Chronic alcoholism: risk factors, stages, treatment at home and inpatient

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In the International Classification of Diseases, chronic alcoholism occupies the same position as drug addiction. The disease is extremely serious and difficult to treat.

Chronic alcoholism

The term "chronic alcoholism" means a disease. But this illness is caused not by some inexplicable external factors, but rather by internal causes sitting in the sick person. The main thing that distinguishes this disease from a banal bad habit is non-stop drinking, uncontrollable craving for drinking, obvious negative changes in the psycho-emotional sphere and defects in internal organs.

In fact, not everyone from moderately drinking people can become an alcoholic. Why is one person able to drink on holidays with his family and friends all his conscious life and at the same time not reach the state of alcoholic idiot, drunk with alcohol, and another sleeps in the shortest possible time?

Domestic narcologists distinguish 8 risk factors for the progression of chronic alcoholism:

1. Severe abuse. People who drink moderately and not too often, usually do not suffer from alcoholism in general. Narcologists recommend drinking no more than one glass of light alcohol per day to women and no more than two to men. In terms of more strong drinks - men are allowed to consume about 75 ml of vodka, women - no more than 50 ml.
2. Tolerance to ethanol. Many boast of the ability to drink and not get drunk, but this is an alarming sign: the body needs a much higher dose to get euphoria than it can take without consequences for itself. Accordingly, alcohol enters the body more, intoxication becomes stronger. Each time the dose becomes even higher, thus, alcoholism develops.
3. Early start. Those who started drinking early, risked the same early and ignominiously finish their mediocre life. Young people consider drinking a sign of adulthood and coolness, they drink beer and cocktails, without thinking that they have all chances to become chronic alcoholics after 5 years.
4. Long-lasting emotional experiences. The emergence and prolonged course of such disorders as depression, asthenic syndrome, hypochondria, bulimia, anorexia increase the risk of the patient in the development of alcoholism. In parallel with the rapid development of chronic alcoholism, the disease itself is progressing.
   Severe heredity, aggravated by psychological trauma, the presence of alcoholics in the family.
5. Circle of communication. Constant libations in the environment of people who drink on and without a reason people greatly increase a person's chances of alcoholization. In the case when the bulk of people surrounding the individual regularly drink alcohol, it is almost impossible for him to resist such a powerful influence. To remove such a risk factor is quite simple - to change the circle of communication to non-drinkers.
6. Chronic diseases. The rapid development of alcoholization is often facilitated by diseases associated with metabolic disorders or the excretion of products of vital activity.
7. Life is in a state of chronic stress. The impossibility of proper rest and relaxation causes neuropsychiatric disorders, on the basis of which various dependencies begin to blossom in different colors - from caffeine and nicotine to alcohol and drugs. Together with other risk factors, stress is quite capable of provoking domestic drunkenness and its transient transition to the stage of chronic alcoholism.

Why alcoholism is considered a disease:

Stages of development of the disease

The term "chronic" means the progression of any illness for a long time. Alcoholic disease has only 3 stages - the initial, medium and heavy. Each degree has its own peculiarities of course and occurrence of complications.

Do not forget about the so-called preliminary stage - prodromal, when there is no alcoholism as such, but all the prerequisites for it already exist. This is the stage of easy domestic drunkenness - the period when a person drinks infrequently, situationally. There are no consequences in the form of loss of memory or consciousness, but the person of the person slowly but surely changes, alcoholic values ​​are formed, a new circle of communication appears.

Waiting for booze brings a sense of joy, an easy euphoria. There is no strong craving for alcohol in the prodromal phase, the patient can stop drinking alone, without the help of an expert in narcology. With periodic abuse and the presence of the circumstances mentioned above, the prodromal stage after a couple of years entails the development of alcoholic illness.

Initial or neurasthenic

This stage can last from three to ten years. For this period is characterized by an increase in craving for alcohol, and this manifests itself already during drinking. To track the amount of alcohol consumed the patient is not able to, tolerance to alcohol is increased, but so far the control over his behavior remains.

Characteristic symptoms of the first stage are:

• no vomiting during drinking;
• short-lived dips in memory after taking a large dose of alcohol;
• increase in resistance to ethanol;
• long time intervals associated with drunkenness;
• increases mental dependence on alcohol, expressed in the pleasure of memories of drunken state of health, the justification of their behavior by a drunken state, aggression against those who condemn, anger and nervousness when in a sober state.

Hangover syndrome at this stage is not expressed clearly, and beginners can quite cope with it, without resorting to alcohol.

Average

Medium or 2nd degree - addictive, can last from five to fifteen years. This phase is characterized by the development and deepening of the manifestations of the neurasthenic stage, and new symptoms also appear.

