What is too much to drink, how to drink in moderation, or should you not drink at all - what should you choose?
In our society, there is a two-sided 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: norm (sobriety) and disease (alcohol addiction). At the same time, teetotalers 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 are constantly talking about its harm, it can be said that the teeth smell bad? " Therefore, the purpose of this article is only the real dangers of excessive alcohol consumption. and not to talk about the harm, but also what is its consumption with minimal health risk.
Let's start with some important definitions. What is alcohol consumption, abuse and alcohol dependence? Alcohol consumption in itself, 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 affect a person's mental activity: emotions, behavior, thoughts. Therefore, alcohol is called psychoactive substances, which also include narcotics (opioids, psychostimulants and cannabis), psychotropic drugs (barbiturates, benzodiazepines) and toxic substances (glue, gasoline, solvents). Alcohol and most psychoactive substances can lead to abuse and dependence in humans. Abuse is understood as a type of consumption that harms a person's physical (increased blood pressure, damage to the liver, heart and nerves) and mental health (insomnia, depression, anxiety), as well as disrupts professional activity (dismissal), family (dismissal). divorces, scandals) and social (arrests, drunk driving) life of a person.
Abuse is already a painful condition and requires the intervention of a doctor, but most importantly at this stage it can also be a general therapist or a neurologist with skills in short-term intervention for alcohol problems. Alcohol addiction is already a disease 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 functions of the body 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) ("no brakes, brakes"); desire or unsuccessful attempts to reduce or control drinking; the withdrawal state (withdrawal syndrome, "waste") when you stop or reduce alcohol intake and relieve this state during drinking; tolerance - a gradual increase in the dose of alcohol consumed; ignoring other interests and increasing drinking time; and finally, the continuation of drinking with its obvious harm to health. Addiction can be diagnosed when three or more of these symptoms are present during the past month (for example, heavy drinking once a week on Fridays after work or four weeks of heavy drinking per year).
If 5-10% of the population in a society abuse alcohol and another 4% of the population (2% of women and 6% of men) are dependent on alcohol, there is about 10-20% more abuse among the rest of the population. detect alcohol consumption. According to the WHO definition, excessive (hazardous or risky) alcohol consumption is considered to be levels or types of alcohol that, if continued, would harm health (ie, subsequently develop into abuse).
It is now believed that the amount of alcohol consumed directly determines the likelihood of developing various alcohol problems (hazardous consumption, abuse and dependence), after which abstinence may be required. To minimize the risk of developing problems, non-alcoholic adults have been shown to consume no more than 20 g of ethyl alcohol per day. At the same time, alcohol intake should not exceed 5 days a week with mandatory 2 sober days. According to WHO, 1 standard unit (dose) of alcohol equals 10 g of ethyl alcohol. There is one dose of 330 ml of alcohol. 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 an alcoholic drink in grams, you need to multiply the volume of the drink by its strength and the conversion factor of 0. 79 (0. 79 g per milliliter of pure ethyl alcohol).
However, in some cases it is not desirable to drink even one or two doses of alcohol a day: if you drive a vehicle, are pregnant or breast-feeding, while taking certain medications, with many diseases, and when you cannot control your drinking. (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 occupational, family and social consequences of excessive drinking.
3-4 drinks per day (20 per week) for men and 2-3 (15 drinks per week) for women are associated with lower risk of alcohol problems. Average problem risk is seen with 25-35 doses per week for men and 15-25 doses per week for women. Drinking more than 35 drinks per week for men and 25 drinks per week for women is associated with a higher risk of alcohol problems. A further increase in consumption indicates abuse and sharply (6. 5 times) increases the risk of developing alcohol dependence and related somatic diseases. Thus, you can calculate the amount of alcohol consumed in the last 7 days, which can generally be considered an indicator of average alcohol consumption. And then you can assess how much risk drinking brings you and whether it's painful anymore.
