What is too much to drink, how to drink moderately or not to drink at all - what to 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 in medicine is often considered 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 total population (including minors and the elderly) to 10-15% of the adult population. In this regard, many people have a question: "Is alcohol consumption so harmful, if it is so common, and the doctors themselves, who constantly talk about its harm, are hardly sober? " Therefore, the purpose of this article is not only to talk aboutthe real dangers and harms of excessive alcohol consumption, but also about what it means to consume it with minimal health risk.
Alcohol abuse
Let's start with some important definitions. What is alcohol consumption, abuse and alcohol addiction? In itself, alcohol consumption, 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, thinking. This is why alcohol is called a psychoactive substance, which includes 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 humans. Abuse is understood as a type of consumption that damages a person's physical (increased pressure, damage to the liver, heart and nerves) and psychological health (insomnia, depression, anxiety), and can disrupt professional (dismissal), family (divorces, scandals) and public (arrests, drunk driving) a person's life.
Abuse is already a painful condition and requires the intervention of a doctor, but, 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, the same as anxiety or depression, in the presence of which a person needs the help of other doctors - narcologists or psychotherapists.
Alcohol addiction includes a combination of disturbances in behavior, thinking and physical functions of the body that occur 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, overeating"); desire or unsuccessful attempts to reduce or control drinking; withdrawal state (withdrawal syndrome, "wasting") when you stop or reduce alcohol intake and alleviate thisthe state when you drink; tolerance - a gradual increase in the amount of alcohol consumed; ignoring other interests and increasing the time you drink; and, finally, continuing to drink despite their obvious harm to your health. The diagnosis of addiction can be made if three or more of these signs are present during oneof the month in the past year (eg weekly one-day binge drinking on Fridays after work or four weekly binges per year).
If in a society 5 to 10% of the population abuses 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 alcohol consumption is detected. According to the definition of the WHO, excessive (dangerous or risky) alcohol consumption is considered to be those levels or types of alcohol that, if continued, will lead to damage to health (that is, what will later become abuse).
Today, it is believed that the amount of alcohol consumed directly determines the likelihood of developing various problems with alcohol (dangerous consumption, abuse and addiction), after which withdrawal from overeating may be necessary. It has been shown that non-alcoholic adults consume no more than 20 g of ethyl alcohol per day to reduce the risk of developing the problem. At the same time, alcohol consumption should not exceed 5 days a week with mandatory 2 sober days. According to WHO, 10 g of ethyl alcohol is taken equal to 1 standard unit (dose) of alcohol. One dose of alcohol is in 330 ml. 5% strength beer; in 140 ml. dry wine (9-11%); in 70 ml. fortified wine (18%); and in 35 ml of spirit (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 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 take certain medications, in many diseases and when you cannot control your drinking (ie you have one of the signs of addiction).
What problems does alcohol cause?
Problems with alcohol 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 seen at 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 was observed 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 (by 6. 5 times) increases the risk of developing alcohol addiction and associated somatic diseases. Thus, you can calculate the amount of alcohol consumed in the last 7 days, which can be considered as an indicator of average alcohol consumption in general. And then you can assess how much risk your drink brings you, as well as whether it is already painful.
In addition to the amount of alcohol consumed, the probability of an individual to develop alcohol abuse and addiction is influenced by hereditary, personal and social factors; they are also called risk factors. Hereditary (genetic) risk factors include alcohol addiction in parents (risk increases by 3-4 times) and other addictions (drug addiction - risk increase by 4-5 and mother's smoking - by 2-3 times). Currently, many genes have been identified that are responsible for the development of alcohol addiction, 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 discovered: a) unusual (slow or accelerated) metabolism (processing) of ethanol - "I quickly or completely get drunk"; b) accelerated development of tolerance - "doesn't take vodka"; c) changed reactions to alcohol (irritability, aggressiveness anddepression).
What characteristics of a person increase the risk of developing alcohol addiction? The main ones are male sex, early first drinking, young age (16-19 years), life outside of marriage (single, divorced or widowed), low income, lack of work, pension. Psychological problems that often predispose to the onset of alcohol addiction at a young age (before 25 years) are emotional instability (mood changes, irritability, aggressive behavior), altered drunkenness, hyperactivity and risky behavior (behavior in search of stimuli - gambling, many sexual relations). partners), as well as a higher level of alcohol consumption in youth.
Psychological problems that often predispose to alcohol addiction in adulthood (after 30 years) are increased levels of anxiety and depression, reduced ability to communicate (shyness), difficulty changing, fear of abandonment, avoidance of problems, lack of meaning in 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), impaired family structure and function (incomplete - For a woman).
What can be advised to a person who drinks alcohol in moderation, but has risk factors for developing alcohol addiction, i. e. can he 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 need to prevent the development of alcohol abuse and addiction, 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 related problems - 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, excessive doses are unacceptable for them.
What can be advised to a person who drinks alcohol in moderation and has no risk factors for developing alcohol addiction, but still risks becoming an alcoholic? In such persons, while 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 alcohol excesses (taking large amounts of alcohol - more than 5 doses per day for 3-7 days) or increaseamount of regularly consumed alcohol, 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 drinking 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, three or even four days a week are better. Try not to get into high-risk situations where you can lose control: in campaigns, with friends, after work, on vacation, after pay, on weekends. Try not to drink when you are bored or lonely, irritable, tense and in a bad mood, with insomnia and anxiety; and if you find yourself in such a situation - go, refuse. Try other forms of entertainment and recreation; and, most importantly, learn to say no. It is important to find those people who use moderately and who 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 for the purpose of relaxation, stress relief, entertainment); you can't control how much you suffer from a hangover the day after heavy drinking and you need a drink to improve your well-being; You need more and more alcohol to get drunk or back to "normal". It is also necessary to stop drinking if you suffer from high blood pressure (alcohol does not cure pressure, but on the contrary, it increases the risk of hypertensive crises and stroke), liver disease, pancreatitis, you take drugs that are incompatible with alcohol (antibiotics, heart drugs, pressure medication, etc. ). If you can't quit your job yourself, then don't despair, now there are enough qualified experts - psychotherapists and narcologists who will provide you with effective help anonymously: without any registration, job advertisement and driver's license suspension. 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 preservation of sobriety for a long time.