Alcoholism ( alcohol dependence syndrome ) - Causes, Symptoms and Treatment .MF .
Alcohol is the most common in the world of psychoactive substances.He is a fixture of festivals, ceremonial meetings, but its systematic abuse leads to the formation of alcohol dependence, which is one of the most common chronic diseases in the world and remains a global health, economic and social problem.
According to the World Health Organization (WHO), alcohol dependence is defined as a disturbance in the mental and physical condition that occurs as a result of continuous or intermittent use of alcohol.It manifests patterns of behavior, violation of disability, loss of volitional control, compelling the patient to drink alcohol for the impact on the psyche or in order to avoid unpleasant conditions at refusal of alcohol intake.Adopted by the Security
standard dose of alcohol per day is 12-14g of pure ethanol, which corresponds to 250-300 ml beer, 100-300 ml of wine or 30 ml vodka.When the dose is exceeded, unhealthy alcohol occurs, leading to the development of alcohol dependence.
unhealthy alcohol use:
1. Unsafe drinking.For women and people over 65 years of age: more than 7 standard drinks per week;for men under 65 years: more than 14 standard drinks per week.The effects of and dependence on alcohol there, but the risk of physical, mental and social threats increases.
2. Drinking alcohol with harmful consequences (synonym - inebriety).The re-emergence in the last 12 months of symptoms associated with alcohol consumption, as the inability to perform a social role in society, conflicts with the law, interpersonal problems.This entails only the consequences for mental and physical health.
3. Alcohol addiction.It complies with the following criteria: compulsive (an irresistible attraction, to realize how wrong) the need for alcohol intake;reduction of control over alcohol intake;the development of withdrawal symptoms at lower doses of alcohol or termination of its acceptance (withdrawal syndrome);increasing tolerance (to achieve euphoria required each time a large dose of alcohol).The emergence and development of somatic diseases: alcoholic liver disease with the outcome of cirrhosis, alcoholic cardiomyopathy, chronic pancreatitis, toxic encephalopathy.
Currently disorders associated with alcohol dependence, is considered as a result of the total interaction of many factors.
1. Genetic predisposition.High risk of disease (4-5) in children whose parents suffer from alcoholism, and have adopted the twins, whose parents suffered from this disease.Maybe - this is due to biochemical reactions (insufficient capacity of the liver enzyme alcohol dehydrogenase to oxidize aldehydes - decay products of alcohol).
2. Psychological factors.Individual susceptibility to alcohol, use of alcohol to relieve internal stress, anxiety, fear, raising the internal self-evaluation.
3. Social factors.Traditions of alcohol abuse in the family environment;low income levels, stress, marital disharmony.
Manifestations of alcohol dependence
The systematic abuse of alcohol over time is an increase in tolerance (tolerance) to alcohol, lost control over the amount of alcohol consumed, in order to achieve euphoria requires increasing dose;disappears protective gag reflex, and aversion to alcohol.
After binge periods of a state of alcohol withdrawal (abstinence syndrome) - a condition caused by the abrupt discontinuation of alcohol intake.It appears oppressive feeling, severe autonomic disorders: facial flushing, tremor (trembling), arms, legs, tongue, eyelids;headache, dizziness, increased blood pressure, heart attacks.It is accompanied by sleep disturbances, anxiety.Abstinence stoped taking regular doses of alcohol.
In the future status of the cancellation occurs after a small dose of alcohol, becomes more severe, up to the development of delirium (delirium tremens).With the development of delirium comes complete insomnia.There are multiple visual deceptions (hallucinations), often in the form of animals and entire scenes in which the patient feels like a party.State accompanied by a violation of orientation in space and time, the sharp motor excitation.Delirium lasts about 5 days, ending a dream, death may occur in severe cases.
may occur epileptiform seizures (alcohol epilepsy) - brief loss of consciousness, seizures.The reason for their occurrence is an organic alcohol damage to the cerebral cortex.
The character of intoxication.At the beginning of the disease, with an average degree of intoxication there is euphoria, verbal agitation, disinhibition, while the decline of intoxication - drowsiness.When alcoholism emotional background drunk alcoholic - grumpy-evil, prone to aggression from the sudden transition to a tearful state.
the course of the disease appear episodes of amnesia (loss of memory), which deepens and the patient can recall only a short period of time prior to the beginning of the booze.
Duration hangover state gradually increases, which leads to the constant use of alcohol, which is interrupted only by external circumstances.Signs of alcohol degradation personality - mendacity with characteristic understatement drunkenness sizes, rude, explosive character, loss of interest in everything except alcohol.Reduces the ethical standards they slovenly, sloppy clothing.Human relationships lose their value and meaning.Patients are deprived of a sense of responsibility for their actions.Reduced intellectual ability.
The syndrome of alcohol dependence affected all the internal organs and systems.Hard to chronic diseases occur more slowly achieved clinical benefit from the prescribed treatment.
consequences of alcoholism
consequence of alcohol are liver disease (alcoholic liver disease with the outcome of cirrhosis), pancreas disease (the development of chronic pancreatitis, secondary diabetes, pancreatic cancer), heart disease (alcoholic dilated cardiomyopathy).As a result
impaired liver damage lipid (fat) metabolism, which leads to atherosclerosis, which leads to the development of stroke and myocardial infarction, congestive heart failure.Patients observed hypertension, with frequent crises.Develops toxic encephalopathy, leading to alcoholic dementia (dementia).Violations occur in the immune system, as a consequence, increased respiratory diseases, frequent pneumonia.Disturbed sexual and reproductive function.
diagnosis of alcohol dependence has the right to deliver only the doctor - psychiatrist.The diagnostic criteria used by doctors when the disease is detected, enables us to distinguish domestic drunkenness and alcoholism.