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 called risk factors. Hereditary (genetic) risk factors include alcohol addiction in parents (the risk increases 3-4 times) and other addictions (drug addiction - 4-5 times the risk, mother's smoking - 2-3 times). Currently, many genes responsible for the development of alcohol dependence have been identified, but they determine only 30-40% of the risk of its occurrence. These are. 60-70% of the risk of alcoholism depends on a person's personality and environment.
Genetic differences also affect the physiological and psychological characteristics of people with alcohol intake. The following characteristics were found: a) unusual (slow or accelerated) metabolism (processing) of ethanol - "I get drunk quickly or completely"; b) accelerated development of tolerance - "does not drink vodka"; c) changes in reactions to alcohol intake (irritation, aggression and depression).
What characteristics of a person increase the risk of developing alcohol addiction? The main ones are male gender, first time drinking, young age (16-19 years old), life outside marriage (single, divorced or widowed), low income, unemployed, pension. Psychological problems that often predispose to the development of alcohol addiction at a young age (before the age of 25) are emotional instability (mood swings, irritability, aggressive behavior), variable drunkenness, hyperactivity, and risky behaviors (stimulus-seeking behavior - gambling, a lot of sex). partners), as well as higher levels of alcohol consumption at a younger age.
In adulthood (after the age of 30), psychological problems that often lead to the development of alcohol addiction are increased levels of anxiety and depression, impaired communication skills (shyness), difficulty changing, fear of abandonment, avoidance of problems, lack of meaning. availability and prospects. Social risk factors for alcoholism include high stress in the family for women and work stress for men, low social status of the family (poverty, poor housing conditions), disruption of the 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 the development of alcohol dependence, i. e. can he be 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 observing the limit of moderate consumption of alcohol. Even a single dose of high-dose 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 genetic, personal and social risk factors. Therefore, excessive doses are unacceptable for them.
What advice can be given to a person who drinks moderately and has no risk factors for developing alcohol dependence, but is still at risk of becoming an alcoholic? By maintaining the same level of alcohol consumption in such people, the risk of addiction is minimal. However, if they are exposed to adverse external (dismissal, divorce, retirement) or internal factors (illness, anxiety and depression) and indulge in excessive alcohol consumption (heavy alcohol intake - more than 5 drinks per day for 3-7 days). day) or an increase in the amount of alcohol consumed regularly, dependence and abuse can develop in a short period of time.
And finally, what advice can be given to someone who is consuming dangerous or harmful amounts of alcohol? What can be said to such a patient? The advice is quite simple - try to drink less or if it doesn't help, stop drinking alcohol. How to drink less? Dilute alcoholic drinks, replace alcohol with soft drinks; eating 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; fasting 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: on campaigns, with friends, after work, on holidays, after pay, on weekends. 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, give up. Try other forms of entertainment and recreation; and most importantly, learn to let go. It is important to find people who use moderately and who are willing to support you in your efforts to overcome your alcohol problems.
The last question that this article will try to answer is: what should a person and his relatives do with alcohol addiction (alcoholism) that already exists?
If there is a frequent desire to drink (even if it is to relax, reduce stress, have fun), you should stop drinking; you can't control how much you drink, you have a hangover a day after drinking heavily, and you need a drink to improve your well-being; It takes more and more alcohol to get drunk or get back to "normal". If you suffer from high blood pressure (alcohol does not cure high blood pressure, on the contrary, it increases the risk of hypertensive crises and strokes), if you suffer from liver disease, pancreatitis, and if you are taking inappropriate medications, you should stop drinking. alcohol (antibiotics, heart medications, blood pressure medications, etc. ). If you can't quit your job yourself, don't despair, now there are enough qualified specialists - psychotherapists and narcologists, who will provide you with effective help anonymously: without any registration, job advertisement and without depriving you of a driver's license. The main thing to remember is that alcoholism is treated, but the result of its treatment is not the restoration of "ability to drink 100 grams again like everyone else in the company", but the effective maintenance of sobriety for a long time.