Tolerance to ethanol is progressing, the patient can drink up to one and a half liters of vodka at a time. The pathologies of mental states continue to develop - nervousness, aggression, inability to concentrate and perform mental work. As a consequence - a strong irresistible craving for alcohol. The second stage is characterized by outbreaks of alcoholic psychosis, white fever, especially when in abstinence. All this requires a serious treatment, both medical and psychological.

The distinctive signs of the second phase in both men and women:

• The emergence of abstinence due to prolonged poisoning of the body with the products of the decomposition of ethanol.
• Alcohol abstinence is characterized by such signs as hand tremor, severe thirst, tachycardia, lack of appetite, headache. In patients, psychoses and hallucinations are not uncommon.
• All the free time the patient spends on alcohol, its purchase, use and drunken sleep.
  the formation of binges.

Severe or encephalopathic

For this, stage 3, the following characteristics are typical:

• Reduced tolerance to alcohol. Alcoholic gets drunk even from one pile of vodka.
• Prevailing binges - the situation of non-stop uninterrupted drunkenness. Being in constant drinking, the patient still continues to feel the need to drink alcohol. Bleeding is interrupted due to complete intolerance to alcohol. With the cessation of drinking, manifestations of withdrawal are very strong. After a few days or weeks of forced sobriety, the alcoholic again feels the urge for alcohol and begins to drink.
• Complete personality rebirth. In chronic patients, the circle of interests sharply narrows, there is no desire to communicate with people, such qualities as falsity, boastfulness, tactlessness appear, there are serious disorders of thinking.
• Dangerous diseases of internal organs, namely: polyneuropathy, encephalopathy, serious liver pathology, alcoholic cardiomyopathy, early dementia.

At the final stage of the disease, life expectancy is no more than five years. Death comes from irreversible changes in the body of a chronic alcoholic( psychosis, Wernicke's encephalopathy), and from concomitant diseases( liver cirrhosis, stroke, myocardial infarction, etc.), and also from an antisocial lifestyle.

Treatment

Unfortunately, the diagnosis of chronic alcoholism is a serious and often incurable disease. A rare alcoholic in the second-third stage succeeds on time and quit drinking independently. Most doctors rightly believe that alcohol can not be completely defeated, there are only long periods of remission. Sometimes these periods last for many years, the patient does not break, but the craving for the green snake still sits deep in his subconscious.

The process of achieving remission consists of several stages.

Withdrawal from drinking-bout

Withdrawal from drinking-bout and withdrawal of abstinence syndrome is the stage that is best spent in the hospital, where everything is needed for resuscitation, favorable conditions for the patient and medical staff are created. The patient is prescribed psychostimulants, sorbents, analeptics and vitamins to improve the physical condition. Dosage is determined individually and depends on the severity of the patient's condition.

Restoration of the body

Elimination of the results of the drinking period - at this stage of the treatment, doctors are trying to partially restore the alcoholic alcoholic and alcoholic alcohol lost as a result of alcoholic libations.

The following drugs are used in treatment:

• Nootropics for improving blood supply and brain nutrition, improving memory and activating thinking - Nootropil, Biotretdin.
• Antidepressants - drugs that relieve anxiety, irritability, chronic fatigue, contribute to mild relaxation and removal of the patient from depressive conditions associated with the refusal of alcohol - Desipramine, Sinekwan, Paroxetine.
• Anticonvulsants, such as Finplepsin, help cope with seizures during abstinence.
• Hepatoprotectors for restoration of liver function.
• Neuroleptics - drugs of this group contribute to the normalization of the state of alcoholic delirium.
• Vitamin-mineral complexes for the restoration of mineral balance in the body.

At this stage it is important not to engage in self-medication, it is necessary to listen to the attending physician and exactly follow its recommendations. Uncontrolled use of strong tranquilizers or antidepressants may lead to the development of other, more severe addictions.

Treatment of psychological dependence

Such treatment can be carried out both in a hospital and at home. At this stage, the patient is very important psychological support from close relatives, friends and necessarily require the help of a psychotherapist.

To support a sober state for a long time narcologists offer various sensitizing techniques aimed at causing physical aversion to alcohol. This includes the administration of disulfiram-based drugs( Esperal, Torpedo) and sodium cyanide( Tempisol), and the use of drugs that reduce cravings for alcohol( Colem), and the administration of opioid receptor antagonists( Vivitrol, Naltrexone).All these methods are good with the patient's firm desire to stop drinking alcohol. If there is no such desire, then one coding for curing and achieving a long-term remission will not be enough.

Rehabilitation

The former alcoholic to maintain a sober lifestyle simply needs to build a new life position, finding interesting activities not related to drinking, finding a sense of life. At the stage of rehabilitation, a new interesting hobby can help a patient, who needs to devote a lot of time - fishing, hunting, sports. An important role is played by social adaptation in society, interesting work and relationships in the family.