What is too much to drink, how to drink in moderation, or not to 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! ", and on the other hand, "who doesn't drink now? ". In our opinion, this is due to the fact that alcohol consumption is often considered 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 general 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, constantly talking about its harm, are not nearly so? " Therefore, the purpose of this articleit is not only to talk about the real dangers and harms of excessive alcohol consumption, but also about what constitutes its consumption with minimal risk to health.
Alcohol abuse
Let's start with some important definitions. What is alcohol consumption, abuse and 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 its ability to influence a person's mental activity: emotions, behavior, thinking. Therefore, alcohol is referred to as psychoactive substances (that act on the psyche), which also include drugs (opioids, psychostimulants and cannabis), psychotropic drugs (barbiturates, benzodiazepines) and toxic substances (glues, petrol, solvents). Alcohol and most psychoactive substances can cause abuse and dependence in humans. Abuse is understood as a type of consumption that damages a person's physical health (increased pressure, damage to the liver, heart and nerves) and mental health (insomnia, depression, anxiety), and can also disrupt professional work (discharge), family (divorces, scandals) and public life (arrests, drunk driving) of a person.
Abuse is already a painful condition and requires the intervention of a doctor, but, more importantly, at this stage it can 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 involves a combination of disturbances in behavior, thinking and physical body functions that develop after repeated use of alcohol. The main symptoms of alcohol addiction are a strong compulsion to "drink" ("craving"); violation of the ability to control alcohol intake (beginning and end of drinking and dosage) ("unbridled, binge"); desire or unsuccessful attempts to reduce or control drinking; a withdrawal state (withdrawal syndrome, "residue") when you stop or reduce alcohol intake and relieve this state when you drink; tolerance - a gradual increase in the dose of alcohol consumed; ignoring other interests and increasing drinking time; and, finally, the continuation of drinking to their obvious detriment to health. A diagnosis of addiction can be made if three or more of these signs are present within one month of the past year (eg, heavy drinking one day a week on Fridays after work, or binge drinking for four weeks a year). .
If in society 5 to 10% of the population abuse alcohol and another 4% of the population (2% of women and 6% of men) are addicted to alcohol, then in the rest of the population, about 10-20%more. detect excessive alcohol consumption. According to the WHO definition, excessive (hazardous or hazardous) alcohol consumption is considered to be those levels or types of alcohol that, if continued, will lead to harm to health (i. e. to what will laterbecomes abuse).
It is now believed that the amount of alcohol consumed directly determines the possibility of developing various alcohol problems (hazardous consumption, abuse and dependence), after which withdrawal from binge drinking may be required. Non-alcoholic 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 sober days. According to WHO, 10 g of ethyl alcohol is equal 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 alcoholic drink (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 cannotcontrol the drink. (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 drinking.
A low risk of alcohol problems is observed 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 observed with 25-35 doses per week for men and 15-25 doses for women. A high risk of alcohol problems is seen when more than 35 drinks are consumed per week for men and more than 25 for women. A further increase in consumption indicates abuse and sharply (by 6. 5 times) increases the risk of developing alcohol dependence and associated somatic diseases. Thus, you can calculate the amount of alcohol consumed in the last 7 days, which can be considered an indicator of average alcohol consumption in general. And then you can assess how much danger drinking brings you, and also 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; also called risk factors. Hereditary (genetic) risk factors include alcohol addiction in parents (the risk increases by 3-4 times) and other addictions (drug addiction - an increase in risk by 4-5 and maternal smoking - by 2-3 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 personality of the person and his 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 completely drunk"; b) accelerated development of tolerance - "doesn't take vodka"; c) altered reactions to alcohol (irritability, aggression and depression).
What characteristics of a person increase the risk of developing alcohol dependence? The main ones are male sex, early first drinking, young age (16-19 years old), 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, having many sexual partners), as well as higher levels of alcohol consumption at a young age.
Psychological problems that often predispose to the development of alcohol dependence in adulthood (after 30 years) are increased levels of anxiety and depression, impaired ability to communicate (shyness), difficulty changing, fear of abandonment, avoidanceof problems, lack of understanding about existence and perspectives. Social risk factors for alcoholism include the high level of family stress for women and work stress for men, low social status of the family (poverty, poor housing conditions), disruption of family structure and function (incomplete- for women).
What can be advised to a person who drinks alcohol in moderation, but has risk factors for developing alcohol dependence, d. m. th. can one become an alcoholic?
In these people, even moderate-risk alcohol consumption can cause the same problems as low-risk alcohol consumption in people without these factors. Therefore, they must prevent the development of alcohol abuse and dependence, and this can only be achieved by constantly 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 who do not have these hereditary, personal and social risk factors. Therefore, for them, excessive doses are unacceptable.
What can be advised to a person who drinks alcohol in moderation and who 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 factors (layoff, divorce, retirement) or internal (illness, anxiety and depression), and if they allow alcoholic excesses (taking large amounts of alcohol - more than5 doses per day for 3-7 days) or increase the amount of alcohol consumed regularly, dependence and abuse can develop within 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 non-alcoholic beverages; 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 best. Try not to get into high-risk situations where you might lose control: on campaigns, with friends, after work, on vacation, after pay, at the weekend. Try not to drink when you are bored or lonely, 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 say no. It is important to find those people who use in moderation and are willing 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 his relatives do with an already existing addiction to alcohol (alcoholism)?
Cessation of consumption is necessary if you have a frequent desire to drink (even if for the purpose of relaxation, stress relief, entertainment); can't control how much you're hungover the day after heavy drinking and need a drink to improve your well-being; You need more and more alcohol to get drunk or "normal". It is also necessary to stop drinking if you suffer from high blood pressure (alcohol does not cure the pressure, but, on the contrary, increases the risk of hypertensive crises and strokes), liver diseases, pancreatitis and take medications incompatible with alcohol (antibiotics, medicationsfor the heart, blood pressure medicine, etc. ). If you can't leave it alone, then don't despair, now there are enough qualified specialists - psychotherapists and narcologists who anonymously: without any registration, job advertisement and driver's license suspension, will provide you with effective help. 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 again in society like everyone else is 100 grams", but the effective maintenance of sobriety for a period oftall.