always follow the directions on the package leaflet and, if symptoms persist, seek medical or pharmaceutical advice.
Alcohol is a major risk factor for the development of several diseases; many of them very serious. Always pay attention to the health of that loved one who has or has problems with alcohol, since many diseases can lead to death.
Some of the main consequences are:
Damage to the nervous system
Exaggerated consumption of alcohol is related to damage to both the central and peripheral nervous systems. When it comes to the CNS, substance abuse can lead to dementia, while in the peripheral there is a possibility of decreased sensitivity and muscle strength of the legs.
Gastritis and ulcers
Not infrequently, alcohol leads to erosion of the stomach walls, triggering inflammation of the stomach mucosa ( gastritis ), as well as gastric ulcers, wounds that may develop in the stomach, esophagus, or intestine.
The liver is the organ that most suffers from the aggressions of alcohol.
It begins with a simple accumulation of fat in the liver, which soon progresses to hepatitis (inflammation) and fibrosis, by an attempt to defend the liver. Gradually, the situation worsens until cirrhosis, a disease characterized by scars and liver failure.
Pancreatitis and diabetes
The aggression of alcohol through the digestive tract can also cause inflammation in the pancreas. This inflammation can lead to the destruction of pancreatic tissue, along with insulin-producing cells. In this way, diabetes can also develop.
Because alcohol affects the absorption of some nutrients, it is common for alcoholics to also suffer from Wernicke-Korsakoff syndrome. This disease is characterized by a lack of vitamin B1 (thiamine), causing paralysis of some muscles, ophthalmic problems, and mental state disorders.
Alcohol also causes changes in blood circulation, which can lead to diseases such as hypertension ( high blood pressure ) and increase the risk of stroke.
By altering liver function, alcohol abuse harms cholesterol levels in the bloodstream. In this way, cholesterol can accumulate in the walls of the arteries, leading to hardening and narrowing of the same. This condition is called atherosclerosis.
Frequent alcohol consumption is a major risk factor for the development of cancer, especially in the digestive tract, which involves the mouth, esophagus, stomach, intestines, and liver. However, the risks of cancer are not limited to this route and may increase in other organs as well.
Fetal Alcohol Syndrome
Alcoholic women of childbearing age should be very careful not to become pregnant until they are fully abstinent. It is because alcohol consumption while pregnant, regardless of amount, causes damage to the fetus, leading to congenital malformations.
The alcoholic can also suffer from many social problems by not being treated.
Not infrequently, the dependent end up lacking at work, school, college or other occupations, because they are places where they can not drink, or because of hangover symptoms. It can lead to unemployment.
Interpersonal relationships are in the background, and many end up being undone. The alcoholic can end up becoming violent, both when drinking and when he is abstinent. Family and friends may abandon him, or he may end up leaving the house to devote himself entirely to the drink, going to live in the street.
Through both acute intoxication and complications, alcohol leads to death. While accumulation above 5g of alcohol per liter of blood can lead to respiratory arrest, several diseases caused by alcohol easily lead to death.
After a few months or years without drinking anything, comes the news: the alcoholic in remission has returned to drinking. It is a horrible situation in which the individual himself feels a failure and the people around him may end up disappointed instead of understanding.
Some tips for doing when this happens are:
- Understand that relapses are part of the recovery process and one should not blame or judge the individual who, in the end, was only seeking to alleviate the bad feelings that come along with abstinence;
- When the individual shows irritability, misses support group meetings, seems frustrated, and performs poorly at work and school, he may be relapsing. In such cases, it is important to seek help as soon as possible;
- Encouraging the dependent on creating new healthy habits helps keep you busy with other things, avoiding a relapse;
- Physical exercises are great substitutes for alcohol, since they release neurotransmitters related to pleasure in the brain, avoiding feelings like anxiety and anxiety caused by abstinence;
- Avoid situations that remind you of addictions: parties, people involved in addictions, celebrations where there are drinks, etc .;
- Encourage new friendships, healthy relationships with people who have good habits and, especially, do not drink;
- In case of relapse, encourage the dependent on returning to the clinic. Leaving as is and pretending that everything will be fine only makes the situation worse;
- Assist the patient in a reorganization of their routine, with new activities such as a new job, courses, therapies, among others. Keeping the mind occupied is important to resist temptations;
- Encourage the alcoholic to never give up the professional follow-up, since many cases of remission, when they stop therapy or support groups, return to drinking;
- The support of family and friends is indispensable for a good recovery. Never rebuke the alcoholic, especially after relapses, and always show support and affection.
Taking into account that alcohol dependence is triggered mainly by its chronic use, the best way to prevent the problem is to keep away from drinks always.
It does not matter if it is at a party, or only once a week: individuals predisposed to the problem should avoid drinking alcoholic beverages.
If you have no family history of alcoholism in the family, that does not mean you are free to drink as much as you want. If you drink, the ideal is to stay within the healthy level stipulated by the WHO of a maximum of 1 drink per day for women and, for men, 2 drinks.
No matter how much one denies, a diagnosis of alcoholism is a serious thing. Often, the individual takes too long to seek help because he denies having any problem with alcohol.
If you know someone who can not stop drinking, or if you identify yourself with those symptoms, get help! Treatment can greatly improve your quality of life and social aspects.
Share this text with your friends and family so that more people can identify and help an alcoholic! Any questions, you can ask that we will respond with pleasure.