Patient advice: neurologist, physician, psychotherapist.In identifying the pathology of internal organs prescribe the necessary range of clinical and diagnostic studies.
Treatment of alcohol dependence
Formation at the patient's motivation to complete abandonment of the use of alcohol is the most important condition for treatment .
Basic principles of treatment of alcoholism:
voluntary consent of the patient, an individual approach, carrying out complex actions.Taking into account genetic factors, family and socio-cultural traditions, personality type, the presence of comorbidity.
Early treatment necessarily carried out detoxification therapy aimed at eliminating the toxic effects of alcohol on the body, normalization of homeostasis (constancy of internal environment).The methods of detoxification (forced diuresis, hemosorbtion, plasmapheresis, gastroenterosorbtsiya, physical hyperthermia) depend on the health of the patient.They are carried out in a specialized facility.
patients with the syndrome of mild cancellation can be applied at home agents:
Medihronal .The contents of 2 packets (packet number 1 and number 2) was dissolved in 1/3 cup boiling water, take 30 minutes before eating.
Regidron .The contents of the package are dissolved in 1 liter of warm water, take in throughout the day.
volume of fluid injected depends on the health of the patient.Regimen and duration of treatment recommended by a doctor - psychiatrist.These treatments are withdrawn from the patient's binge.
also used drugs that cause discomfort (nausea, vomiting) after drinking alcohol (disulfiram), minimizes the craving for alcohol (naltrexone), they also appoint a specialist - psychiatrist.
Treatment of alcohol dependence folk remedies
applied decoctions of herbs, causing an aversion to alcohol (centaury, wormwood, lovage root, thyme herb).
Formation of motivation of refusal of alcohol
Receiving only medicines and means of herbal medicine for the treatment of dependence without motivation does not give a positive result.
Currently, the best effect is the use of combination therapy - medications prescribed under the supervision of the psychiatrist and psychological methods, carried out by psychotherapists.Often the need to change the behavior and attitudes among all the people close to the patient dependent.
frequently used and the most effective methods: cognitive-behavioral therapy (CBT), a group of Alcoholics Anonymous (12 step program).
Psychotherapists working with CBT method, the main reason for the presence of dependence is considered a person of negative attitude to yourself, to your future, to the world, the transformation of these beliefs, improving their own self-esteem, a voluntary abstinence from alcohol - is the main task of the therapist.Working with patients is carried out both individually and in groups.Apply homework to consolidate the positive changes.
most widely applicability of the method in the world - it is a group of Alcoholics Anonymous.They are in the form of meetings, where everyone can talk about their problems and share their experiences of sobriety.Most patients are denied in his addiction to alcohol and do not seek help.The main purpose of such groups is the recognition of the members of his addiction and change the dependent thinking.12 step program is designed so that people with more experience in applying its train new members.
often good psychological influence so-called "conspiracy", but only in the case when a person wants to give up alcohol addiction.
coding method alcoholics
Technique emotionally - stressful therapy (coding) is widespread in Russia and Ukraine.Its essence lies in the suggestion patient hard settings - a sense of the fear of death or fear of contracting a serious disease, if he did not stop drinking.There are different types of coding:
1. Programming for A.G.Dovzhenko method.A patient under hypnosis disgust for alcohol and a ban on its use.This method is not recognized by many narcologists, since it is not effective.
2. Implantation (implantation) of drugs causes discomfort (nausea, vomiting, abdominal pain, headache) in the use of even a small dose of spirits.
3. The method of "Torpedo".The method is based on the patient's arrival in the body for a long time, drugs that cause an aversion to alcohol.
We are coding and negative sides.Drugs used in encoding, and have many toxic contraindications for use.The patient receives a strict ban on the use of alcohol, but the problems that have led to dependence remained.As a result, it receives an additional stress, depressive moods are enhanced (hopelessness, despair), which makes it extremely painful period of abstinence from alcohol (remission).And the effectiveness of this method is very low, about 85% of patients within one year once again begin to abuse alcohol.Therefore, the encoding is used only at the initial stage, under the supervision of the psychiatrist, in certain groups of patients, and further psychological methods used.
Treatment of alcohol dependence only impossible prohibitions should be changes in the patient's consciousness, appear responsible for their lives, feel the new features that implement it as a person.To do this, the psychological methods used.Current treatments include the use of alcohol dependence variety of methods and treatments, and is usually a long process.
complications of alcohol dependence:
1. Mental disorders: acute - delirium tremens (delirium tremens);chronic - epileptiform seizures (alcohol epilepsy), dementia (dementia), Korsakoff's psychosis (rough memory deficits on current events, the impossibility of remembering).
2. Somatic (visceral) disorders: alcoholic liver cirrhosis, chronic pancreatitis, alcoholic cardiomyopathy.
Drinking alcohol is closely linked with the rituals and customs.The centuries-old tradition, it is impossible to suppress the ban or substitute something else.Only with increasing levels of internal culture, consciousness raising intellectual values lead to the rejection of the abuse of alcoholic beverages.Of course, very important nation-wide program of advertising healthy lifestyles.Formation of plants is that drinking alcohol - it's bad and not prestigious.
Question: Is it possible to drink alcohol in moderate amounts for the prevention of heart disease?
Answer: Results of recent studies suggest that the use of even small doses of alcohol in older patients and those suffering from cardio - vascular disease significantly increases the risk of ischemic stroke.Therefore, such patients should completely give up drinking alcohol.
Question: Is it possible to cure the patient with alcoholism without his knowledge?
Answer: No, it is not possible.This disease is not only the body but also the soul, which can only help considering the individual characteristics of a person.The treatment will be effective only if the patient is fully aware of his condition and determined to leave this problem.
therapists Vostrenkova I.N